Tag Archives: generic medication

Mental health or Medication

We have seen the premise in a few stages in the last decade and for the most people lean towards one or the other and that is fine, it is a hard choice to make and there is no real evidence which of the two is better in the long run. Mental health needs treatment, medication is at times not a cure, merely a way to create a timeline for treatment, or to minimise the impact of the situation. Yet there is also a medial state that is not mental health based, for example treating people with cystic fibrosis who have two copies of the F508del mutation, for them there is Orkambi. Yet, what is the status when this involves a politician? How delusional is a public speaker allowed to become before he is considered unhealthy and unable to perform his function?

That question came up when the Guardian gave me ‘Labour pledges to break patents and offer latest drugs on NHS‘ (at https://www.theguardian.com/politics/2019/sep/24/labour-pledges-to-break-patents-and-offer-latest-drugs-on-nhs). So not only is he making claims, he is basically pronouncing war on the World Trade Organisation, abolishing the TRIPS agreement and throwing it all overboard. As we realise that the World Health Organisation gives us: “As of February 2005, 148 countries are Members of the WTO. In becoming Members of the WTO, countries undertake to adhere to the 18 specific agreements annexed to the Agreement establishing the WTO. They cannot choose to be party to some agreements but not others“, the UK and the EU are both signatories, so Jeremy Corbyn is stupid enough to set a stage of war that endangers millions. To give a little consideration to the metrics, we get the numbers on Cystic Fibrosis, not merely those with these two mutations (a specific subset), we see that more than 70,000 people worldwide are living with cystic fibrosis. Approximately 1,000 new cases of CF are diagnosed each year. More than 75 percent of people with CF are diagnosed by age 2. More than half of the CF population is age 18 or older. Now this is not a good thing, we admit, yet we are looking to a population that is less than 0.001% of the entire population, more important the people that need Orkambi are a mere subset of that. And for the UK it would linearly mean that it affects only 0.1% of the 0.001% that optionally have it. That is his ‘limelight’; can someone please kick this idiot out of the Labour party (preferably out of UK politics altogether)?

And in the second part, no political party has any business being in the pharmaceutical industry, there is a reason why industrials should never have any political power (well, we lost that one ages ago, but still). His voice giving us: ‘party will create company to make cheap versions of drugs‘, whilst the metrics give us that it will be a population less than a 100 that have this version of Cystic Fibrosis that is what he is fighting for? He cannot even properly represent his constituency and now he is starting patent wars as well as a war with the World Trade Organisation on abolishing or severely changing The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS)? Not only does it not make sense, the impact could be devastating for the UK. This is a person screaming ‘election’ and then spinning silent when it was offered.

It is my personal view that UK labour is better off getting the clown Ronald McDonald to do the Labour party bidding, and it will do a better job than Jeremy Corbyn ever could. His promises are no longer empty, they are now right-out dangerous.

Pharmaceuticals

There is a larger pharmaceutical issue and it has been going on for well over a decade, the issue that patents are reapplied well over 30 years after date, often in a slightly changed form, only barely passing the innovation line is the largest concern for generic medication, yet there are dozens of examples and Orkambi is nowhere near the top 10 in this. Lyrica (Pfizer), Rituxan (roche), Cialis (Eli Lilly), Xolair (Roche/Novartis), Restatis (Allergan) are 5 of the top 10 expiring patents with a value of a little over $16 billion in total, and those owners would like a little longer exclusivity, because the expiration will hit their bottom line in a real hard way. In that list Orkambi does not even stack up to any decent degree and we have larger issues gaining patents with a generic option and Corbyn’s need to make war with TRIPS, whilst the NHS has larger issues, especially as it was Labour who botched the NHS IT project losing £11 billion and small change to the degree of several millions is not one who should be casting voices on ending patents.

