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This is not a real news story -- it's from today's edition of The Onion.
But it could be real if we don't address the building momentum towards evidence-based medicine and its cost-centric vs. patient-centric worldview.
End-Life Crisis Marked By Extravagant Spending Spree
The Onion, November 20, 2006
TOLEDO, OH—Ever since his retirement nearly a decade ago, area resident Oscar Subitzky just hasn't been the same. What began as a single, uncharacteristic extravagance—the payment of $15,000 for a coronary angioplasty to expand his narrowing arterial wall—has given way to a growing number of personal luxuries, from the latest brand-name heart medications to the most advanced palliative care. The unusual developments have led concerned family members to suspect that the once prudent and conservative 74-year-old widower is undergoing an acute end-life crisis.
"Sure, the operation seemed a little indulgent at first, but we could tell it was really important to Dad, so we didn't try to stop him from having it," said daughter Martha Welsch, 46, who can still remember when her father didn't need "pricey doodads" like defibrillators and cardiopulmonary-resuscitation devices to be content. "We all thought this was going to be a one-time thing, that it was just something Dad had to get out of his system, and then things would go back to normal," she said.
"Unfortunately, one surgery quickly became two surgeries, which soon turned into three surgeries," Welsch added. "That's when we realized the whole thing was a lot more serious than Dad just wanting to get a clogged artery cleared."
Subitzky's end-life crisis began when he suddenly left a secure job as an accountant at the age of 65. Welsch admitted she didn't quite understand what had come over Subitzky until he announced six months after his retirement that he had started seeing a cardiologist nearly half his age.
"You hear those stories about men in their late 60s all of a sudden coming home with an expensive new pacemaker or deciding to get work done on their kidneys out of the blue, but Dad just never seemed like the type," Welsch said. "If he honestly thinks that spending thousands of dollars on blood transfusions is going to change the way he feels inside, I'm afraid he's got another think coming."
Lately, Welsch said, between "all those fancy new breathing tubes he now wears," and the company of a new live-in nurse only a few years older than some of his grandchildren, she sometimes doesn't recognize her father.
"What's he going to do next, gallivant off to some $10,000-a-day, all-inclusive hospice?" she wondered.
In addition to throwing money around "like there's no tomorrow," as Welsch puts it, Subitzky has also reportedly grown obsessed with his appearance, examining his body for lumps, bruises, or signs of congested veins dozens of times a day. According to son Patrick Subitzky, 39, who admits to being a little embarrassed by his father's newfound vanity, the older man's obsession with his looks has also resulted in a "ridiculous new diet" of only dark-green leafy vegetables, fruits high in citric acid, whole-grain cereals, and absolutely no meat or dairy products.
"I love him and everything, but I don't know who my father thinks he is anymore," said Subitzky, who cringes every time his elderly father speeds around town in that "loud and flashy" ambulance. "He's even talking about a trip to Denver to see some heart specialist there. Whatever happened to the Oscar Subitzky who hated to travel?"
According to psychologist Elizabeth Schulz, who specializes in mortality-identity issues, an end-life crisis is an emotional state of fear and anxiety that often affects men and women between the ages of 65 and 100, and is usually sparked by the uncomfortable realization that one's time on earth is limited.
"Individuals in the middle of an end-life crisis are usually easy to spot, as they tend to foolishly acquire big-ticket items such as liver transplants to compensate for feelings of growing inadequacy," said Schulz, who in the past several years has observed increasing numbers of clients suffering from the common disorder wheeling themselves into her office. "While these shortsighted material purchases will often work at first, leaving the individual feeling rejuvenated and even energized, in the long term they have very little effect."
In the meantime, Welsch is hopeful that her father will eventually move beyond his present situation into a better place.
"I'm praying this is just a phase that will pass," Welsch said. "Hopefully in a couple of months this will all be over."
But it could be real if we don't address the building momentum towards evidence-based medicine and its cost-centric vs. patient-centric worldview.
