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Showing posts with label drug sales. Show all posts
Showing posts with label drug sales. Show all posts

DEA, Big Pharma and the Hard Drug Epidemic: DEA Secretly Approved Ever Greater Quantities of Oxycodone and Morphine

This is how the various "drug enforcement" law agencies make sure they have big budgets and a job to do.

DEA approved drug production



By John Temple
The feds could choke off the supply of pills flooding American streets tomorrow. Instead, they let Big Pharma crank out 151 tons of it last year.

The federal government is actively fueling a killer drug epidemic behind closed doors.

The Drug Enforcement Administration—tasked with fighting the war on drugs—has for the past two decades approved ever-greater quantities of controlled substances like oxycodone for manufacture and sale in the U.S. by pharmaceutical companies.

In 1993, the DEA allowed pharmaceutical companies to manufacture 3,520 kilograms of oxycodone. In 2015, the DEA authorized production of 137,500 kilograms of oxycodone. That’s a 39-fold increase in 22 years, the equivalent of turning two Buicks into four Boeing 737s. Either Americans are in 39 times more pain than we were 20 years ago, or something else is wrong.

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Drugged America: 40 Million Tranquilizer Prescriptions Were Paid for by Medicare in 2013 Alone


Photo by epSos .de.
Photo by epSos .de.

By Charles Ornstein and Ryann Grochowski Jones
This story was co-published with the Boston Globe, the Miami Herald and Health News Florida.

In 2012, Medicare's massive prescription drug program didn't spend a penny on popular tranquilizers such as Valium, Xanax and Ativan.

The following year, it doled out more than $377 million for the drugs.

While it might appear that an epidemic of anxiety swept the nation's Medicare enrollees, the spike actually reflects a failed policy initiative by Congress.

More than a decade ago, when lawmakers created Medicare's drug program, called Part D, they decided not to pay for anti-anxiety medications. Some of these drugs, known as benzodiazepines, had been linked to abuse and an increased risk of falls and fractures among the elderly, who make up most of the Medicare population.

__________________

The Doctors and Drugs in Medicare Part D

Our Prescriber Checkup tool has been updated with 2013 data
from Medicare, including controlled substance
prescribing for each provider.
Explore the App


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But doctors didn't stop prescribing the drugs to Medicare enrollees. Patients just found other ways to pay for them. When Congress later reversed the payment policy under pressure from patient groups and medical societies, it swiftly became clear that a huge swath of Medicare's patients were already using the drugs despite the lack of coverage.

In 2013, the year Medicare started covering benzodiazepines, it paid for nearly 40 million prescriptions, a ProPublica analysis of recently released federal data shows. Generic versions of the drugs — alprazolam (which goes by the trade name of Xanax), lorazepam (Ativan) and clonazepam (Klonopin) — were among the top 32 most-prescribed medications in Medicare Part D that year.

And it appears these were not new prescriptions.

IMS Health, a healthcare analytics company that tracks drug sales nationwide, logged only a tiny increase in all benzodiazepine prescriptions, including those covered by Medicare, from 2012 to 2013. That probably means Medicare paid mostly for refills of existing prescriptions, said Michael Kleinrock, director of research for the IMS Institute.


That millions of seniors are taking Xanax, Ativan and other tranquilizers represents a very real safety concern, said Dr. Brent Forester, a geriatric psychiatrist at Harvard-affiliated McLean Hospital in Belmont, Mass.

The drugs are popular because they are fast-acting — working quickly, for example, to quell debilitating panic attacks. But they can be habit-forming and disorienting and their effects last longer in older patients. For that reason, the American Geriatrics Society discourages their use in seniors for agitation, insomnia or delirium. The group says they may be appropriate to treat seizure disorders, severe anxiety, withdrawal and in end-of-life care.

Forester said he and others who specialize in geriatric psychiatry don't use benzodiazepines as a "first-, second- or third-line treatment because we see more of the downside than the good side."

