Atorvastatin, a.k.a Lipitor, is the best-selling drug in history. Annual sales are nearly $13B.
Lipitor is a great drug, and it probably saves a lot of lives. The patent expires next June, so expect to hear how a slightly reformulated Lipitor is actually much better for you over the next year.
Since I'm paying my own health insurance costs these days, I got quite the shock in January when I had to meet the deductible for my meds. For the first time in ten years of taking Lipitor, I actually tried to find out how much it cost.
Walgreens wasn't allowed to tell me how much it cost. But they wanted to! And since I already knew the scam, no harm was done.
You can look this up yourself, on drugstore.com. 100 Lipitor pills @ 20mg costs $415. Guess how much 100 pills @ 40mg costs? $415. And the 80mg? Yup, $415. I could have been saving about $1200/year by chopping 80mg pills into 10 or 20mg pills. (Since the half-life of atorvastatin is only about 24 hours, it would probably be a bad idea to take a larger dose every other day).
The kind folks at Walgreens pointed out that some insurance companies actually require their customers to get the higher dose pills and chop them up. But nobody designs a pill to be chopped into 8 pieces.
Pfizer considers chopping up the pills to be a form of 'cheating'. From their point of view (and I have some sympathy with it), they are renting you their intellectual property, and in a way that doesn't discriminate against people who need higher doses.
Understand, my complaint here isn't about Pfizer's pricing strategy. My complaint is that the vast majority of people taking Lipitor have no idea how wildly expensive it is, and that there's a simple way to cut the price down to a small fraction. Most of those people just don't care. And that is what is broken in the health care market. That simple problem explains most of the unsustainable rise in health care costs.
Now for the kicker... you can buy generic atorvastatin from overseas pharmacies for a fraction of the cost of Pfizer's product. A sample price - $75 for 100@20mg. That's actually less than my co-payment through my insurance company. Prices will plummet further by next year.
Friday, April 23, 2010
Thursday, April 22, 2010
Tea Party Freaks
I don't know anything about the Tea Party. Their website claims three tenets: Fiscal Responsibility, Limited Government, and Free Markets. As a libertarian, I couldn't be tickled any pinker by the idea that a huge movement has embraced half of my political ideology.
But everything I see in the news and on the net seems to be making fun of them, and some of this criticism is pretty ugly. I'm looking at you, John Stewart.
When I was involved with protesting Gulf War I, I spent a lot of time around protesters on the left. Yup, I was one of them. I was even kind of involved in organizing some of it. One of the things you could count on with any protest was the Freaks. We had some freaks. And it was a little annoying to me, since I wanted to get my freak on, but when a TV camera scans over you and your pals, the marijuana-leaf t-shirts, giant pink afros, conspiracy nuts, and wide-eyed crystal-worshiping space aliens, you can fall a little off message.
To combat this, at one protest (in front of an Orlando TV station, for sponsoring a "bring your kids to visit the Patriot Missile and crew" event...) I even wore a suit jacket and a tie.
I suspect there are a few suit-and-tie folks at the Tea Party protests wishing that the tiny fraction of 'birthers', racists, and red-baiting nutjobs would stop drawing attention away from their main point: that the government and the tax burden are growing unsustainably, and that a massive expansion in health care smack in the middle of the worst economic crisis in generations might not be the best idea.
Hey, you know how it makes you feel when someone calls you a 'socialist' for supporting health care reform? Yeah. That's how the tea party people probably feel when you portray them as illiterate racist rednecks.
But everything I see in the news and on the net seems to be making fun of them, and some of this criticism is pretty ugly. I'm looking at you, John Stewart.
When I was involved with protesting Gulf War I, I spent a lot of time around protesters on the left. Yup, I was one of them. I was even kind of involved in organizing some of it. One of the things you could count on with any protest was the Freaks. We had some freaks. And it was a little annoying to me, since I wanted to get my freak on, but when a TV camera scans over you and your pals, the marijuana-leaf t-shirts, giant pink afros, conspiracy nuts, and wide-eyed crystal-worshiping space aliens, you can fall a little off message.
To combat this, at one protest (in front of an Orlando TV station, for sponsoring a "bring your kids to visit the Patriot Missile and crew" event...) I even wore a suit jacket and a tie.
