A Reader Shares Their Thoughts, And Changes My Life. (Part I Of A Blog Trilogy)

I should have expected this.

Using the word "liberal" in turn of the 21st century America is like waving a red flag in front of a bull. Except in this case the bull is usually a balding, middle aged, paunchy know it all white guy. Think of the guy who doesn't bat an eye when you tell him his Viagra isn't covered on his insurance plan then whips out his credit card. That kind of guy. I used the "L" word right in a post's headline, so sure enough right on cue the next morning this is waiting in my mailbox:

How can you call yourself a liberal? Your a Pharmacist, in the top 10% of all incomes in the good 'ole US of A. Do you like being taxed to death to fund all the sick lame and lazy people in this country. That is what your average tax and spend liberal wants. I hope you feel good about being a "liberal" every time a worthless state mediciad recipient comes into your Pharmacy. At least you will know where that 35% of your patcheck is going. If the liberals have there way it will be closed to 60%. At least then Mary Rottencrotch and her 16 kids from 16 different guys will be able to get Pulmicourt repules, Xopenex and Sigular chewable for all 16 kids minor runny noses. By the way your blog is funny as hell. Every Pharmacists goes through what you blog about on a daily basis. Its funny to read someone else observations of the ridiculous stuff we have to deal with.

My first thought upon reading this was an uncontrollable urge to raise taxes. That way we could afford to fund our public schools so someday I could stop getting comments with such disregard for the rules of grammar and spelling of the English language. Then I saw it. I read the message again to make sure. Yes. A connection to my very soul was being made.

I read the message a third time. What was so mesmerizing was how the words were obviously written just for me. The way AJ, the person who cared enough to write, didn't just spit up the same right wing drool that one can hear up and down the AM radio dial, see on Fox news, read in The Washington Times or hear wherever middle aged white people talk amongst themselves. AJ carefully took my thoughts on hospital charity care, which he obviously read very carefully, and by adding his own unique, personal take on what I had written, which he obviously read very carefully, was able to show me the error of my ways in a way Rush Limbaugh or Bill O'Reilly or the guys down at the elks lodge never could. Thank you AJ. Thanks to your intervention I now realize:

1) The fact I own property in the most insane real estate market in human history and drive a two year old paid for car are signs that I am being taxed to death.

2) That social services are the only thing the government spends tax dollars on. It really was a relief to find out that the war in Iraq, a war that I despise, a war that I hate with every past, current and future living part of me, is evidently not costing us a single dollar. Maybe Bush Sr. got a "buy one get one free" special on the first Gulf War. Republicans are smarter that the rest of you, and since I've only been one for about 5 minutes, I'll leave it up to them to explain how the free war thing works.

3) There is no such thing as a rich slut. That the fact Paris Hilton doesn't have 16 different kids by 16 different guys has nothing to do with the fact liberals have fought for a woman's right to contraception access.

I feel like AJ has removed the cataracts from my eyes, but also foolish for having wasted so many years taxing myself to death. I vow to you, to each and every reader of this blog, that I will make up for lost time. That I, the drugnazi, will so help me God turn this blog into every tax and spend hippie fornicator's worst nightmare.

Let's get started.

You Know Why I'm A Liberal? Because I'm A Selfish Bastard And The World Revolves Around Me, That's Why

I don't hate gay guys. Not at all. Why? Because every penis that decides to chase another penis means more women for ME! I wish all guys were gay, and not Rock Hudson in the closet gay either. I wish every single male besides myself were flamboyantly fabulous to the extreme Village People kinda gay, so there's no doubt for the ladies that I'm the only game in town. ME!

I want homeless people to get the help they need to make their sorry asses productive members of society. Why?

1) I want to walk down the street someday without seeing them , smelling them, or hearing them ask for my spare change.

2) If they get jobs, that widens the tax base, meaning I pay less. ME!

3) I have heard rumors that some homeless people might be mentally ill. If it turns out there is some truth to this, then getting them the meds that stop the voices in their heads will mean more business for, and therefore more money for......ME!