End-Life Crisis Marked By Extravagant Spending Spree
The Onion, November 20, 2006
TOLEDO, OH—Ever since his retirement nearly a decade ago, area resident Oscar Subitzky just hasn't been the same. What began as a single, uncharacteristic extravagance—the payment of $15,000 for a coronary angioplasty to expand his narrowing arterial wall—has given way to a growing number of personal luxuries, from the latest brand-name heart medications to the most advanced palliative care. The unusual developments have led concerned family members to suspect that the once prudent and conservative 74-year-old widower is undergoing an acute end-life crisis.
"Sure, the operation seemed a little indulgent at first, but we could tell it was really important to Dad, so we didn't try to stop him from having it," said daughter Martha Welsch, 46, who can still remember when her father didn't need "pricey doodads" like defibrillators and cardiopulmonary-resuscitation devices to be content. "We all thought this was going to be a one-time thing, that it was just something Dad had to get out of his system, and then things would go back to normal," she said.
"Unfortunately, one surgery quickly became two surgeries, which soon turned into three surgeries," Welsch added. "That's when we realized the whole thing was a lot more serious than Dad just wanting to get a clogged artery cleared."
Subitzky's end-life crisis began when he suddenly left a secure job as an accountant at the age of 65. Welsch admitted she didn't quite understand what had come over Subitzky until he announced six months after his retirement that he had started seeing a cardiologist nearly half his age.
"You hear those stories about men in their late 60s all of a sudden coming home with an expensive new pacemaker or deciding to get work done on their kidneys out of the blue, but Dad just never seemed like the type," Welsch said. "If he honestly thinks that spending thousands of dollars on blood transfusions is going to change the way he feels inside, I'm afraid he's got another think coming."
Lately, Welsch said, between "all those fancy new breathing tubes he now wears," and the company of a new live-in nurse only a few years older than some of his grandchildren, she sometimes doesn't recognize her father.
"What's he going to do next, gallivant off to some $10,000-a-day, all-inclusive hospice?" she wondered.
In addition to throwing money around "like there's no tomorrow," as Welsch puts it, Subitzky has also reportedly grown obsessed with his appearance, examining his body for lumps, bruises, or signs of congested veins dozens of times a day. According to son Patrick Subitzky, 39, who admits to being a little embarrassed by his father's newfound vanity, the older man's obsession with his looks has also resulted in a "ridiculous new diet" of only dark-green leafy vegetables, fruits high in citric acid, whole-grain cereals, and absolutely no meat or dairy products.
"I love him and everything, but I don't know who my father thinks he is anymore," said Subitzky, who cringes every time his elderly father speeds around town in that "loud and flashy" ambulance. "He's even talking about a trip to Denver to see some heart specialist there. Whatever happened to the Oscar Subitzky who hated to travel?"
According to psychologist Elizabeth Schulz, who specializes in mortality-identity issues, an end-life crisis is an emotional state of fear and anxiety that often affects men and women between the ages of 65 and 100, and is usually sparked by the uncomfortable realization that one's time on earth is limited.
"Individuals in the middle of an end-life crisis are usually easy to spot, as they tend to foolishly acquire big-ticket items such as liver transplants to compensate for feelings of growing inadequacy," said Schulz, who in the past several years has observed increasing numbers of clients suffering from the common disorder wheeling themselves into her office. "While these shortsighted material purchases will often work at first, leaving the individual feeling rejuvenated and even energized, in the long term they have very little effect."
In the meantime, Welsch is hopeful that her father will eventually move beyond his present situation into a better place.
"I'm praying this is just a phase that will pass," Welsch said. "Hopefully in a couple of months this will all be over."
What a difference a day (or two) makes.
On 11/15 Senator Grassley wrote to Senator Enzi and Senator Kennedy that the FDA “needs and deserves a strong permanent Commissioner.â€
On 11/17 he placed a “hold†on the nomination of Dr. von Eschenbach.
