June 30, 2011 § Leave a comment
I supposed it began with a notion called the Knowledge Economy… many years after this seeming to have been how those who had the knowledge performed most economically over those who did not have the knowledge..
Well, in what looks a pure strain of purple the onion has come up with an IN THE KNOW news segment. With promo ledes looking like: wind power to knock earth off its orbit.. and solar will soak up our sun.. so saith their opponents at anyrate..
Gottabe good for you and your weeekend, huh.. so do visit and enjoy!
June 29, 2011 § Leave a comment
Once upon a time — nay this is not a story about three little pigs! — more involving five somewhat larger anima acronymed in global business and financial spheres thusly, PIIGS. Before which telling I shall relata refero** the tale of two firms in one market. With one drug(pharmaceutical) by chemical name though two brand names. ie one for each firm.
Now it so happened the two firms, neither of whom had been at all involved in the discovery and R&D for this wonderful compound, but both of which sought use in its indicated patient population. At a price, admittedly, fit to blow anybody’s socks off. That is to say, and emphasising, the same price, same indication, different firms. Competitive, not, I imagine people joked at the time.
Still, it was a very good drug, and still is so far as I know though largely as a result of being parked in a usage category perhaps known for ‘drug-resistant only’ chemotherapy. Which at the time had specialist physicians willing to wave their reputations for their suffering patients in front of funding bodies. So assured were they of success.
Whilst asking: “Why, oh why is it so expensive?” To receive a well-harmonized answer from both firms to effect that it was so difficult to manufacture. [ said as if you understand they had manufactured it ]. But, physicians knew, no one would market the compound unless adequate quantities were available to tablet etc and besides, its discovery had been in Italy… and in Italy back then there were no patents on medicines… so what is going on and just who is setting the prices here.?
Before proceeding let me once again explain that my earlier intention to cover ‘Evergreening’ shall have to wait until next time.
To the main story of whence Big Pharma’s mongrel over-ate to put its belly on the ground and, at size megalo, pleaded its owner/trainer for a free ride.
The Economist i/u has a very blunt message from its comprehensive oversight analysis of Portugal:—
Large multinationals, which mostly import finished products, dominate the market.
and obligingly explains:—
In 2006.. Portugal spent 21.8% of total healthcare(itself about 10% GDP, according to the same doco) spending on pharmaceuticals, which is about the same proportion as in Spain (21.7%), much greater than in Germany (14.8%) and France (16.3%), but lower than in Greece (22.7%). The government estimates that medicines account for 18% of the NHS budget. The main reason for the high share of spending on medicines is that many medicines in Portugal are imported, and so prices of drugs are relatively high compared with domestic price levels.
The Portuguese story we might say, so what of Ireland and the Irish..?
In a report entitled Pharmaceuticals and Consumers we find a simply-stated independence to confirm the Irish experience in its European context:—
Most prescriptions in Europe are written using a brand name. The rate of brand prescriptions in Ireland is approximately 85 – 95%”
… In some EU countries, pharmacists may substitute a prescribed brand drug with a cheaper generic alternative. In Ireland, pharmacists are not allowed to provide substitutions.
Wow! Not allowed? In the now warn words of pharm exec: What Were They Thinking ?
What the people who agreed to this were not thinking was what buy branded at patent monopoly prices amounted to.
On to Italy, our once thought unpatented wonder medicines innovator.
Reading as kindness itself for Big Pharma this overview of May/2011 says:—
Due to high pharmaceutical spend driven by limited generic usage, Italy employs a range of pricing and reimbursement tools to control costs. As a result, drug prices in Italy are among the lowest in Europe, a factor which is largely behind the country´s high parallel export activity.
Landmines everywhere here. “Driven by limited generic usage” ? Like don’t use their own but export it..variation on not allowed? Working up a lotta low value (unpatented or generic) for supply-side credits. Waitta minute..! Wouldn’t you want to bet how Big Pharma players e.g. the American and Swiss in our forgoing tale would be giving nothing away in costs as they try take whole bellyfulls of profit from their own domestic consumers!? And other markets.