The sentiment is not wrong, but the chosen field is a little beyond stupid, making us wonder whether the man is personally dealing with mental health issues. We all have had that moment where we wanted to stand in front of Dwayne Johnson calling him Tinkerbell, not really wise, but we all have those inflated moments of self, to do what Jeremy Corbyn does worse hiding behind one 9 year old with: “Luis is denied the medicine he needs because its American manufacturer refuses to sell the drug to the NHS for an affordable price“, so this is not some Cystic Fibrosis case, this is a very specific case and the medication required many millions to create and pass FDA approval. A medication for CF patients with a rare mutation. With two specific mutations in a disease that knows more than 1,700 mutations that had been found in the CFTR gene. Orkambi works for patients with the F508del mutation in both copies the CFTR gene, the most common mutation in people with cystic fibrosis worldwide. So even if it is the most common, there are 1700 mutations meaning that his war on one medication to a specific subset that comes down to a lot less than 100 patients in the UK. So this idiot (read: Jeremy Corbyn) goes to war, promising to abolish TRIPS and leaving the WTO, all for a subset of people, too small to fill a village? Now consider that the UK has Pharmaceutical interests as well, the top two players in the UK are GlaxoSmithKline and AstraZeneca representing almost £132 billion pounds, because if he does what he does, then those two will vacate as well, this is how stupid Jeremy Corbyn is, but he is hoping that you will not notice this as he is in feigned tears for one nine year old child. I only mentioned the top two, the field is larger than that, but Jeremy Corbyn is willing to throw it all in the air.

Can you please explain to me how the government budget will be met when two companies representing a taxable £100,000,000,000 leave the UK? This is the kind of short-sighted, BS carrying ventures that Jeremy Corbyn is handing its constituents. His claim is ‘In England about 5,000 young patients could benefit, but the NHS said it could not afford to pay the bill‘, if there are worldwide 70,000 Cystic Fibrosis (CF) patients the UK cannot have that many, the claim of “US drugs company Vertex priced Orkambi at over £100,000 per patient per year” might be true and for 100 patients that is still serious money, but we need to recognise that we cannot hand every working person a Ferrari, we do not have the money, and it is that extreme. We are in a position where until a patent ends, the maker gets to set the price, or not sell the product. In light of the numbers I see, I want Jeremy Corbyn to give us an exact list of these 5,000 patients and what medication they need. I reckon that the picture shifts a lot faster at that point. And we agree that larger changes are required, yet making a direct case to the WTO that patents cannot be extended above the 35 years is a lot better than abolishing the WTO. Yet Jeremy Corbyn has no options to do that, so he comes with a delusional plan to start a company that ‘create company to make cheap versions of drugs‘, whilst there are plenty of companies doing that, the case remains that patents hand exclusivity until they expire, this year 26 drugs are facing patent expiration and yet, Orkambi is not among them, but 26 patents will become generic, before 2022 42 patents will expire and that is good for a lot of people, yet this system is already in place, we do not need some delusional politician to add his need to become a rich pharmaceutical cat as well.

To be honest, I have never had such a low regard of UK Labour ever before, the fact that I have twice the regard towards LibDems than towards Labour at present is something I never thought possible in the age of Ed Miliband, whomever thought that Corbyn would be a worthy successor deserved the title ‘Joker of the Year‘, as I personally see it, it is actually that bad at present.

So whomever is happy that this optional mental health case is running the UK labour party is in desperate need of some medication (generic NHS funded options will be available).

 

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The UK NHS is fine

This is the view that some seem to impair on the Britons. When we look at the article (at http://www.bbc.com/news/health-37331350), “Seven-day NHS ‘impossible under current funding levels’“, we see that there is an initial massive problem. I have no reason to doubt any of this, yet consider the issues in play. The Guardian gave us “Jeremy Corbyn has urged his supporters to campaign for jobs and the NHS once the current leadership battle is over. A year and a day after he was first elected as leader, Labour’s leader told a rally in Brighton that whatever the result, he hoped that they would join with him to convince the rest of Britain to join in a quest for a fairer society“, this is just a from one article. Yet, when we look a little further we get the Canary, which gives us “All the time I’ve been in parliament, I’ve been opposed to privatisation of the NHS and I voted against it with colleagues in the Parliamentary Labour Party over many years because we wanted to see a fully-funded, public, National Health Service. The Tories have sought to privatise it. A Labour government will have to take the whole NHS into public ownership and make sure it remains there. The next Labour government will go further than reversing Tory cuts. We intend to deliver a modern health and social care policy, fully publicly provided, and fully publicly funded, by integrating health and social care into a single system, so that everyone gets the care they need when they need it.” (at http://www.thecanary.co/2016/09/05/jeremy-corbyn-lays-out-his-plan-for-the-nhs-in-under-a-minute/). You see, we all want that, the Conservatives are not against it, the government just cannot afford it such a solution. When you take the government Credit Card and spend over a trillion pounds. Under Labour the debt went from less than 400 million to well over a trillion. Even though 2004 did not hit the UK as hard as other places, Labour should have changed their approach to budgets by a lot, then in 2008 there would have been no option but to radically implement austerity measures. This was never done the way it required to be. The people were told these overly optimistic views, mainly, as I personally see it to let money roll. In December 2007, the 2008 forecast was between 1% and 1.3%, The European Commission in 2008 was “In summary, growth in the UK economy is expected to slow to around 1¾% in 2008. In 2009, with no large carryover effect from 2008, the gradual recovery in domestic demand through the year will bring annual growth to just over 1½%“. Yet, when we see the BBC report (not forecasting) at http://news.bbc.co.uk/2/hi/business/8479639.stm, we see that 2008 went per quarter from +0.6% to -1.7% in 2009 it grew from -2.5% to 0.1%. So at no point was any forecast ever met. This is something that has been going on for over a decade. Not just the UK mind you, the EU as a whole is playing that same managed bad news cycle that starts with overinflated positivity whilst those behind this game are delusional beyond belief. Until a massive change is made in the approach business and politicians are taking to blow up the governmental credit card. This relates to Jeremy Corbyn because unless the man was lobotomised in 2001, he should know better. Under Labour governance, the debt went up by a little over 600 billion pounds. Did they not consider the consequences? Overspending year after year, followed by managed bad news is not a solution. It never was and any politicians voicing that it could should be barred from public office for life! (Again, this applies to both sides of the political isle). That simple realisation is all UKIP needed and the mistakes made today and the symbiotic relationship of required spending between business and government needs to come to an end. In this coming decade we need actual solutions, an actual path to restore the pushed imbalance of Wall Street status quo pushed us all towards. So until we all realise that, the NHS is fine, because soon many people will have too many additional problems and the NHS will not show up on their radar. That is my prediction if the current wave of weighted misinformation continues.