Maybe he’ll change his mind again tomorrow.
Maybe. Maybe not.
Maybe he needs to stop playing politics with the public health.
Maybe isn't good for the public health or the future of the FDA.
On 11/15 Senator Grassley wrote to Senator Enzi and Senator Kennedy that the FDA “needs and deserves a strong permanent Commissioner.â€
On 11/17 he placed a “hold†on the nomination of Dr. von Eschenbach.
Maybe he’ll change his mind again tomorrow.
Maybe. Maybe not.
Maybe he needs to stop playing politics with the public health.
Maybe isn't good for the public health or the future of the FDA.
Some new and crucial statistics from the WHO:
* Medicines purchased over the Internet from sites that conceal their actual physical address are counterfeit in over 50% of cases.
This should be cause for pause and reflection for those in the US who are calling for various and sundry importation schemes.
* Counterfeiters exploit weaknesses in border control whenever governments try to promote world commerce by reducing border inspections.
And yet we've passed a law that prohibits US customs and border control agents from opening packages of foreign prescription drugs coming into the US.
* In 2004 over 60 tons of stolen, expired, and counterfeit pharmaceuticals were seized by federal agents in Mexico.
And it's been shown time and time again that many of the drugs being sent from the Great White North into the US begin their journey in sunny Mexico.
The complete WHO report can be found at:
Counterfeit Medicines: an update on estimates
We here at Drugwonks respectfully suggest that, when it comes to trying to legalize drugs "from Canada" ("In Canada," as always, in quotes), Speaker-Presumptive Pelosi stop asking "how" and start asking "WHO."
* Medicines purchased over the Internet from sites that conceal their actual physical address are counterfeit in over 50% of cases.
This should be cause for pause and reflection for those in the US who are calling for various and sundry importation schemes.
* Counterfeiters exploit weaknesses in border control whenever governments try to promote world commerce by reducing border inspections.
And yet we've passed a law that prohibits US customs and border control agents from opening packages of foreign prescription drugs coming into the US.
* In 2004 over 60 tons of stolen, expired, and counterfeit pharmaceuticals were seized by federal agents in Mexico.
And it's been shown time and time again that many of the drugs being sent from the Great White North into the US begin their journey in sunny Mexico.
The complete WHO report can be found at:
Counterfeit Medicines: an update on estimates
We here at Drugwonks respectfully suggest that, when it comes to trying to legalize drugs "from Canada" ("In Canada," as always, in quotes), Speaker-Presumptive Pelosi stop asking "how" and start asking "WHO."
Further thoughts on "banning" pharmaceutical sales representatives from Stanford University Medical Center ...
Click on the link below. The article is on page 8:
http://rxcompliancereport.com/issues/2006/RxComp1116.pdf
Click on the link below. The article is on page 8:
http://rxcompliancereport.com/issues/2006/RxComp1116.pdf
To read the testimony of all of but one (and a half) of the witnesses who presented before the Senate HELP committee, you can't help wonder whether the object was to pay homage to the dreadful IOM report or ignore the connection between science and FDA reform. Witnesses -- with the exception of Greg Simon's Faster Cures and the head of Benefit and Risk analysis at J and J were literally tripping over themselves talking about how important it was to spend all this money on making sure each and every drug was equally safe. Only Greg and the J and J guy managed to point out that embedding bean counters and epidemiologists from the Office of Drug Safety and giving them authority over drug appovals and study designs might add to the cost and time of new drug approvals without regard to the relative benefits of medicines. And the entire discussion was disconnected from ongoing efforts by the FDA to make pre-approval a more targered path that actually focused on eliminating safety problems.
