Thursday, February 24, 2011

The Article Too Hot For Drug Topics.

So, yeah, some of you know I spend some time cooking up words for the industry's leading trade magazine, Drug Topics. I admit I try to be a little edgy and push the envelope a bit in my columns for them. After all, I firmly believe if you're not pissing someone off with what you're saying, you're probably not saying anything very important.

Evidently I finally pushed them too far though, although not with the piece with which I thought I would. I've been working on a a column about Walgreen's POWER program, and although they decided to take out my favorite line about being at a bar and overhearing the company's CFO, it looks like that one's gonna run.

Walgreen's CFO, you see, has been busted for drunk driving twice. That line was absolute gold and you'd have to see it in context to fully appreciate it. Oh well. It's nice to have these professional writer type problems I guess.

The article that got rejected was about worstpills.org, which I thought was tame compared to the Walgreen's one. Evidently though, it got a little too close to the industry that actually buys ads in trade magazines. Don't get me wrong. I'm not the least bit angry at Drug Topics. They've been very good to me and the chance to make some money without having to mortgage my soul is one I'm happy to have. Given a choice between pissing off the pharmaceutical industry or one of the corporations responsible for destroying our profession, I'll choose pissing off Walgreen's every time.

I just thought it would be a shame to let the article go to waste. So here it is:


I don’t have to tell you retail pharmacists are overworked. The constant whir of the fax machine, the never-ending ring of the five phone lines, the three customers demanding our immediate attention, that’s been the story line in our profession since long before my first day as an intern. Actually, the more I think about it, the more surprised I am you’re even reading this, and the more I wonder.

Where are you getting your drug information? If you’re looking at these words, I’ll guess you’re getting a good part of it from the advertisements on these pages. Which worries me a little.

Not that there’s anything wrong with a drug manufacturer taking out an ad to tell pharmacists about the introduction of Zegerid (omeprazole/sodium bicarbonate), or to make a sales pitch touting the benefits of Lexapro (escitalopram) mind you. As someone who ends up with some of the dollars generated by these ads, I wholeheartedly encourage such behavior. Let’s not kid ourselves though. By educating us about their products, the corporations that take out these ads are aggressively advocating for their interests, which is exactly what they should be doing under a competitive capitalist economic system.

In this competition though, who is advocating for the interests of our patients? After all, no sane corporation would ever take out an ad to let us know they think Fanapt (Iloperidone) isn’t as effective as older medications for the treatment of schizophrenia, or that the risk to benefit ratio of propoxyphene probably doesn’t justify it remaining on the market. You’ll never see a commercial on “60 Minutes” telling you to ask your doctor about alternatives to sleeping pills.

That is, however, exactly the kind of information and opinion you’ll find at the website worstpills.org. Part of Public Citizen, a nonprofit consumer advocacy group founded in 1971, worstpills is as aggressive in advocating for the interests of patients as Merck and Schering are in advocating for the interests of Zetia (ezetimibe). As a profession that serves as a bridge between the makers of medicines and the people who take them, we should welcome a no holds barred argument between the two sides, the same way the American judicial system values intellectual combat as a way to find the truth. I would love nothing more than to see the pharmaceutical industry and worstpills.org in a steel cage death match.

Unfortunately it wouldn’t be a fair fight. One side has a multibillion dollar advertising budget, the other is supported by foundation grants, publication sales, and member dues. One side fields a sales force army to make in person contacts with health care professionals across the country, while I have never had a representative from Public Citizen ask for some of my time at work. Some days there are so many direct to consumer drug ads on the evening news I feel like I should get continuing education for watching, while if it weren’t for the occasional e-mail reminder, I might forget about my subscription to worstpills.org entirely.

Which would be a shame, because I consider the money I spend to access worstpills.org as a sound investment in my professional career. Because of worstpills.org, I was able to sound a warning to doctors who asked my opinion of Avandia (rosiglitazone) well before stories about that controversial drug made the papers. I told a friend of mine to forget about their Darvocet (propoxyphene/acetaminophen) prescription and just go with some Tylenol instead, and I was able to get some sober, clear headed advice regarding Tamiflu, (oseltamivir) during last year’s H1N1 flu mania. I don’t always agree with the opinions of worstpills.org, but I have found them to be valuable.

