Wednesday, March 27, 2013

Insist On Brand Name Poly-Vi-Flor Or Your Baby Will Be Crazy, Mentally Challenged, Eaten By Their Own White Blood Cells, Then Finished Off By Cancer.

I just saved you the effort of reading the latest fax from Zytera Pharmaceuticals with that headline. Those of you wise enough to already have a copy of my latest book know that Zytera is the company that bought the rights to the Poly-Vi-Flor and Tri-Vi-Flor brand names, and that both products were boring old baby vitamins on the market as long as anyone can remember, only requiring a prescription to make sure your kid wasn't getting too much fluoride, the tooth hardener that turns your teeth to mush when taken in excess.

Anyway, boring old product most doctors still prescribe by name, even though 99.9% of those prescriptions have been filled with a generic for decades, then a new company buys the name. Most of you know where this is going. The old "minor change" trick. The company buys the name, makes a minor change in the formula, and now, all the sudden all those Poly-Vi-Flor prescriptions can no longer be filled with the cheap generic. I'm looking at you Auralgan.

In the case of Poly and Tri-Vi-Flor......Zytera uses a slightly different form of folic acid, one of the B vitamins. The folic acid we eat or take in vitamin supplements, like a gazillion other drugs and food parts, is metabolized into the form your body eventually uses. That is the full time job of your liver. Changing the stuff you eat into the stuff you use. Zytera uses the form of folate that comes out of your liver for the new Poly and Tri-Vi-Flor.

Ho hum.

Not to hear the folks at Zylera tell it though, after the usual blah blah blah about how the new formulations are NOT pharmaceutically equivalent to previous (inexpensive) formulations, this is what today's fax said, word for word:

Recent studies have indicated that 40-75% of the population has a genetic variant called methylenetetrahydrofolate reductase also known as MTHFR that impairs the ability to process folate. This defective gene leads to elevated levels of homocysteine and defective methylation. Defective methylation is associated with psychiatric illnesses, such as schizophrenia, depression and bipolar, as well as autoimmunity disorders, ADD, autism, spina bifida, Down's syndrome, miscarriages, and cancer.

I'm not making this up. Basically a pharmaceutical manufacturer this day sent out a fax to pharmacies around the country that essentially said... HOLY MOTHER OF GOD IF YOU DON'T USE BRAND NAME POLY-VI-FLOR THE BABIES WILL BE CRAZY AND RETARDED AND DEAD!!! THEIR OWN WHITE BLOOD CELLS WILL JOIN UP WITH RAMPAGING CANCER TO EAT THE CHILDREN FROM THE INSIDE!!!!! BE AFRAID BE AFRAID BE AFRAID!!!!!!

I will step back here and remind you we are talking about baby vitamins. Hopefully you won't need me to tell you that 40 to 75% of babies born in the last 40 years have not turned out to be spina bifida wrecked schizophrenics, despite how badly the people at Zylera would like you to believe that. My guess is there's a reason these incredibly irresponsible bullshit claims were made in a fax, and not in the more permanent and traceable form of a postal letter or advertisement.

So thank you Zylera. Before I got this fax the temptation was very strong not to use my limited amount of time behind the counter calling doctors to explain why Poly-Vi-Flor is now bullshit. You can bet your left testicle that whenever I see a prescription for your crap in a bottle from now on though, time will be made.

Fuckers.

Tuesday, March 26, 2013

My New Book Is Now Here In All Its Glory And In All Forms Paper And Electronic. Get Your Copy Or Be Forever Doomed To Pay Too Much For Your Vicodin.

Because those of us in the know all know that the new Vicodin is a rip off. Nothing but a cynical ploy to take advantage of the brand name of the most prescribed drug in America in order to score some unearned dollars.

If you don't know that, then you seriously need to get on Amazon right now. Click on this link as fast as you can. 

Or click here if you get your words from a Nook. 

If you do know that, and wanna know more about this kind of crap in a bottle, than you really should click on that link too. 'Cause you'll find a new book chock full of examples of the bullshit that sometimes passes for innovation in the world of Big Pharma.

