My Ex-Wife Called It "Upselling".....At Least I Think That's What She Called It. I Don't Really Remember.

She managed a Hallmark store back in the day, and whatever it was actually called, it was one of the things they were evaluated on by the corporate mothership. It went something like this:

A customer would approach the cash register. An employee would say. "Have you seen our (insert name of gay product being promoted this month we can't sell any other way) they're just adorable!"

The ex-wife never saw the similarity between this and the pimply-faced teen behind the McDonalds counter asking "do you want fries with that?" No matter how adamantly or how many times I pointed this out. One of the reasons I have an ex-wife I suppose.

Big Pharma's got it a lot easier though. They don't bother to ask if you want your product supersized. To Sunday's New York Times:

The drug...... Cerezyme, is used to treat a rare inherited enzyme deficiency called Gaucher disease. Some experts say that for most patients, as little as one-fourth the standard top dose would work...

The standard Cerezyme dose — an infusion of 60 units of the drug per kilogram of body weight every two weeks — was set in a clinical trial involving only 12 patients.

Dr. Beutler of Scripps said that it was reasonable to use a high dose in the initial trial to prove the drug worked. But after that, he said, “the reasonable thing was to cut back and see what you really need. It didn’t fit Genzyme’s business plan, so they never cut back."

What? A drug company putting its financial interests ahead of those of patients? I've never heard of such a thing. Where would a person get an idea like this? Maybe from Genzyme itself:

Dr. David Meeker, the president of the Genzyme division that sells Cerezyme, said the company thought doctors should determine doses specific to each patient. So there was no point in doing a clinical trial comparing different doses.

“Showing that 6 out of 10 got by with a certain dose doesn’t help us,” he said.

No.....but it might help those 6 out of 10 patients. Let's go over what Dr. David Meeker said again. Dr. David Meeker thinks doctors should determine doses specific to each patient. But Dr. David Meeker thinks those doctors should have no data upon which to base these decisions.

So.....what.....should they throw darts at the package insert to determine the dose? My friends, Dr. David Meeker just provided you with a fine example of corporate bullshit.

And the stakes aren't small. Cerezyme costs $300,000 a year at the dose given in that 12 person study. That wasn't a typo. Three-hundred thousand dollars a year.

Not to mention when other companies do this type of thing with other drugs there's some evidence you can end up dead.

"Stupid drugmonkey" say the Republicans among you. "Why the hell can't you understand these drugs have to cost so much because of the incredible amount of research involved?"

Try again:

...critics say the company’s development costs were minimal, because the early work on the treatment was done by the National Institutes of Health, which gave Genzyme a contract to manufacture it.

That would be the government-run National Institutes of Health. I wrote about this type of thing before by the way. Tell me again why I'm supposed to be afraid of socialized medicine?

I think I'll pass on the fries today.