“High parallel export activity”? Above use is cart before the horse, surely? Else, how long has this been going on? They are both deals, but guess who is for keeping the export drive going! No R&D, no labor to speak of, less pollution..(blah.. blah)
Seeking clarity I dug out a pertinent report to value this market. It read: —
The prescription pharmaceutical market in Italy was valued at $24.9 billion in 2009. Key growth drivers for branded pharma include the growing use of chronic high-value innovative treatments driven by a growing elderly population, the high proportion of the healthcare budget spent on pharmaceuticals, and a high level of brand loyalty among Italian patients.
Pretty clear, huh. Several already familiar themes and, even in the new – 2011 – language which adds Italian patient ‘loyalty’ for Big Pharma’s own benefit—talk about telling them what they want to hear.
Hence to grade G as in Greece. No surprise is the Globe & Mail’s* take “Greece’s generic product utilization is currently one of the lowest in Europe..” Meaning, don’t we know, low generics high brand imports.
Yet also meaning that today hard facts tell of a mongrel finally hitting the ground. And no, not running, far far from it. As Jack and Hope@ ft.com report:—
The Greek government has fallen sharply behind on payments to healthcare companies only months after restructuring its €5.4bn ($7.6bn) debt to suppliers, raising doubts about patient safety while revealing the looming cash-flow crisis faced by the state.
The pharmaceutical industry says only 30 per cent of €1.2bn in payments owed by public hospitals since the start of last year have been made. Of debt due from the start of 2011, just 1 per cent has so far been paid.
* Going for a song is what happens when a country is cash-strapped.
Spain. Old friend Reuters has the story:—
The Spanish prescription pharmaceutical market was valued at $22.1bn in sales in 2009, with an annual growth rate of 6.4% between 2008 and 2009.
… Key growth drivers include growing use of chronic high-value innovative treatments driven by an aging population, with a high proportion of healthcare expenditure spent on prescription pharmaceuticals.
Familiar, sure. Yet with greater clarity still it adds, “The introduction of reference pricing in Spain during 2000, numerous rounds of price cuts..”
Mob meets mongrel, huh. Does the mutt make one final leap into Big Pharma’s arms or..? Like I said before, waitta minute.. there was an Italian connection… Later, yes, yet better than never:—
As a result of reforms introduced [ Italy ] in April 2009, branded pharma companies are now forced to maintain brand prices at a higher price than the first generic product to market. [ Reference pricing.. anyone? ]
Which is likely – Spain would know, being how they modelled RP first – to increase brand erosion and any ‘patient loyalty’ premium after patents expire.
Before closing a message for agent mu@sul(NZ) and/or its ill-advised sponsor could usefully say: know what and its global context before alleging, or even accusing kiwis, of things others have deemed entirely justifiable within the aegis of chemotherapeutic care bestowed upon them.
PIIGS in no wise the less so, have their debt problems as at least part result Big Pharma commercial arrangements upon their pricing and marketing methods. Overdone.
As for the mongrel, my message is firm: SLIM DOWN, boy! Else it is the cattle for you and likely trod upon.
** relato refero = I tell as I heard it
June 27, 2011 § Leave a comment
goes the song by I don’t recall who..
Just as well, for what I am about to relate is how hydrofracks are for suckers, according to this NYT report citing oil industry insiders..
When I emailed about it recently – some guy speiling loud, long and strong on radio FOR hydrofracking shale etc – my argument was how gas is a volume thing, that gas direct sources had to be very large indeed to make for condensed to liquid storage and portability etc., and that most shale deposits in no way had revealed this enormity.. Indirect gas – y’know like town gas from coal/coke burning and stored in large metal gasometers at the edge of town – has long been phased out..
Occasioning one to ask well, where’s the rort.. in bringing it back? Directly or indirectly?
The Times do tell… enjoy!
June 26, 2011 § Leave a comment
No, not to me.. well not yet.. but him — because he did make mention.. and.. modest sort that he is (adding a couple of comments to clarify shall I say blogging-to-effect).. of meat in the Sandwich etc.. and I being your usual speed reader missed the capital S didn’t I… BUT YOU CAN BET his other readers did not.
Gee, I’ll have to lift my game..
June 24, 2011 § Leave a comment
Ho, darl, I almost spelled that with a K..