Doryx anyone? Treximet? Makena? And more zit creams than you can shake a stick at.

Actually now that I think about it, I'm realizing this may just be the most important book ever written. Seriously. Everyone from kids with zits to seniors with Alzheimer's will benefit from the words I have written. I never realized until now just what a humanitarian I am.

I should get an award. Anyway, here's another excerpt so you can see what I'm talking about.

 Aricept 23



The Med


Aricept, the brand name of donepezil, is a member of a class of meds known as cholinesterase inhibitors. It works by increasing the amount of acetylcholine in the brain, and has become a cornerstone of Alzheimer's therapy. While not a cure, it can delay the progression of symptoms and is one of the limited options available to sufferers of the disease. As such it became a blockbuster seller for its makers, the Japanese company Eisai and their American partners Pfizer, generating over $2 billion in annual revenue. It was set to lose its patent protection in November of 2010 however, which would lead the way for generic competition.

The Scam

I almost didn’t list the meds in this book alphabetically, because I wanted to save this one for last, as it crosses a line I thought would never be crossed. Aricept was available for years in 5 and 10 milligram strengths. Shortly before its patent protection was set to expire however, Eisai and Pfizer applied for approval of a 23 milligram version.

“What an odd number” you may be saying to yourself. Notice how that odd number cannot be reached by using the soon to be cheap 5 and 10 mg strengths.

Still, it is intuitive that a higher dose of medication would improve clinical outcomes. Science doesn’t run on intuition though, in science things have to be proven, so a study was started. The FDA set a benchmark that said the new strength had to improve both cognitive (mental) and global (overall) function in Alzheimer's patients in order to be approved.  

Aricept 23 flunked. The study showed only slight improvement in cognitive function and no improvement at all in global function. The FDA however, against the advice of both a clinical and statistical reviewer, approved Aricept 23 anyway. The New York Times reported that Dr. Russell Katz, director of the F.D.A.’s neurology products division, “acknowledged side effects from the higher dose ‘could lead to significant morbidities and even increased mortality,’ but concluded that the drug most likely improved overall functioning even though the study did not show that.”

Two points about what just happened here:

1) “but concluded that the drug most likely improved overall functioning even though the study did not show that.” So much for science not running on intuition, as the intuition of the right person was what got this drug approved. The medical professions have become used to numbers being massaged, facts being twisted, and any and everything possible being done to put a med in the best light possible in the scientific literature, but this is the first time I’m aware of when they’ve given up on even pretending like the scientific facts matter. “The study did not show that,” and it still didn’t matter.

2) Which might be forgivable if it were done in the name of trying anything possible to help the victims of a terrible disease. But Katz also “acknowledged side effects could lead to significant morbidities and even increased mortality.” Just to be clear, morbidity is a fancy word for sickness. Mortality is one for death.

So the FDA approved a drug that did not meet its criteria for effectiveness, and that its head of neurology products said may leave more people dead. That’s the story of Aricept 23 in one sentence.

Oh, and Aricept 23 costs about 90 dollars a month more than the safer and effective 10mg generic version.


What To Do

Let me be clear: Aricept 5 and 10mg are perfectly appropriate choices for Alzheimer's patients. It’s only when the dose went up to 23mg that it crossed the line into bullshit. There may be isolated cases where a dose that high is beneficial, but they tried to prove its effectiveness at that dose and got marginal results. What Aricept 23 does do is more than triple the incidence of nausea and vomiting, increase by 60 percent the chance of diarrhea, and depletes your loved one’s assets by over a thousand dollars a year. Unless there is a good reason not to, stick with the lower doses.


_____________________________________________


Wow. That was awesome. And there's plenty more where that came from my friends.


Friday, March 22, 2013

You Are The Donkey Here. The Chair Is CVS.

Or Rite Aid. Or Walgreens. You get the idea.


And sometimes the chains that bind us are 7,000 store corporations.

