Once Again, The Drugmonkey Gets Results. Merck and Schering's Head Partially Emerges From Their Ass.

It was a little over a month ago that I wrote the two titans of Big Pharma a public letter in this very blog:

Dear Merck/Schering.

Your bullshit has been called. Please remove your head from your ass and do the right thing.

Sincerely,

Drugmonkey, Master of Pharmacy.

Regular readers of my little blog garden already know that what had my boxers in such a bunch was Merck and Schering's decision to alter the definition of the Enhance study's "primary endpoint." For those of you playing along at home, that means they started this study with one definition of what they were going to measure, then when the data actually came in decided that no, they changed their mind and they were going to look for something else. This kind of thing is not done in science, and the Drugmonkey was not going to let them get away with it.

Behold, the caving of Big Pharma:

The lead researcher of a long-delayed drug study says he regrets not standing up to Merck & Co. and Schering-Plough Corp. when they first told him last month that they planned to alter the statistical analysis of their jointly sponsored trial.

Under mounting criticism, the companies last week reversed the earlier decision to change the primary measure to evaluate the drug. The study, called Enhance, tested 720 people to determine whether a combination of Schering-Plough's Zetia and Merck's now off-patent cholesterol fighter Zocor works better than Zocor alone.

John P. Kastelein, a cardiologist at Academic Medical Center, Amsterdam, and principal investigator of the study, said he breathed a "sigh of relief" when the companies told him last week they were reversing course.

"It's never, ever right to change the primary endpoint of a study," especially after all the data are in, he says. "It is statistically not good and it gives the wrong impression to the outside world." He says he initially went along with the plan but now regrets not firmly resisting it from the outset.

You are now my bitch John P. Kastelein. You now say you wish you had opposed this cockamanie plan from the moment you heard of it. I did. I own you.

Big Pharma is so afraid of me they couldn't even personally tell me of their decision, leaving it up to an alert reader to inform me of my triumph. That was kinda rude of them. Not to mention they are still hiding the extent to which they know Zetia can harm your liver. We know that the number of people who had to stop taking Zetia in the Enhance study due to elevated liver enzymes was somewhere between 1 and everyone. Merck and Schering will not be more specific than this. We also know Merck and Schering have done other studies that raise questions about Zetia's risks to the liver, but never bothered to publish them. It's time for another letter:

Dear Merck/Schering,

While your head appears to have moved, possibly to the part of your large intestine just above the rectum, it still has a ways to go to get completely out of your ass.

Consider me your laxative.

Sincerely,

Drugmonkey, Master of Pharmacy

Merck And Schering Don't Want You To Know They Have Studies Showing Zetia May Harm Your Liver. Whoops. Maybe I Wasn't Supposed To Say That.

Regular readers of this very blog already are well aware of how these two companies, joint marketers of the wildly popular cholesterol med, appear appeared to be sitting on data gathered to show how well the med works until they can could manipulate it to say what they want.

Readers of the New York Times also know this.

Well today, lucky readers, you will get another scoop concerning Merck, Schering, and Zetia skulduggery. And you will get it a mere 4 days after the readers of The New York Times.

New evidence shows that the drug makers Merck and Schering-Plough have conducted several studies of their popular cholesterol medicine Zetia that raise questions about its risks to the liver, but the companies have never published those results.

The unpublished studies, conducted from 2000 to 2003 according to the F.D.A. documents, were not listed on the industry Web sites where companies are supposed to register the results of all drug trials that were ongoing after October 2002. The New York Times discovered references to the studies in briefing papers on the F.D.A. Web site.

Huh. Wonder why that is. Because you know, the studies that show Zetia lowers cholesterol don't have any trouble showing up in these databases. Or as the first thing you see when you punch up the Zetia information for health care professionals web page. Yet the studies that show Zetia may put your liver at risk seem to get lost. What are the odds really?

A Schering executive, when asked by a reporter about the unpublished studies, confirmed their existence. But the executive, Dr. Robert J. Spiegel, said the companies had not considered the studies scientifically important enough to publish their findings. Some may eventually be published, he said.

I can't believe I just fucking read that. Here's a wild, crazy idea. Publish the studies, the way you are supposed to publish every single study done since October 2002, and let scientists not on Big Pharma's payroll decide what is scientifically important. That's why the clinical trial database was set up in the first place you numbnuts.

There is at least one big-ass scientifically important study involving Zetia going on at the moment though. It's called Enhance. Big Pharma loves to give its studies cute sounding names. Enhance is the effectiveness study I mentioned at the top of this post whose data Merck and Schering are sitting on while they change seriously thought about changing the definition of the study's "primary endpoint" science speak for what they were looking for. The enhance study was completed in April, 2006, but we still don't know the results. Except for this little tidbit:

Schering spokesman Lee Davies, disclosed this week that some patients in the Enhance trial had been dropped from it after tests showed that they had elevated liver enzymes — a potential sign of organ damage. But Mr. Davies said he could not disclose how many.

Why not? If the number were zero I'll bet you he'd be disclosing it. I think the story here is that Schering spokesman Lee Davies would not deny that 100% of patients in the Enhance trial had to drop out because of elevated liver enzymes. If Schering spokesman Lee Davies would like to issue a denial that 100% of patients in the Enhance trial had to drop out due to liver damage, I will happily print it here. Until he does though, all we know is that the number of people who had to drop out of the Enhance trial due to elevated liver enzymes is somewhere between one patient and all the patients. I'm sure Merck and Schering have a good reason for keeping us in the dark about this though.

There are also no studies that show Zetia actually lowers the number of heart attacks or deaths in people who take it. Unless Merck and Schering are sitting on that data as well. Don't bet on it.

Now That I Think About It, There's Really No Need For Me To Be Scared Of Vampires Anymore.

I mean, the AIDS probably killed off most of the vampires back in the 80's I imagine. And quite honestly, even if there are any vampires left, between HIV, Hep C, Ebola and a host of other blood-borne diseases, they are probably more afraid of us these days than we are of them.

In your face vampires.

I Can Think Of No Better Way Of Saying "Merry Christmas" Than By Rerunning An Old Blog Post.

That sounds like a snarky line, but it also happens to be the literal truth. I'm not in a state of mind conducive to writing new stuff at the moment. Don't ask me why. I'm just not. I originally posted this last Christmas Eve under the title Well Tonight Thank God It's Them, Instead Of You. Enjoy it again. Or not.

You got the best line in the whole song Bono. Of course back then you deserved it. You're sorely missed you Irish bastard, all the more so because you're still around.

We're not so different Mr. Bono, you and I. We both saw how the world shits on people who don't deserve it and were beside ourselves as to why. I decided that I wouldn't do anyone any good if I couldn't put food in my own stomach though, and I'm sure you felt the same way about your band; doesn't do any good to bug someone if they're not listening I suppose. But by the time our personal dollars had been stabilized we both found ourselves swept away by forces we no longer controlled. I took a job for corpo-pharmacy and your concerts were promoted by Clear Channel Communications. You sell your red iPods and I write a check to Oxfam and on the day we die the world will be shitting on people who don't deserve it. I miss you Bono. I miss me too.

Merry Christmas fuckers. Tonight thank God it's them instead of you.

I May Be Single Handedly Responsible For Every Chain Pharmacy In This Country Being Woefully Understaffed

Why? Because Corpo-pharmacy bigwigs know that the very second I am not drowning in prescriptions, things like this start happening to their displays.



The horses have been going at it for two days now. If anyone bothers to notice, and figure out the source, It'll probably make my lobbying for more tech help a little harder.

Does make the 12 hour day go a bit quicker though.

George Bush Issues A Challenge To The Drugmonkey, To Which I Say Bring It On

Unfortunately it wasn't in the boxing ring. George's challenge came in a speech given in front of a Rotary club. Who knew the most powerful person on the planet spends his time talking to Rotary Clubs in BFE Virginia?

I'm going to tell you something -- we have fabulous health care in America, just so you know. I think it's very important -- before people start griping about the health care system here ....just to compare it with other systems around the world.

Yeah...you know what?....I'm gonna tell you something. You don't say things like that around the Drugmonkey. Because the Drugmonkey will call your bullshit and bitch slap you with the facts so hard you may never get up again. You wanna compare US health care with other systems around the world? Fine. It's go time:

-The United States has fewer doctors, fewer nurses, and fewer hospital beds per capita than the average country in the Organization for Economic Co-operation and Development. Maybe by "fabulous health care" George Bush meant "fewer people providing health care"

-Rates of chronic disease are significantly higher among middle-aged people in the United States (before they are eligible for Medicare) than in that den of socialized medicine, the United Kingdom. The rate of diabetes is twice as high. Heart disease, 57% higher. Lung disease, 29% higher. Cancer.......73% higher. Maybe by "fabulous health care" George Bush meant "more people that need health care"

-37 countries have a higher life expectancy than the United States. Including Cuba, Chile, The United Arab Emirates, Costa Rica, Cyprus, and Malta. You wanted me to compare our health care with other systems around the world president wanker-boy. Be careful what you ask for.

