Hannah Whitall Smith, 1902

A good fiend of mine, Tony P, suggested a great book to me on Monday. I purchased it and 48 hours later I was done. The book? The One Minute Millionaire. by Mark Victor Hansen (author of Chicken Soup for the Soul) and Robert G. Allen (Nothing Down and Creating Wealth) . It is set up as a novel on the right hand page and a text book on the left hand pages. The plot reinforces the didactic work and vice versa. I was not particularly interested in the real estate portion but still learned at least enough to understand what all of those "We BUY UGLY HOUSES" billboards are all about. You don't have to start your own business to profit from this book….you can apply the principles to most situations. What are your PASSIONS, TALENTS, VALUES and DESTINY? Are you a Hare, Owls, Turtle or Squirrel? (You should have at least one of each on every work team or it will not accomplish its goals easily.) If you consider it as two books then they are only about $10 apiece. We all have million dollar ideas in us…and this book just might help you release yours. When you make yours, remember to generously share your profits with the community. I would advise you purchase and read this book. You are good enough, you are strong enough, and you deserve to be wealthy! (It beats the alternative!)

1) "Somebody moved my cheese…again!"

No sooner do I change my eating habits (I don't butter my bacon anymore) and reduce my lipid levels than "they" move the guideline. New lowered cholesterol goal will push most people with medium risk to drug therapy to get LDL levels below 130. (I still need to be below 190) I'm glad I'm not a smoker or have heart failure…their goal is 70!

While WALL STREET is looking for bigger sales of Lipitor, Zocor etc. I doubt it because :

1)     the guidelines for the majority of patients will stay the same

2)     those people at highest risk (about 5%) might need a dosage increase but many physicians do not treat to the “old” optimal lipid profiles

3)     compliance remains a problems as most people don’t feel any better when taking the these drugs

4)     physicians are notorious for being slow to embrace new guideline

5)     the sale of the HMG are more sensitive to Direct To Consumer ads or the most recent young celebrity heart attack than new guidelines (unless the docs are rewarded for doing it or penalized for not doing it by their medical director)

As far as projecting new cholesterol spend for the next year goes I wouldn't increase it by much if anything. (Just my opinion…I could be wrong!)

http://www.reuters.com/newsArticle.jhtml?type=healthNews&storyID=5648634

To see the guidelines themselves….

http://www.nhlbi.nih.gov/guidelines/cholesterol/atglance.pdf

2)When is "half-off" not a good idea?

Canadian internet "drugs" contained no active ingredient. Maybe prices are sometimes 57% of US because they don’t contain any active ingredient! These were pretty "sleazy" operations by all accounts but even some "good" pharmacies in Canada send sub-potent drug (illegally I might add)

http://www.fda.gov/bbs/topics/news/2004/NEW01087.html

http://biz.yahoo.com/rc/040713/health_imports_1.html

3) An Aspirin a day keeps the colonoscope away… but Celebrex didn't.

A recent study comparing the protective effect against colon cancer between aspirin and Celebrex. The rationale is that inflamation leads to polyps and polys can turn cancerous. Reduced the inflamation and stop the cascade before it begins. I am happy to see comparative studies contributing to, dare I say, evidence-based medicine.

http://www.medscape.com/viewarticle/482785_print

4) Visual and auditory hallucinations due to a bisphosphonate.

Hearing voices can be just from schizophrenia and other psychotic episodes but we always look for an "organic" (toxic effect of chemicals or aberrant physiology) when visual hallucinations appear. The bisphosphonates are used against bone problems like osteoporosis.

5) More softness in the ED market.

Lilly offers to by the competitor's product for patients if Cialis does not satisfy. Mechanics work like this: get a coupon for free Cialis trial. If you like it you can get one more trial prescription. If you don't like it then you get a coupon for the competitor's product. This take a lot of chutzpah. Appears to be a response to the recent Viagra ploy of buy 5 prescriptions and get the 6th free.

http://www.pharmalive.com/news/index.cfm?articleID=152815&categoryid=9&newsletter=1

6) Glad to see you won't have to join Martha Stewart in jail....Pharmacy plans stay legal!

Many small and large American employers provide prescription drug coverage for their employees and dependents. Taft-Hartley union plans, health insurers, state and federal-employee benefit plans and state Medicaid plans have seen how  PBMs help drive down the cost of prescription drugs for consumers and plan sponsors by negotiating discounts with drug manufacturers and all the clinical programs offered. This is a significant ruling people….. take a look.

http://www.pharmacyonesource.com/members/work/daily_news/article.asp?category_id=19&record_id=111806

In the story a few "upstanding citizens" passed by someone who fell in with robbers before an unlikely person came to his aid. Read the attached scenario and tell me if it sounds familiar (but with a twist).

Democlergy passes by the old mugged traveler (democrats having been in office for 8 years). Then the Samarepublican pushes for, passes, and institutes the Medicare drug program. AARP (the old mugged traveler) now complains about the care and accommodations while the democlergy complain that the Samarepublican did not do enough! (Maybe next week we will do a revisionist Grasshopper and Ant)

http://www.pharmacyonesource.com/members/print_page.asp?page_title=PharmacyOneSource%2Ecom+Members%3A+Daily+News&request_method=GET