So impressed was I with Saturday’s first guest choice, more especially an author’s* guessing how the fungibility of finances worked up the trillions thriller cloudbanking in the 1970s. Stress timing. Monetarist moguls needed a baseload and if there’s one thing you put down prior to accessing the action.. well that would have to be it. Besides, I am saving you a bundle by telling of the corps-contract.. plan 25 years out. They had gotten it from ruskies who failed in corps-speak because they were dumb enough to order Ten Year Plans.. et cetera.
Smart guy.. yes really! To put it another way – this being the big multinationals’ app from somewhat smaller sovereign wealth flows [ hey, kings and queens go back aways unlike governments which come and go on their own periodic tables 🙂 ]
Anyways, the 70s.. remember the 70s —kiwis don’t answer that—Muldoon was the two of too much for everyone! [ Actually perjjo-the-doc @ our old friend has told of their meeting—”a sharp witty fellow”.. depended on the tipple I’d suppose ]. Thatcher after Heath yet without Mike Joseph(deceased) who had scored the real deal, BUT with Ronnie Reagan playing Guvnor backstop from California and later the White House. Neither of whom ever knew the real deal.
But instead spouted what politicians weren’t gonna do through free markets and trade. World trade. Money flows. In the so-called firmament-speak of the day, cloud-banking—hey bro—whaddya know! Get in, sign the dotted line, and whoopsie away ya go!
Conditional of course. At the table, shoed feet on the carpet never the ground, five, six, seven, eight, nine—however many courses it takes to totally tax-free (hey Mark(agent mu@sul), now here’s a much better use of your colorful, if misplaced, word) “bludging” on everybody else’s community.
* Title = Treasure Islands. Stocking filler.. chrissietime can use a laff.
RNZ’s Country Life hour played 7-8 a.m. One feature being an organic sheep, beef and vegie property near Gore in the South Island. They do a half lamb deal. All cut to leg, chops, rack etc meal items. Supplied by courier from farm gate to customers. I liked the traceability aspect. The idea of knowing exactly where your meat comes from in these otherwise mass-produced times has an appeal. Maybe even enough to, on occasion, afford the $175 delivered tag(~5kgm meat = $35/kgm to my reckoning). If I come across the location any time soon – is there a url ? – I’ll ask perjjo give it a show.. and take the feedback of course—no,no, you don’t tell him this, leave it to me 🙂
Gotta go.. there was something else but I can’t remember what it was.. till next time..
c u — keep on the good work..
June 22, 2011 § Leave a comment
In from lawyer Senak @ fda watch( something like this) a welcome advisory..
Today, the FDA announced a new global initiative aimed at bolstering the safety of imported products. In the press release announcing the initiative, FDA Commissioner Hamburg notes that with the explosion of manufacturers and ingredients from around the globe all having a hand in the development of products – the distinction between domestic and imported products is “obsolete” and she calls for the implementation of a “dramatic change in strategy” to deal with the issues.
Unfortunately, there are limits to what the FDA can do and the steps outlined, while sensible and important, may not necessarily be described as dramatic. According to the release, there are four key elements needed to make the change:
1. The FDA will partner with its counterparts worldwide to create global coalitions of regulators focused on ensuring and improving global product safety and quality.
2. The coalitions of regulators will develop international data information systems and networks and increase the regular and proactive sharing of data and regulatory resources across world markets.
3. The FDA will build in additional information gathering and analysis capabilities with an increased focus on risk analytics and information technology.
4. The FDA increasingly will leverage the efforts of public and private third parties and industry and allocate FDA resources based on risk.
These actions are a good start, but beg the question whether it is enough. Dr. Hamburg notes in her remarks that since 2000 imports have quadrupled and that FDA has increased the number of foreign drug manufacturing inspections by 27 percent between 2007 and 2009.
Risk recognition is how one makes a start: response is next and thru to the end game.
Collabs are good news, item 3 with its global meta promise potential could be excellent
Can’t say for folks in kiwi – I’d guess with medsafe on the way out and the new Aussie NZ therapeutics set up in the pipeline then there’d be a solid something there to look forward to. Assuming no compromise to its independence to and for its own constituency goes with the astroturf.
ps: omission blog 4: Meta & Material: 303 — * ad rem = to the point; aegrescit medondo = the remedy is worse than the disease!
June 22, 2011 § Leave a comment
The “patent claptrap” was how I finished up last time. So said because I believe Big Pharma patent holders, patent perpetrators and patent monopoly priced pharmaceuticals buyers are trapped by their own appalling practices..