But, you do not have to be bound to that plastic chair my friends. Trust me on this. News is coming soon.

I'm free.......:)


Friday, March 15, 2013

So, Yeah, The New Book's Still Coming. Here's An Excerpt To Whet Your Appetite

Remember that nice cover I talked about last time? You can blame it for the current delay. I think "Scribus" is some sort of Latin word that translates as "software from hell"

Nothing that can't be handled though, it'll just be a matter of finding some time to work it in now that I have another project. A big project. Huge this project is. In about a month or so I'm gonna drop a bomb on you muthas that you may not believe. In the meantime, here's a piece of my book. Just to recap for those of you playing along at home. It's called "The Pharmacy Ripoff List" and it calls out 50 of the biggest pieces of crap stocked on pharmacy shelves across the country. Like this one....

_______________________________________________________________________________


Chapter 25: Latisse


The Med

When I first heard of Latisse, it made me question my medical knowledge. Later, as I learned more, it made me question my sexuality. Latisse, you see, is the first prescription eye drop to treat hypotrichosis, which sounds scary and serious. My first thought was maybe hypotrichosis was the fancy medical name for African River Blindness or some other dreadful sight-threatening condition. But when I looked it up I learned that scary sounding hypotrichosis is actually:

”inadequate or not enough eyelashes”

This was a problem? I started a search for the signs and symptoms of this condition. I wondered what the prognosis was for sufferers. Allergan, the maker of Latisse, seemed very excited about it, so I figured this new treatment must be some type of revolutionary medical breakthrough. But after I dug into things for awhile, I learned that most “patients” that were to come to me with prescriptions for Latisse simply wanted to be sexier.

That was a surprise to me, because I’m pretty sure I’ve never once said to myself, or heard anyone else ever say anything like, “Whoa!! Check out her eyelashes!!” I’ve never once had eyelashes figure into a dating decision or complimented a woman on hers a single time. Maybe eyelashes play a role in human sexuality that I was completely unaware of. Maybe I’m some sort of pervert.

The Scam

Or maybe Allergan is taking advantage of the extreme shallowness that prevails in modern society. Latisse is nothing new. It is simply a repackaging of the anti-glaucoma medicine Lumigan. The people at Allergan noticed that glaucoma sufferers using their product sometimes grew thicker eyelashes, so they put it in a different box and pretended it was something new. It is not. It is the same stuff, in the same strength, with the same side effects, including the risk that it may change the color of your eyes to brown. The only difference is Latisse is packaged with a supply of little brushes that make applying it to your lashes easier. Let me repeat this to be clear: There is no difference between Latisse and Lumigan other than the name on the box.

If you decide that sexy eyelashes are what you want though, and you really desire the little brushes to help you put on your Lumig....er....Latisse, be ready to pay around $110 a month.

What To Do

Pick up a book, because a smart woman is the sexiest of them all. Why do you think librarians and nurses play such prominent roles in fantasy lives? While you’re in that book maybe you’ll learn that African River Blindness has taken the sight of over 300,000 people even though it can be treated for only a few dollars. Maybe then you’ll be at the bar talking about the unfairness of it all and you’ll sweep a socially conscious hunk of a man right off his feet. Or, at the very least, you could join a gym, and develop the parts of your body a shallow man-pig would actually be attracted to while doing wonders to improve your overall health.

Because Latisse, while marketed for the treatment of hypotrichosis, is far more effective in curing “more money than brains” syndrome.  


____________________________________________________________________


Holy crap this sounds like a great book. After reading that chapter again I am nothing but thankful this night I have a copy here on my computer that I can read anytime I want. 


Soon you will too my friends. Just as soon as the Scibus is overcome. 

Fucking Scibus.



Friday, March 08, 2013

Drugmonkey, What's This I Hear About A New Book? I Hope It Addresses A Need And Maybe Annoys Some Drug Companies.

Well you are in luck my friends, because the new book does just that.