Only Greg pointed out that the real value of a cliniical ttrials registry was to help avoid potential safety flaws and develop more targeted medicines and treatment regimens on a real time basis. (I think the industry is inching towards acceptance ... as it should)
And only Greg made the point, diplomatically, that the real crisis is not a lack of safe drugs but a lack of effective CURES being developed for patients being killed and crippled by horrible illnesses. As Garret Fitzgerald cogently observed and was cogently quoted (kudos to those reporters who did their job in this regard) with respect to studies about Arcoxia, Merck's latest COX-2, the use of many drugs for broadly shared problems (pain) will have to be tailored by metabolic response, age, co-morbidity, instead of banned and panned outright.
There is an unhealthy relationship between the HELP committee and the IOM panel ... There is no speaking truth to power. Instead, it is an effort on the part of the IOM committee to pass legislation it likes. I hope the committee ignores IOM and listens to Greg Simon.
Better use of medicines in a targeted fashion require a total feedback loop and not a balance of cultures or a massive purcahse of claims databases or the FDA's equivalents of a quasi-kosher certification as the IOM proposes. It would have been nice if the IOM had some really scientists on the panel...but that would have meant having a chair who wasn't threatend byy such expertise....
Only Greg pointed out that the real value of a cliniical ttrials registry was to help avoid potential safety flaws and develop more targeted medicines and treatment regimens on a real time basis. (I think the industry is inching towards acceptance ... as it should)
And only Greg made the point, diplomatically, that the real crisis is not a lack of safe drugs but a lack of effective CURES being developed for patients being killed and crippled by horrible illnesses. As Garret Fitzgerald cogently observed and was cogently quoted (kudos to those reporters who did their job in this regard) with respect to studies about Arcoxia, Merck's latest COX-2, the use of many drugs for broadly shared problems (pain) will have to be tailored by metabolic response, age, co-morbidity, instead of banned and panned outright.
There is an unhealthy relationship between the HELP committee and the IOM panel ... There is no speaking truth to power. Instead, it is an effort on the part of the IOM committee to pass legislation it likes. I hope the committee ignores IOM and listens to Greg Simon.
Better use of medicines in a targeted fashion require a total feedback loop and not a balance of cultures or a massive purcahse of claims databases or the FDA's equivalents of a quasi-kosher certification as the IOM proposes. It would have been nice if the IOM had some really scientists on the panel...but that would have meant having a chair who wasn't threatend byy such expertise....
Merck, Lilly and Celgene have all invested heavily in technologies or companies that enable or are directly engaged in stem cell research. None of the projects are turning a profit or will likely do so for years. If Pelosi's Part D plan is implemented....slashing prices and profits of today's drugs by 40 percent with more of the same for stem cell cures in the future along with
new hurdles including comparative effectiveneess studies that take years to compelte and mandatory delays of at least a year (that's the VA anyway) in even allowing something to be used off formulary...what will happen?
Oh, and let's not forget the safety requirements that add at least two years to the time it takes to get such cures to dying patients.
Great assurances of safety in the Post-Pelosi/Waxman world means more and longer clinical trials instead of personalized medicine.
Well, the D's said they didn't want the status quo.
new hurdles including comparative effectiveneess studies that take years to compelte and mandatory delays of at least a year (that's the VA anyway) in even allowing something to be used off formulary...what will happen?
Oh, and let's not forget the safety requirements that add at least two years to the time it takes to get such cures to dying patients.
Great assurances of safety in the Post-Pelosi/Waxman world means more and longer clinical trials instead of personalized medicine.
Well, the D's said they didn't want the status quo.
Last month Rep. Henry Waxman requested an investigation of the effects of US trade policy on public health from the Government Accountability Office and called for the US to drop pressure on WHO to bury a report on trade and health critical of US policies.
Rep. Waxman said, “Administration trade agreements have numerous provisions that threaten access to affordable medicine. We have to recognise that the Bush administration’s single-minded pursuit of intellectual property protections for drug companies can have potentially devastating consequences for the public health in developing countries.â€
Last month he was just wacky. Soon he'll be wacky with a gavel.
