ppp 10-09-06

Quote of the day: For man, autumn is a time of harvest, of gathering together.

For nature, it is a time of sowing, of scattering abroad. -Edwin Teale

When the children were small and we only had one large tree in the back yard they would pile all of the leaves together near the swing set. They would jump from the slide into the leaves until there was just a pile of leaf dust left. They did not want the fun to end after our leaves were used up so they went next door to the elderly neighbor to ask for his leaves. Ray was "blessed" with many mature trees and had a wealth of leaves. He was more than delighted to allow us to take his leaves. This activity served a number of purposes. It helped a neighbor too proud to ask for help, kept the kids busy doing something constructive while making them happy and safe by supplying more leaves to cushion there decent to earth. I later told them how much their work helped Ray. They had not considered it work.

In the 3 days I was away at the Academy of Managed Care Pharmacy (AMCP) meeting in Chicago, all of my trees decided to simultaneously let go of their leaves. When you rake leaves this autumn you may just be right about how much work it is. If you ever want to get a visual image of the number 1 million just look into an average 40 foot tall tree and take in the number of leaves (about 1 million). After raking the leaves from 5 such trees this weekend I wished that money did grow on trees and that my leaf blower had a non-shredding mode. Toward the end I noticed that there were still about 3 bag's worth in the street at the curb that had obviously come from my boulevard tree. I could have left them there to blow away (to the neighbors' yards) but didn't. I remembered how upset I was the year that we first moved into our house; I had every leaf picked up and carted away but every time I opened the garage door the neighbor's unraked leaves would run across both yards and the street to seek asylum in my garage. With that thought, I did the right thing and picked up the leaves at the curb.

It then dawned on me that the time and effort I had expended at the AMCP meeting on the Editorial Advisory Board was a lot like how my children felt when they raked the neighbor's leaves. It was something worthwhile that had to be done and that I was having so much fun doing it with friends and colleagues that I never noticed the work part of it. Often "it is in giving that we receive." Get involved in your professional societies, communities, and neighborhoods. Work will happen by accident while you are having fun.

ps. Best answer this week to the question "How are you?" was "Not half bad" (a slightly optimistic CEO of a small hospital)

pps. Occasionally, some of the links require FREE registration.... I'm sure you can handle THAT slight inconvenience.

Don't expect this one to break your drug budget but vorinostat capsules will not be cheap. As an orphan drug it is likely to be of use in less than 200,000 people. Side effects are not trivial.

Tools such as quantity level limits, prior authorization and step therapies as well as negotiated rebates from manufacturers allow a better value to employers and participants.

Asthma docs say that EVERYONE with asthma should be vaccinated against influenza this year. The vaccines have been shipping over that last few weeks and should be available NOW (hint…hint).

4) … and another source was approved last week from Canada where the leaves have peaked.

This Canadian drug was approved for use in the USA as a USA drug. Glaxo is behind it and the FDA allowed research done in Canada to be used in the approval process.

FDA sidetracks efforts by Lilly for approval of a medication to treat diabetic eye problems. In the mean time (added studies estimated to take 5 years) more diabetics will lose their sight. Who may not be seeing the forest for the trees.

6) Maybe your perception that drugs ads were as plentiful as leaves on a tree were right.

It appears that drug advertising (DTC) increased by 9% so far in 2006. The only thing worse will be the plethora of political campaign ads to take over the airwaves for the next month.

New Jersey is the last state to allow the over the counter sale of syringes. This change is aimed at people who now share needles when using illegal drugs. While it is hoped that this will help it may not do much. One study several years ago offered addicts clean or dirty syringes for no cost. The determining factor in a junkie's choice was which syringe was closest.

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