There is one area of health care where the American system clearly leads the world. Spending! Here's a nice little factoid for those of you who like to think of yourselves as guardians of our taxpayer dollars. In the US, about 45% of the total amount spent on health care is paid for with government dollars. Our Canadian friends use government funds to foot the bill for about 70% of all health care in that country. And use fewer government dollars per person to do it.

Are you getting this? Canada runs an entire health care system, for everyone, for less per person than we spend on just Medicare and Medicaid. So does France. And Japan. You'll find Japan at the top of the list of life expectancy by country. The UK that so kicks our ass in chronic disease prevention does it while spending about 60% less per person than we do.

Tell me again why I'm supposed to be afraid of socialized medicine?

I could go on all night my friends. There are few issues where those on the right are so clearly and demonstrably wrong. Yet you let them pull the wool over your eyes with nothing but a little jingoistic flag waving. Americans love to hear we are the best in the world, but in health care we most assuredly aren't. Stop saying we are, and start working to make it so.

If I Were Rudolph The Reindeer, I Would Have Told Santa To Go Fuck Himself.

I would have been like. "You bastards have given me shit my whole life and NOW you want me to bail you out?? You can kiss my reindeer ass"

Then I would have been like "You know, while I was excluded and ostracized all those years, I worked on a few reindeer games of my own, since you would never let me play any of yours" There would be a crazy look in my eye.

Then I would take off and fly around in circles while Dancer and Prancer and the rest of those asswipes sat grounded with all the undeliverable toys on the shipping dock. Every once in awhile I would swoop down and kick them in the head or maybe bite them in the back while yelling "WHAT CHA THINK OF MY NOSE NOW MUTHA FUCKER?? TELL ME WHAT YOU THINK OF MY NOSE!!!!!"

I guess that wouldn't be a good way to mark Jesus' birthday though. I mean, hell, Jesus would never punish you years after the fact for being a bad person.

I don't think I can take listening to those songs at work for another week.

A Special Message To All My Friends In Iowa.

And really, I consider everyone in the Hawkeye state to be my friend. Sit down Iowans, have some scotch. I'll have you know I don't share my scotch with just anyone, only my friends.

I take back all those mean things I said about you four years ago. It was just, well, after doing a lot of work for no pay for the one presidential candidate who could have changed the direction of this country, I was a little testy when you were too stupid.....er.....I mean...when you saw things differently. I made a bad choice when I called you a bunch of hillbilly inbred simpletons whose biggest worry was whether Jesus would ever see you naked, just like you made a bad choice when you handed the Democratic presidential nomination to John Kerry. We've both grown in the last four years, and I bet neither one of us will ever make a mistake like that ever again. There's a way you can undo your mistake though:




I bet you realize by now my Iowa friends, that when you have the privilege of making your selection for party nominee so early in the process, far removed from the actual issues we might be facing on Inauguration Day 2009, all you can really go on is leadership and judgment skills. Leadership and judgment skills like recognizing what the Iraq war was from the outset, and not being afraid to say so. Like Barack Obama did, 5 months before the war started:

That’s what I’m opposed to. A dumb war. A rash war. A war based not on reason but on passion, not on principle but on politics.

George Bush on the other hand, led Hillary Clinton off a cliff into a headfirst dive that landed nose deep in the stinking cesspool of Iraq. These days Hillary likes to say it's George's war, but she voted to authorize it and has never apologized for doing so. Don't take my word for it though, take hers. This is what she said as she took George's hand and made that cliff jump:

President Bush's speech in Cincinnati and the changes in policy that have come forth since the Administration began broaching this issue some weeks ago have made my vote easier. Even though the resolution before the Senate is not as strong as I would like in requiring the diplomatic route first and placing highest priority on a simple, clear requirement for unlimited inspections, I will take the President at his word that he will try hard to pass a UN resolution and will seek to avoid war, if at all possible.

That worked out really well, taking the president at his word. Because it was always so obvious how trustworthy George Bush was.

She also believed her husband when he said he never had sexual relations with that woman, which means she fell for the lies of two consecutive presidents. I'm afraid this means if she is elected president she will then believe her own lies, which I'm pretty sure would mean we're aquascrewed.

You can't vote for Edwards because he talks funny. I'm serious about this. I'm sick of having a president who talks funny.

So my dear Iowa friends, the choice is yours. Wait..... I forgot how you always force every serious presidential candidate to promise to support ethanol as a fuel additive. Something about the corn. You people are crazy about the corn, and ethanol has something to do with corn. So, yeah, I totally support whatever the deal is with ethanol, and I'm pretty sure Obama is in favor of you and the corn as well.

I know you'll do the right thing January 3rd.

Highlights From Today's Pill Counting Action.

The day started with me busting my thumb in the Gate Opening Olympics. I always pretend that I'm in some sort of competition when I'm turning the crank that opens the pharmacy gate to start the day, like the honor of my country is at stake and I am going for the gold. Sometimes when my keystone tech shows up early I issue an actual gate-opening challenge and I always win. It's one of the few joys I have at work. Today my hand slipped and I think I sprained my thumb. Glory does not come to those of faint mind or body.

The day's first customer witnessed my injury and thought it funny. The second asked me where the breakfast cereal was. This was as I overheard a third customer asking the stock clerk what would be the best product to remove ear wax. I looked around for the looking glass I surely slipped through.

Later in the day the cashier asked a customer picking up a prescription for clarification on how to pronounce the customers last name.

"Just like the bowling pin company" said the customer. Of course.

The same cashier speaks a few words of Russian, and later decided to surprise an elderly Russian customer by speaking a few words of her native language. The customer was delighted.

"Do you speak English too?" The customer asked in English.

A woman asked me what I thought of using super glue to repair her dentures. The store's assistant manager interrupted the conversation to ask if either of us had seen the skateboarding dog on YouTube.

A man asked me if we sold "Alloy Vortex" I eventually figured out he wanted some aloe vera. I also figured out he tried to alter the number of refills on his Soma prescription. I don't think these two facts are unrelated to each other.

I think exactly one customer requesting a refill had their prescription number and my thumb still hurts. You do not want to find yourself between me and the scotch bottle tonight.

From The "It's Their Real Name" File.

An Australian Catholic school is at the centre of an unholy row over claims it refused entry to a five-year-old boy with the surname Hell.

Alex Hell said St Peter the Apostle School, Melbourne, had welcomed his son Max when enrolled under his mother's maiden name, Wembridge.

But they baulked when the family had a change of heart over the surname.

Mr Hell said he initially decided to enroll Max at the school under his wife's maiden name, to avoid the ridicule he himself had suffered as a schoolboy.

OK, you know what there Hell, I might feel a little sympathy for you IF YOU HADN'T HAVE NAMED YOUR KID MAX.

MAX HELL.

You can't really blame the Catholic school. I'm pretty sure the book of Revelation warns of the day of the coming of Max Hell.

I Bet I Could Defeat George Bush In A Boxing Match

The key would be my arms. I have freaky long arms. That's why I usually wear short-sleeved shirts to work. Finding a long sleeve shirt that doesn't end a couple inches above my wrist can be a pain in the ass.

So what I would have to do is use my jab to keep Bush on the outside, because you know damn well if he got in close he would fight dirty. Elbows, kidney punches, ear biting, he would do it all. I would definitely have to establish my jab early. And watch out for any attempted waterboarding or extraordinary rendition attempts between rounds.

Plus George Bush is old, and he really doesn't look like he's aged well these last couple years. Yeah, I'm pretty sure in a fair fight he wouldn't stand a chance.

Of course to this point in his life George Bush has never been in a fair fight. I may be screwed.

Once Again, My Employer's Drug Utilization Review Software Saves My Ass.

And of course what I mean by "saves my ass" is "wastes my fucking time"....and yours.

Someone deep in the bowels of my employer's IT department decided it would be a good idea not long ago to add a new DUR warning to our system. DUR warnings stop the prescription filling process in its tracks. They must be overridden by me, and if they actually pointed out things that a pharmacist genuinely should be concerned about, they would be a good thing. The latest batch of DUR updates released into our system though, included one for the anti-acne med Accutane.

"Isotretinoin should be used with caution in women of childbearing age" says the warning that I must override every single time a prescription for Accutane or one of its generics is filled. Thanks. Fucking thank you for that. How about a warning next that sleeping pills may make you drowsy?

Real life sometimes steals your best material. There actually is a drowsiness warning label that prints out with every Ambien prescription filled at my store.