Evidently I'm not the only greedy bastard out there. It seems like a few hospitals have figured out that offering free care means more for THEM! That's right, giving away their product saves them money. I'll let today's New York Times explain:

AUSTIN, Tex. — Unable to afford health insurance, Dee Dee Dodd had for years been mixing occasional doctor visits with clumsy efforts to self-manage her insulin-dependent diabetes, getting sicker all the while

In one 18-month period, Ms. Dodd, 38, was rushed almost monthly to the emergency room, spent weeks in the intensive care unit and accumulated more than $191,000 in unpaid bills.

That is when nurses at the Seton Family of Hospitals tagged her as a “frequent flier,” a repeat visitor whose ailments — and expenses — might be curbed with more regular care. The hospital began offering her free primary care through its charity program.

With patients like Ms. Dodd, “they can have better care and we can reduce the costs for the hospital,” said Dr. Melissa Smith, medical director of three community health centers run by Seton, a Roman Catholic hospital network that uses its profits and donations to provide nearly free care to 5,000 of the working poor. Over the last 18 months, Ms. Dodd’s health has improved, and her medical bills have been cut nearly in half.

Now who do you think ends up paying the $191,000 tab patients like this ring up? That's right, ME! and YOU! through higher taxes and insurance premiums. So by being smarter about it's charity care, this hospital cuts our bill in half. More for everyone! But most importantly, more for ME!

The other alternative of course is to cut off all charity care and let poor people with diabetes, asthma, heart disease and other chronic conditions die in the streets. If you think this is a viable option, then seriously, I don't want to be in the same society as you. Please go to Alabama and form your own country, with my apologies that we didn't let that state leave the first time it tried. Getting back to the Times story:

Other answers to the insurance crisis are being tried around the country, including the creation of subsidized, bare-bones policies for small businesses. Vermont, Maine and especially Massachusetts are using combinations of state and federal money and employer mandates to extend insurance.

Still, only a fraction of the uninsured, in Central Texas and in most other states, are benefiting.

“All these local efforts are commendable, but they are like sticking fingers in the dikes,” Ms. Davis of the Commonwealth Fund said,

I suppose based on what I said earlier I should hate dikes, since they generally don't want me sticking fingers or anything else in them. From what I've seen however, the dikes are no great loss to the average straight guy.

Getting back to the point of this post though, the hospital in Austin becomes more.....liberal about it's charity care, ends up saving money and making more resources available for us all. Remember that the next time some gasbag, condescending caveman conservative tries to tell you liberal ideas just don't work in the real world.

Survey Says........18% Of People May Not Have Heard The Question

So I'm leafing through a copy of the trade magazine Drug Topics shortly before closing time tonight. I like reading a well-written publication that can hold your attention and even entertain a little while it keeps you up on the latest happenings in the profession, but I was leafing through the Drug Topics anyway. I was bored. Buried deep in an insomnia-busting piece entitled "Consumers happy with pharmacy experience" I find this nugget of information:

Eighty-two percent of respondents indicated that it was very important to have prescriptions filled accurately

Yesterday I would have thought this question too incredibly stupid to ask, today I learn almost 1 in 5 people don't sweat it too much if I fuck something up now and then.

Sweet.

If You Are A Doctor That's Ever Written A Prescription For Pexeva, You Are By Definition A Numbnut.

I think we have finally hit bottom.

In the 20 months I've been tending my little blog garden, I've been keeping an eye out for the most pointless, inane, rip-off piece of crap peddled by Big Pharma. There has never been a shortage of contenders, and I can't think of a better way to spend part of my day right now than by going over a few. That's what I do. I'm the Drugnazi.

Niravam- An orally disintegrating form of alprazolam, an anti-anxiety med available for years as Xanax and as a cheap as dirt generic. Not only will Niravam cost you more than 5 times the price of generic alprazolam, but alprazolam tablets are among the smallest you're gonna find, making the benefit of an orally disintegrating version a little dubious. But hey, I suppose there might be one or two people out there a bit too retarded to swallow a tablet the size of a grain of rice. (Price comparison from drugstore.com)

Bidil- A combination of isosorbide dinitrate and hydralazine, two meds that have been on the market for years and are also cheap as dirt. Bidil combines the two old meds into one tablet, then markets itself to African Americans as a race specific remedy for heart failure. Of course there's no reason you can't prescribe the two drugs separately and save money, but hey, maybe it is easier for people to just swallow one tablet, and at least there is research to support the claim this combination of meds is more effective for black folks.

