“The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick and the needy, and the handicapped.” – Hubert Humphrey
passionate pachyderms
Pharmacist Steve steve@steveariens.com 502.938.2414
folks who do not understand the industry. I know when I submit a bid to a PBM there is not an exorbitant profit built into the equation…in fact, after all of the rebates and discounts, the profit margin is unbelievably slim. I also hear how the gov. Does not negotiate prices, well here is what I do know, when I submit anything to the government I have to use a formula to get a GNUP and use that number. It is far from retail. Most of the drugs that are at issue are specialty drugs and can be more of a supply and demand play. I have actually had to accept a 64% rebate demand from a PBM, not to mention administration fees of 4.5% and an early pay discount of 2%. There was another fee as well ~3%.
For those keeping score at home, that is 73.5% off of AWP (average wholesale price)
I had always heard that the PBM’s demanded rebates/kickbacks/discounts from the pharmas of up to 50% to have one of their drugs on the PBM’s formulary and being approved without going thru a PA.
Now it is more apparent was to why insulin is now several hundred dollars for a 10 ml vial.
With a vial of insulin costing $50 a few years ago .. it is easy to see why it could now be $200 because of demands of the PBM’s to PAD THEIR POCKETS.
For every $1 that a pharma wants to raise their price to cover increased business expenses… they would have to raise the price $4 to cover the kickback money to the PBM’s.
This also explains why Canada and other countries with national health insurance… there is no for profit insurance and PBM middlemen… and thus their retail price could be 75% less expensive.
It has been stated that the Insurance/PBM industries have one of the largest pots of money to funding lobbying, so.. it is unlikely that Congress will pass any such price controls… with 435 members of the House and 33-34 members of Senate up for reelection is 10 months..
It is with a heavy and broken heart that I must share the news that we are just learning of a #SuicideDue2Pain. She lives here in Oklahoma near me and was very active in many groups as well as planning to join us in advocacy events next year.
She was able to find a doctor to treat her pain a few months ago, but for some reason that Doctor left practice soon after she found her. This caused withdrawals again. During that time, she had a stroke that caused so much damage. She was discharged from the hospital after her stroke but apparently without good plans in place for care. We are still gathering exact details, so this is all the information we have at the moment and even this is still being confirmed. I will share more as I can, specifically her name & picture as soon as the family gives us permission.
On Nov 10th Michelle C. decided she couldn’t take the pain any more. We have & are reaching out to her state Senator and Representative as well as local media. We hope to make something positive of this, as that is something her and I spoke of at length –
she just wants her death to count and create change!
No Help, no medication. I want out. I’m not strong enough
this is what I tried to do to myself tonight but I couldn’t cut deep enough I didn’t have a sharp enough blade. I am completely out of medication and no doctor will take me. I was again taken to Scripps ER. They wanted to hold me overnight, but I refused since all they would give me was gabapentin for nerve pain and stingily 2 mg of oxycodone. The nurse told me flippantly you fell asleep right after I gave it to you. I barked back That’s because I took a bunch of pills before being brought here by my mom. That’s the truth. I was talking to an old friend in Maryland and he excepted Christ on the phone with me. I took all the bottles I had = ketamine probably about six hundred milligrams, plus oxycodone 60 mg, +4 mg of Xanax. Unfortunately, my mom rushed me to Encinitas ER. Now I have no medication and I want out. I can’t handle it. The pain is way too severe. No doctor will give me what my body requires to stop hurting, and ER is just as strict because of the CDC and the DEA. They don’t care. I hope to be gone very soon. I can’t take anymore. Much love to both of you for trying so hard to help me. When I listen to that last interview from the Senators office, my hopes really dropped. He stated this is more of a federal issue, as much as we feel for this individual, meaning me, this is a much bigger problem which is going to take some time. I don’t have any more time. My body can’t take another day of this torture and neither could any other human being. Good luck on your crusade. Again use every bit of arsenal I have sent you. I know I email blessed you a lot last night = the sound of pain, some of my writings, some of my experiences, even picture of the hospital board with my name on it from last night. Today The straw broke the camels back. I could no longer do this, especially with no medication whatsoever. My doctor prescribed me a very small amount and said have a happy Christmas I’ll be back after the holidays I could only prescribe you a small amount but I hope it gets you through. It didn’t it’s already gone and not because I’m a drug attic, but my pain requires more medication then a doctor is allowed to prescribe. I love you both. Thank you for fighting so hard for me. I hope you can make a difference for somebody else.
Several individuals in Nebraska developed severe infections after receiving unapproved cell-based therapies said to include exosomes, state health officials said.
These patients — fewer than five — became seriously ill, with some developing sepsis, Leah Bucco-White, a spokesperson with the Nebraska Department of Health and Human Services, told MedPage Today via email.
All were given an exosome product that was derived from C-sectioned placentas, according to a health alert sent by the state to clinicians. MedPage Today has previously reported on a growing trend of hospitals implementing placenta donation programs and potential links to unapproved stem cell products.
“We continue to carefully and actively assess this situation with our federal partners,” including the CDC and the FDA, Bucco-White said. She added that she couldn’t share further details at this time, including the name of the product used, the source of the C-sectioned placentas it came from, the clinics where it was administered, or the bacteria that caused the infections.
While exosomes are being evaluated in legitimate research studies, some clinics — often those peddling unapproved stem cell therapies — are offering exosome therapy for all kinds of conditions. One site for a clinic in San Diego describes the treatment as “the ultimate anti-aging hack” and even offers financing for the therapy. Delaware Integrative Medicine advertises exosome therapy as being helpful for patients with “chronic inflammation, autoimmune disease, Lyme disease, and other chronic degenerative diseases.”