For those of you not in the profession, let me recap what happens before a female of penis-receiving age gets any Isotretinoin into her grubby little hands.

-She needs to be on two different forms of birth control. Not all types of birth control cut it. No female condoms, No progesterone-only birth control pills.

-She needs to be on the two different forms of contraception for 1 month before a prescription is issued.

-Her doctor must document this and enter the information into the database of a "risk management" program called iPledge.

- iPledge then issues an authorization number that allows no more than a 30-days supply of Isotretinoin to be dispensed.

- She brings the prescription to me. I have to call the iPledge mothership to get her authorization number.

- Authorization number has to be recorded on the prescription as well as in our computer.

-She needs to have a negative pregnancy test every month while taking isotretinoin, and this information must be entered into the iPledge database, a new prescription must be issued, and a new authorization number obtained. Every month.

-Men have to get an authorization number as well. Just in case they're hiding some ovaries.

AFTER ALL THIS. Some numbnut at the company that employs me has now decided it would be a good idea to stop the prescription filling process seconds before it is complete to tell me "Isotretinoin should be used with caution in women of child bearing age"

I forgot to mention I counted at least five different places on a box of Isotretinoin where there is a picture of a woman with a big 'ol belly surrounded by a red circle with a slash through it above the words "CAUSES BIRTH DEFECTS -DO NOT USE IF PREGNANT"

The reasons your prescription takes so goddamn long to fill just keep on a 'comin. Release the scotch.

Upon Further Reflection, I Wonder If My Thoughts Didn't Somehow Kill Evel Knievel.

I mean, seriously, the first time I think about that motorcycle in years and he dies the next day. I'm sensing there may be some big-time bad karma involved with that motorcycle that my Mom was hip to.

I'm going to slowly back away from the topic of the Evel Knievel motorcycle and never mention it again.

Tonight, One Of My Life's Great Mysteries Is Solved, After Evel Knievel Leaves This World By Kicking Me In The Nuts One Last Time.

So my keystone tech finally asked me why I was so warped. I told her I think it has a lot to do with the Evel Knievel motorcycle. I don't even know why I asked for it that first year. I'm pretty sure I never actually saw Evel do any of his televised jumps as a young Drugmonkey. It was probably the fourth or fifth thing on my Christmas list that year, but the only one I didn't get. I thought that was a little weird, and made sure to put the Evel Knievel stunt motorcycle at the top of my greed list the next year. Again, every single thing on my list, and then some, appeared under the tree come Christmas, but no Evel Knievel motorcycle. I thought maybe Santa was fucking with me.

The third year Evel was my top priority. I started lobbying weeks in advance. One time I shoveled the driveway without being asked. Dad yelled at me because I did it in my tennis shoes. Dad always had a thing about proper winter footwear. For the last time in my life, I made an effort to be good and kind and caring. The third year was gonna be make or break for Evel, and I pulled out all the stops.

You know what happened. I got a Bionic Man rocket ship that turned into an operating table. Whose idea was it to even design such a thing? I mean, would you want the space shuttle to turn into a giant surgical suite for some reason? My spirit was broken, but I continued to ask for the Evel Knievel motorcycle, its place lower and lower each year until it was replaced with a request for The Beatles White Album. I didn't get that either.

A couple years ago I finally asked my Mom why I never got the Evel Knievel motorcycle. "Oh, I don't remember" was the reply. The mystery of Evel Knievel would never be solved. A part of me would never be at peace.

My keystone tech got a good chuckle out of this, but my other tech had not a clue what I was talking about. Exactly like when I try to tell the other tech there is a difference between Effexor and Effexor XR. As I tried to explain the concept of the Evel Knievel stunt motorcycle set to the other tech, all those old feelings came back to me. It was like I was lobbying my Mom all over again, telling her how incredibly cool this toy was, and how cool I would be if only I could have it.

Then I realized. I'm an adult now, with my own money and control over my own purchasing decisions. Betcha I could totally find an Evel Knievel motorcycle on eBay. I decided as soon as this long work weekend was over, I was gonna set aside some time to find me an Evel Knievel motorcycle.

Of course that's when the bastard decided to die. The price of an Evel Knievel motorcycle has now I'm sure gone through the roof. I poured myself a giant dry martini, entered that magical buzz state where only gin can take you, pondered the situation, and after 30 years, it hit me.

That tone of voice. That my mom had when she said she couldn't remember. It was the exact same tone she uses when she doesn't want to talk about something. Dad had some sort of problem with Evel Knievel. I can't believe it took me this long to realize. I bet Dad thought Evel Knievel was gay. Jesus it all makes sense now.

I may sleep well tonight for the first time in years.

I Really Don't Want To Blow My Back Door Santa Wad Tonight.

It's still early in the season, and it just doesn't feel right yet. I think the time for Back Door Santa is yet to come.

I suppose I should probably explain.

Back in the carefree days when presidents struggled to define the word "is" and not the word "torture," I found an old vinyl copy of "A Very Special Christmas", an album put together to benefit a charity of some sort, at my favorite thrift shop. I bought it for only one reason, the prospect of hearing Jon Bon Jovi sing a song called "Back Door Santa." The thought of Jon Bon Jovi as a Back Door Santa was frighteningly alluring.

Jon did not disappoint. The tune is delightfully horrible. It's an old Blues number redone in 80's hairband excess, right down to the piped-in fake crowd noise. Every time I hear the opening power keyboard riff, I never fail to laugh non-stop for a good four minutes. It's unintentionally hilarious, which is the worst way to suck.....if you're a band. Jon sounds like he's taking himself so seriously in the song, I honestly wonder if he knew how the words "Back Door Santa" could be interpreted, and that at the time he totally looked like a girl. He still kinda does.

At any rate, "Back Door Santa" became a holiday tradition around the Drugmonkey household. It started with a girlfriend who would only consent to listen to the song one time between Thanksgiving and Christmas. Naturally, I would try to pick the time that would produce maximum annoyance, which is probably part of the reason she is now an ex-girlfriend. She's long gone, but the tradition of the once-annual playing of Back Door Santa remains. Yes, I could listen to Back Door Santa whenever I want to now, but that would be like eating turkey every day. The holidays should stand for something dammit.

So anyway, today I realized we are now in the post-Thanksgiving period, and I really wanted to fire up the turntable. Part of me though, felt like the time wasn't quite right. I'm thinking there will be a better time for Back Door Santa, although I cannot tell you when that might be. My gut is telling me to hold off for now.

I just did a google image search. Jon Bon Jovi still totally looks like a girl

Words I Never Thought I Would Write. I Agree With The Actions Of A Political Appointee Of The Bush Administration.

I feel confused. Disoriented. Like the life force that provides certainty for the universe has been altered. I fear the very nature of time/space may never be the same again.

It all started simply enough. An AP wire story about the latest shenanigans of Big Pharma:

WASHINGTON (AP) - Legislation aimed at speeding the availability of cheaper generic drugs has stalled in Congress in the face of major lobbying by the drug industry.

The Senate bill would ban most settlements known as "reverse payments," in which a brand-name company pays a generic manufacturer to delay the introduction of the generic drug.

Allow me to bring out the "Bullshit Exposure Through Dramitization Players" to illustrate what's happening here.

Generic Drugmakers: Oh Big Pharma, can't we just get along? Why, when your patent runs out for a medicine, must we sue each other for years instead of competing in the marketplace? Can't we just play by the rules and both earn a legitimate profit?

Big Pharma: There, there little guy. You think our lawyers are mean when they sue each other, but really they are doing us both a favor. Yes, you could make a billion dollars selling a generic version of our drug for 70% less than what we charge, but that would involve you actually doing work. When we sue each other, we can settle, and I can pay you three quarters of a billion dollars to do nothing. We both win.

Generic Drugmakers: But what about the American people, who will continue to have to pay whatever you want to charge for access to this medicine?

(30 seconds of silence)

Big Pharma: Here's a big check.

Generic Drugmakers: You are wise and just Big Pharma.

Ho-hum. Big Pharma acting like corporate asses to the determent of the American consumer. What else is new? Hang with me though, here's where we start to go through the looking glass:

The Federal Trade Commission, which has called on Congress to take action, says such settlements could cost American consumers billions of dollars.

Federal Trade Commission? That's the executive branch. The branch headed by......doing something against the interests of Big .......nnnnnnaaaawwwww.....

I double checked.

The FTC has called on Congress to pass legislation to crack down on the reverse payment settlements, although it hasn't endorsed any specific bill.

"Such settlements restrict competition at the expense of consumers, whose access to lower-priced generic drugs is delayed, sometimes for many years," FTC Chairwoman Deborah Platt Majoras said in testimony before a House task force in September.

