GLG News by John Spurlock, MD

Implications: 1. Lilly should be pleased with approval of Strattera in children and adolescents 2. Strattera is the superior agent for ADHD 3. approval should boost Liily sales

Analysis:

 Lilly should be pleased with approval of Strattera in children and adolescents. Strattera is the superior agent for ADHD and the approval should boost Liily sales of Strattera. As ADHD ids probably a life long condition a non stimulating agent like strattera is ideal for daily therapy. Many children are upset if other children know they take medication for ADHD. Strattera is superior because it works well with few side effects and is once a day.  

                                   Dr Spurlock

Implications: 1. Do doctors accept bribes? 2. Would a bribe affect a doctors usage of a product 3. Is there a need for a greater crack down on bribes?

Analysis: Certainly the offering of a bribe to influence another person has been around as long as man has walked the earth. From cops and judges on the take, to inspectors who take a bribe to look the other way, bribes will continue to be offered. In the case of doctors the bribe is rarely cash in the hand, but may be more subtle such as an honorarium to speak on a manufacturers product. At one time golf outings and weekends at a resort paid by the pharmaceutical industry were common, however none of that is now permitted. Prosecution of several doctors who accepted large honoraria for little or no work has resulted in a cap on honoraria. While bribes will always be with us, it looks as though bribery of physicians will decrease.
                                            dr spurlock

Implications: 1. overworked interns are the result of service versus education 2. Hour's of work limitations need to be expanded.

Analysis: The issue of overworked Interns has been a long standing problem. Many interns work 80 or more hours per week. We would not allow our truck drivers or airline pilots to work these hours but we allow doctors in training to care for us without sufficient rest to think straight! We need to further reduce work hours to 8 hours per day.   john spurlock md

Implications: 1.PercSys Accordion(R) Stone Management Device is more effective than present devices. 2.  PercSys Accordion(R) Stone Management Device should improve sales at Percutaneous Systems, Inc

Analysis: As a urologist I have had the opportunity to use Percutaneous Systems, Inc PercSys Accordion(R) Stone Management Device's and find it easier to use compared to other device. I would anticipate increased use and sales of this device.    john spurlock MD

Implications: 1. Diabetes and depression increases risk of heart disease
2. This study will lead to greater prescribing of anti depression medication to diabetics.
3. Depressed diabetics may lack motivation to control diabetes

Analysis: It has been known for some time that both diabetes and depression both increase the risk of heart disease. Diabetes increases heart disease because of all the abnormal physiologic changes diabetes causes. Depression leads to destructive behaviors like smoking, drinking and over eating. This study confirms what many physicians already know. If a diabetic patient gets depressed they stop exercising, they may over eat, smoke, and drink more alcohol. This study will encourage Physician's to prescribe more anti depressants to their diabetic patients. - Dr Spurlock

Implications: 1. Public use of prescribing data may increase heath costs
2. Publishing of prescribing data by private physicians is invasion of privacy.
3. Publishing of prescribing data leads to over prescribing of brand names and less generics
4. This will lead to less doctor calls and more direct to consumer advertising

Analysis: I believe that the selling of prescribing information is a violation of privacy. The Government has gone to great lengths to insure the privacy of patients (HIPPA), but allows the publication of the actual numbers of prescriptions of doctors with the products named. Pharmaceutical reps come into my office and show me lists of the number of prescriptions written for myself and other physicians of there drugs and their competitors products. This leads to manipulation of the physician to prescribe brand names and not generics. This will lead to doctors banning of sales reps coming into the office. The phamaceutical industry will then have to do more direct to consumer advertising. - Dr Spurlock

Implications: 1. High deductible health plans reduce employer costs.
2. These plans pass more of the costs to the employee

Analysis: I am in private practice and I am seeing more and more $40 deductible health plans for office visits. Sometimes my office visit only costs $40 so the patient is paying for the entire visit. This will have the effect of decreasing unneeded office visits and will save the employer money.   -dr spurlock

Implications: 1. This is simply a way for Insurance companies to cut Physician reimbursement.
2. Doctor's will fight pay for performance

Analysis: Pay for performance was first proposed by the Government to reward health care providers, but also penalize others. Of course private insurance would also jump on the band wagon. California has a large proportion of managed care and will be one of the first insurance companies to try this. I predict that the state medical associations will fight this idea. It takes away a physicians right to practice medicine and rewards those who provide "cheap" medical care.  -Dr Spurlock

Implications: 1. Sanofi and Bristol Myers small victory has major implications!
2. Lipitor should also be safe from a similar suit.
3. Patent protection extends across borders in this case and should equal increased Plavix sales!