Some geriatric psychiatrists worry that doctors may have turned to the drugs in place of antipsychotic medications to sedate patients with conditions such as dementia. In the past several years, Medicare has pushed to reduce the use of antipsychotics, particularly in nursing homes, because of strong warnings about their risks.

In 2013, Medicare covered more prescriptions for benzodiazepines than for antipsychotics.

"At the end of the day," Forester said, "in terms of risk, the risk with benzodiazepines seems so much worse to me … There's significant danger and there's no spotlight."

A spokeswoman at the Centers for Medicare and Medicaid Services declined to answer questions about Medicare's suddenly soaring tab for benzodiazepines.

Some doctors who ranked among Medicare's top prescribers of the drugs said any risks were outweighed by their benefits.

Fall River, Mass., psychiatrist Claude Curran wrote more than 11,700 prescriptions for benzodiazepines (including refills) in 2013, ranking him behind only four other doctors, all from Puerto Rico. He said the drugs worked well for his patients, many of whom are trying to kick addictions to narcotics but struggle with anxiety and depression.

"First of all, they're reliable," he said. "Second of all, they're cheap because they're all generic … They tickle the brain in the same way alcohol does."

Without benzodiazepines, he added, patients in recovery often need higher doses of methadone, which carries significant risks of its own. "Anyone who's ever had a panic attack is sympathetic to the use of the benzos," Curran said. "Anyone who has never had a panic attack doesn't understand it."

Notes: Counts include initial prescriptions and refills dispensed. Retail price includes patients' out-of-pocket costs but does not reflect drug maker rebates. Average prescriptions per patient, per provider has been adjusted to give more weight to doctors who treat more patients. (The unadjusted average is 5.7).

The vast majority of Curran's Medicare patients were younger than 65 and qualified for coverage based on a disability. Disabled patients made up about a quarter of Part D's 35 million enrollees in 2013, but used benzodiazepines disproportionately, accounting for about half of all prescriptions.

Miami psychiatrist Rigoberto Rodriguez also ranked high among Medicare prescribers of benzodiazepines, writing 9,900 prescriptions in 2013, but most of his patients were seniors. Many, he said, are Cuban immigrants who experienced traumas that left them with lingering anxiety, and they have been taking the drugs for years.

Rodriguez readily acknowledged the risks of the drugs for elderly users — recently, researchers found that the longer a person took benzodiazepines, the higher his or her risk of being diagnosed with Alzheimer's Disease. The drugs' labels say they are generally for short-term use but many patients take them for years.

Rodriguez said he has been working to reduce his benzodiazepine prescriptions in light of emerging research. He expects that when Medicare releases data for 2014 and 2015, his totals will be lower.

"This is fresh information coming out in the last couple years … telling us that benzos are probably not good and you should try to avoid them," Rodriguez said. "I totally agree with that."

Roberto Hernando, another Miami psychiatrist who wrote high numbers of benzodiazepine prescriptions in 2013, said he intends to review his prescribing after a reporter told him his totals.

"Some people may need it; some people may not," he said. "You're bringing to my attention something that I wasn't even aware of."

When Congress created Medicare's drug program in 2003, there wasn't much discussion about whether it should cover benzodiazepines.

They were on a larger list of drugs excluded for coverage, along with barbiturates, fertility drugs, and drugs for weight loss and cosmetic purposes. The list mirrored one from a law years earlier allowing states to voluntarily exclude certain drugs from Medicaid programs for the poor. (Medicare now also pays for barbiturates.)

Andrew Sperling, director of federal legislative advocacy for National Alliance on Mental Illness, said it's unclear why Congress made the exclusions mandatory for Medicare when they had only been voluntary for Medicaid. He believes it was a drafting error.