Deborah Platt Majoras is most assuredly an appointee of George The Lessor. And hot enough that I would probably do her if I were a little more drunk than I am right now. There has to be an explanation for this presidential appointee taking a stand in favor of the people of this country. Here are my best theories:

1) Deborah Platt Majoras showed up at FTC headquarters, read their mission statement, and didn't realize it was bullshit. Since her job doesn't involve blowing anything up or killing anyone, no one else in the administration really notices anything she does.

2) Generic drug manufacturers have agreed to use part of their profits to finance the war in Iraq.

3) I am on acid.

Only time will tell I suppose. I vote for #2, although I cannot completely rule out #3.

Tomorrow I shall look to the west to anticipate the sunrise.

The Ten Millionth Sign I Have Seen Of The Impending Collapse Of Civilization......This Month.

"Thank you for calling corpo-pharmacy, may I help you?"

"Yes.....I was just at the counter, and I realized I forgot to say thank you"

I remembered seeing my keystone tech wait on this woman 5 minutes ago. The reason she didn't say thank you.....or anything else..... to the real people in her world was that she was busy chatting on her cellphone.

She still was. I looked up and saw that she was calling from the other side of the store.

It's Either Hate Mail Or A Proposition For Hot Sweaty Hate Sex, I'm Not Sure Which.

I think you keep deleting my comments. I'm the one who told you to eat shit. Did it taste good?

Just to clarify, everyone thought I was male. I'm female. 5'10", auburn hair, blue eyes and fucking gorgeous. I have absolutely NO PharmD degree, but I do have a master's degree in a different area.

Why do you delete me, Drug Nazi? Feel bad now that you know I'm a woman? And probably one you'd want to fuck?

I'll send you my blog with pics if you publish this.

OK, Consider it published.....

I guess......I'm flattered?...that someone so badly wants to be part of my little blog garden. I wonder if I can get naked pics if I put it in the "Highlights From The Archive" section.

The scotch may have kicked in tonight earlier than usual. And I promised you guys my next post would be sober.....

Drugmonkey Radio Is Back, Not That Any Of You Missed Drugmonkey Radio

Technical problems have beset my effort to embed a playlist into the blog for the last few weeks. I was using a site called tunefeed.com and it just quit working for some reason. It made me sad, but I received exactly zero comments about this from anyone. I don't care. I want a playlist, and it's my blog. I found another site, projectplaylist.com, and everything seems to be working well.

So I know you don't come here for the music, but you really should at least listen to the first song on the list. It is the perfect theme song for my little blog garden.

Actually you should listen to the second song too. I wrote earlier about how it's the tune I listen to most days on the way to work. If you work in retail pharmacy you'll understand why.

Come to think of it, I think you should also listen to the third song. Last year I wrote about Whoo Guy. I love Whoo Guy, and now you can hear him for yourself. He comes on at about the 50 second mark.

Really you should listen to all the songs. I did pick them out just for you. And for me to listen to while I clean the bathroom. My computer is within easy earshot of the bathroom.

I promise I'll write my next post while I'm sober.

After Roughly 400 Years, I Think The Lesson Of Thanksgiving Is Crystal Clear.

If strange white people come wandering into your neighborhood, kill them. That is the lesson of Thanksgiving. I seriously don't think you can make a case that the Indians wouldn't have been better off if they had just killed the Pilgrims. Or let them starve.

Same way with Louis and Clark. Indians totally should have just killed those honkies.

Remember the lesson of Thanksgiving always.

Do Me A Favor. Print Out The Article I Link To Here And Shove It Down The Throat Of The Next Merck Or Schering Rep That Sets Foot In Your Store.

This wasn't supposed to happen anymore.

After Glaxo Smith Kline got busted for withholding studies that suggested Paxil may increase the risk of suicide in children, Big Pharma promised to be good. "We have learned our lesson" they metaphorically said. "And we are so ashamed of what we have done to the good name of science we shall not oppose mandating that we put all our clinical trials in a database searchable by anyone. All our data shall be absolutely transparent from this day forward"

"Don't worry about including any penalties in this mandate though, because we will be forever good and pure."

Well today we have this, From The New York Times:

Nearly two years after (the makers of cholesterol lowering drugs Zetia and Vytorin,) Merck and Schering-Plough completed a clinical trial of the drugs, they still have not released the findings. The delay has led to a growing chorus of complaints from cardiologists. And yesterday, the companies responded by promising to publish a portion of the results next March — but not the entire set of data.

Doctors say that decision is highly unusual and will do little to quell concerns about the trial, as well as broader questions about the effectiveness of the drugs.

"BBBBWWWAAAHHHHAAAHAHHAAAAHHAAAHHAAAAAA!!!!!!! SSSSSUUUCCKKKEERRRRR!!!!!!! WE NEVER SAID WHEN WE'D RELEASE ANYTHING TO YOUR LITTLE DATABASE!" That is my interpretation of an actual quote you would get from a Big Pharma executive under the influence of truth serum.

Wait. That was just the opening act. There's more:

Of particular concern in this case is that Merck and Schering-Plough said yesterday that they had changed the trial’s “primary endpoint” — the main medical result being measured. The companies now say that they will use only partial results to assess the trial’s success in deterring the formation of plaque that can cause artery blockages and lead to heart attacks.

The companies had said they would measure the thickness of plaque in two arteries — the carotid, which runs through the neck and supplies the brain with blood, and the femoral, which runs through the hips and supplies the legs. The primary endpoint of the trial was supposed to be the amount of plaque at three points in the carotid artery.

But the companies said yesterday that they had changed the primary endpoint to measuring thickness at just one place in the carotid. And they do not expect to release any results at all from the femoral artery.

Let me make sure we all understand what's happened here. Merck and Schering started a study, and once the data started rolling in, they decided to change the definition of what they were looking for. Why would they do this? Here's a guess. The data wasn't going to give the result Merck and Schering wanted. Of course I have no way of knowing this, but ask yourself what Merck and Schering would be doing if they were looking at numbers that suggested Zetia and/or Vytorin were clearly lowering heart disease risk more than any other therapy. They'd have an ex-college cheerleader sales rep in every doctor's office in the country waving those numbers in front of their cleavage, that's what they'd be doing.

Here's my favorite part. Even though a source in the Times article is quoted as saying this type of action "sounds highly unusual to me" Merck/Schering says it's OK because:

A panel of outside scientists recommended the change last Friday, said Lee Davies, a spokesman for Schering. Mr. Davies declined to disclose the members of the panel.

So........a panel that for all we know could consist of Santa Claus, The Unabomber, and the president of The National Association for The Promotion of Heart Attacks says it's OK to make a "highly unusual" move......and we're supposed to feel better about that? Sigh. How the fuck stupid do they think we are?

Dear Merck/Schering.

Your bullshit has been called. Please remove your head from your ass and do the right thing.

Sincerely,

Drugmonkey, Master of Pharmacy.

My Boy Crush On Michael Moore Has Convinced Me I Need To Have Sex With A Jew.

I am a bit of a Michael Moore groupie. That is no surprise to most of you. What might surprise you is that it's taken me this long to track down "Blood In The Face." a documentary Mike did some work on early in his career that features his first cinematic moment of note, the interview with the hot nazi chick:




"You don't look like a typical Nazi" Mike tells the woman, who is obviously flattered.

At any rate, the film is a look into the world of white supremacist whack jobs. A few minutes in, one of the whack jobs is ranting about Filipinos. This reminded me of the most beautiful woman one of the most beautiful women I ever had the privilege of nailing. That woman's skin felt like velvet and I will never forget it. She was a Filipina, and I still miss her sometimes, even though she was a whack job herself in a different sort of way.

Then one of the Nazi whack jobs starts ranting about mixed-race women. I once was nail-buddies with a woman whose hair would put goosebumps on the skin of any heterosexual male or lesbian. She was absolutely gorgeous and she was half black/half white. Sadly, the nail-buddy experience is now part of my personal history book. Sigh.

The people in the movie spent most of their time ranting about Jews though. Wow they really didn't like Jewish people. Now I have to be honest, I don't think I know any Jewish people in the real world, but I walked away from this film totally convinced that I have to nail one or two. I think to be a complete traitor to my race, I really should complete the trifecta.

Plus I learned from the film that Jews control everything. Which is kinda hot.

I wonder if it would be worth getting circumcised.

I Live With The Most Thoughtful, Caring, And Kind Person On God's Green Earth.

Although the Earth is predominately blue. That's beside the point. What's important is the surprise package.

I saw it by the front door on my way to work. Actually I almost tripped over it. My first thought was that Mom had sent her baby boy Christmas goodies a little early. Mom can be like that. She never did trust the mail. My sister works at the Post Office.

Confirmation would have to wait though. I have the habit of making it to the happy pill room with not a second to spare down to an art. I slid the package inside the door where it was subjected to a full inspection from my feline second in command. Her ultimate lack of interest told me there was nothing edible inside. Off to the pharmacy to get retarded.