Lemmie ask you something. Are you tired of the bullshit you end up stocking on your shelf? When I say Doryx everyone who's ever worked in a pharmacy knows exactly what I'm talking about. There is a whole sub industry that has evolved in the pharmaceutical world over the last few years devoted to ripping off people and their insurance companies.

Solodyn. Need I say more? In case I do check out the product offerings from Shionogi Inc. A company built on crap. Every day I hear the eyes rolling from the pharmacy workers of the world as the Latisse, Sarafem, Treximet and Paxil CR roll out the door.

Not to mention the Aricept 23. It was the Aricept 23 that pushed me over the edge. They crossed a line with that med I thought would never be crossed.

I also hear your voices every day as you slap the label on the Acanya and deal with another goddamn "savings card." "Someone really needs to call bullshit on this." you say over and over again. Well now someone has.

Me.

I've taken 50 of the biggest rip offs disguised as medicine ever to stink up a pharmacy counter and called them out for the world to see. Aplenzin, Duexis, Moxatag and Zipsor. They're all here plus lots more. All together in one handy guide to the way loopholes are taken advantage of in order to maximize the separation of patient and money that happens with every medical encounter. I explain what they are, what the rip off is, and what to do about it for each of them.

"What a great thing to have available for your patients", the Drugmonkey said to every independent pharmacy owner. What a great thing to sell next to your cash register. I can hook you up at wholesale prices.

It's coming soon my friends. Like within days. I'm going away fro the weekend, but when I get back I'll post a sample for you all to see. In the meantime I'll tell you the cover looks nicer than my last one. If you're the type of person who judges a book by nothing but its cover, you're gonna think this one is way better.

It's about time someone wrote this book.




Thursday, March 07, 2013

CVS. Ye Olde Pharmacy That Hearkens Back To A Simpler Time.

In this age of technology, when we start our days checking our iPads for text messages, then catch up on our Facebook friends before breakfast then browse to Google for the latest traffic updates before hitting the road, it's easy to feel a bit...overwhelmed. Like we're all moving a bit too fast. Even the most techo-savvy among us, while consulting with Yelp to find the best place for lunch while Skyping with Aunt Elizabeth during her vacation to Tanzania, can at times can long for the more simple pleasures of life. Taking time out to enjoy a beautiful walk by the lake, an apple pie baked from scratch, or even 30 seconds to have an uninterrupted thought can add so much to the quality of your day. One drugstore understands. When it comes to taking a stand against inappropriate prescription drug use, CVS appreciates the charms of the pre-digital era as well.

In Weymouth, Massachusetts, for example, the nation's second largest drugstore chain has been delightfully stubborn about adapting some fancy new technology:

Walgreens does it. So do Rite Aid, Wal-Mart and small independent pharmacies.
But CVS, one of the largest pharmacy chains in the state, says it’s still unable to have pharmacists connect online to a state database that advocates say is a simple way to help stem the flow of powerful prescription painkillers such as OxyContin onto the street. 
Mike DeAngelis, a spokesman for Rhode Island-based CVS, said the company can’t yet have its pharmacists sign up to use the Prescription Monitoring Program because they do not have Internet access at the company’s 350 Massachusetts locations.

"Inter...what? said DeAngelis. "Is that something like Compuserve? I've been thinking about getting that."

DeAngelis added that when it comes to technology "involving those computation machines" it is important to realize that a company must have priorities that sometimes limit how quickly an organization that recently installed software to automatically calculate when a customer is due for a prescription refill and then fills the prescription can adopt a new technological innovation.

"This internet sounds intriguing" said DeAngelis. "And I'm sure once it's proven its worth as a business tool we'll give it a good hard look. It works with computers, right? And it won't interfere with how we use them to currently measure our pharmacists performance in a dozen different performance categories? And constantly generate reports that allow us to crunch loads of data to maximize our human resource paradigm efficiency algorithm? Quite honestly, from what you've told me I don't understand why we haven't adopted use of this... internet"

"Wait" he then continued after a long pause. "These so called 'problem' prescriptions this fancy internet would flag. It would stop us from filling them?"