Moving up a level on the rip off scale we have:

Sarafem- The exact same fucking thing as Prozac. But hey, at least it comes in a different box so someone snooping in your medicine cabinet will just see that you're PMSing, not crazy.

Proquin XR- A pointless version of extended release ciprofloxacin, an antibiotic. But hey, the labeling says to take it with food, so they can claim it causes less stomach upset when taken as directed than the other extended release version of ciprofloxacin on the market, Cipro XR.

There's no way it can get worse than the med you are about to meet though, unless Big Pharma starts to make products that are actually less effective and more expensive than what they're designed to replace. Crap. Probably just gave them an idea. Anyway..... drum roll please.............

Introducing Pexeva. Brand name for paroxetine mesylate.

Paroxetine is already sold under the brand name Paxil. Paxil lost it's patent a few years back, prompting GlaxoSmithKline to introduce Paxil CR, itself a contender for most useless piece of drug crap ever. Pexeva though, is not a continuous release version of paroxetine. It doesn't come in a different package telling you it's for a different indication. It's not orally disintegrating. The maker of Pexeva, JDS Pharmaceuticals, has made it just different enough from Paxil (it is a different salt form, mesylate vs. HCl) that it isn't substitutable. Then they don't even respect your intelligence enough to try and bullshit you into thinking that makes any difference whatsoever in the two meds. They just want you to buy Pexeva, and pay 69% more for it than you would for generic paroxitine, (Price comparison from Consumer Reports)

Which leads to the question, why would any doctor ever write a prescription for Pexeva?

Because they're a dumbass, that's why. And if a Pexeva prescription is ever handed to you, tell your doctor I said so.

President Monkey Boy And His Republican Bitches Face A Choice Between Helping Those In Uniform Or Helping Big Pharma. Guess Which One They Went With?

C'mon, you know as well as I do which one they chose. Sure, when it doesn't cost them anything, Republicans love to stand in front of the flag and a few hundred buzz-cut camouflage wearing hoo-ahs and proclaim their unwavering devotion to both. But when the rubber meets the road, or more specifically, when the campaign contribution meets governmental policy decisions, their true colors come out, and they ain't red, white, and blue. I'll let the military paper Stars and Stripes set the stage:

Pressured by the White House and drug industry lobbyists, Congress has killed a Senate-passed provision that would have forced pharmaceutical manufacturers to grant the Department of Defense deep discounts on drugs dispensed through the Tricare retail pharmacy network.

Key words: "Pressured by the White House and drug industry lobbyists"

The situation in a nutshell was this. A dispute arose as to whether a federal procurement law passed in 1992 that gave discounts to drugs purchased by the Department of Veterans Affairs also applied to drugs paid for through the Tricare retail network. The language in the law was evidently a bit ambiguous. The Department of Defense said "we get the same discount", Big Pharma said "in your dreams GI Joe", and the whole thing was headed to court. The situation was a lawyers wet dream. The Senate made a move to end the whole thing by putting language in this years defense authorization bill that made it clear that the men and women in uniform are indeed entitled to the same prices for meds as the men and women who used to wear the uniform. This set up a fight with the most well organized, well-prepared, brutally efficient enemy the military has ever seen. A fearsome alliance of Merck, Pfizer, Bayer, Sanofi-Aventis, Takeda Pharmaceuticals and others, representing forces of capital from the US, The United Kingdom, France, Germany, and Japan, sprang into action against our armed forces. George Bush, commander in chief, took a look at the situation and put the power of the presidency...... behind the worldwide axis of profit. Back to Stars and Stripes:

After the Senate passed its bill, White House politicos began to pressure House Republicans to fight the Senate provision in final negotiations over the defense bill, in effect, undercutting their own Defense Department as it strives to curb soaring drug costs.