It haunted me all day though, this package. It was from Amazon, and my Mom definitely still lives in the pre-Amazon age. My sisters hate me. I really don't have any friends. I hoped it wasn't a bomb. My cat doesn't really have the skills or the thumbs required to diffuse explosives.

I skipped my usual after work date with Jack In The Box. I could count on Jack to always be there. Right now the suspense was killing me.

The box was right where I left it. I tore into it with penknife and found........"The Bass Tab White Pages." Bass Tabs are a way to record song information in a way helpful to those of us who can't read music. This was the best book ever. A thousand pages of bass tabs. I almost wept with joy.

But......the number of people who know that I pick up the bass and make noise with it on occasion is very small. Less than 5 probably.

I don't play the bass. I pick it up and make noise with it. It's an important distinction.

There was more. A copy of "Bruce Springsteen & The E Street Band Live At Hammersmith Odeon, London 1975" My God. Just the other day I had heard a bit of this at Borders and had been amazed at the quality of the recording. Live albums from the 70's usually sound like they've been recorded on an 8-track. Not this one. And they managed to get it on CD without it sounding all digitally crappy.

But wait. Those thoughts had never traveled outside my head. I must be dealing with a stalker. Some sort of all-powerful omnipotent super stalker.

It didn't matter. The mind reading stalker was very generous and had a knack for picking out very nice gifts. I decided I would marry this stalker the moment they left me the slightest clue as to their identity. I looked at the packing slip and saw.......

My own name. And that the order was charged to my own credit card. I had no memory. I suspect the involvement of scotch. I send myself the best surprise packages, God I love me. And I really see no reason this night that I should stop drinking. I am going to pour some scotch and make some noise with the bass now.

A Catholic Priest Runs A Project Called Homeboy Industries. A Fact That Reads Like A Joke.

There really is a Homeboy Industries. Go here to get the scoop. I had to learn more, so I interviewed founder Rev. Gregory Boyle in my imagination.

"What was really exciting in the beginning was the tremendous support we found from within the church for this idea" said Boyle only in my mind. "We literally had priests, bishops, and cardinals from all over the world asking how they could help. Some days we would show up first thing in the morning and find 4 or 5 men of the cloth at our front door eager to roll up their sleeves and get their hands dirty."

Boyle did acknowledge disappointment that many volunteers leave after learning that they do not get to actually take a boy home with them.

"We're still very excited about the financial support provided by Michael Jackson however" said Boyle not in real life. "We're still not quite sure how he found us, or why he keeps asking for pictures of our clients......odd really"

Boyle was then silent for a few moments, a look of deep ponderance on his face. Suddenly his expression changed.

"Oh my" He didn't say. "Maybe it has something to do with that name."

Over A Year After I Gave You The Scoop, Trasylol Finally Bites The Dust,

...and joins the distinguished company of Rezulin, Baycol, Bextra, Duract, Posicor, Propulsid, Tequin, Redux, Seldane, and Vioxx. From the November 6th New York Times:

Pressured by regulators, the German pharmaceutical giant Bayer AG announced Monday that it had agreed to withdraw the controversial heart surgery drug Trasylol after a Canadian study suggested that it increased death rates.

Dr. John K. Jenkins, a leading official of the Food and Drug Administration, said, “F.D.A. could not identify a specific patient population where the benefits of using Trasylol could outweigh the risks.”

Here's an idea. How about maybe identifying a specific patient population where the benefits of a drug outweigh the risks BEFORE YOU LET IT ON THE MARKET. It wouldn't have to be a big population. Just some friggin' evidence that somebody, somewhere, might get some net good out of the thing before you give it to them.

You may say I'm a dreamer.........

Here's another idea. How about maybe doing something to hold people accountable when they hide evidence that a drug is killing people? Last September I told you about this:

The F.D.A. convened a panel of experts in September of last year to review the safety of the drug, and the panel concluded that Trasylol should remain on the market. But within days of the panel’s meeting, the agency discovered that Bayer had sponsored yet another study of Trasylol suggesting that the drug increased the risks of death and stroke.

The company had failed to disclose the results of its study to the agency or the advisory panel. Indeed, Bayer scientists had defended Trasylol at the panel’s hearing but had not mentioned their own study or its worrisome findings. A company investigation later concluded that the findings had been withheld as a result of “regrettable human error.”

Are you getting this? Bayer:

1) Sponsored a study that concluded Trasylol kills people.

2) Then sent its scientists to an FDA panel meeting to tell them how safe Trasylol is, without mentioning that it knows it kills people.

In fairness though, Bayer was only building on the strategy of GlaxoSmithKline, which hid information on the suicide risk of Paxil in teenagers. Gotta stay competitive in this dog-eat-dog, profit before life corporate world we live in you know.

And I really do believe Bayer regrets this whole episode. They regret very sincerely that news of this got out and was published in the newspaper.

So the feds are getting ready to kick some ass, Enron-style, right? I mean, at least Ken Lay never hid evidence of dead people. We can all rest assured that someone at Bayer has been held to account.......

Um, no, we can't. Over a year and all that has happened is a new law saying they can't do it again. You see, hiding evidence that your drug killed people wasn't illegal at the time. The fact they misled the FDA panel seems to have been forgotten.

GSK was sued by the Attorney General of New York over the Paxil episode. It settled for $2.4 million dollars. The equivalent of a $50 fine for me based on my rate of pay and GSK's 2004 profit. Meaning that California took my last speeding ticket more seriously than anyone took the fact that GSK was hiding negative information about Paxil, which was taken more seriously than Bayer hiding negative information about Trasylol and then misleading the FDA.

Wonder if I could get away with killing someone for 50 bucks? You may say I'm a dreamer......

Today I Form A Bond With A Customer Across Ideological Lines, And Other Passive-Aggresive Ways To Get Back At Your Employer.

I thought after being forced to sling pills next to the singing fish a few years ago I could withstand anything, but the singing Band-Aid kid was soon to prove me wrong. Every time a person walked by the first-aid section they, and more importantly, me, were assaulted by the singing Band-Aid kid. A little black box sticking out from where the bandages were with a TV screen, activated by motion to show a 10 second commercial featuring the little snot nose singing brat. Hundreds of times a day I heard the jingle. I started to hear it at night as I tried to fall asleep. It was immune to scotch. I was going to crack.

Then one of George's kids walked by. One of the troops that I wholeheartedly support in finding another line of work.

"Jesus Christ that's annoying" he said.

"You're telling me. I've got a $20 dollar bounty on that things head" The idea of actually offering a bounty came to me just that second. I was desperate, I knew this boy could kill things, and I wouldn't get fired if I could get him to do my dirty work while he was doing my country's.

He didn't disappoint. The vandal-proof black box didn't stand a chance against someone used to taking on IED's. I promptly handed over a Jackson for a job well done. I'd much rather be paying him to kill virtual people than real ones.

Passive-Aggressive revenge on your soulless corporate employer doesn't have to involve hiring hit men though:

There's the pill strike. Every single pill that hits the floor gets thrown away. Those of you not in the profession may not realize that dropped pills almost always get picked up and put in your vial. You may also not realize that some of the ones I chuck away depending on how I feel about my employer at the moment are easily worth a buck or two each, but what kind of organization is going to tell me I have to sell floor pills to customers? And I am a serious klutz. Corpo-pharmacy pays dearly during a pill strike. Of course individual pill strike exceptions can be made based on customer behavior.

Then there's the customer service is #1 maneuver. What happens when someone comes in who needs 5 tablets of a product that comes in bottles of 100, is crazy expensive, and will most assuredly never produce a prescription at this store ever again? If my employer is sending love and happy feelings my way, I call around to see if someplace in town might have some on their shelves, a win-win for everyone. The day after a decision is made to drown me in pointless paperwork though, I happily order it in for next day delivery, and corpo-pharmacy now has paid $500 for the privilege of filling one prescription.

It's all about happy customers though, right boss?.....:) Customer service is always top priority. Definitely higher than remembering to keep track of the pills you spotted a customer to tide them over until their doctor could authorize a refill of their prescription. Expensive pills.

Don't get me started on forgetting to keep track of products taken off the shelf for store use. And taking the most expensive products.

It pays you to keep me happy boss. Literally. Put that Band-Aid kid back on the shelf at your peril.

Norman Mailer, We Did Know Ye, And You Will Be Missed.

If you're a good writer with a penis today, you are more than likely naval-gazing, wussified, soft-spoken, Oprahtized, and generally testosterone challenged. It didn't always used to be so:

Norman Mailer, the pugnacious prince of American letters who for decades reigned as the country's literary conscience and provocateur with such books as "The Naked and the Dead" and "The Executioner's Song" has died at the age of 84.