IMS Health data suggests that while the Medicare ban was in effect, seniors and disabled patients paid for benzodiazepines in other ways. Many paid out of pocket for the relatively inexpensive drugs, which can cost less than $10 for a 30-day supply. Some, particularly those with disabilities, qualified for state Medicaid programs, which continued to cover the drugs even though they didn't have to. Another set of patients chose Medicare Advantage plans that offered the drugs as an added benefit.

Dr. Michael Ong, an associate professor at UCLA, co-authored a 2012 paper concluding that many patients continued using benzodiazepines after Congress banned coverage in Medicare Part D and that some turned to more powerful psychiatric drugs.

"Just mandating something and saying we're not going to pay for the benzodiazepines is probably not the right type of policy solution to change the behaviors of both the providers who are providing these medications and also the patients who are using them," Ong said.

A worrisome aspect of the newly released data is that some doctors appear to be prescribing benzodiazepines and narcotic painkillers to the same patients, increasing the risk of misuse and overdose. The drugs, paired together, can depress breathing.

ProPublica found that this pattern was most common in southeastern states, which struggle with opioid abuse and overdoses. In 2013, 158 doctors in Florida wrote at least 1,000 prescriptions each for opioids and for benzodiazepines, tops in the nation. Alabama, Kentucky and Tennessee also had unusually high numbers of doctors who often prescribed both narcotics and benzodiazepines. The data does not indicate if the prescriptions were given to the same patients, although that prospect worries experts.

Dr. Leonard J. Paulozzi, a medical epidemiologist at the Centers for Disease Control and Prevention, co-authored an analysis showing that benzodiazepines were involved in about 30 percent of the fatal narcotic overdoses that occurred nationwide in 2010.

"It increases the possibility of overdoses," he said.

Look up the drugs your doctor prescribes with our Prescriber Checkup tool. For more stories about physician prescribing, see our related reporting.


Reprinted with permission from ProPublica


Jamaica's Marijuana Decriminalization: Will the Rest of the Caribbean Follow Suit?

“Ganja”, photo by Justin Schuck, used under a CC BY-NC-ND 2.0 license.
“Ganja”, photo by Justin Schuck, used under a CC BY-NC-ND 2.0 license.
By Janine Mendes-Franco
Jamaica has long been the Caribbean island that the developed world most associates with liberal marijuana use.

This perception might stem from the fact that the island's biggest global icon, the late reggae musician Bob Marley, was a committed Rastafarian, who routinely smoked herb as path to deeper spiritual awareness. In this sense, weed might seem as synonymous with Jamaica as reggae music, but despite tourists flocking from the Global North with dreams of spliffing up on a beach and feeling irie, cannabis use was illegal on the island until recently.

That all changed last month — quite fittingly the month of Marley's birth — when the Jamaican House of Representatives passed a law decriminalising possession of up to two ounces of marijuana. The new legislation also allows people to grow up to five plants for personal use, and guidelines are currently being established for the cultivation and distribution of medical marijuana and use of the herb for religious application.

The law has made Jamaica the first Caribbean nation to make the bold move of attempting to regulate cannabis use in a region where, in most cases, its illegality has not quelled consumption. Across the Caribbean, national justice systems are backlogged with minor possession offences that accomplish nothing more than sullying a young person's police record.

Jamaica joins a number of other countries who are pioneering this approach to dealing with marijuana use. In August last year, Global Voices published a story which suggested that decriminalisation could eventually happen across the Caribbean. Jamaica remains the single largest exporter of marijuana in the region.

Reaction to the news on Twitter was swift. There were several congratulatory tweets about the legislation, acknowledging the significance of the measure:




Some users of the microblogging service wondered what the benefits would be:


This Twitter user thought the move was long overdue…


…while others underscored the developed world's perceptions of the island:



In the Caribbean itself, however, some bloggers were surprised by the decision.
Rishona Campbell wrote in a post titled ‘Can Jamaica Profit from Marijuana Legalisation?':
This is a really surprising, but timely move by the Jamaican government. In spite of marijuana being so intrinsically tied into Jamaican culture, thanks to the Rastafarians, the laws of the country have prohibited its possession and use since 1913. [...]

