• Short Of God, Who Do We Appeal To, To Stop All This?

    Posted April 26, 2014: by Bill Sardi

    It’s the era of injectable drugs.

    A new experimental drug that can protect against the AIDS virus for months at a time has just been successfully tested in animals.  The drug would eliminate the need to take pills every single day and improve effectiveness since patients often forget to take their pills.  [NBC News, March 4, 2014]

    Two new experimental drugs, one delivered intravenously and the other by injection, are posed to help prevent migraine headache attacks for prolonged periods of time.  After 5-8 weeks the intravenous drug was shown to reduce migraine attacks by 66% compared to 52% when patients were given an inactive placebo pill. [WebMD, April 22, 2014]  The effect was not dramatically better than no treatment, but it did eliminate the need for daily use of medications.

    The market for these anti-migraine drugs is large.  There are an estimated 36 million chronic migraine sufferers in the U.S.

    These two experimental drugs may soon be added to Botox injections that are already being injected in doctors’ offices for migraine attacks.  Botox is injected in selected migraine sufferers about every 12 weeks.  [Review Journal, March 30, 2014] Botox costs $300-500 for 3-4 months of relief. [Realself.com]

    Botox was initially introduced for cosmetic purposes– to reduce facial wrinkles in the brow– but its maker believes its therapeutic indications will far surpass its use as a wrinkle reducer.  Sales of Botox to quell or prevent migraine attacks are predicted to rise to $1 billion by 2015. [New York Times]

    Botox injections for wrinkles or migraine attacks comprise a fast-growing sector of discretionary health care spending. It’s no wonder U.S. health care costs now exceed $3.8 trillion a year.

    Drug companies are finding a way to get away with marketing over-priced blockbuster drugs is to cut doctors in on procedure fees to inject medicines and the docs garner additional fees for extra office visits and accompanying tests.

    Once doctors find a cash cow, they are likely to over-prescribe and not search for more economical alternatives.

    For example, migraines are linked with cell energy problems in cellular compartments called mitochondria.  There are a number of less costly non-prescription remedies that address mitochondrial energy deficiency such as magnesium and coenzyme Q10.  [Seminars Pediatric Neurology Vol. 20, page 188, Sept 2013] Injectable drugs may quell the symptoms but not address its true cause.

    Some researchers argue that the prevalence of magnesium deficiency is so high among migraine sufferers that this mineral ought to be universally supplemented orally or even intravenously to alleviate debilitating migraine attacks.  [Journal Neural Transmission Vol. 119, p. 575, May 2012]

    Another underlying cause of menstrual migraines is iron-deficiency anemia. [Acta Clinica Croatica Vol. 49, page 389, Dec. 2010] Yet doctors are given to treating every malady as a drug deficiency rather than a nutrient deficiency.

    In another study acupuncture worked better than a popular drug used to treat migraine.  [Cephalgia Vol. 31, page 1510, Nov. 2011]  Yet another study found the simple recommendation to drink more water alleviates many migraine attacks.  [Family Practice Vol. 29, page 370, Aug. 2012]

    But the financial incentives for doctors to inject long-lasting medicines in their offices and capture significant insurance reimbursement suggests permission to gouge a healthcare system that is already bankrupt (Medicare faces shortfalls of trillions of dollars). [CNS News, April 23, 2012]

    True, many of these patients will find lasting relief for their conditions and these intravenous or injectable medicines may save on costs of other less effective medicines and therapies.  And the patients don’t have to take so many pills.  But are these high-tech therapies the most cost effective and should they be front-line treatment?

    Doctors simply have no financial incentives or penalties to recommend more cost-effective remedies.

    The most egregious example of the injectable medicine craze are drugs used to treat a form of macular degeneration, an eye disorder that robs senior Americans of their sight.

    A major drug company was informed by an eye doctor that one of its anti-cancer drugs designed to cause blood vessels to recede so as to starve growing tumors also saved the sight of older Americans who had no other effective options available to them.

    The drug Avastin, available in a 300-milliliter multi-dose vial for intravenous therapy, was then used by eye doctors who simply withdrew 1-milliliter and injected it directly into the eye.  The cost was about $50 per monthly treatment for the medicine.

    But the drug company chose to slightly alter Avastin and package it in a single-dose vial and change its name to Lucentis.  This version of the drug gained FDA approval, but its price soared to ~$2000 per dose.

    That the drug company sought FDA approval for its more expensive drug and never applied for approval for its more economical cousin is unprecedented in the history of pharmaceutics. It is the worst example of gouging public health insurance funds in history.

    A subsequent study found both Lucentis and Avastin exhibit comparable safety and effectiveness. But Lucentis and another similar drug Eylea rack up billions of dollars of billings to Medicare annually.

    Yet Forbes Magazine online chose to extol one of the companies that pulled off this overcharging maneuver and practically enshrine its leaders into the pharmaceutical hall of fame after it struggled for 25 years in obscurity. [Forbes.com, Aug. 15, 2013]

    How do these drug companies get away with all of this? An eyebrow-raising report in USA Today says drug companies spend hundreds of millions of dollars on lobbyists. It comes as no surprise to learn that the two companies that gouge Medicare for these eye drugs are among the biggest spenders on lobbyists in Congress. [USA Today, April 24, 2014]

    Don’t go complain to Congress. They’re paid off. And we wonder why healthcare costs keep rising?

    As amazing as this class of drugs has been for the fast-progressive form of macular degeneration, they aren’t always effective. About 15% of the time the drugs are ineffective and patients progress to legal blindness. [British Journal Ophthalmology Vol. 97, page 1443, Nov. 2013]

    Serendipitously, researchers at the North Chicago Veterans Administration hospital set out to find other ways to spare these helpless patients from permanent sight loss. They investigated the use of polyphenols from red wine as inhibitors of abnormal blood vessels. [Nutrients Vol. 5, page 1989, June 2013]

    In 16 of the first 17 patients given this natural remedy, available as a dietary supplement, vision improved. It worked when the expensive injectable drugs didn’t. [EyeDoctorRicher.com]

    But eye doctors saw the threat this natural non-prescription remedy posed to their incomes.  Despite promising early reports, ophthalmologists decided to ignore this remedy claiming it isn’t FDA approved. But neither is Avastin, a drug that is still used to treat the leaky (wet) form of macular degeneration.

    It is unconscionable to think eye doctors would allow patients to progress into irreversible blindness and hide behind the FDA approval process to protect their incomes.

    Peter Brill, author of BITTER PILL: Why Medical Bills Are Killing Us says: “We have changed the rules related to who pays for what with the Affordable Care Act, but we haven’t done much to change the prices.”

    Who will fix all this? GOK*.

    ©2014 Bill Sardi, Knowledge of Health, Inc.

    * God Only Knows

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