He drank, fought, smoked pot, married six times and stabbed his second wife, almost fatally, during a drunken party. He had nine children, made a quixotic bid to become mayor of New York City, challenged professional boxers, and was banned from a Manhattan YWHA for reciting obscene poetry.

Do you really have to ask why the Drugmonkey's world feels a bit emptier this night?

Mailer had numerous minor run-ins with the law, usually for being drunk or disorderly, but was also jailed briefly during the Pentagon protests in the late 1960s. While directing the film "Maidstone" in 1968, the self-described "old club fighter" punched actor Lane Smith, breaking his jaw, and bit actor Rip Torn's ear in another scuffle.

But as Newsweek reviewer Raymond Sokolov said in 1968, "In the end, it is the writing that will count."

There was a time when you could be an asshole, but ultimately if your ideas and your art were good enough, they could not help but to be celebrated. Today, it's the act of being an asshole itself that gets you fame.

This makes me sad. Go read "The Naked And The Dead" right now. You will not see its like ever again.

You Are Witness This Day To The Birth Of Drugmonkey, Pharmacy Master.

I am prepared to strike a deal with all the pharmacy "doctors" out there.

I have heard your words. I have felt your desperate need for recognition for the extra year of schooling you went through. Indeed, I've not only felt it, I've secretly shared it for over 15 years now.

I mean, I went though an extra year too. Compared to the 4-year BSPharms. There are still some out there you know. And I need to tell the world I went through an extra year of school, just like you. We're not so different really.

So I have decided it is me that has the equivalent of a Masters Degree. Most Bachelor's Degrees are four year programs. My BSPharm was a 5 year one. I deserve recognition for this.

So yes, the fact that you went to school for two more years than required for a Bachelor's degree in most fields now makes you a doctor for some reason, and the fact I went for one more makes me a master.

You shall now address me as "Drugmonkey, Master of Pharmacy" I shall answer to no other name. I will sign my checks and credit card slips with this title. Not only is my title cooler sounding than yours, it conveys a far more accurate impression of what we do to the layperson.

I feel better about myself already. I suddenly have no desire for scotch. I think I shall go outside and enjoy the gift that is life. Perhaps take a job with CVS, where I can perform ordinary miracles each and every day.

I am a Pharmacy Master, and the world is now beautiful. Thank you, thank you, thank you oh Pharmacy Doctors, for opening my eyes to the benefits of title inflation.

It was an OK Hate Mail. It Was A Far Better Illustration Of The Pompous Assholiness That Can Come With A PharmD

Presented for the amusement of all who work in retail pharmacy:

Just curious---do you do early fills for vicodin when the customer is hot and fuck up other people's pain meds when you don't like them?

Wow. I guess unattractive, poor or "lunatic" people just get fucked when it comes to healthcare. You're only in charge of saving lives...but I guess the hot people are worth saving more, huh?

Fuck off, dumbass.

-Dr. Anonymous, PharmD.

PS. Eat shit.

Here's the post that set off the person who insists on calling himself a doctor when he has the equivalent of a Master's degree. Long story short, we decided we no longer wanted the business of a customer who continuously acted like an asshole, and I ran him off. There was a throwaway line about me staying after closing if a customer was hot. It had little to do with the subject of the post, but you sure wouldn't know that from this comment would you? The (ahem) Doctor....snicker snicker.....jumped all over that hot comment like stink on the shit he recommends for dietary purposes. Probably because he's ugly. I've learned ugly people are super-sensitive to the fact that hot people like me get treated better than they do.

Early refills on controlled substances were never mentioned. Let it be noted that the (ahem).....Doctor with the Master's degree was the first one to bring it up. Wonder why that is? I'd say it might be a reflection of the way the (ahem)......Doctor with the master's degree runs his store if it weren't for the fact I would bet every single asset I own or will ever acquire that the (ahem).....Doctor has never set foot behind a community pharmacy counter.

Anyone who's read this blog for more than 5 minutes, especially if they're smart enough to be a (ahem).....Doctor.....,would have little doubt how I feel about the state of health care for poor people in this country. Funny how the (ahem).......Doctor........seems to assume that the person I wrote about is poor. Again, says a lot about the (ahem)..... Doctor's...... own biases.

Eat shit back 'atcha......

wait.......I'm sorry......

Eat shit back 'atcha Doctor......

Doctor.....bbbwwaaaahhhaaahhhaaahhaaaaa.......

If You're A CVS Pharmacist, You May Have To Commit Suicide.

I can think of no other honorable way for you out of this situation:

I had to watch this three times out of sheer disbelief of its complete gayness. It still hasn't quite sunk in. I mean gay like lame, not gay like homosexual. Butt sex is far less offensive than this. Wrapping a rainbow around an old woman on the way to work? WRAPPING A RAINBOW AROUND AN OLD WOMAN ON THE WAY TO WORK!!?? You know what I do on the way to work most days? I play The Black Eyed Peas "Let's Get Retarded"

Everybody, everybody, let's get into it.
Get stupid.
Get retarded, get retarded, get retarded.
Let's get retarded (ha), let's get retarded in here.......

It's the perfect song to put you in that retail pharmacy state of mind. Why? Because if that CVS video would have been a few seconds longer, you would have witnessed the following exchange between the customer and the rainbow wrapper.

Rainbow Wrapper: "Here's your everyday miracle!!!"

Customer: "WHY IS MY COPAY SO HIGH!!???"

Rainbow Wrapper: "I love sunshine and fluffy baby chicks"

Customer: "I love Norco"

Rainbow Wrapper: "I love the rain that gives us all life."

Blue Cross: "Rain is not on our formulary. None of you may have any rain"

Thanks to the alert reader who alerted me to the video. I think.

Exubera. We Hardly Knew Ye.

From those money-lovin' folks at Forbes.com (Semi-related side note: I once remember seeing Steve Forbes, publisher of Forbes magazine, 2-time presidential candidate, and gazbillionare, host Saturday Night Live........ "Ladies and Gentlemen" he said as he introduced that week's musical guest, "Rage Against The Machine!!!!" I almost shot scotch through my nose.)

Pfizer announced it's cleaning its system of the disappointing inhaled diabetes drug Exubera, giving Wall Street hope the world's largest pharmaceutical company is getting its act together.

The drug-maker’s weakness stems from Exubera, a drug that has disappointed everyone but Pfizer's competitors (See "Pfizer's Latest Hit"). In October, Pfizer announced it was ending production of the inhaled insulin, and taking a $2.8 billion charge.

Hmmmm.....for some reason Exubera just never seemed to catch on.





Who could have known? Um, me. I called this over a year ago, and I remember interviewing Pfizer CEO Jeffrey B. Kindler at the time and asking what the hell he was thinking*:

"We really think the porn star experience adds an exciting new dimension to diabetes treatment." said Kindler. "We all know that erectile dysfunction is a common complication of diabetes, and our focus groups tell us that many diabetics feel that simulated oral sex with a plastic tube is a great way to get back some of those intimate feelings that have been missing from their lives due to this cruel disease."

"Did you really do focus groups?" I asked.

"No, we didn't. But our accounting intern said that making people think about having a hairy penis in their mouth might be a good way to get them to stick to their diets. We went with that thought."

"You're insane"

"Insane like a fox Drugmonkey" said Kindler. Then he started laughing hysterically and threw me out of his office.

So I guess the failure of an erotisized version of an injectable drug means the project to develop Viagra shots will be put on hold**. Goodbye Exubera. Thanks for the memories, the laughs, and the chubby MILF semi-porn. My world feels a bit emptier already.

But not my pharmacy shelves. I never bothered to order one.

*this interview actually took place in an alternate fake world.

**the injectable Viagra project exists only in my imagination.

This Day I Receive The Coolest Excuse For Not Showing Up To Work Ever

"Hello, Drugmonkey?"

"Yeah, R, get your ass in here, we're getting killed"

"I can't come in today"

"DAMMIT!! What are you doing to me here? I thought we were friends"

"Yeah, well, I just got out of jail."

"Seriously?"

"Yeah"

"Whoa, you mind sharing here?"

"Um, well......I was in a car with some friends, and we were driving through (insert name of affluent lilly-white town full of old people with corks up their asses) and we got pulled over. It was bullshit. And the cop had an attitude....."

"And you got into it with the cop?" I knew R had a temper.

"yeah"

"You fucking rock! Take the day off"

"I'd come in, but I'm kinda tired. I didn't get much sleep when I was in there"

"Don't worry about it. We'll get by"

"Thanks"

So the rich old fucks who called the cops because my tech's radio was too loud ended up having to wait twice as long for their Viagra today than they would have otherwise. Justice, oh sweet justice.

He's a good kid. Plus he's in the Air Force Reserve, which makes him a troop you have to support. Ha ha.