Don't you just love oversight!
Rep. Waxman said, “Administration trade agreements have numerous provisions that threaten access to affordable medicine. We have to recognise that the Bush administration’s single-minded pursuit of intellectual property protections for drug companies can have potentially devastating consequences for the public health in developing countries.â€
Last month he was just wacky. Soon he'll be wacky with a gavel.
Don't you just love oversight!
Sometimes when you put a stake in the ground and stand up for what’s right, good things happen.
From today’s edition of the Wall Street Journal …
“In a case that adds momentum to Merck & Co.'s Vioxx defense strategy, the drug maker prevailed in the 11th trial over the painkiller after a New Orleans jury cleared the company of responsibility in a man's heart attack.â€
“Merck's win, which came after the jury deliberated just 90 minutes, gives the company a slight edge on the trial scorecard with six victories and four losses. (Another Merck victory was tossed out and will be retried in January.) It still faces some 24,000 lawsuits, however, and the pendulum could swing back in the plaintiffs' direction. Both sides are eager to notch as many early victories as possible before judges overseeing the litigation start corralling them into a settlement.â€
“Merck's strategy of fighting each lawsuit one by one, and its recent winning streak in the courtroom, have helped to restore confidence in the prospects of the Whitehouse Station, N.J., company. After being preoccupied with Merck's Vioxx liability for much of the past two years, investors lately have become much less worried about the litigation.â€
From today’s edition of the Wall Street Journal …
“In a case that adds momentum to Merck & Co.'s Vioxx defense strategy, the drug maker prevailed in the 11th trial over the painkiller after a New Orleans jury cleared the company of responsibility in a man's heart attack.â€
“Merck's win, which came after the jury deliberated just 90 minutes, gives the company a slight edge on the trial scorecard with six victories and four losses. (Another Merck victory was tossed out and will be retried in January.) It still faces some 24,000 lawsuits, however, and the pendulum could swing back in the plaintiffs' direction. Both sides are eager to notch as many early victories as possible before judges overseeing the litigation start corralling them into a settlement.â€
“Merck's strategy of fighting each lawsuit one by one, and its recent winning streak in the courtroom, have helped to restore confidence in the prospects of the Whitehouse Station, N.J., company. After being preoccupied with Merck's Vioxx liability for much of the past two years, investors lately have become much less worried about the litigation.â€
Talking about making the auto industry competitive, Senator Carl Levin and John Dingell maintained yesterday that the problem isn't the other car companies but the anti-competitive practices of other countries that allow imports to be brought in at artificially low prices that include labor costs that are lower because of subsizied health care (a factual inaccuracy but whose counting).
Let's remember that the next time Dingell and Levin and Stabenow argue for drug importation which of course a function, not of companies but of countries....
Let's remember that the next time Dingell and Levin and Stabenow argue for drug importation which of course a function, not of companies but of countries....
In am in Israel for the week visiting my son. Interesting article in the Jerusalem Post amidst the items about Hezbollah rearming, Hamas attacking and Iran building up its nuclear weaponry as it hopes the election of Democrats is the beginning of the end of American support for Israel..
Seems as though Israel's pharmaceutical industry is being hammered by counterfeits and patent theft. For those who think this is just an fiction fabricated to screw the Third World -- an idea that can get you a GENIUS AWARD.
It turns out that Israel's pharma and biotech industry has lost about $331 million a year from such practices.
The Jerusalem Post article can be found here:
Intellectual property fraud an 'epidemic'
Seems as though Israel's pharmaceutical industry is being hammered by counterfeits and patent theft. For those who think this is just an fiction fabricated to screw the Third World -- an idea that can get you a GENIUS AWARD.
It turns out that Israel's pharma and biotech industry has lost about $331 million a year from such practices.
The Jerusalem Post article can be found here:
Intellectual property fraud an 'epidemic'
Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.