I suspect there are a few suit-and-tie folks at the Tea Party protests wishing that the tiny fraction of 'birthers', racists, and red-baiting nutjobs would stop drawing attention away from their main point: that the government and the tax burden are growing unsustainably, and that a massive expansion in health care smack in the middle of the worst economic crisis in generations might not be the best idea.
Hey, you know how it makes you feel when someone calls you a 'socialist' for supporting health care reform? Yeah. That's how the tea party people probably feel when you portray them as illiterate racist rednecks.
Wednesday, April 21, 2010
why you don't want network neutrality
It's nice to go down to the grocery store and buy a loaf of fancy whole-grain organic unbleached homeopathic artisan bread. But sitting a couple shelves lower is the wonder bread, at a fraction of the price.
Advocates of "network neutrality" want you to believe that wonder bread will kill you, and want to make everything but the fancy whole-grain bread illegal. That means fifth-grade kids will have to eat peanut butter and jelly sandwiches on 'ferrari bread'.
Let me explain the difference between the breads. See, about 90% of the bandwidth on a network like Comcast's is used by something like 1% of their customers. Those customers are almost certainly using bittorrent to exchange huge media files, much of it (though not all) illegal copying. The other 99% of customers are paying for all the extra infrastructure needed to support this.
Comcast (or any other high-speed ISP) would love to segregate those customers out, and offer a cheaper product to the masses. Right now they achieve this partially by filtering or slowing down the traffic used by the gluttons. But if 'network neutrality' laws are passed, Comcast won't have that option. They'll be forced to feed the gluttons from everyone else's wallet.
Yes, I hear ya. I know, yeah... big bad corporations are going to block protocols that they don't like. They'll likely censor data, spy on you, etc. They'll likely sell cheaper access to their networks to their corporate friends and co-sponsors. Oh, the horror. It might even one day lead to free network access for the non-porn-sharing majority.
My solution: let them. As long as you give me the choice to pick another provider, one that doesn't filter or tarpit my data, then I'm fine with it. I'll be happy to pay the premium.
What you should watch out for: when they make network neutrality illegal. When the government starts filtering or blocking anything that looks encrypted. Stop lobbying on Google's behalf, and lobby on your own: it's the government you need to fear, not 'corporations'. Because every Comcast will have an AT&T breathing down its neck. But there's only one Big Brother.
Advocates of "network neutrality" want you to believe that wonder bread will kill you, and want to make everything but the fancy whole-grain bread illegal. That means fifth-grade kids will have to eat peanut butter and jelly sandwiches on 'ferrari bread'.
Let me explain the difference between the breads. See, about 90% of the bandwidth on a network like Comcast's is used by something like 1% of their customers. Those customers are almost certainly using bittorrent to exchange huge media files, much of it (though not all) illegal copying. The other 99% of customers are paying for all the extra infrastructure needed to support this.
Comcast (or any other high-speed ISP) would love to segregate those customers out, and offer a cheaper product to the masses. Right now they achieve this partially by filtering or slowing down the traffic used by the gluttons. But if 'network neutrality' laws are passed, Comcast won't have that option. They'll be forced to feed the gluttons from everyone else's wallet.
Yes, I hear ya. I know, yeah... big bad corporations are going to block protocols that they don't like. They'll likely censor data, spy on you, etc. They'll likely sell cheaper access to their networks to their corporate friends and co-sponsors. Oh, the horror. It might even one day lead to free network access for the non-porn-sharing majority.
My solution: let them. As long as you give me the choice to pick another provider, one that doesn't filter or tarpit my data, then I'm fine with it. I'll be happy to pay the premium.
What you should watch out for: when they make network neutrality illegal. When the government starts filtering or blocking anything that looks encrypted. Stop lobbying on Google's behalf, and lobby on your own: it's the government you need to fear, not 'corporations'. Because every Comcast will have an AT&T breathing down its neck. But there's only one Big Brother.
Richard Dawkins in Hiding
Jul 7, 2011 (Reuters) Evolutionary Biologist Richard Dawkins has disappeared from public view after narrowly escaping an abduction attempt by members of the fanatical Teapot Church. Several of his speaking engagements have erupted in madness, when thousands of followers overwhelmed security, forcing the audience to flee. Earlier this year the religious group publicly declared Dawkins to be the "Second Coming", based on interpretations of biblical scripture and the writings of Nostradamus. According to his spokesman Robert Nearly, "Richard is quite terrified - he doesn't understand why a cult would choose one of the world's most outspoken atheists as their savior. He is baffled." Although many theories have been proposed, Dr. Ebenezer Grue, Professor of Religion at Cornell University, believes "this may have something to do with the Pope".