Not a bad day at all really.

What We Really Need In Our Next President Is Someone Who Can Protect Us From Cough Syrup.

From the Sept. 3rd edition of the trade mag Drug Topics:

First, the bad news. Recent studies have spotlighted an alarming trend among teens who intentionally consume large amounts of cough medicine containing the ingredient dextromethorphan (DXM). The Partnership for a Drug-Free America reports that one in 10, or 2.4 million, young people report having abused DXM-containing medications to get high.

The good news: The Consumer Healthcare Products Association (CHPA) is collaborating with the Partnership and other organizations to launch educational initiatives to combat this disturbing trend.

Wow. That is good news. An educational initiative is exactly what we need to deal with this problem. Who can forget the way educational initiatives made marijuana use but a distant memory?

In June, the Senate passed S. Res. 225, a resolution designating August 2007 as "National Medicine Abuse Awareness Month." Introduced by Sen. Joseph Biden Jr., (D, Del.), the resolution encourages parents to educate themselves and to talk to their teens about the dangers associated with medicine abuse.

Great. National Medicine Abuse Awareness Month. Sigh. How about National Lame-O awareness month? Let me point out here that Senator Biden is currently running for president. Now call me a bit cranky, but I would like to think people running for president would be worried about things like.....hmmm.....I dunno....terrorists?

"The only thing we have to fear is........the Robitussin in aisle 4"

"You don't seem to be taking this problem very seriously Drugmonkey" I can hear some of you saying, and you would be right. While doing a little poking around the internet I came across testimonials of dumbass kids who swear dextromethorphan took them on Timothy Leary like trips to altered consciousness and ultimate truth. I can tell you that there were times when I took as much dextromethorphan as some of these kids in a desperate attempt to stop hacking up a lung. You know what happened?

I continued to hack up a lung. The cold viruses that were in my body tied up the dextromethorphan, put one of those little red balls in its mouth and made the dextromethorphan their little bitch boy until my white blood cells could come to the rescue. It doesn't work, and I put any stupid kid who thinks it gets them high in the same league with the stupid hippies who swore in the 60's that Coca-Cola and aspirin would give you the ultimate out of body experience. If there wasn't a war going on back then maybe idiotic politicians would have legislated Bayer out of existence.

Wait. There's a war going on now. Wow, that makes Biden look even lamer.

Can chugging the dextromethorphan kill you? Sure. So can chugging water, so should I have to start carding everyone who wants to buy a bottle of Aquafina? Christ we are turning into a nation of wussies. I tell you what though, if Joe Biden really wants to stop teenagers from guzzling dextromethorphan, I'll tell you how he can do it in 30 seconds. Seeing a picture of Joe Biden is the key to understanding my plan:




"Hello children, I'm a cool United States Senator, and you know what's really far out? Popping the top off a bottle of cough syrup and getting jiggy with it. I'm totally down with trippin on the robo... you know what I'm sayin? If you think you can hang with me and my U.S. Senate G's then get yourself some today. I recommend the cherry flavor"

Then he could smile and try to give a gang sign. Except it would really be like an "OK" symbol over his left nipple. One public service announcement stops this cough syrup thing in its tracks.

Stick with the weed kids.

Walgreens Cuts Maintenance Budget, Local Pimps Mount Protest

.



"We don't actually make a substantial profit on the new product line itself" explained Walgreens CEO Jeffrey A. Rein. "What we've discovered in our test markets however, is that sales of high margin products such as condoms, personal lubricants, and anal plugs experience double digit increases"

Of course I made that quote up. Walgreens doesn't sell anal plugs. Yet.

Thanks to the alert reader who sent in the pic.

A Story Of Unparalled Customer Service. In Your Face Walgreens.

I had been getting the living piss beat out of me for about 9 and a half hours. A customer interrupted the filling of another's prescription to ask if we had a product called "air." I shit you not. If there is a company out there that is dumb enough to name a product "air," I don't want to know about it and will happily blow off anyone wanting to buy it. Then the phone rings. This is the unedited beginning of the conversation:

Me: Thank you for calling corpo-pharmacy, may I help you?

Dumbass: IS THERE A (name of corpo pharmacy chain here) OFF THE LAWRENCE EXPRESSWAY??

Here is a summary of my thoughts over the next two seconds:

Well hello to you too.

There is one highway in this little town. Its name isn't Lawrence.

The nearest city that is big enough to name its highways would be at least 80 miles away.

There is no guarantee that is the city this person is talking about.

Fuck this guy.

"Yeah, you take the first exit after the big overpass, make a right at the light, and it's in the strip center with the McDonalds. " Is what I said. Or something like that. I don't remember exactly, as it was a totally random set of directions for a city that existed only in my mind. If I had been given the name of a real city maybe I would have done better.

The sound the dumbass made before he hung up the phone was something like..."hhhuuurroookk"

I immediately felt bad. What if I just steered some prissy-ass white boy into the ghetto and a carjacking? What if he was trying to get a prescription filled for a kid who didn't know Daddy was both extremely dumb and extremely rude? Crap. Maybe this time the Drugmonkey had gone too far.

Another call about 10 minutes later. "YEAH, I'M AT THE COUNTER HERE AND THIS PHARMACIST SAYS THEY DON'T HAVE MY INSURANCE ON FILE."

He found it. The dumbass fucking found it. I think the key was my mentioning of the McDonalds. "Take a right and look for the McDonalds" just might work in any situation really. I wondered if Burger King might be the key to getting the guy's insurance card to work.

I suppose I could use Google to find out where the Lawrence Expressway is, but at this point I really don't want to know. I also don't want to know where you can buy air.

I hate all people.

Maybe I Really Wouldn't Make The World's Worst Parent, Part 2

THERE'S NO WAY I CAN JUSTIFY THAT MUCH FOR SOME MEDICINE!!!!! Said the selfish milfish Mom. Then the cellphone came out. That wonder of modern life, the cellphone. It can solve any problem by getting you connected right away to a machine that will spend the next 20 minutes telling you how important your call is to it and showing you by not answering it.

It was Sunday. The doctor was out having a life. The cellphone wasn't going to solve this problem either.

ISN'T THERE SOMETHING ELSE YOU CAN GIVE HER THAT'S CHEAPER??!!?? Said the selfish milfish Mom. "Her" in this case being her daughter, who was standing right next to her. The daughter who was hearing all about how Mom couldn't justify paying for the Levaquin that would treat her sinus infection.

I should point out here that Mom's handbag probably cost as much as three or four Levaquin prescriptions. I'll also add that the last time I had a sinus infection, I would have let the doctor cut off my left testicle to get some relief, so I knew the kid was miserable. Think the girl in "Little Miss Sunshine", except maybe 14 years old and past the point of realization that she had no business in a beauty pageant. That was this kid.

After the cellphone failed to solve anything, after being told that matching the right antibiotic to the right bug is a matter of clinical judgment for a prescriber, which is why you have to be examined by a prescriber before you can get an antibiotic, and that no, I, who did not examine anybody, could not just pull the cheapest antibiotic off the shelf and hand it over so you can get those new shoes at Macy's, Mom left in a huff. The daughter came back alone a few minutes later with two boxes in her hand.

One was Airborne. The other was a private brand imitation Airborne. She had a check from Mom to pay for the Levaquin, but if I were to tell her that either of the Airbornes might help, she was prepared to buy one with her own money and forget the Levaquin. If it had been a little quieter in the store you could have heard my heart break for this kid. I know all about trying to win the approval of an irrational parent. I wanted to tell the kid that the good news was that eventually she'd be able to break away from the family that made her feel guilty for being sick.

As it was I told her tactfully that she was past the point where the Airborne would do any good. I didn't mention we're all past the point where Airborne will do us any good. That point doesn't exist. Eating the cardboard box Airborne comes in is equally as effective as taking the tablets that are inside. The kid asked for a pen to make out the selfish milfish Mom's check and I reached into my lab coat and handed her one. I noticed too late it was my Viagra pen. DAMMIT! I never let the Viagra pen anywhere near a customer!! It's the only one I have left! How the hell did it get in my lab coat!!?

A little chuckle as the kid saw the logo. "You could totally sell this on ebay I bet"

"You can have it"

"Really?"

"Sure, I got plenty. Spend this much and you oughta get a free pen"

And the dorky kid with the sinus infection who I knew felt miserable smiled and said thanks.

I think I did OK today.

Highlights From Friday's Pill Counting Action.

It was 9:30 and I was worried. I had taken the usual opening flurry of phone calls, which were, in order, people checking to see if their Vicodin, Valium, Soma, Vicodin and Vicodin were ready to pick up, but none of them were from John. I checked the calendar to make sure it was Friday. Never had I worked at this store on a Friday morning and had John fail to call to check on his Vicodin by now. I briefly considered the possibility that John had finally learned that not once had any of these calls resulted in anything other than "it's a little too soon to fill that John"

Briefly considered the possibility I said. I knew it was more likely that something had happened to John. I hoped he was OK. He really isn't that bad of a guy.