So the NHS is fine according to those who needs funds to the directions they desire. You see, here we get confronted with the reality that the Conservatives are dealing with. Do you actually think that the quote “Prime minister declines to guarantee points-based system and extra £100m a week for health service“, the reality of a budget is that money runs out. It did 2 years ago and solutions need to be found. I personally, as a conservative would have preferred that the NHS was higher on the list. Yet, reality got in the way here too. The UK got into Brexit and we all knew that there would be consequences even though realistically the extent would never be a given. In that regard, the issues that Japanese PM Shinzo Abe raised might be regarded as a joke. My reasoning here is that the quote “Countries such as Japan have already warned the UK that a lack of clarity about Brexit and loss of the benefits that access to the single market brings could lead” brought. So this PM is crying on the UK doorstep whilst he should have asked President of the European Union Donald Tusk. No, he wants to know this from the UK, which in my view makes him sound more like a servant of the Washington Oval Office than the PM of Japan he is supposed to be. In addition, is it not interesting that an organisation like the EU has nothing in place regarding the notion a leaving nation will have as an impact of its structure? All this reflects back to the NHS, because as we see more and more political bashing from the people who are now finally realising that their Gravy Train is about to stop and that their cushy incomes based upon virtual works and situations will not continue, now they all come up into the light to push people into continuing disaster that could soon be the former EU.

This all relates to the NHS, because it will impact the NHS. I am not pushing for the entire Junior Doctor Contracts. Whatever the stance is there, the truth is that a pilot strike for better conditions would be the same, the airline would be put under pressure, but the airline would continue. With the NHS it is not that simple and the impact could be harder, yet the people have a right to stand up what they consider to be their right. Yet in all this people are very easy to ignore that the government has been giving into pharmaceutical companies not just the TTIP and in that regard they did not take a tougher stance on those pharmaceutical parts, opening stronger ties with India and the essential need for Generic medical solutions (where applicable), because that also impacts the NHS, lower costs for medications means more for staff, equipment and location. We all accept that the NHS needs solutions and so far there is a lack of actual actions that are leading to longer term solutions.

Yet we need to see that Labour isn’t the only lose screw on the political bench, Tim Farron from the Liberal Democrats are on the same foot. I gave my answer earlier. Unless the UK can get the budgets truly under control and until massive changes are implemented that will allow for better budgeting, the NHS would stop because business people want profit through privatisation and too many people are wasting the true future options of Britons through misrepresentation of forecasts. If you think that this is off? That forecasting is too complex, which can be concurred by many including me to some extent, it is not the case to the extent that we saw for too long a time. I discussed part of this in ‘A noun of non-profit‘ (at https://lawlordtobe.com/2013/05/15/a-noun-of-non-profit/), in addition there is ‘Cooking the books?‘ (at https://lawlordtobe.com/2014/01/22/cooking-the-books/) where I proved some of these points and showed the danger. So basically, the predictions I made in January 2014 are now showing to be correct. So as people are looking at a way for the government to spend more money and show cooked forecasts, consider the next time this is done and the austerities that will then follow., We can no longer continue this irresponsible push for unrealistic solutions that do not lead anywhere and takes us to look away from the solutions that actually need solving. The NHS needs solving and it needs it now.