But stem cell researchers say exosomes — packages of proteins and RNAs that can be transferred from cell to cell — are nowhere near ready for prime time.
Until 2007, researchers thought exosomes were just a way for cells to get rid of trash. But that year, Swedish researchers showed that some cells use them to transfer genetic material. Chemical & Engineering News reported that companies are looking at exosomes in drug delivery, and a PubMed search reveals scores of experiments with these compounds.
But what’s in them, and their actual function, remains up for debate.
“A lot more evidence is required to understand what they are, and it may be that a lot of claims about what they do in the end go by the wayside,” Sean Morrison, PhD, a stem cell biologist and director of the Children’s Medical Research Institute at UT Southwestern, told MedPage Today. Disagreement continues as to whether exosomes even have a physiologic function, “or if they’re just some cellular waste product,” he said.
Even the methods for purifying exosomes grown from culture are controversial within the scientific community, he added — raising questions about what’s in the vials being used in treatment.
“What these snake oil salesmen do is they pick a word out of the scientific literature that gets people excited, and they start to sell it,” Morrison told MedPage Today.
The same companies that are willing to ignore FDA requirements for safety and efficacy testing are the same ones willing to ignore regulations for good manufacturing practices and cut corners to sell things that are contaminated with bacteria, he added.
The FDA has long been trying to get a handle on unapproved stem cell therapies. Last week, the agency sent a warning letter to Liveyon, the company involved in a spate of infections tied to stem cell products last year. It has warned several other stem cell companies as well. In 2017, the agency issued guidance on regenerative medicine products, with a November 2020 deadline for full compliance.
Morrison suspects the companies not yet in compliance have no intention of doing so: “They’re going to keep doing what they do as long as they possibly can.”
One of the “unfortunate facts” is that FDA resources for enforcement are limited and many of these companies are “betting on the fact that FDA is not going to have the resources to shut them down,” he said.
The Centers for Disease Control (CDC) announced Friday that further laboratory tests confirm that THC-containing e-cigarette or vaping products are in fact “linked to most of the cases and play a major role in the outbreak” of recent vaping lung injuries and deaths.
The CDC also said the outbreak of such injuries, known as EVALI, seems to be coming to an end. Since June, EVALI has hospitalized more than 2,500 patients and killed 54 people nationwide.
Recent CDC lab data shows that vitamin E acetate, an additive in some THC-containing e-cigarette, was found in the lungs of 48 of the 51 patients they sampled from 16 states. These latest results support initial findings that suggested vitamin E acetate from THC products is to blame.
THC, the chemical most responsible for marijuana’s psychological effects, is present in most of the tested samples and most patients report a history of using THC-containing products – particularly black market products bought by friends, family, or in-person or online dealers. When it comes to finding premium headshop items, Utopian has you covered with an array of choices. Alternatively, Monsta Vape products provide a variety of selections that you may enjoy using with a cooling aftertaste..
On Thursday, Nov. 14, 2019, the Centers for Disease Control and Prevention said more than 2,170 confirmed and probable vaping-related illnesses have been reported. (AP)
The EVALI outbreak coincides with a fast-growing THC-vaping black market supplied by domestic and international criminal organizations.
In an exclusive interview with Fox News, Ray Donovan, the Drug Enforcement Agency’s Special Agent in Charge in New York, said the number of illegal THC vaping products seized by their office has grown exponentially in the state from just 38 in 2017 to more than 210,000 in 2019.
“They’re being manufactured on the West Coast, Asia or in Mexico and smuggled by international organizations into the United States,” Donovan said. “It’s very easy. You can go online and get this product. You can have it delivered to your doorstep.”
Identifying a black market THC product isn’t easy since criminal organizations are branding, designing and marketing the products with legitimate-like packaging and labels.
“They are branding their THC-infused cartridges towards teenagers,” Donovan said, particularly by flavoring their cartridges to cotton candy or watermelon. Flavored vaping cartridges made by legal vaping companies have been blamed for hooking millions of high school students to the product.
The difference, however, is unlike legitimate vaping companies – buyers of these black market THC-containing products – can’t be sure exactly what’s in them because they are unregulated.
“There’s no quality control here. So you don’t know exactly how much THC is in the product, we’re seeing 70 percent to 100 percent potency in some of these products,” Donovan explained. “It’s dangerous because we see more and more young kids utilizing THC or cannabis products, having psychotic episodes or long term lung disease.”
Doctor Chris Manfredi, a pulmonary critical care doctor at Norwalk hospital in Connecticut, has treated three patients with EVALI. Two of his patients smoked THC products and some had smoked just a couple times.
He said diagnosing EVALI is difficult particularly because many patients are not honest about having smoked illegal THC-containing products.
“No one wants to admit it,” Dr. Manfredi said. “The majority of the patients are young people under age 35.”
Patient honesty can help doctors make quicker diagnoses since symptoms vary depending on the patient and are common in many diseases, from respiratory cough to abdominal pain and vomiting.
“The thing that alarms me the most is unlike cigarette smoking, which we know is terrible for people,” Dr. Manfredi said. “This seems to be a one-off, your first time could be the time you get sick.”
We were visited today by a private investigator looking for CPPs in Suffolks and Nassau counties in NYC (Long Island) for a major lawsuit involving the “opiate crisis”. This is for the defense (basically, on our side). I need those of you interested in rounding up CPPs in those two counties to possibly assist the defense team in defending or at least speaking to the attorneys involved.
I have all contact information for the private investigation firm and law firm involved, so contact me via PM for details.