So by all means, look over the ads you find in this magazine, pay attention to the messages that bombard your customers every time they turn on the television or open a magazine, and give the sales rep at your counter a few minutes of your time. You’ll probably learn something and be glad you did. But then, make an effort to get some balance in your drug information from sources that have different biases than those you are used to. Make them compete for your attention and opinions.

I know you’re busy, but you’ll be glad you did.

Thursday, February 17, 2011

Highlights From Pill Slinging On The Day Of Love.

Although I've never needed it, yet, I took comfort in noticing the liquor store opened at 8 in the morning. I sat in the drive through at Jack In The Box, and waited for my extreme sausage biscuit, and saw the old man with the scraggly beard leave the store across the street with a brown bottle bag tucked under his arm and felt much the same way a trapeze artist must feel when they look down and see a safety net far below them. Getting some extreme sausage in the morning before a twelve hour day has been a ritual of mine for well over half a decade now, but it was only today I noticed the liquor store across the street opens at 8 AM. Comforting as it is, I don't think it's a good sign.

I put the sausage in my stomach and slowly strode forth across the parking lot to face the day. Halfway to the front door a midget woman flagged me down. Not really a midget I guess, but pretty damn short.

"Excuse please.....can you help? I park but afraid to put in reverse."

That was the condensed version. Her actual communication took far longer. Her car wasn't quite lined up with the parking space but she didn't want to back up. She actually did seem afraid. Did I park her car for her because I have a desire to help my fellow humans or because I have the alcoholic child's pathological desire to please people at all costs? As I struggled to wrest myself from the front seat that was set for a person a good foot and a half shorter than me, I couldn't help but to think it was the latter. Afterwards she hugged me, which added insult to injury.

Once inside the pill garden I noticed a little pin doohicky had fallen out from the handle used to crank the pharmacy gate open. It's half an inch long and it's impossible to raise the gate without it. For some reason I went to the hardware section of the store and McGuyvered a solution instead of standing around and staring at where the pin used to be like everyone else. The district office called to let me know how much they appreciated the type of employee who can think on their feet like that and save them the time and expense of a service call.

BWWWWWWAAAAAAAAAHHHHHHHAAAAAHAHHHHHAAAAAHHHHHHAAAAA!!!!!!! Oh God I kill me. Anyone who believed that last sentence has never worked retail a day in their lives.

The first customer of the day payed for an 8 dollar prescription with a hundred dollar bill and the second wanted to know if her prescription was ready yet. "The machine said I could pick it up after noon" she said. It was 9:15. Yeah, knowing I could walk right out the front door and buy a bottle of gin at this hour definitely made it more tolerable.

At the mid-morning mark I was presented with a prescription for Nuvigil, a stimulant used to keep people awake, and temazepam, a sleep aid, both with instructions to take one in the morning. I wondered if the purpose was to let them fight it out to see who'd win. I looked up and saw what looked like a 17 year old kid carrying a heart shaped box of copro-pharmacy chocolates and wondered if that was really gonna get him laid as I sat on hold with the doctor's office.

At the mid-afternoon mark I decided I would invent a new type of prescription vial. My revolutionary device would let the patient see all the way to the bottom, which will allow them to be fully aware of when they are getting low on their prescription and therefore able to call a few days ahead of time to have it ready, instead of the current system, in which 80% of non-Vicodin patients seem to be totally unaware of when they have taken their last tablet. Coupled with my other idea, a ground-breaking new prescription label that would clearly state when there are no refills left, patients will now have all the information they need to competently manage their prescription affairs. I mean.....no one but a complete dumbass would let their prescription run totally out if they could clearly see there were no tablets left to take and no refills remaining.

BWWWWWWWAAAAAAAAHHHHHHAAAAAHAHHHHHAAAAAHHHHAAAA!!!!!! Seriously, I really do kill me. Where's the gin?

The second and last time I was required to perform a professional function on Valentine's Day was when I explained to a woman why her doctor discontinued her potassium prescription when he switched her blood pressure med to lisinopril. I was interrupted twice while doing this. Once by a man who wanted to know where the bathroom was and again by a lady who wanted to find the bendable straws. Potassium lady eventually accepted my explanation, but didn't seem nearly as grateful for it as the lady who had me park her car.