It seems that Jamaica has grown hip to the changing climate globally in regards to marijuana decriminalization. In all honesty, I thought that this would have happened much sooner in Jamaica, especially when the success of weed tourism in the Netherlands proved that you could tolerate marijuana use, and not have society implode itself.

Interestingly enough, the Netherlands actually allots for a lesser amount, 5 grams, for personal use. However the Netherlands allows public use, and it is fully legal. Whereas in Jamaica (similar to the states of California and New York in the United States), it is simply decriminalized.
Her post went on to describe some of the ways in which she thought the island could reap huge profits from the harvest and sale of the drug, explaining that both medical marijuana and weed tourism could generate significant economic yields. She also added that Jamaica was in a unique position to capitalise on the “almost mythical marketing pull of all things marijuana-related”.

A pro-weed region?

On Facebook, many netizens echoed the opinion of Trinidad and Tobago-based Shaz Hudson, whose reaction to news of the legislation was:
we need to move with the times
And indeed, other jurisdictions are definitely taking notice. Trinidad and Tobago News Blog reported:
With Caribbean neighbour Jamaica making moves to decriminalise marijuana, University of the West Indies (UWI) Professor Emeritus Kenneth Ramchand is renewing his calls for marijuana to be decriminalised in Trinidad and Tobago for medicinal purposes [...] and pointed to a good argument for decriminalising for personal use in limited quantities.
Rhisona Cambell, continuing her post, noted:
St. Lucia, Trinidad & Tobago and Antigua all have leaders who have addressed the topic. They acknowledged at CARICOM meetings that Jamaica is a leader in this area and are watching to see how they can make similar legislative moves in their own respective countries. Perhaps this is the type of peer pressure that Jamaica needs in order to make the right moves to turn marijuana from a proverbial villain, to an economic friend.
Rising to new heights

Time will tell whether or not Jamaica has started the ball rolling in terms of the legalisation of marijuana in the Caribbean, but satirical blog The Late O'Clock News, which positions itself as ‘the only legitimate news source in the Caribbean' thought it would help the process along:
Trinidad and Tobago will become the second, but more important country in the Caribbean to legalize the growth, sale and lighting up of marijuana. The ‘Just Gimme D Light and Pass the Dro’ Bill of 2015 is hoped to be passed unanimously in the House of Representatives [in] April this year [...]

In between puffs the Minister stated ‘Of course we weren’t going to let Jamaica show us up like that. T&T has always been a leader in the Caribbean, and anything Jamaica can do we can do better!’

Prime Minister Kamla Persad-Biessessar took full credit for the landmark legislation. During a press conference at the Diplomatic Centre the PM proudly proclaimed ‘I have always promised that your government would take our country to new heights but few predicted how high we aspire to be!’
The blog also humorously anticipated a ‘munchies'-related economic boom:
Many local businessmen in the food service industry (chiefly doubles and corn soup vendors) are looking forward to a sudden and rapid increase in revenue after the bill passes in Parliament. As one vendor in Arima said: ‘To put it bluntly, we go have reelll [real] people to feed cuz men will be coming out like mad to satisfy some food cravings. Trust I.’
Currently, the new law is generating a lot of ideas, from groups proposing a ‘Ganja Cooperative’ of Jamaican weed farmers, to marijuana aficionados imagining the future of pot tourism in the region.


Reprinted with permission from Global Voices.

Narco Terrorists Now Using Drones To Bring Drugs Into US: Drone Crashes With 6 Pounds of Cyrstal Meth Near Border

Screen capture from CNN video.
By Nick Valencia
A smuggler's drone flying from Mexico crash-landed just south of the U.S. border city of San Ysidro, California, in a failed drug delivery this week, the Tijuana Municipal Police said.