“Tremendous forces” targeted conferees from the armed services committees as they began to negotiate over the bill, said a staff member. “Pharmacies, drug manufacturers … the politics went right through the roof.”

Key words: UNDERCUTTING THEIR OWN DEFENSE DEPARTMENT

You know how it ended. They may have fought bravely for what they believed in, but the armed services of The United States of America were quite simply no match for the Pharmaceutical industry. Perhaps someday we'll build a nice monument to those who so valiantly opposed the idea that the federal government should pay as much as it possibly can when it buys things. Maybe we'll give out some medals and ribbons as well.

After all, that wouldn't cost us very much.

My Employer Really Needs To Give Me More To Do......

.....because when it gets to the point where I'm bored enough to clean, bad things can happen.

Such a point was reached a couple weeks ago. It was a beautiful day and most people had sense enough not to waste it in a drugstore. This left me with a choice of staring blankly at the family planning section while listening to the likes of John Mayer serenade me through the in store music system, or do a badly-needed reorganization of the miscellaneous "we don't need this but don't want to throw it away" section at the back of the happy little pill room. I went with option one as long as I could, about an hour, before the sound of "No Such Thing" was like that of an icepick being driven through my eardrum.

Fine. I'll clean something.

One of the first things I found was a pile of old auxiliary labels. You know, the "may cause drowsiness" type stickers we put on your vial so our ass is covered when you take 10 Xanax then wrap your car around a tree. These days, most of them are printed along with your label and not put on separately, meaning the half empty box of "for anal use only" tags I found would probably never be used. How sad. If only there were some way for these little stickers not to go to waste.

I looked back at the family planning section.

Why not a little experiment? You know, in the name of science, the way the TV show "Candid camera" was all about science. I discreetly slipped over to where my favorite type of Trojans were on display. Two rows side by side, perfect. One row got the "for anal use only" stickers on their front corner, one didn't. After two weeks, here's what I can report:

3 boxes of anal condoms picked up and put back when the customer realized they weren't designed for the planned hole.

1 customer carefully looking over his options and going with the anal prophylactics.

1 customer question to me as to what the difference was. I assured the customer they were both the same product and was shocked, just shocked, that someone could be so immature as to put these stickers on as some sort of sick joke. The customer still went non-anal.

Today I saw the store manager taking the labels off, so these will be my final results. Damn.

Although I do still have some "for the ear" stickers left.......

From The "Actual Conversation With An Actual Customer" File....

At the end of this 12 hour work shift, my tired brain has but two memories of the workday, both quotes from the public:

Number 1

Me: I don't have this in stock right now, I could order it and have it here tomorrow morning.

Customer: What does that mean?

Number 2

Me: Do you have any type of insurance card that helps pay for your prescriptions?

Customer: No, but I have an insurance card.

I have not changed these quotes in any way, and the scotch cannot go down my throat fast enough tonight.

I hate everyone.

With This Post, I Save You $19.95,

So I'm answering my fan mail today, and for this I use a gmail account. For those of you not familiar with gmail, or the entity behind it that will soon be ruling the planet, I'll tell you that one of it's unique features is that alongside any e-mail message, gmail puts in text-based ads supposedly targeted to the topic being discussed. One of these ads in my mailbox today had a link to a site run by one Frank Buachie, who for a mere $19.95, will sell you the e-book "A Guide To Become A Pharmacist." not "A Guide To Becoming A Pharmacist" mind you, or "A Guide To Help You Become A Pharmacist," but "A Guide To Become A Pharmacist" Frank says of his e-book:

It comes with 30 days no question asked, money back guarantee.We will give you a full refund.

So what are you waiting for, you have nothing to loose. (emphasis mine)

Somehow this man couldn't find a publisher.

When I read over this cheap attempt to take advantage of poor students who want nothing more than a chance at a decent paying career, I was enraged, upset beyond belief that I didn't think of this way to rip off people first. So for no other reason than to show that I am a petty, spiteful man, I am going to tell you, right here, right now, how to become a pharmacist for free.

The process will start sometime around your junior year of high school:

1) If you see a class with chemistry and/or biology in the name, take it. Try to learn something.

