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Too many pills
#21650 04/19/12 08:52 AM
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grelber Offline OP
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Some useful information with regard to medications and their interactions ...

Too Many Pills

Sources for details:

American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults (16 pages)
The American Geriatrics Society 2012 Beers Criteria Update Expert Panel
J Am Geriatr Soc 2012. DOI: 10.1111/j.1532-5415.2012.03923.x
http://www.americangeriatrics.org/files/documents/beers/2012BeersCriteria_JAGS.pdf

AGS Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults (2012) – Web Resources (1 page)
http://www.americangeriatrics.org/health...mendations/2012

AGS Beers Criteria Summary - For Patients & Caregivers (16 pages)
http://www.americangeriatrics.org/files/documents/beers/BeersCriteriaPublicTranslation.pdf

AGS Beers Criteria Pocket Card (8 pages)
http://www.americangeriatrics.org/files/documents/beers/PrintableBeersPocketCard.pdf

Re: Too many pills
grelber #21652 04/19/12 04:44 PM
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Originally Posted By: grelber
Some useful information with regard to medications and their interactions ...

Too Many Pills

The statement: "In adults over age 80, the team warned, aspirin taken to prevent heart attacks “may do more harm than good,”" could just as easily have said "....may kill you" with a rebound effect if you quit it without taking precautions.

This piece at the Mayo Clinic is quite an eye-opener.

Last edited by ryck; 04/19/12 04:45 PM.

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Re: Too many pills
grelber #21653 04/19/12 05:07 PM
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It's a complicated issue. On the one hand, it's easy and tempting to blame "the medical system," which a lot of critics characterize as being much too eager to write prescriptions without doing thorough patient tests to see what the problem is (though that's a difficult position to put doctors and hospitals in, because when they DO take the time to do more thorough examinations, they get criticized for profiteering by ordering unnecessary tests).

But the fact is, we live in a society that embraces the "pill to fix it"mentality. We WANT to take pills to fix all our ailments. When people walk into a doctor's office with a complaint, they want to walk out with a prescription.

And if they don't, or if the doctor says that the fix is something that they don't want to do (change their eating habits, stop smoking, adopt more healthy habits) what do they do? Instead of taking their doctor's advice, they run down to the alternative "medicine" store and look for pills there. The medical community is at a disadvantage because they aren't allowed to sell any drugs that haven't been tested; the alt "medicine" community can sell you any pills they want with neither oversight nor testing, as long as they call them "nutritional supplements."

So to be honest, I think a large part of the problem is with us. We WANT to take a pill to cure our ailments. We don't like being told that sometimes the healthy thing to do might be inconvenient (like cut down on caffeine and stop eating so much fried food) or hard (like giving up smoking).


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Re: Too many pills
tacit #21655 04/19/12 08:10 PM
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Originally Posted By: tacit
On the one hand, it's easy and tempting to blame "the medical system," which a lot of critics characterize as being much too eager to write prescriptions without doing thorough patient tests...

Originally Posted By: tacit
When people walk into a doctor's office with a complaint, they want to walk out with a prescription.

I don't think you're wrong but I do wonder how much of the problem can be laid at the foot of the pharmaceutical industry, with its constant brainwashing on television. There is an incredible number of ads pushing medicines for this or that ailment, urging the viewer to "ask their Doctor about it".

The ads must be effective because, although they always end with a long list of somewhat frightening side effects, they don't seem to scare anyone off. The ads continue to run and, of course, pharmaceuticals has managed to become a $900 billion industry.

Last edited by ryck; 04/19/12 08:11 PM.

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Re: Too many pills
ryck #21656 04/19/12 08:52 PM
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Originally Posted By: ryck
There is an incredible number of ads pushing medicines for this or that ailment, urging the viewer to "ask their Doctor about it".

Physicians last only so long against a pent up demand like this. Eventually, many seem to capitulate and prescribe after seeing patients leave for 'shores' faster prescribed (or at least perceived to be so).


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Re: Too many pills
ryck #21666 04/21/12 05:55 AM
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Originally Posted By: ryck

I don't think you're wrong but I do wonder how much of the problem can be laid at the foot of the pharmaceutical industry, with its constant brainwashing on television. There is an incredible number of ads pushing medicines for this or that ailment, urging the viewer to "ask their Doctor about it".


I'm always a little skeptical about the power of advertising to "brainwash" people.

I mean, yes, obviously advertising is effective or else it wouldn't work. But on some level, it's only effective at selling things people are predisposed to wanting; it can't make something from nothing. People want to go into the doctor's office and get a pill that fixes their problem; the advertising works because it suggests that they can do that.

I think advertising is extremely limited in its ability to get folks to do things they don't already want to do. I doubt, for example, that any of the ads the "DARE" folks have produced have actually persuaded people not to use recreational drugs. I'm not sure it can really be called "brainwashing" if it only works on desires that folks already have to begin with.