The incident showed that smugglers aren't just going underground any more, using tunnels beneath the U.S.-Mexico border to transport drugs and migrants.

Now the smugglers are trying to do business by air, too, in unmanned aerial vehicles.

The drone was loaded with more than 6 pounds of the synthetic drug crystal meth, Tijuana police said.
RELATED STORY: Mexican Cartels Are Worse Than ISIS — Big Media Hides This -- To Demonize Muslims And Coverup What's Happening On America's Border
The drone crashed Tuesday night in a supermarket parking lot in Tijuana.

Apparently the smugglers became too greedy, authorities said.

The silver and black, six-propeller Spreading Wings S900 model was not able to withstand the weight of the load and crashed, police said.

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The CIA and Drugs, Inc: A Covert History — Drug Trafficking as Strategic Intelligence

The fact of the matter is that the US government has always managed large portions of the illicit, international drug business, and was doing so long before the CIA came into existence.



The US Government:

The Greatest Drug Dealer on Earth?



By Doug Valentine
Gary Webb was a good investigator. He linked a drug dealer in Los Angeles, through Contra suppliers, to CIA officers and Republican politicians. His editor let the story rip, and the “Dark Alliance” series made a mighty impact on Black Americans, who saw it as evidence that the ruling class was as racist as ever.

Webb stuck a stake in the evil heart of the national security state and embarrassed the CIA’s contacts in the mainstream media. All of which was unforgiveable. Pressure was applied, history re-written, and Webb, in despair, apparently committed suicide.

The irony, of course, is that Webb had exposed only a small part of the story. The fact of the matter is that the US government has always managed large portions of the illicit, international drug business, and was doing so long before the CIA came into existence.

Documented cases abound, like the Opium Scandal of 1927, in which a “former” US Attorney in Shanghai provided a Chinese warlord with 6500 Mausers in exchange for $500,000 worth of opium.

Two years later, US Customs inspectors found a huge quantity of opium, heroin, and morphine in the luggage of Mrs. Kao, the wife of a Nationalist Chinese official in San Francisco. At which point Secretary of State Henry L. Stimson hustled Chiang Kai-shek’s ring of drug dealing diplomats out of the country.

The State Department likewise protected a ring of drug smugglers in 1934, and thus allowed heroin to pour into New Orleans. Two historians said about the Honduran Drugs-For-Guns case: “the defense of the Western hemisphere against the Axis powers…reduced to insignificance clandestine attempts to link the managerial personnel of a major cargo airline to smuggling.”

As it was in the beginning, it is now and ever shall be: the ruling class’s power resides in its control of the criminal underworld; and since 1947, it has been the CIA’s job to advance and protect the conspiracy.

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Criminalizing A Generation: Anti-Marijuana Movement is Funded by Private Prisons, Law Enforcement, Big Pharma and Alcoholic Beverage Companies

Photo by Hammerin Man.
Photo by Hammerin Man.
By Noel Brinkerhof
Legalized marijuana may have taken root in Colorado and Washington, but that doesn’t mean it has to spread to other parts of the country, as far as a bevy of special interests are concerned.

Some of the most lucrative and powerful industries in America oppose marijuana decriminalization because it threatens their financial bottom-line or jobs for their workers. Five different interest groups form the backbone of the anti-pot campaign, according to OpenSecrets.org, which tracks political spending.

First, there’s the spirits, wine and beer companies. Legalized marijuana represents a direct threat to this industry’s business model. The more people can legally smoke a bud, the less need they’ll have to buy a Bud. Four years ago, the California Beer and Beverage Distributors contributed $10,000 to help defeat California’s Proposition 19, which sought to legalize recreational marijuana in the state.

Law enforcement groups also want to maintain criminal penalties for pot possession. If the country stops waging its war on drugs, including marijuana, fewer government dollars will flow to police efforts to address this public policy issue. Municipalities will also receive less money from property seized in drug raids.