I ended the day wondering how much I could make as a valet, but secure in the knowledge that I had to make it to the liquor store by eleven. I've known the closing time of the liquor store for years.

Tuesday, February 08, 2011

"Someone Is Making A Big Profit Out Of Woo Woo"

Meanwhile, my employer gets a $1.50 dispensing fee from your warfarin prescription:

Saturday, February 05, 2011

A Modest Proposal For The Cleveland Cavaliers Basketball Team.

Dear Sir/Madam/Whoever is in charge of your train wreck,

I don't have to tell you times are tough. The housing bubble and its resulting ills have hit this country hard, and Cleveland harder. Unemployment and its resulting ills have settled upon your city like a two foot blanket of snow. You face despair, homelessness, crime, drugs and violence each and every day, and things aren't good off of the basketball court either. I write you this day not to wallow in your misery however, but to ignite the flame of hope. When you have hit bottom there is only one way to go, and today I offer you a solution that I am confident will contribute to the long term improvement of your bottom line.

I propose that you immediately terminate the employment of every player on your active roster and replace them with a team consisting entirely of myself. I will perform the duties of every position; forward, center, and guard, and will play the entirety of every game. Furthermore, I will do so for a salary of $2 million a year, a savings of approximately $49 million from your current payroll. This may appear at first to be quite a radical move on your part, but my projections show that had this plan been put in place at the beginning of the current basketball season, the net result would only be eight fewer wins for your team at this point. Sacrificing quality in order to achieve cost savings has long been a tradition in the business world, and I feel the time is right for the Cleveland Cavaliers to join the predominating corporate paradigm. When you do, you are most certain to find out what many successful companies have found out before you, that the elimination of quality is good for profits. In your case, the spectacle of a 6 foot tall white guy taking on the entire roster of the Los Angeles Lakers would surely be far more entertaining than the product you are currently marketing. Ticket sales are likely to see a significant increase.

I also would be returning to my native Ohio to continue my basketball journey. Making it possible to market me as the anti-LeBron James.

I would be available immediately after giving the customary two week notice to my current employer, and have been working out regularly for the last three years, although I don't see what possible difference that would make. I do see a future for us as bright as the Cuyahoga River aflame on a clear winter's night.

I look forward to the chance to improve both of our finances.

Sincerely,

Drugmonkey.

Friday, February 04, 2011

A Quickie From The Morning Paper

They have a thing about making certain stories available only in the print edition, and not online, but I swear I'm not making this up:

WaterPlus includes a collection of prominent locals. In addition to Weitzman, the new group includes such well known figures as Nader Agha, Harvey Billing, Bob Massaro, Dick Rotter, and George Schroeder, among others. 

BWWWWWWAAAAAHHHHHHHAHAAAAHHAHHHAAAAAAAA!!!!!!!!!!! Dick Rotter!!!!!! BWWWWAAAAAHHHHHHAAAAAHHHHHAAAAHHHHHAAAAAAA!!!!!!!  Well of course Dick Rotter is well known. Who can ever forget his work in the basic training Gonorrhea film used by the US Army for over 40 years? Classic stuff, that appearance by Dick Rotter was. And who knew you could make a living making porn for people with a leprosy fetish?  "I Left My Schlong In San Francisco" was groundbreaking in its day. I've often wondered what Dick Rotter could be up to these days.

I'm kidding. I don't know who the fuck Dick Rotter is. But I have a feeling the paper wouldn't be as likely to be calling him well known if he went by Richard.

Wednesday, February 02, 2011

I Owe The Pharmacists For Life International A Big Apology.

I'm sorry Pharmacists For Life International. I thought you just hated women. When you cranked up your public relations machine a few years ago to draw attention to the cause of  "pharmacist conscience," putting Karen Brauer in front of the nation's TV cameras and Lloyd Duplantis behind the microphone of National Public Radio, I thought your objective was to put a stop to or at least a dent in the number of abortions that take place in this country. I was mistaken, and again I apologize.

Fortunately the legislature of the state of Idaho didn't listen to the likes of me when they passed a health care worker conscience law of the type you fought so hard for. It didn't take long for a pharmacist to take advantage of that law, less than a year actually.