There is no debate about the NHS and privatisation. Everyone would happily get rid of the idea if there was money to do that. I am not mentioning the aging population, because that has been known for a very long time and we can only partially blame the economic crash, because that hit everyone square in the face. So when I read the LibDems demanding the end of playing politics, whilst they are sitting next to Labour doing just that, we have to wonder where they got their view from. The independent reported only 3 days ago. The article (at http://www.independent.co.uk/news/uk/lib-dems-demand-end-to-playing-politics-with-the-nhs-a7315236.html) gives a few quotes on that matter. “Mr Lamb has also launched a consultation on the introduction of a NHS specific income tax, which would ring fence a possible one pence per pound earned for the NHS budget, and appear on people’s payslips as such“, that is an optional solution. You see, this was introduced within the Netherlands decades ago and it solved plenty of issues. It is hard to talk about taxing this, but consider that the NHS will be short by 6 billion in the near future is at the heart of the issue. Consider that from your pay check, the government takes an additional £2 a week. Now consider the working population of 31 million people meaning that we have an optional 62 million pounds at our disposal, money that is destined exclusively for the NHS. Now, do not think for a moment that this will be temporary. There is the realistic consideration that this will be for all time, giving us two groups of people, those entitled to full health care and those with the minimum package. Now, retired people would get full health care on principle that they paid their dues a long time ago. There is every chance that people will not feel happy regarding this solution, but what options are left. The irresponsible ones seem to think that it will fit in the budget, especially those who haven’t been able to keep one since 1997. In this solution I feel decently comfortable with the solution that is consulted on by Liberal Democrat health spokesperson Norman Lamb. For one, I have seen this work in the Netherlands. In addition his version of “introduction of a NHS specific income tax, which would ring fence a possible one pence per pound earned for the NHS budget” sounds better than my £2 a week on small incomes. On the other hand, if we consider the minimum income of £286.54 per week, my amount sounded a little better, but we cannot deny the minimum £2.86 a week could solve nearly all options over time. It gets even better when we see that the average is £403.36 per week, so we are looking at a possible £120 million per week. I do believe that there should be an upper limit, yet where that ends is something that cannot be answered at this time. What is important is to seriously start taking up the ideas out there and see which one could lead to pressure release on the NHS, because at this point, every day not acted is another nail in the coffin that will be used soon enough to bury a past NHS era.

 

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The Illusion of control

It is three days after writing ‘Concerning the Commonwealth!‘, I stand by my piece. I think that the Commonwealth is facing increasing issues all over the field and as the numbers go up and up and up, healthcare will take a centre seat in a diminishing population of workers, which by the way include issues that will hit Australian shores too. Today (at http://news.sky.com/story/1287088/government-has-lost-control-of-the-nhs) we get to see more about the NHS, the mention of a 3 billion pound fiasco, which gets attached to the name Andrew Lansley, who is currently Leader of the House of Commons. He is also behind the Health and Social Care Act 2012, which is regarded to be highly controversial. However, before we go into any controversial parts, try finding a document called ‘ABPI UK NHS medicines bill projection 2012 – 2015‘, it is a PDF file (the Google link was too messy). There is a massive revelation on page 5, which diminishes a bible chapter with a similar name to a mere Paddington bear story.

As we ignore earlier mentions of a shake-up gone awry at 3 billion and mentions of an IT structure at the price of 10 billion that never worked, here we see that over the term 2013-2015 the use of brands go up from 14.2 to 15.5 billion, yet generic medication needs only rises from 3.2 to 3.9 billion. The interesting part is that even though there is still a brand growth, the bio-similar mention (generics) go up from 134 to 328, so there is more than 100% growth in change to generic medication, whilst the cost is still growing steadily on both sides (generic versus brands), what would the brand side have done if the generic side did not exist?

Three days ago I was extremely outspoken in regards to the need to get the NHS costs down. It seems that the search for generic alternatives is taking a backseat to other options. In an age of finding ways to make ends meet, the Health and Social Care Act 2012 has no space reserved in regards to the need for a stronger presence of generic medication.

When we look at:

233 General duties
(1) In exercising its functions NICE must have regard to—
               (a) the broad balance between the benefits and costs of the provision of health services or of social care in
               England,
               (b) the degree of need of persons for health services or social care in England, and
               (c) the desirability of promoting innovation in the provision of health services or of social care in England.

