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Jack is a graduate of Rutgers University where he majored in history. His career in the life and health insurance industry involved medical risk selection and brokerage management. Retired in Florida for over two decades after many years in NJ and NY, he occasionally writes, paints, plays poker, participates in play readings and is catching up on Shakespeare, Melville and Joyce, etc.

Monday, February 25, 2019

Drug Ads on TV, a Letter and Electronic Musings





Drug Advertisements on TV

Ever wonder about the many advertisements for prescription drugs you see on TV?  These drugs all have several things in common.  (1) They must be prescribed by a physician.  (2)  They are all for serious diseases.  (3)  They all, even though they don’t say it, are very, very expensive and (4) they all include warnings in very small print, or hastily spoken, about the dangers of possible side effects. Often, the word “fatal” in breezed over in these caveats.

Absent from these ads are drugs commonly used for elevated blood pressure or elevated cholesterol.  That’s because most of them are available in generic versions and are not tremendously expensive.  It is inconceivable to me that the folks these advertisements are aimed at are not already under the care of physicians and under treatment for their serious illness or condition.  The aim of the ads is to get the patient to suggest to their doctor to perhaps put them on the medication they saw advertised on television.  If only a few patients do this, and their doctor switches them to the advertised product, the price of these expensive TV ads is a good investment for the pharmaceutical company.  The most common medical histories toward which these ads are targeted are cancer, intestinal disorders (ileitis, Crohn’s Disease), rheumatoid arthritis, psoriasis of rheumatic origin, diabetes, bladder problems and hepatitis-C, all of which are serious disorders.

Pharmaceutical companies have invested millions of dollars into developing these drugs.  That’s why they are so expensive.  In order to both recoup the cost of the drug’s development and to create profits for the pharmaceutical company, they actively try to increase their use.  That’s what the ads are about. The high cost of these drugs is borne by the patient through their own resources or co-payments and by insurance companies and the Federal government.  (Sometimes, the drug companies offer them at a more modest cost to those without insurance and below certain income levels, but they do it through a charitable “foundation” approach, which provides them with a tax deduction for the full amount of the drug, so the government really ends up footing the bill.)  And of course, nothing is “free” so both insurance and Medicare premiums and Federal taxes to support paying for expensive drugs all go up.

All of this must be accomplished during the first twenty years of a drug’s availability on the market in the United States.  During that period, the drug company can charge its sky-high price.  After that, when the patent runs out, less expensive generic versions of the drug usually will become available and its role as a company profit center will end.  That is why, during the first twenty years of an expensive new drug’s availability in the United States, drug companies advertise furiously to increase its use.  That’s when they make their money.  And of course, they are always busy developing new drugs or modifying existing ones to create more opportunities to lock in a high price for twenty years.  Here's an example:

Opdivo is a cancer-fighting drug
Opdivo is a cancer-fighting drug.  
Three vials of it cost a bit over $8,000.  A year’s worth of treatment can run about $250,000.  The fine print on its TV ads claims it increases life expectancy over more traditional chemotherapy.  That figure is quoted in months.  Note the wan smiles on the actors in the ads, as they enjoy the extra time afforded them to spend with their grandchildren.  But you know that they know their time is limited.  Most recently, studies have shown this drug increases the five-year survival rate for certain types of lung cancer up to 16% from a far lower figure.  That’s not very much, but it is something.  And it comes at a steep price.

Yes, these drugs come at a price.  Here are the monthly costs of five heavily advertised drugs for those without insurance.  You won’t see these prices on the TV ads.  Remember that Insurance companies often negotiate for better prices for their insureds, which helps a bit.

 
Otezla Commercial

Keytruda       $8,369
Taltz               $6,194
Otezla            $3,764
Humira          $5,846
Lyrica            $1,070
Xeljan            $4,915




Jack Lippman



An Unpublished Letter

Someone wrote a letter to the Palm Beach Post last week explaining that the President is legally empowered to keep aliens out of the country and that justifies his declaring a national emergency to do so.  I disagreed and wrote the following letter to the Post, which up to today, they have not published.  I think they are sick of me.

“The President’s broad authority to exclude aliens based on provisions in the United States Code, as cited by a recent letter writer (Friday, Feb. 22), does not extend so far as to give him the ability to take such an action by declaring it to be in response to what he considers to be a national emergency.  There is a difference between what powers the United States Code gives the President and the much greater power available to him through his declaring a national emergency.  He chose to take the latter course only because Congress refused to provide him with the funds to fully carry out the action described in the U.S.C. citation.  According to the Constitution, that is their job.   Sadly, the President does not fully understand the separation of powers laid out in the Constitution which he, and members of Congress, have sworn to uphold.  Fortunately for America, most members of both Houses of Congress do understand it.”
 JL


Brave New World of Technology Department

I used to believe I was sufficiently technologically oriented but when I step outside of the world of retirees, I realize how far behind the times I am.   My desktop computer is about as obsolete as a Princess telephone.  I do have an Apple IPhone, but it’s only a “7” and most younger folks use a “10” now, or its Android equivalent, or more likely a tablet of some kind, which is probably ten times as powerful as my desktop.  Hey, my desktop is really an old laptop, discarded by my son, but far more powerful than the “tower” I used to have.  Somehow, it’s linked to the 24” wide monitor sitting before me right now.  But that works for me.

I played around with Facebook for a while but it was too confusing and overwhelming for me so I cancelled out of that.  I never got into Twitter but wanted to give Instagram a try.  It sounded interesting.  But lo and behold, you can’t (or at least, I can’t) work Instagram from my computer.  It must be used from a mobile phone (my “7” is fine) and is based on sending pictures taken on that phone (or stored on it) out to whomever “follows” you on Instagram, possibly with added pithy comments.

People get to “like” postings and I get to “follow” what posts I like.  And there are all sort of gimmicks possible, using “hashtags,” which are a big thing on Twitter too.  I’ve learned that they call a number sign or a pound sign a hashtag in today’s language. Right now, having posted five pictures on Instagram, I have eleven followers and follow nineteen people who post.  I have been told to “like” (post a heart icon) their postings and thereby grow my following.  On Instagram, I am “jacobelippman.” (or maybe “#jacobelippman.” I am not sure.) Check me out.  Oh, yes, to get on Instagram, I had to resurrect my Facebook account (Facebook owns Instagram) but am assiduously avoiding posting on it again.  I don’t trust Zuckerberg … but Instagram seems harmless enough.

Mobile phones seem to be everything.  Younger people use them where old folks still use computers.  Only professional photographers and really serious hobbyists own cameras anymore.  Young people don’t even use credit cards much anymore.  They just flash their phones and the bartender or clerk just scans it, and even that isn’t always necessary.  Same goes for banking and gas stations. Even I do it when boarding planes (but I usually have a printed boarding pass in my pocket just in case).   But I still have friends who don’t even have the skills to use an ATM.  If they need a cab, they “call” one whereas younger generations have Uber or Lyft apps on their mobile phones.  There isn’t much call for real money any longer. All this electronic spending shows up eventually on a credit card bill which for many, is available only on their mobile phone’s screen … payable from one’s bank account, only a click away.  I dunno where all this is leading.

Meanwhile, I am busy preparing a posting for my dusty old blog which sits on the Internet and to which I alert people by an ancient vehicle known as Email.  I am contemplating moving these alerts to “texting” because that seems to be more the preference of younger people than Email.  First though, I have to figure out a way to get my “mailing list” from my computer’s “doc” file onto my IPhone. Oy!


I will include this screed on the blog.
JL

Is this where it's all heading?


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Jack Lippman 


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