"And....we wouldn't get paid...because we wouldn't have filled the prescription. It's not like we'd get some fancy internet money or something would we? Oh.... I totally understand why we haven't done this now"

So while most of the world marches forward into the modern electronic world, CVS is content to keep beat with its own drummer. It knows that for some of the customers it wants to serve, stopping and smelling the roses, and letting others have their gee-whiz techno-toys, can be the pathway to life's real pleasures.

And by roses I mean OxyContin. And by life's real pleasures I mean profits.

Monday, March 04, 2013

It's Like The Pharmacy Oscars. With A Lot Less Fashion Sense And A Lot More Ego.

Good evening ladies and gentlemen and can't you just FEEL the excitement in the air!!!!! I'm currently outside the Los Angeles Convention Center, which this night has been transformed into the center of the pharmacy world as the profession anxiously awaits the announcement of the year, the honor of honors in the drugs, the presentation of the APhA H.A.B. Dunning Award!! I don't have to tell you tonight what is going through the minds of almost everyone involved in the pharmacy universe when they see that....

"Who the hell is H.A.B Dunning?"

For the less than 25% of pharmacists who are APhA members though, that question needs no explanation. H.A.B Dunning is the biggest opportunity they have to pose in front of a camera while holding a plaque, and in an organization that can shake hands while posing for a picture like no other, that makes this night like Christmas and the Super Bowl and the climax of a Roman orgy all rolled into one!! Wait! I think I see a pharmacist making her way down the red carpet now!!!!

Oh...no....that's actually just someone with an MBA holding a large check made out to APhA. We'll let you know if any actual pharmacists show up.

In the meantime you can cut the tension inside the auditorium with a knife! In a year when such progress towards moving the profession towards the patient centered counselling, medication monitoring, drug fact knowin' future we've all been promised for two decades now has been made, the excitement over who will get credit for the game-changing changes that have taken place in our profession is building to a fever pitch!!

I mean, what better way to show you're in touch with actual practitioners of the profession than to talk about how pharmacists are now "empowered to provide preventative care to the patients they serve." Am I right? Who out there is feeling nice and empowered? No wonder APhA is so popular!!!!

And now the moment we've all been waiting for.....the winner of this year's H.A.B Dunning master handshake of the year........

WAAAAAAAAALLLLLLLLLLGGGRRRRREEEEEENNNNNNNSSSSSSSSSSS!!!!!!!!!!!!!!


That's right my friends! The purveyor of the POWER program is now the apex of professionalism in the pharmacy world! As the official APhA press release says:

Walgreens has supported American Pharmacist’s Month since its inception, bringing the message to consumers that pharmacists are an integral part of health care. Each October, “Know Your Medicine, Know Your Pharmacist” is spread across the country through Walgreens stores. This ongoing support has allowed professionals and student pharmacists to wage a large and effective public relations campaign across the country.

But wait, there's more!!!

Walgreens is also the largest retail provider of MTM services. These programs have allowed pharmacists to move from behind the counter to provide comprehensive health services to the community.”

Out from behind the counter you guys!!! This is awesome! Let's get a reaction from an actual Walgreens pharmacist:

--as far as walgreen's being a healthcare provider and actually caring about consultations, etc...that is the biggest joke i ever heard...all i do is ring out bull**** items.....in my store, i ring out jack daniels with bags of junk food and candy with pateints metformin, etc...it used to make me laugh...now it makes me very upset that a company would belittle their pharmacists this way.