On Nov. 6 a Walgreens pharmacist refused to fill a prescription ordered by one of Planned Parenthood's Boise-based nurse practitioners. The prescription was for a Planned Parenthood patient for Methergine, a medicine used to prevent or control bleeding of the uterus following childbirth or an abortion.

This is awesome. I can see now that this is one step closer to what is now our common goal. I'm so sorry I was so wrong, that I couldn't see that you were simply using the dim-witted twits in the anti-abortion movement as pawns in your brilliant chess match. That prescription for Methergine, you see, doesn't do a damn thing to stop an abortion whether its filled or not. Hell, probably at least half the time you see one it doesn't have anything to do with an abortion at all, stopping bleeding the way it does after a natural miscarriage or regular childbirth with complications. And when it is abortion related? By the time you see the prescription it's too late if you're interested in stopping one, because the abortion has already happened. So what the pharmacist was doing by refusing to fill that Methergine prescription then, was assuming the power of cop, judge, jury and executioner against someone who they thought might have done something they didn't like. Literally, executioner. That Walgreen's pharmacy customer could have bled to death.

Sweet. Because a lot of my customers do things that I don't like, and I cannot wait to use my new God-like powers just as soon as the Idaho Board of Pharmacy rules against Planned Parenthood in its complaint against that Walgreen's pharmacist. I'm hoping Pharmacists For Life International can now maybe team up with The National Rifle Association so we can just start shooting people dead at the pharmacy counter. I'll go after the Type-2 diabetics first, then probably the fibromyalgics. I'll probably off a smoker or two as well just for shits and giggles.

And I'll have The Pharmacists For Life International to thank. For making pharmacy the single most powerful profession on the planet. I can't believe I was so foolish not to have seen their plan.

Definitely beats the shit out of anything APhA's ever done for us.

Thanks to the alert reader who tipped me to the story.

Tuesday, February 01, 2011

I Must Have Missed The Outcry About The Rape Panels.

I mean, I totally remember the blue in the face teabaggers getting their boxers in a bunch over death panels. Sara Palin and her ilk telling us that Big Government was gonna be deciding whether to pull the plug on Grandma, deciding whether she would live or die. Scary stuff.

Also total fiction.

Which is good news for rapists. Because if we keep Grandma in a coma and unable to fight back, someday  she might just be fair game for an unlimited gangbang thanks to the Republicans those teabaggers put in power. From the website of Mother Jones magazine:

Rape is only really rape if it involves force. So says the new House Republican majority as it now moves to change abortion law.
For years, federal laws restricting the use of government funds to pay for abortions have included exemptions for pregnancies resulting from rape or incest. But the "No Taxpayer Funding for Abortion Act," a bill with 173 mostly Republican co-sponsors that House Speaker John Boehner (R-Ohio) has dubbed a top priority in the new Congress, contains a provision that would rewrite the rules to limit drastically the definition of rape and incest in these cases.
With this legislation, which was introduced last week by Rep. Chris Smith (R-N.J.), Republicans propose that the rape exemption be limited to "forcible rape." This would rule out federal assistance for abortions in many rape cases, including instances of statutory rape, many of which are non-forcible.
Other types of rapes that would no longer be covered by the exemption include rapes in which the woman was drugged or given excessive amounts of alcohol, rapes of women with limited mental capacity, and many date rapes."

Victory at last for lobbyists working for the manufacturers of Jim Beam and Rohypnol no doubt.

That was a snarky comment, but there is one line in the article that will bring joy to the hearts of rapists everywhere:

The bill hasn't been carefully constructed, Levenson notes. The term "forcible rape" is not defined in the federal criminal code, and the bill's authors don't offer their own definition.

Should this bill ever pass however, that definition will come. And when it does, most of you know how it'll go from there.. "Forcible rape" will become synonymous with "real rape," the distinction meaning if you didn't fight with all your might against a 300 pound lunatic high on PCP, then your violation isn't to be taken quite so seriously.

And if you were drugged to the point of not being able to fight back, well that's just too bad slut, you shouldn't have been wearing that miniskirt anyway.

And who better really, to come up with that definition than a panel of government appointed bureaucrats working to implement the will of politicians?

A rape panel. It's far closer to reality than the death panels ever were, and the ensuing silence says volumes about the value we place on women.

You've come a long way baby.

Thanks to the alert reader who tipped me to this.