The Friday controlled substance extravaganza continued as the next person at the counter had their prescription denied by their insurance company. It was Friday, so I assumed it was a refill too soon. You know what they say about assume. This one was a "drug not covered"

"But.....but.......what do poor people with no insurance do?" said the customer with the newly acquired interest in his fellow human beings.

"Not get prescriptions for Ambien, that's what they do, because they have to save their money for when they're really sick" was on its way from my brain to my mouth when a recall was issued. I decided if a sleepless weekend was what it took for this man to become aware of the insurance crisis in this country then me being a smartass probably wouldn't help anything. I listened to him as if he were Lou Gehrig telling Yankee stadium he was the luckiest man on earth.

Lady with poison oak: Do you have any recommendations?

Me: Put some hydrocortisone cream on it.

Lady with poison oak: Is there any kind of cream I could put on it?

Sometimes the only reason I don't kill myself dear customer, is that would mean you won.

A call came in around midafternoon. Thank God, John was all right. He's is a plumber you see, and his work took him out of town this week. Walgreens was calling for a transfer of his Vicodin. I told Walgreen's the last date of fill assuming it would sink in.

Me: I don't think you'll want to fill that one.

Walgreens: There are no refills?

Me: There are, but he got a 30 day supply a week ago.

Walgreens: What?

Me: It's too soon to fill. You don't want this one. This guy's got a history.

Walgreens: Can I have your DEA number?

Me: Hang on.

Then I put Walgreens on hold and called John's cellphone. It was way easier to explain to John his prescription was too soon to fill than it was this dumbass at Walgreens. John understood right away. I left Walgreens on hold until they hung up.

Half an hour later I accidentally called someone the name of a famous porn star. Whoops. It was close to the customers actual name though.

Last prescription of the day was a woman who couldn't remember her child's date of birth. She knew it was the 30th. No doubt in her mind on that one. She kept going back and forth as to whether it was January 30th or April 30th though, and she couldn't remember the year for the life of her.

"She's 18 months old" was the best she could do. Maybe I really wouldn't be the world's worst parent.

Oh, and I saved someone from a phenobarbital overdose. They totally would have died if the prescription would have been filled as written. The fact that that felt like the most insignificant part of the day was the main reason it was washed away in a river of scotch.

So I Got An E-Mail From My Editor On Wednesday......

.......I don't really have a point here, I just like going around saying I have an editor.

Which i do. I totally have an editor.

I've decided I'm going to buy a drum machine with my first writing paycheck.

Tonight I Catch George Bush In A Lie. It Really Wasn't That Hard.

Presidential debates are like playoff games for political nerds, and it may shock you to hear I am a bit of a political nerd. So much so that I remember these debates and their highlights long after they have been tossed onto the ash heap of history. Much the same way you may have the image of Carlton Fisk guiding a World Series ball to the right side of the foul pole during the '75 world series burned into your brain, I shall always remember moments such as "you, sir are no Jack Kennedy" and the way that phrase went on to help our team kick Dan Quayle's ass in 1988.

Wait, never mind. It was Carlton Fisk's Red Sox that got their ass kicked the night after that home run. I forgot.

At any rate, it's not just the big moments I remember in these debates. I can clearly recall Al Gore giving George the Lessor some flack about the state of health care in Texas during a debate in 2000. I found George's response more than a bit amusing:

Our CHIPS program got a late start because our government meets only four months out of every two years, Mr. Vice President. It may come as a shock for somebody who has been in Washington for so long. But actually limited government can work in the second largest state in the union.

Sooooo.........Texas got a late start implementing its SCHIP program, a state/federal partnership to provide health insurance to uninsured children, because its legislature is in session only 17% of the time. Hundreds of thousands of children had to wait for the coverage they were eligible for because the members of the Texas legislature couldn't get off their lazy ass.

And the lesson to be learned from this, according to George W. Bush, was that this shows limited government can work. I may have been the only person in the country to get the irony.

And he really did call it the "CHIPS" program. That probably surprises no one. It was really mean to get Erik Estrada's hope for a comeback up like that though.

I buried this memory, along with all others associated with the election in 2000, which will go down someday as the beginning of the end times, until I heard this snippet in Bush the Lessor's Saturday radio address a couple weeks ago:

I strongly supported SCHIP as a governor, and have strongly supported it as President.

This is the kind of shit that drives me crazy. Tee totally bat shit crazy. A lie. A straight out boldface lie. Not spin doctoring or torturing the truth like a high value detainee, but a goddamn lie. Unless you call being unwilling to call the legislature into session strong support, unless you call missing out on $618.2 million the federal government was willing to give your state strong support. Just in case you're not getting this, allow me to bring the "Bullshit Exposure Through Dramatization Players" out quickly to demonstrate what Bush calls "strong support"

Federal Government: "Hi, I'd like to give you six hundred million dollars to help you provide health insurance coverage for your state's children."

Governor Bush: "I support your idea so strongly I will take none of this money"

Jesus Christ I wish Bush would give the troops the same kind of strong support he gives sick children. At least he didn't lie about a blowjob though. It's much better to have a president, the person we hire to run the federal government, lie about matters of federal government policy.

It's also much better to have a media structure where the lead story on the CBS Evening News can be that a lot of people will be traveling over the Thanksgiving holiday and some guy with a computer is exposing the lies of the most powerful person on the planet.

End times indeed. We're fucked.

The Most Dangerous Chemical On The Market Cuts A Woman's Cancer Risk By 12%. Which Makes Me Very Optimistic Regarding The Least Dangerous Chemical.

So now it's official. Lloyd DuPlantis of Gray, Louisiana, the pharmacist who got on national radio and told the world he refused to dispense oral contraceptives "in the name of science" has been scientifically proven to be full of shit. You can listen here to Lloyd tell us his decision was about nothing but science. He comes on around the 13 minute mark. Around 16:30 he says oral contraceptives are "the most dangerous chemicals that have ever been put on the market." Lloyd made God so mad when he said this that God sent a hurricane to Louisiana to try and wipe Lloyd out. Unfortunately God missed. If God had been on target though, it would have spared Lloyd a lifetime of humiliation. To the Sept 12th UK Guardian:

The contraceptive pill actually protects women against cancer in later life, according to the largest study ever set up to evaluate the risks and benefits.

The pill, which has been a source of controversy since it was introduced in the 1960s, is today revealed to have an overall net benefit for the women who take it. Researchers who have followed 46,000 women taking the pill - beginning in 1968 - say that it cuts the individual's risk of cancer of any kind by up to 12%.

Um, maybe it's just me, but this doesn't sound like the most dangerous chemical on the market. Honestly, I really don't think a scientist would have to look very hard to find something more dangerous. A religious crackpot with an ulterior motive might not be able to come up with something more dangerous, but not a scientist.

"Drugmonkey I'm not gonna let you blow smoke up my ass" I can hear some of you saying. "I know damn well Oral Contraceptives raise a woman's risk of breast cancer. You're wrong! Lloyd DuPlantis of Gray, Louisiana is a scientist!"

You would be right about the breast cancer. Back to the Guardian:

It is accepted that the pill raises the risk of breast cancer while a woman is taking it and for about five years afterwards. But the real benefits kick in 15 years or more after she has stopped. Most women go on the pill in their late teens or early twenties and have given up by their late twenties.

.....women who were once on the pill - as long as they did not take it for more than eight years, and most do not - are no more likely to get breast cancer than others. And they are significantly less likely to suffer from certain other cancers, in particular ovarian cancer and endometrial cancer, which affects the lining of the womb. They are also better protected from bowel cancer.

I'll translate this for you. Women do have a higher risk of breast cancer while they are taking the pill. This risk vanishes by the time they have been off the pill for five years. How many 20 somethings do you know who are battling breast cancer? Exactly. The pill raises these women's breast cancer risk from incredibly small, to slightly more than incredibly small.

But the protection from other types of cancer is permanent. You can be an 80 year old hag, but if you took oral contraceptives back when you were penis hunting in your 20's, your chances of dying of cancer are lower.

Lloyd DuPlantis of Gray, Louisiana is not a scientist. We now have scientific proof.

The lesson to be learned here is to be true to what you are. If Lloyd Duplantis of Gray, Louisiana had just been honest back in 2005, if he had just admitted he was a Christian fundamentalist trying to impose his beliefs on us all through his professional practice, he would look less foolish today. Because now he has to take back everything he said back then. He has to tell everyone he knows that he was either wrong or he was a liar.

Be true to yourself. If you're a religious fascist, just admit it. At least then you can have some self respect.