That's great!!! You keep on keeping empowered my friend!! How about another pharmacist's take:

rphs....or pharmD's like i am....how do you feel about never EVER using your mind for anything anymore.....when i worked @ CPO at least i got to talk to patients about interactions, etc...(mind you there were 300 calls a day which kills your throat and is like a sweat shop)....but in the stores i honestly do nothing with my mind except think (hmm, does this 104 year old woman need her scotch and vodka double bagged with her orange juice and bread?).....clinical knowledge is forever lost

Allright then, making a difference in the community......and you sir, could you talk about Walgreens commitment to healthcare privacy?

i asked about the privacy issues with trying to take voicemails at the register while counseling patients while trying to talk to doctors about allergies or refill too soons on oxycontins etc all while there are 15 customers staring at you......keep in mind you have no ability to use a phone where you used to work because that is used by techs only.....the answer i was given was "some pharmacists have the screen up on their computer with pateint information and bounce back and forth between hiding behind bays while talking about something private and bouncing back to remember what was on their screen"....i said "you do realize that privacy and hipaa laws are broken every single day, right?"...they said "there are no real good answers for that question...we can merely suggest ways to help...but this process is not perfect"

Leading the profession into the future....with just a touch of humility. Oh Walgreens, could you be any dreamier?

Well that about raps it up for this year my friends, I'm off to the afterparties, secure in the knowledge my scotch is properly double bagged. Until next year, when we'll gather to honor innovations in customer restroom guidance, I'll leave you with this thought:

The APhA awards and honors program is the most comprehensive recognition program in the profession of pharmacy.

On that we can all agree. No one passes out the recognition like the APhA.

Just imagine what it would be like if that recognition was the least bit tied to reality.

Sunday, March 03, 2013

So Drugmonkey, Where The Hell Have You Been? Not Investigating The Link Between Rite Aid's Flu Shots And Bubonic Plague, That's For Sure.

Oh, dear reader, the answer to that question is long and complex. Multifaceted and mutilayered. A drama of epic proportions involving long stretches of sitting on my ass looking out at the ocean, a visit from the pharmacy fairy godmother who bopped me on the nose with her magic wand, an evil pharmacist named John David Bodtker who took it all away, and time enough to finally finish up another book.

I hardly know where to start.

The most common question I got during the hiatus would be something along the lines of, "is there some legal reason for this? Did the man crack down on our beloved Drugmonkey?" The answer to that is no. You can't be sued for telling the truth, so as long as I stick to the right side of the facts, I'm fine. For example, I probably couldn't write something like "Rite Aid's flu shots give people Bubonic Plague," because there's no proof of that.

Of course, before Christopher Columbus, the mainstream scientific world said there was no proof the world was round. Just sayin'

And now that I'm sitting here pondering truth and my responsibilities to it, I should probably point out that I had direct contact with only a tiny fraction of the millions of doses of flu shots administered by Rite Aid. While it's true that I saw no evidence of a Rite Aid/Bubonic Plague connection, it's also true that my experience was such a small and limited part of Rite Aid's vaccination program that it probably shouldn't be considered representative of the risks involved. You should definitely inform yourself and carefully weigh the benefits of getting a flu shot at Rite Aid versus the risk of contracting a deadly disease that at one point almost wiped out Western Civilization. On that much I think we can all agree.

For what it's worth though, I never saw anyone get Bubonic Plague from a Rite Aid flu shot. Now, where was I?

Oh, the blog hiatus. You can thank the aforementioned John David Bodtker. I got a job he wanted you see, and he decided the best way to say "congratulations" would be to send select Drugmonkey writings to my boss. And when my boss didn't care, he just kept sending all the way up the corporate chain until he found someone who would listen. My boss cried when they told her they had to let me go. Took it harder than I did.

Other than that I'm sure John David Bodker is a nice guy. Honorable in a backstabbing kinda way.

So I suspended the little blog garden while all this drama was exploding. Until I decided what my plan would be. And then you guys broke my heart. Every time I got an email asking what was up I got a little sad. And I got a lot of those emails.

The good news is, I'm very close to engineering a happy ending to this sad story. One that will bathe the corporate stink off of me forever. I said when the Rite Aid drama went down, which had nothing to do with anyone getting Bubonic Plague from one of their flu shots, that from that day forward I would be a real pharmacist. And I'm very close to making that happen.

Good for me. And for my future patients, who will have found a refuge from the forces destroying our profession.

I'll keep you posted.