Wednesday, March 24, 2010
soldiers and drugs
The military is worried about all the drugs that soldiers are taking:
Abuse of pain pills by troops concerns Pentagon
Senator Jim Webb has made comparisons to his time in Vietnam, when soldiers were mostly getting hooked on heroin. Now it's prescription antidepressants and pain killers.
Your first reaction may be to wonder how things have changed... but I bet they haven't changed much at all. One of the things that most people don't know about the opiates - they are some of the best antidepressants known to man, even in this modern age of Prozac. They haven't been prescribed that way since the 1950's, because they're addictive (and somewhat dangerous).
Most likely war is a pretty depressing thing, and soldiers who can't get treatment one way will find it another way. So they take speed on the way in, and opiates on the way out.
Abuse of pain pills by troops concerns Pentagon
Senator Jim Webb has made comparisons to his time in Vietnam, when soldiers were mostly getting hooked on heroin. Now it's prescription antidepressants and pain killers.
Your first reaction may be to wonder how things have changed... but I bet they haven't changed much at all. One of the things that most people don't know about the opiates - they are some of the best antidepressants known to man, even in this modern age of Prozac. They haven't been prescribed that way since the 1950's, because they're addictive (and somewhat dangerous).
Most likely war is a pretty depressing thing, and soldiers who can't get treatment one way will find it another way. So they take speed on the way in, and opiates on the way out.
Tuesday, March 16, 2010
"Hurry up on healthy food"
The administration is telling manufacturers to hurry up and make food more "healthy". The hidden message with this sort of prodding is that if an industry doesn't move voluntarily, they'll sic the Congress on you and make it a law.
The problem with such government meddling: it assumes that we know what 'healthy' is. Not only does the government not know what 'healthy' is, neither does Science. We have some ideas, but nutritional science should have a little more humility.
Fat
For a while now, evidence has been accumulating that we don't really understand how or even whether fats are bad for us. Thirty years ago Americans dropped butter as if it were made at Love Canal, and switched to margarine. Of course, now we know that margarine is actually worse than butter, and that the ill effects of butter were exaggerated. Similar damage was done to the reputation of Palm Oil and other saturated fats.
Cholesterol
Conventional wisdom holds that lots of fat in the diet leads to high cholesterol and other problems. But the evidence shows otherwise:
http://www.amazon.com/Good-Calories-Bad-Controversial-Science/dp/1400033462
Metabolic Syndrome
After decades of lazy 'consensus science', researchers are taking a fresh look at 'metabolic syndrome' - the very heart of the current 'obesity epidemic' - and may (once again) learn that we've been given bad advice:
A Game of Consequences?
The Food Pyramid
Another great government victory... not. The 1992 food pyramid turns out to have had a lot of problems. Of course, the 2005 pyramid is much better. We should all switch to its guidelines immediately. Not.
http://en.wikipedia.org/wiki/Food_guide_pyramid#Controversy
My Point
You should view dietary pronouncements with a healthy dose of skepticism (but no more than 1000mg daily!). It's one thing for the government to distribute dodgy information - another entirely to legislate on it. Science has a particularly bad reputation in this area - it doesn't help that food choices have a kind of 'moral' component to them. Government has no business telling people what to eat.
By the Way
If you've never tried Foie Gras, you might want to do that soon. In some parts of the U.S. (including California) it will soon be illegal.
The administration is telling manufacturers to hurry up and make food more "healthy". The hidden message with this sort of prodding is that if an industry doesn't move voluntarily, they'll sic the Congress on you and make it a law.
The problem with such government meddling: it assumes that we know what 'healthy' is. Not only does the government not know what 'healthy' is, neither does Science. We have some ideas, but nutritional science should have a little more humility.
Fat
For a while now, evidence has been accumulating that we don't really understand how or even whether fats are bad for us. Thirty years ago Americans dropped butter as if it were made at Love Canal, and switched to margarine. Of course, now we know that margarine is actually worse than butter, and that the ill effects of butter were exaggerated. Similar damage was done to the reputation of Palm Oil and other saturated fats.