And yes, as I’ll explain in this and the next blog just as war has its mongers, Big Pharma today constitutes itself false arbiter ( in this blog) and mongrel of debt(following blog)
An insightful link with regard to the above is Matthew Herper. Around ten years ago he had a very sound reputation for coverage for investors in the US pharmaceutical industry @ Forbes magazine. In a widely read piece, 2002, he called for a 15 year rule ( giving effect to drug patent term price monopoly ) to enable drug companies return to a science-based R&D focus. Adding:—
A 15-year rule would remove uncertainty from both the generic and branded drug businesses and put the focus on science where it belongs
Optimistic to my way of thinking, yet heartfelt for all that. Ignored, what was to happen could be accurately described as the bungle of MBA managements.
Going on from the earlier point Matt also said: “Lately, there have been signs that the U.S. Federal Trade Commission** might crack down on the patent games drug giants play. Last week, Biovail acknowledged that it had been warned that some of the patents it filed on key drugs were illegal.” [ my highlight ]
A game which I’ll cover next time – it has not been mentioned here though it is evidenced in Australia and likely also in NZ(unless the PMA has nipped it in the bud, so to speak) is said to be non-patent whilst commercially at anyrate, related thereto. ‘Evergreening’. If you have time and a mind for it, Google EGA (European Generics (medicines) Assoc.) for a solid pithy 2006 take on this topic.
My third reason for citing MH is that the year 2002 was in one very important and highly relevant respect, a game-changer year. More especially in terms of Big Pharma’s roles vis a vis governments.
Recall if you will O’Neal’s report @ SundayStarTimes(stuff online):—
… activity comes as New Zealand presses for a bilateral free-trade agreement with the US and enters multilateral negotiations called the Trans Pacific Partnership (TPP) with Pacific Rim nations.
In a submission to those negotiations, US drug industry association PhRMA has cried foul over Pharmac’s stringent cost containment strategies and asked the US Trade Representative** to put New Zealand on a trade watchlist.
My double asterisk above marks the beginning(2002) and end (2010/11) in which the Big Pharma lobby has effected large self-favorable change. Not without reason, on the evidence, though such reason d’etre is entirely now misplaced.
To be utterly transparent on this, the G. W. Bush Administration were concerned that a Senator Kerry(Democrats) contention for the 2004 Presidential Election would seriously risk Bush’s loss. Taking over a democratic constituency like AARP (American Association of Retired Persons) was determined to avoid this. And permitting medicines subsidy to the tune of $400B (Part D to Medicare, 2003) the means of bringing them onside.
Yes, related parties – private health insurance etc – took back a good chunk of this money, but for Big Pharma circulation it was a goner. That said, henceforth the G.O.P. and republicans had secured both their latest majority-maker plus very significant support from Big Pharma.
And BTW, folks, a good lesson to learn from how serious political forces operate stateside is that to gain attention one contends targets. You want something you get access to take it. At that time Republicans ‘owned’ the show – Congress, Senate, White House, and a good heap of states. Set against this level of dominance we see how losers fall over themselves just getting back. Hence, in this case – (Politics, stupid!) – BAU was over. And this industry tasked itself to.. if it could not take over the government.. then undermining it was okay. Therein Industry’s executive elites embedded an aggrieved, or injured party, state of mind.
Against not its commercial competitors so much, but governments or bodies or entities anywhere who might impede, delay or thwart its market intentions. As your old friend HIM and my new friend would say: they don’t seek it yet they sure do deliver it—contention!
Revealed then a meta-full distortion that has no place playing out around the rest of the world. But will – as a driver to Big Pharma’s advantage – if pharmaceutical markets around the globe are unaware. And thus prejudiced, allow it.
To illustrate this Big Pharma sees the US Medicare as a “pressure on prices”. And New Zealand’s Pharmac as restricting prices as well as their prescription available drugs. Yet interestingly and ad rem lowered prices would answer both complaints satisfactorily.
In the absence of which aegrescit medondo* shall appear the only Big Pharma reality. In such a state of meta the oddness of one’s own position cannot be discerned. By participants. Neither accurately nor honestly.
The need of both HIM and I thusly appropriate.
Next time – blog-the-second upon the mongrel of debt…