2) If you are in a band, any band making any kind of music, drop out, as you will have to eliminate all right brain creative and artistic function. This does not apply to marching bands however, as i) marching bands don't make music, and ii) mindlessly following orders will help you immensely in your career choice.

3) Start thinking about colleges. Forget the Ivy league, the big state school known only for it's football team will do you just fine.


High School Senior year:

1) Take them chemistry and biology classes like you are crazy for the science.

2) Drop your creative writing class.

3) Start asking people if they have their prescription card with them. Practice being incredibly fucking annoyed when they don't.

3) Visit some college campuses and look for one with a lot of white people. Not poor white people, but preferably middle class white people who never got the memo they're not rich.

4) If you do not graduate in the top 10% of your high school class, immediately kill yourself, as your life is over. Or join the military.

Pre-pharmacy college years:

1) Foolishly show up on campus under the impression you are going to learn something about drugs sometime soon. Wash away your disappointment in a river of beer.

2) Master the process of counting by fives while waving a short metal stick from right to left.

3) More chemistry! Remember, you are a chemistry loving fool!

4) Start negotiations with Satan over the price of your soul. He will not offer enough to cover tuition.

5) Imagine for a few hours what it would be like to want to help people. This will help you write the required essay when the time comes to apply for pharmacy school.

6) Develop an intense hatred for the business major who lives across the hall from you. The same one that knocks on your door EVERY FUCKING NIGHT TO ASK IF YOU WANT TO GO BAR HOPPING! JESUS H. CHRIST DON'T THESE FUCKING BUSINESS MAJORS EVER HAVE TO LOOK AT THE INSIDE OF A BOOK AT ANY TIME IN THEIR COLLEGE CAREER? The experience you have with business majors during college will set the stage for relations with your district manager or hospital administrator throughout your working life.

Pharmacy School:

1)Congratulations! The second an actual college of pharmacy accepts your application, you never have to worry about grades again. Simply remember this GPA formula; 2.0=$110kyear

2) Show up for your first day of work as a pharmacy intern, feel the door close behind you, and as the chill settles into your spine, know that all joy is gone from your existence, forever.

3) Take a philosophy class. You need this class in order to graduate. No one working for the University seems to know why.

4) Still more chemistry. And they still haven't taught you how to make crystal meth.

5) Realize that gin mixed in orange juice really doesn't taste all that bad when you have no money. Lose your virginity to that girl in pharmaceutics lab who wears the coke bottle glasses and never talks.

6) You will have no recollection of anything that happens between mid-April of your last year of school and the end of your college career. Memory will fade back in as you walk across a stage wearing a gown and suffering from the worst hangover of your life. The president of the University will hand you a document you assume is your diploma. Upon opening it 5 days later, you see it is actually a student loan repayment schedule. Your first payment is already a week late.

7) Attempt to cram everything you've learned over the last 6 years into the 3 months you have to ready yourself for the pharmacy licensure exam. Realize you've learned nothing, rekindle the relationship with coke-bottle chick so you can sit next to her during the test and copy her answers.

8) Find out that yes, the condom did break and coke bottle chick is absolutely thrilled to be starting a family. Marriage certificate is issued on the same day pharmacy license arrives in the mail, officially documenting the end of your life.

At least now though, thanks to me you will have an extra $19.95 in your pocket before that day comes. I recommend spending it on a bottle of vermouth so you can quit pouring good gin in orange juice. That's just gross.

Random Election Night Observations

At least it's election night for me, as California has a permanent absentee/early voting system that means you can sit down in front of the information superhighway and do your election research and voting all in one easy step. While doing so I come across the website of the candidate for governor of the Peace and Freedom party, Janice Jordan. At the top of one of the pages there's a picture of Ms. Jordan holding a giant banner reading "Free Leonard Peltier" and another of her being led away by the cops after being arrested at a San Diego protest.

Now I ask you, how the hell could I not vote for that? So I did.

Sure, the current governor thinks he's some sort of tough guy because he used to lift weights and pretend to fight aliens from a Hollywood movie set, but MY candidate rages against the man and gets led away by the pigs.

Sweet.