Cholesterol
Conventional wisdom holds that lots of fat in the diet leads to high cholesterol and other problems. But the evidence shows otherwise:
http://www.amazon.com/Good-Calories-Bad-Controversial-Science/dp/1400033462
Metabolic Syndrome
After decades of lazy 'consensus science', researchers are taking a fresh look at 'metabolic syndrome' - the very heart of the current 'obesity epidemic' - and may (once again) learn that we've been given bad advice:
A Game of Consequences?
The Food Pyramid
Another great government victory... not. The 1992 food pyramid turns out to have had a lot of problems. Of course, the 2005 pyramid is much better. We should all switch to its guidelines immediately. Not.
http://en.wikipedia.org/wiki/Food_guide_pyramid#Controversy
My Point
You should view dietary pronouncements with a healthy dose of skepticism (but no more than 1000mg daily!). It's one thing for the government to distribute dodgy information - another entirely to legislate on it. Science has a particularly bad reputation in this area - it doesn't help that food choices have a kind of 'moral' component to them. Government has no business telling people what to eat.
By the Way
If you've never tried Foie Gras, you might want to do that soon. In some parts of the U.S. (including California) it will soon be illegal.
Friday, March 5, 2010
Nerds and Diet Coke
Have you ever wondered why nerds drink so much Diet Coke? So did I.
My Diet Coke habit started in about 1986. Within a year or so, I was up to 4 liters a day, sometimes more. That's about 12 cans in a day. I drink morning, noon, and night. I knew other nerds with the Diet Coke Monkey on their backs, but didn't think much of it. Once, my friends at NASA tried to help me kick the habit, but after a few days of Head Down on the Keyboard they enthusiastically supported my return to the caffeine.
I once lived in an apartment with some other nerds, and we collected the empty 2-liter bottles. Eventually we had enough to fill the kitchen to a depth of a couple feet, like a ball pit. Good times.
When I moved to Silicon Valley 10 years ago, it made perfect sense that Diet Coke should be free to all engineers. It would be insane to do otherwise.
The first glimmer of understanding came when my wife and I were considering getting ADHD meds for our 9 year old son. We had resisted this for a long time. I started to read about the symptoms, and the drugs, and how they worked. Mostly stimulants. They have a 'paradoxical' effect of calming you down and allowing you to concentrate on things.
Then I realized that all those jokes about my 'intravenous diet coke' maybe weren't so funny. Or at least not in the same way. Wow. I had been self-medicating for ADHD for over 20 years.
Ok, so you might be wondering "Why Diet Coke? What's wrong with just Coke?" Well, at about 100 calories per can, I would have put on about 2.5 lbs per week (~100 lbs/year). I made the switch to Diet during my freshman year, in 1986.
My Diet Coke habit started in about 1986. Within a year or so, I was up to 4 liters a day, sometimes more. That's about 12 cans in a day. I drink morning, noon, and night. I knew other nerds with the Diet Coke Monkey on their backs, but didn't think much of it. Once, my friends at NASA tried to help me kick the habit, but after a few days of Head Down on the Keyboard they enthusiastically supported my return to the caffeine.
I once lived in an apartment with some other nerds, and we collected the empty 2-liter bottles. Eventually we had enough to fill the kitchen to a depth of a couple feet, like a ball pit. Good times.
When I moved to Silicon Valley 10 years ago, it made perfect sense that Diet Coke should be free to all engineers. It would be insane to do otherwise.
The first glimmer of understanding came when my wife and I were considering getting ADHD meds for our 9 year old son. We had resisted this for a long time. I started to read about the symptoms, and the drugs, and how they worked. Mostly stimulants. They have a 'paradoxical' effect of calming you down and allowing you to concentrate on things.
Then I realized that all those jokes about my 'intravenous diet coke' maybe weren't so funny. Or at least not in the same way. Wow. I had been self-medicating for ADHD for over 20 years.
Ok, so you might be wondering "Why Diet Coke? What's wrong with just Coke?" Well, at about 100 calories per can, I would have put on about 2.5 lbs per week (~100 lbs/year). I made the switch to Diet during my freshman year, in 1986.
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