Analysis: While legal scholars may view this international patent victory a small win for Bristol- Meyers and Sanofi. The implications are much larger. Sales of Plavix will increase as illegal generics are banned in Canada. This should also be viewed as a future victory for Pfizer as well with increased sales of Lipitor assured.

Implications: 1. Health middlemen drive up costs of healthcare

2. Larger companies can probably do without the middleman

3. Middlemen are probably necessary for most firms

Analysis: Heathcare middlemen (which are often health insurance companies) serve a valuable purpose, to administer health care for companies.  In a capitalistic market place middlemen have always flourished, increasingly companies are concerned about the "costs" of these middlemen. If a company can afford to administer health care costs themselves it usually saves money, however, most companies are not willing to set up health insurance administration within their human resource departments. Therefore, I predict continuous growth of middlemen. 

Implications: 1. Portable device will be used by multiple industries

2. Device should help to combat a growing problem

3. $75 billion in counterfeit  drugs

Analysis: The counterfeit drug market is estimated to be 75 billion world wide. Hospitals, insurance companies, formularies are all concerned about this issue. The RxSpec 700Z is a tool that fits the FDA's call for applying new technologies to distinguish legitimate drugs from counterfeits. I would anticipate that the use for this device will be large as it allows for instant identification. 

Implications: 1. Most women of reproductive age have HPV; therefore, most women undergoing invitro fertilization have HPV.
2. I do not believe in vitro rates will decrease.
3. News should boost Gardasil use!
4. Should boost rates of In Vitro

Analysis: Once again, HPV is in the news. With the launch of Gardasil, a vaccine to prevent HPV, HPV is now frequently discussed. Most women who desire a child are willing to undergo almost any procedure to have a baby. I do not believe that a women knowing she has HPV will decrease invitro rates. On the contrary it should boost rates as women will need to undergo more cycles.

Implications: 1. Digene should corner the market for HPV testing.
2. HPV testing will become mandatory with introduction of HPV vaccines.
3. Mutations should not be a problem for Digene.

Analysis: Digene currently controls the market for HPV DNA testing. As the HPV vaccine is widely adopted women will begin to reduce pap smear use...thats why HPV DNA identification will become more important. I dont think mutations of the HPV virus will be a problem for Digene as they should be able to modify their test to compensate.

Implications: 1.CollaGUARD should be a significant improvement over existing products for wound care.
2.CollaGUARD is a profitable addition to the billion dollar wound care market.
3.CollaGUARD may be superior to Regranex.

Analysis: The wound care market is estimated to be 1 billion dollars annually. The approval of CollaGUARD should result in significant profit for its manufacturer. The advantage of collagen is that it is fairly cheap to manufacture and is biologically friendly to wounds (it is slowly resorbed or integrated into the wound). 

Implications: 1. New CEO Hemsley should improve UnitedHealth's profits
2. The exit of McGuire should be good for UnitedHealth

Analysis: In my opinion, UnitedHealth has needed a new person at the top for some time now. I believe Hemsley has the experience to improve profits at UnitedHealth. Former ceo McGuire certainly was unable to stem the hemorrhage at UnitedHealth.

Implications:

1. Fondaparinux Sodium is a new class of agents in the war against thrombosis.

2. Fondaparinux Sodium should achieve significant sales in the short term.

3. Fondaparinux Sodium is possibly superior to present agents, such as Plavix

Analysis: GlaxoSmithKline's new agent Fondaparinux Sodium is a new class of agent for the treatment of thrombosis. It is already used for deep vein thrombosis but should have significant impact in the treatment of coronary events such as acute coronary syndromes. I would predict significant usage over the next 12 months and the capture of market share from Plavix

Implications: 1. Ozarelix is a revolutionary new medication for the treatment of benign prostatic hypertrophy.
2. Ozarelix should replace current formulary medications for BPH
3. Ozarelix is a significant improvement over GNRH agonists which have significant side effects.

Analysis: Ozarelix is a new agent that has been shown to significantly improve benign prostatic hypertrophy. Also, Ozarelix does not seem to have any side effects especially erectile dysfunction. This is a significant improvement over GNRH agonists which have significant side effects.