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Re: Too many pills
tacit #21667 04/21/12 06:56 AM
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I think the pharmaceutical advertising cum brainwashing to which ryck referred would be more accurately described as pandering (Edit: to a market created by brainwashing, albeit of a different sort).

Last edited by artie505; 04/21/12 08:15 AM. Reason: Clean up & expand

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Re: Too many pills
tacit #21669 04/21/12 07:54 PM
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Originally Posted By: tacit
I'm always a little skeptical about the power of advertising to "brainwash" people.

I mean, yes, obviously advertising is effective or else it wouldn't work. But on some level, it's only effective at selling things people are predisposed to wanting...

Whether or not it's "brainwashing", the result is the same. The pharmaceutical companies have people showing up at the Doctor's office armed with information about drugs that may or may not be good for them. There was a time when the pharmaceutical sales people dealt only with the Doctors.

I'm quite sure that, if the huge pile of money spent on advertising the drugs wasn't having the desired effect on their profits, the pharmaceutical companies wouldn't be spending it.

And, they likely have places other than advertising to spend money in order to get their drugs into patients. I recall an incident about 15 years ago when I developed a continuous cough the day before I was to deliver a eulogy. I didn't want to be coughing my way through the eulogy and knew exactly which cough suppressant I wanted.

I knew because, about a year earlier, I had a serious bout of pneumonia that my family Doctor whacked in about three days with an antibiotic. An extremely painful cough accompanied the pneumonia and I was given a cough suppressant whose effect was immediate.

The weekend of the eulogy my Doctor's practice was closed so I went to a walk-in clinic. While in the waiting room I noticed that the walls were covered with posters showing the products of a drug company.

I explained to the Doctor what I wanted - this particular suppressant and just enough to get me through a couple of hours. I got a prescription and left.

At the drugstore my pharmacist asked what the prescription was for. When I explained he said: "That's not what you've got." It turned out I had a prescription for a large amount of a different drug along with a three month supply of inhalers.

Can you guess who made both the medicine and the inhalers? Yup, the same company on all the posters at the walk-in clinic waiting room. Needless to say, the prescription was not filled and I got by with an over-the-counter suppressant.

I've often wondered how much "promotional money" is spent at places like that walk-in clinic. It seems that the pharmaceutical companies have less interest in making people healthy than they have in improving the health of their bottom lines.

Last edited by ryck; 04/21/12 07:56 PM.

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Re: Too many pills
ryck #21745 04/27/12 11:40 PM
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Better living through chemistry... wink

Re: Too many pills
grelber #22393 07/03/12 08:56 AM
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Another pharmaceutical company fine.

It's interesting that, even with penalties running into the billions of dollars, the fines are simply regarded by some as "the cost of doing business".

Perhaps it's time to start putting people in jail.

Last edited by ryck; 07/03/12 08:59 AM.

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Re: Too many pills
ryck #22394 07/03/12 09:16 AM
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> It's interesting that, even with penalties running into the billions of dollars, the fines are simply regarded by some as "the cost of doing business".

With the fines penalties approaching the sales volumes of the drugs involved, i.e. resulting in little or no profit, if not a loss, on those sales, that rationale will quickly cease to be a rationale. (If my tax knowledge is up to date, those penalties are non-deductible.)

Last edited by artie505; 07/03/12 09:45 AM.

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Re: Too many pills
ryck #22395 07/03/12 09:41 AM
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The penalties are starting to add up to real money. Glaxo Agrees to Pay $3 Billion in Fraud Settlement.


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Re: Too many pills
artie505 #22413 07/03/12 04:10 PM
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Originally Posted By: artie505
> [i]With the fines penalties approaching the sales volumes of the drugs involved, i.e. resulting in little or no profit, if not a loss, on those sales, that rationale will quickly cease to be a rationale.

If only it were so. Global sales of prescription drugs exceeds $600 billion annually.

Last edited by ryck; 07/03/12 04:26 PM.

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Re: Too many pills
ryck #22414 07/03/12 04:11 PM
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Originally Posted By: ryck
Perhaps it's time to start putting people in jail.


That's why they incorporate or llc. you can't put a company in jail and they know it.


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Re: Too many pills
jchuzi #22418 07/03/12 04:25 PM
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Originally Posted By: jchuzi
The penalties are starting to add up to real money.

From the average person's point of view, absolutely....from the pharmaceutical companies' view, not so much.

Considering these fines are usually for activities covering several years, because of the time needed to investigate and prosecute, a few billions amortized over an extended period isn't hefty.


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Re: Too many pills
Virtual1 #22419 07/03/12 04:38 PM
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Originally Posted By: Virtual1
Originally Posted By: ryck
Perhaps it's time to start putting people in jail.


That's why they incorporate or llc. you can't put a company in jail and they know it.