Those of you who regularly read my little blog garden also know I've been covering Dick Mountjoy's campaign for US Senate like a ribbed Trojan. My inner Beavis has been eagerly anticipating the moment when I would see the words "Dick Mountjoy" printed on official election material. My expectations were exceeded though when I opened my ballot envelope and saw this:







Huh huh......ok......so I understand wanting the name "Richard" on your ballot line. But then to go out of your way to make sure "Dick" gets in there as well.....in quotation marks! BBBBWWWAAAAHHHAAAAAHHHHAAAAHHHHAAAAHHHHH!!!!!!! It's like someone at the print shop hates him and decided to stick in a random insult.

Immaturity can so lift the spirit sometimes.

The Institute Of Medicine Tells The FDA To Stop Being Big Pharma's Little Bitch Boy

Some of you in the profession may have noticed, around the time you were packing up a new wonder drug to be sent back to the manufacturer for the 6th, 7th, or 8th time, that there seems to have been a problem develop with new drug safety over the last few years. You may have noticed, but your government seems to have been a little slow. Maybe they like issuing recalls because it makes them feel all powerful and stuff. Maybe they let safety standards fall because more than half the budget the FDA spends to test new drugs comes from the pharmaceutical industry that submits the new drugs for review. I'll let you decide which is more likely. Regardless of the reason however, after Rezulin, Baycol, Bextra, Duract, Posicor, Propulsid, Tequin, Redux, Seldane, and Vioxx, the FDA had enough. It was time for action.

A study was commissioned. I wish that were a joke, but it's not.

For what it's worth, the study was released at the end of last month, and it did not have kind things to say about the FDA. According to the New York Times:

The report’s conclusions are often damning. It describes the Food and Drug Administration as rife with internal squabbles and hobbled by under financing, poor management and outdated regulations.

“Every organization has its share of dysfunctions, unhappy staff members and internal disputes,” the report said. But panel members said that they were deeply concerned about the agency’s “organizational health” and its ability to ensure the safety of the nation’s drug supply.

That's all well and good for those of us who are fascinated with the latest FDA gossip, but after 10 new drug recalls that I can think of off the top of my head while in a bit of a scotch induced haze, I'm thinking we need to have some proposed solutions. Fortunately the study has some. Back to the Times:

The report made these recommendations, most of which would require Congressional authorization:

¶Newly approved drugs should display a black triangle on their labels for two years to warn consumers that their safety is more uncertain than that of older drugs.

¶Drug advertisements should be restricted during this initial period.

¶The F.D.A. should be given the authority to issue fines, injunctions and withdrawals when drug makers fail — as they often do — to complete required safety studies.

¶The F.D.A. should thoroughly review the safety of drugs at least once every five years.

¶The F.D.A. commissioner should be appointed to a six-year term.

¶Drug makers should be required to post publicly the results of nearly all human drug trials.

The most controversial of these recommendations appears to be the advertising restrictions. The press conference called to announce the study's findings was interrupted at one point by a rabid beaver and an actor dressed as Abraham Lincoln. The beaver reportedly ran amok biting commission members in the kneecaps, while the actor playing Lincoln repeatedly fired a musket in the air in an attempt to halt the proceedings. After 20 minutes of anarchy, both the beaver and Lincoln settled into a restful sleep and the press conference continued.

Nah, I made that last paragraph up. I still can't get over those Rozerem ads.

The real reaction from the FDA was.....hmmm, searching for the right word.....wussy. Again to the Times:

In a telephone conference with reporters on Friday, top F.D.A. officials struck an awkward balance between thanking the institute for its work and defending their own leadership. They said they needed to study the report before deciding which of its recommendations to endorse.

So they have to study the study. I have an idea. Maybe they could create a commission to study the study that they commissioned.......*sigh*

When they are done studying the study, the Times story says that most of the changes would require Congressional authorization. This is where you come in. Your member of Congress is up for election next month. They all are. Can you trust your representative to put the interests of real people above those of the "artificial persons" that are corporations? If you're not sure, there's a easy way to tell. If they have a "R" after their name on the ballot the answer is no. If they have a "D" after their name the answer is "maybe, depending on which corporation is involved."

Good luck to us all.