Others in the criminal justice world that want to keep the status quo of locking up marijuana offenders are private prison operators and prison guard unions. States that legalize marijuana use are likely to experience a decline in prison populations—and that will reduce the need for government to hire private prison companies and correctional officers.

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Big Pharma Accused of Fraudulently Pushing Painkillers to "A Population of Addicts"

Photo by Patrick Strandberg.
Photo by Patrick Strandberg.
By GottaLaff
Big Pharma is pushing deadly drugs and addicting my home state of California. Allegedly. Painkillers like OxyContin are involved in more than 16,000 deaths every year. Traffic accidents are now taking a back seat to meds when it comes to causes of deaths.  Per an article in the Los Angeles Times, two counties are now suing drugmakers for violating California laws against false advertising, unfair business practices and creating a public nuisance.

Big Pharma encourages patients, including veterans and the elderly, to request painkillers when they have everyday headaches, arthritis and back pain. Allegedly. The reason the headline includes the phrase "population of addicts" is that heroin use has also increased as a result of all the prescriptions, because it not only creates a similar high, but it's also cheaper, per the lawsuit.

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Ex-Navy Seal Caught With Bricks of Cocaine in Miami — Admits To Drug Smuggling: Arrested Christmas 2013 — Info Hidden Until May 3, 2014

il
cbp.gov.


The cocaine smuggling ex-Navy Seal was arrested on Christmas Eve, 2013. But news of his arrest was not released until May 3, 2014.

By Richard Webster
Angel Martinez-Ramos, a Navy SEAL who served in active duty from 1999 – 2010, was busted on Christmas Eve 2013 along with his wife, Bibiana Marcela Lopez-Correa, attempting to smuggle 10 kilograms of cocaine into the U.S. from Aruba. The news of their arrests and the fact that Martinez-Ramos eventually pleaded guilty to conspiring to smuggle drugs into the U.S. was just released on May 3.

ABC News reported yesterday that Martinez-Ramos worked throughout Central and South America on official Navy business and was arrested in Miami trying to slip those 10 bricks of cocaine into the U.S. DEA agents working in Columbia were already on to the smuggling operation and identified Martinez-Ramos as a suspect in the next shipment of drugs to be brought through...



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Biggest Drug Problem Not Crack or Heroin of Inner Cities — It's Drugs Provided To People Who Can Afford Doctors Who Write Prescriptions

Drug use in the United States
Substance Abuse and Mental Health Services Administration

By
The abuse of heroin in America has gotten a lot of attention lately, but there's another type of drug that is abused far more widely and kills more people than heroin and cocaine combined: prescription pills.

According to a 2012 Substance Abuse and Mental Health Services Administration survey, prescription drugs were the second-most abused substance behind marijuana. Cocaine, hallucinogens, and inhalants were also more commonly used than heroin.


This chart shows illicit drug use among people ages 12 and older in the month before the survey:

Drug use in the United States
Substance Abuse and Mental Health Services Administration

As the chart illustrates, prescription pills greatly outstrip heroin in terms of raw numbers — 6.8 million people abused prescription pills over the course of one month, while only about 300,000 used heroin. Politicians and drug officials have called heroin use an "epidemic," but there isn't any recent national data that backs up that language. In fact, the Centers for Disease Control and Prevention doesn't consider heroin use to be at epidemic levels yet, a spokesperson told Fusion just last month.

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Doctors Un-Masked: As Implementation of Full Disclosure Nears - Doctors' Cash from Drug Companies Plummets

"Doctor Payoffs" (Illustration by Mike Licht)
"Doctor Payoffs" (Illustration by Mike Licht)
By Charles Ornstein, Eric Sagara and Ryann Grochowski Jones
Some of the nation's largest pharmaceutical companies have slashed payments to health professionals for promotional speeches amid heightened public scrutiny of such spending, a new ProPublica analysis shows.