I don't know much about American law but I'd be surprised if prosecutors are unable to charge the individuals responsible for a corporation's actions when those actions result in wrongdoing.

Last edited by ryck; 07/03/12 04:40 PM.

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Re: Too many pills
Virtual1 #22423 07/03/12 07:58 PM
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Originally Posted By: Virtual1
you can't put a company in jail and they know it.
Why not? According to the Supreme Court, a company (corporation) is a person.


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Re: Too many pills
ryck #22429 07/04/12 05:40 AM
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Originally Posted By: ryck
Originally Posted By: artie505
> [i]With the fines penalties approaching the sales volumes of the drugs involved, i.e. resulting in little or no profit, if not a loss, on those sales, that rationale will quickly cease to be a rationale.

If only it were so. Global sales of prescription drugs exceeds $600 billion annually.

Since the penalties relate to wrongdoing regarding only a very few drugs, and considering that they are non-decuctible, i.e. paid with after-tax dollars (US tax law, anyhow), they could conceivably negate the entire ill-gained profits generated by those particular drugs. (Or are you suggesting that the practice is pervasive throughout the entire industry's entire product line, something I'd seriously doubt.)

The government appears to be on the right track.

I wonder how the shareholders will feel?


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Re: Too many pills
jchuzi #22430 07/04/12 05:42 AM
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Originally Posted By: jchuzi
Originally Posted By: Virtual1
you can't put a company in jail and they know it.
Why not? According to the Supreme Court, a company (corporation) is a person.

Only in election years, unfortunately. frown


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Re: Too many pills
artie505 #22434 07/04/12 10:02 AM
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Quote:
Or are you suggesting that the practice is pervasive throughout the entire industry's entire product line, something I'd seriously doubt.

Take a look at “Born with a Junk Food Deficiency”.



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Re: Too many pills
dkmarsh #22435 07/04/12 10:31 AM
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Nice link; thanks.

For years I thought it was I who coined the phrase "medical-industrial complex," but search results suggest that somebody may have beaten me by a bit.

The review nicely describes what I've watched (in horror) happening for years, but it's not particularly applicable to my post, which simply suggested that the entire industry is not hyping every one of its products for unapproved purposes...the reason for most of the penalty.

As suggested by the review, though, the industry really needs to be penalized for manufacturing ailments to necessitate a need for medication rather than manufacturing medication necessitated by ailments.


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Re: Too many pills
artie505 #22436 07/04/12 10:51 AM
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Originally Posted By: artie505
Since the penalties relate to wrongdoing regarding only a very few drugs, and considering that they are non-decuctible, i.e. paid with after-tax dollars (US tax law, anyhow), they could conceivably negate the entire ill-gained profits generated by those particular drugs.

Not according to the NYT article, which states:

"Despite the large amount, $3 billion represents only a portion of what Glaxo made on the drugs. Avandia, for example, racked up $10.4 billion in sales, Paxil brought in $11.6 billion, and Wellbutin sales were $5.9 billion during the years covered by the settlement, according to IMS Health, a data group that consults for drugmakers."

Originally Posted By: artie505
Or are you suggesting that the practice is pervasive throughout the entire industry's entire product line, something I'd seriously doubt.

No, that is not what I'm suggesting.

I am suggesting that, when companies make decisions that harm people, monetary penalties against the companies are not sufficient. The people behind those decisions should also experience hurt through jail time and/or massive fines.

And, to be clear, I would also suggest that this approach should apply to companies other than pharmaceuticals.

Originally Posted By: artie505
The government appears to be on the right track.

That's right but I think even the government prosecutors, as happy as they must be with this decision, would agree they have a long way to go.

Originally Posted By: artie505
I wonder how the shareholders will feel?

If this decision has any effect on share prices, it is only temporary. I assume shareholders are more interested in which pharmaceuticals are close to the end of patents, opening the door for generics.

Otherwise, I'm not overly worried about any shareholder who is concerned that their portfolio might be adversely affected because the company they hold is compelled to divulge potentially fatal dangers.

Last edited by ryck; 07/04/12 04:50 PM.

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Re: Too many pills
dkmarsh #22438 07/04/12 11:18 AM
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Originally Posted By: dkmarsh
Take a look at "Born with a Junk Food Deficiency".

Wow. There's a book I want to read. Thanks.


ryck

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Re: Too many pills
artie505 #22439 07/04/12 11:22 AM
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Quote:
...but it's not particularly applicable to my post...

The review, perhaps not, but the book itself might convince you otherwise. I only linked to that review because it seemed more thoughtful than the other few I checked out (and because I dislike the way Amazon has become the world's de facto card catalog).

It seems to be common practice for pharmaceutical companies to obtain approvals for new drugs on relatively narrow grounds (aided by a regulatory apparatus permeated with former/future pharamaceutical executives), then to mount extensive lobbying campaigns with health care providers to broaden their scope of use.



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