Why was the following not added?

                (d) the choice of generic medication where possibility for a responsible health care alternative warrants it.

Now, I will be the first one to admit that my choice of words is not the best one, but it seems where it is known that generic medication is such an important part for the survival of the NHS, that no mention at all (as far as I could tell) seems to raise a few more questions. Key message 4 on page 11 of the PDF shows exactly the part that matters: “Nine of the current top 20 selling brands lose patent exclusivity between 2012 and 2015” and when we consider the growth through bio-similars, we see that the right path seems to be taken as we read the numbers from the office of health economics. So, there is a path to better growth through managed costs (to some degree), the question becomes, why is this report quoting Jane Ellison as secretly taped? More important, why is Sky News not giving proper light to the NHS issues as they are (to a small extent) resolved? Why are they not taking a look a Professor Adrian Towse, Jon Sussex, Lesley Cockcroft or Martina Garau. I would think that the latter two as statistician and economist might be able to light a candle in the tunnel of ambiguous ‘tell tailing’ darkness ‘some’ are sailing.

None of these matters are coming to light at any stage. Even the Guardian on April fool’s day, did little more then http://www.theguardian.com/society/2014/apr/01/health-service-biggest-challenge-history-nhs-boss. I will admit that the article of the Guardian was decent, yet the quote “the NHS is facing a perfect storm of rising demand, funding pressures and worryingly low staff morale“, no matter how true, seems to be about the hardships (which remain true). Yet the information that the Office of health economics seem to have is escaping these Journo’s of bad news writings. Slide 13 of the initial PDF shows an even stronger view on how the UK is getting by, whilst the US is facing an overall hike from 176% to 281% compared to the UK index, Only Spain, Finland and France were barely better off. That part remains in question when we consider their population, if the results was correctly weighted (small oops on that slide), then the pressures for patent change from American shows just how desperate the American position is, which is shown even stronger on slide 6 when we see just how hard medication hits both Japan and USA as they spend well over 2% of GDP there, whilst the population of Japan is twice that of UK and the population of the USA is set at well over 400%. These slides will also leave is with other questions in several regards, yet the initial positive view is not reverberated over the press sites, or by the UK journalists. It seems to me that the information by certain newsgroups, especially in the LACKING sight on the importance of generic medication leaves us with questions. However, the Guardian was all over the business side of Pfizer trying to take over AstraZeneca. Did no one properly wonder why they were willing to dish over 69 billion? When did a US company EVER spend such an amount unless they knew that they would end up with double the amount? When we consider those events, we should wonder why the papers aren’t a lot more outspoken in regards to informing the public.

Even if this was all not true, don’t you think that the press would (should is a better word) have been all over the members of the Office of health economics I mentioned asking them the questions I am voicing and a few more after that? Is the silence of the press not deafening? The late April article in regards to Pfizer – Astranezeca headlines as ‘Pfizer refuses to guarantee UK jobs if AstraZeneca takeover goes through‘, which should make us wonder whether this is about income, jobs or patents. Would that takeover stopped any patents, or at least delayed them? If many patents have 1-2 years left, why pay that many billions, which information was kept hidden from us? It is the quote from Pfizer CEO Ian Read that states “The combination of Pfizer and AstraZeneca could further enhance the ability to create value for shareholders of both companies and bring an expanded portfolio of important treatments to patients.” This is a fair, honest (to some degree) and clear message. It is about the shareholders and the message that these billion will come back to ‘us’ and then some. This is clear business, I do not object, yet the overview for the UK? What will it cost them besides jobs? We saw little of that and the NHS has been played like a piñata donkey for a little too long. This is not me stating that the NHS is okay. Actually it is far from that, it is about getting the proper illumination on events, which does not seem to be happening either.

In the end, the quote in the Sky News article “A spokesman for the Department of Health told Sky News: ‘Giving operational control for the day-to-day running of services to doctors was the right decision but we’ve always been clear that ministers are responsible for the NHS’” might have been a correct one, the added information could have been a lot more insightful. When you Google ‘Office of health economics‘ you will not find any links to any newspaper, which is puzzling when you go to the Office of health economics and look at some of their publications. If I would add one more ‘light‘ remark then it would be that the members of the editorial and the policy board of the Office of health economics seem to have more degrees then a Kelvin scale, making them in my mind an essential source of health information for any journalist.

So where are these articles informing the public?

 

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