Eli Lilly and Co.'s payments to speakers dropped by 55 percent, from $47.9 million in 2011 to $21.6 million in 2012.

What the New 2018Collaborative Media' Can Mean
Our Dollars for Docs Database We compiled two million records from all the companies that have disclosed their payments to doctors so far. Search for your physician.
Pfizer's speaking payments fell 62 percent over the same period, from nearly $22 million to $8.3 million.

And Novartis, the largest U.S. drug maker as measured by 2012 sales, spent 40 percent less on speakers that year than it did between October 2010 and September 2011, reducing payments from $24.8 million to $14.8 million.

The sharp declines coincide with increased attention from regulators, academic institutions and the public to pharmaceutical company marketing practices. A number of companies have settled federal whistleblower lawsuits in recent years that accused them of improperly marketing their drugs.

In addition, the Physician Payment Sunshine Act, a part of the 2010 health reform law, will soon require all pharmaceutical and medical device companies to publicly report payments to physicians. The first disclosures required under the act are expected in September and will cover the period of August to December 2013.

Within the industry, some companies are reevaluating the role of physician speakers in their marketing repertoire. GlaxoSmithKline announced in December that it would stop paying doctors to speak on behalf of its drugs. Its speaking tab plummeted from $24 million in 2011 to $9.3 million in 2012.

Not all companies have cut speaker payments: Johnson and Johnson increased such spending by 17 percent from 2011 to 2012; AstraZeneca's payments stayed about flat in 2012 after a steep decline the previous year.

ProPublica has been tracking publicly reported payments by drug companies since 2010 as part of its Dollars for Docs project. Users can search for their doctors to see if they have received compensation from the 15 companies that make such information available online. (We've just updated our application to include payments made through the end of 2012, totaling $2.5 billion. Forest Labs, which only began reporting in 2012, reported speaking payments of $40 million, more than any other company in Dollars for Docs.)

Some companies in the database said their declines have less to do with the Sunshine Act and more to do with the loss of patent protection for key products. Lilly, for example, began facing generic competition to its blockbuster antipsychotic Zyprexa in late 2011. Its antidepressant Cymbalta lost its patent at the end of 2013.

"The value of educational programs tends to be higher when we're launching a new medicine or we have new clinical data/new indication," Lilly spokesman J. Scott MacGregor said in an email, adding that the drop in speaking payments also reflects the increased use of web conferencing.

Pfizer's patent on Lipitor, its top-selling cholesterol drug, expired in 2011.

"Like any other company, our business practices must adapt to the changing nature of our product portfolio, based in part on products going off patent and new products being introduced into the market," company spokesman Dean Mastrojohn said in an email.

Novartis' patent for its breast cancer drug Femara expired in 2011, its hypertension drug Diovan in 2012 and its cancer drug Zometa in 2013. In a statement, Novartis said that speaking payments dropped in 2012, in part, because of a shift from big blockbuster drugs that many doctors prescribe toward specialty products prescribed by fewer physicians. Resources were also shifted "to support potential future product launches."

The industry's increased emphasis on expensive specialty medications for such conditions as multiple sclerosis or Hepatitis C, has been striking, said Aaron Kesselheim, an assistant professor of medicine at Harvard Medical School. A piece in the New England Journal of Medicine last week noted that half of the 139 drugs approved by the Food and Drug Administration since 2009 were for rare diseases and cancers.

"It's possible the number of physicians they need to support sales of these items is less, leading to lower payments overall," Kesselheim said.

In some cases, companies maintained or made smaller cuts to other forms of physician compensation while pulling back dramatically on speaking payments. Pfizer's spending on consultants dropped 9 percent from 2011 to 2012, far less than its payments to speakers. The company's spending on research stayed essentially the same.

Lilly increased spending on physician researchers by more than 20 percent, while reducing payments to consultants by more than two-thirds.

Many bioethicists and leaders of major academic medical centers frown upon physicians delivering promotional talks for drug companies, saying they turn doctors into sales representatives rather than leaders in research and patient care.

Officials with the Pharmaceutical Research and Manufacturers of America, the industry trade group, dispute this characterization. They said they are working with their member companies to prepare for the Sunshine Act and have created a campaign to promote the value of drug company-doctor collaborations.

"Companies will make their own independent decisions about how to engage professionals," said Kendra Martello, PhRMA's deputy vice president of strategic operations.

Scott Liebman, an attorney who advises pharmaceutical companies on the Sunshine Act, said it's too early to know how much the law's requirements are affecting company practices, in part because it's so new. The fact that some companies are cutting back on speaking while preserving their spending on research and consulting suggests that other business forces could be at play, he added.

"It's very hard to pinpoint exactly why that's happening," Liebman said. "I think there's a lot of potential answers to that. I just don't know which is the right one."



Reprinted with permission from ProPublica

New Mass Graves in Mexico Dredge Up Plight of Missing: At Least 54 Bodies Found - 'National Emergeny' Compared to Balkan Wars

New mass graves in Mexico dredge up plight of missing (via AFP)
Amid Mexico's continuous drug conflict, the recent discovery of dozens of bodies in mass graves has led some to describe the plight of the country's disappeared as a national emergency. At least 54 corpses have been recovered in clandestine pits in…

Tea Party Congressman Who Called Himself the 'Hip Hop Conservative': Busted for Cocaine - His 'Dealer' Snitched

The freshman Congressman (Republican, FL), said he was a fan of ERIC B and BIG DADDY KANE. He said he liked PUBLIC ENEMY in particular because some of their raps had "a conservative message."


US congressman Radel arrested for cocaine possession (via AFP)
First-term US congressman Trey Radel of Florida has been arrested for possession of cocaine, court documents showed Tuesday. A form filed with Washington DC Superior Court says Radel, a 37-year-old Republican, will be arraigned Wednesday on misdemeanor…

A Living Death: Life Without Parole for Nonviolent Offenses

Extreme Sentencing: The "New Normal?" - An ACLU Report

"Of the 3,278 prisoners doing life for nonviolent crimes, 63% were sentenced by federal courts; the rest are in nine state prison systems. Click here to meet some of the individual prisoners waiting to die behind bars and see where they’re serving time. These accounts include interviews with prisoners' parents, children, and spouses who have been punished emotionally and economically by their loved ones’ permanent absence." —American Civil Liberties Union.

Illustration: Prison Industrial Complex
Prison Industrial Complex
(Illustration: Natasha Mayers)

By Vanita Gupta, Center for Justice & Chloe Cockburn, Advocacy and Policy Counsel, ACLU  
It should outrage us that a homeless man will be in prison for the rest of his life because he was the middleman in the sale of $10 worth of marijuana. We can all pretty much agree that the punishment of growing old and dying behind bars for such offenses is a wildly extreme, tragic and wasteful overreaction to the crime.

But it should not surprise us. Cases like this man's are just the tip of the iceberg.

Hundreds of thousands of people in American prisons are serving decades-long sentences that are far out of proportion to their crimes. They comprise an increasingly aging prison population that costs more and more to maintain as their health deteriorates, increasingly strapping state budgets. In many cases, the person incarcerated could have been effectively held accountable in the community with no prison time at all. In other more serious cases where incarceration may be warranted, the person incarcerated could successfully return to the community after a much shorter time in prison, especially if job training and education were available to ease reentry. But this is not the norm.

Instead, in jurisdictions all around the country, incarceration has been touted as the solution to scores of problems it is ill equipped to address, pushing the number of people in jail and prison to over 2.3 million people. That's more than the number of people living in New Mexico.

READ MORE...

Check out the complete report: Here

Check out the interactive story map "Map: A Living Death"

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