Wednesday, July 2, 2008

The Misery of Pfizer Could Be The Joy Of Texas - Generic Drugs Are On The Rise

Pfizer can't be happy. Its patent on the best-selling drug in the world, Lipitor, expires in 2011, which doesn't give the pharmaceutical giant much time to figure out how to compensate for the billions of dollars in sales that will be lost when it happens, courtesy of generic companies reproducing the medicine's active ingredients. The United States alone buys $5 billion worth of the brand-name drug every year.

It's hard to believe that the world's greatest selling pharmaceutical medicine is a treatment for cholesterol, rather than for some horrible, chronic illness. . .well, that is until one considers it purely from a business perspective. Heart disease is still the number one killer of Americans, and one-third of all deaths in this country in 2004 were attributed to it. That means big bucks for companies that can market a treatment for this exploding, life-threatening problem.

Consumers can save up to fifty percent on prescription drugs, according to the Food and Drug Administration, if they just buy generic. Generic drug companies, health insurance providers, and patients alike are practically salivating in anticipation; Lipitor's expiring patent means that not only can other pharmaceutical companies reproduce the coveted, and much guarded, active ingredients, but also that dramatic price slashes will happen for consumers. Texas, with the majority of its population now obese -- a risk factor for heart disease -- and twenty-five percent of its population going without any health insurance, particularly stands to benefit from more cost-effective medication.

But Pfizer shouldn't feel so bad; Lipitor is not the only one. In fact, experts are predicting a golden era for generic drugs as patents on several high-dollar medications come due over the next few years -- $60 billion a year worth -- including Ambien, Norvasc, Zyrtec and Fosamax. Johnson & Johnson announced last week that it will eliminate close to 5,000 jobs in preparation for the generic reproductions of Risperdal, a drug for schizophrenia, Topamax, a seizure medication, and other medicines used for migraines. In 2009, Prevacid's formula, as well, relinquishes its secrets, a heartburn and ulcer drug producing $3.5 billion in annual sales.

While advances in treatments for cancer and other potentially fatal illnesses seem promising, few new medications with mass-market appeal are waiting to replace the old. While this is bad news, indeed, for pharmaceutical giants, it seems to be great news for the rest of the population.

Such patents expiring, without comparable replacements waiting, means the drug price inflation rate will remain under ten percent, despite the aging population's ever-increasing need for medication. This figure has almost always been in the double digits in recent years, according to Steven B. Miller, chief medical officer for ExpressScripts, which manages drug benefit plans. In 2002, in fact, it was eighteen and a half percent. "(The inflation rate) is much better than it was in the '90s, before these drugs starting going generic," said Miller.

Ronny Gal, analyst for Sanford C. Bernstein, which follows generic companies' activities, predicts a ten to thirteen percent growth in the generic drug industry by 2010. "(The change) is good for everybody but the branded pharmaceutical companies."

The high sticker price of many brand-name pharmaceutical drugs is, to a large extent, due to their research and development processes; industry leaders must invest billions of dollars and spend years of time to create a viable medication. They, then, make up for such significant initial costs by setting a high sale price, thereby ensuring billions in profits. Generic companies, on the other hand, do not invest such time and resources on development, which is one of the many reasons they can sell their versions anywhere from thirty to eighty percent cheaper, though they meet the same quality standards and contain the same active ingredients.

". . .(The lack of new drug formulas is) basically a failure of innovation," said Richard T. Evans, a consultant with Avos Life Sciences, a research and consulting firm for the drug industry.

Part of that industry, however, protests such claims. Caroline Loew, senior vice-president for scientific and regulatory affairs for the Pharmaceutical Research and Manufacturers of America, a trade group for brand-name companies, defends the ups and downs of the process. "I don't think we would support the contention there's a lull." Finding treatments for chronic and complicated diseases, like Alzhiemer's, Parkinson's, and cancer, takes more time and effort than for other conditions. The production of pharmaceutical drugs is "very much an emerging science," she said, and "the biological mechanisms are very poorly understood."

The high price of brand-name pharmaceutical medications and the exploding number of those going without health insurance have combined to create a growing demand for less expensive, imported drugs. Finding the cost of their medications too much to bear, many Americans are turning to Canada and Mexico to meet their pharmaceutical needs, despite warnings against possible safety issues. Though statistics on just how many are getting their medications from foreign sources are difficult to document, border states are especially susceptible to such temptations. A trip across international lines, after all, is under a day's drive away for most Texans.

The additional criticism that drugs cost thirty to fifty percent more in the U.S. than in Europe, due to the for-profit structure of the domestic pharmaceutical industry, only adds fuel to the fire on the debate over universal health care. With healthcare systems in cities like Dallas, Houston, and Austin nearly crushed by the flood of uninsured coming in from other parts of the state to receive care, it's easy to see where the argument for universal coverage may have some validity.

Research and proper investing seem the most viable solution to the current problem of high-cost prescription drugs in the U.S. Investing in a health insurance plan appropriate to one's needs and researching the availability of generic drugs can dramatically reduce one's healthcare costs. In fact, sixty percent of prescriptions written in this country are for generic medications, and that number is expected to rise. Patients also have the right to ask for a generic version, if available, to cut costs. As usual, much of a patient's outcome depends on his or her willingness to be assertive and research those issues dramatically affecting personal health. To keep its high profits going, Pfizer is just going to have to come up with some new innovation to amaze us, and to save us, from the overwhelming tide of disease.

Being aware of issues affecting the cost of healthcare is an important aspect of minding your health. How you take care of yourself will certainly affect you as you age, and eventually your wallet, as well. If you're a young individual who tries to keep informed and maintain a healthy condition and lifestyle, you should take a look at the revolutionary, comprehensive and highly-affordable individual health insurance solutions created by Precedent specifically for you. Visit our website, www.precedent.com, for more information. We offer a unique and innovative suite of individual health insurance solutions, including highly-competitive HSA-qualified plans, and an unparalleled "real time" application and acceptance experience.

Precedent puts a new spin on health insurance. Learn more at http://www.precedent.com

Oppositional Defiant Disorder Treatment

About a year ago I wrote an article on Oppositional Defiant Disorder discussing the condition, symptoms and treatment options. This article is an update describing what is new.

-Introduction

Oppositional defiant disorder (ODD) is a psychiatric behavior disorder that is characterized by aggressiveness and a tendency to purposefully bother and irritate others. These behaviors cause significant difficulties with family and friends and at school or work.

-Description

Oppositional defiant children show a consistent pattern of refusing to follow commands or requests by adults. These children repeatedly lose their temper, argue with adults, and refuse to comply with rules and directions. They are easily annoyed and blame others for their mistakes. Children with ODD show a pattern of stubbornness and frequently test limits, even in early childhood.

These children can be manipulative and often induce discord in those around them. Commonly they turn attention away from themselves by inciting parents and other family members to fight with one and other.

-Behavioral Symptoms

Normal children occasionally have episodes of defiant behavior, particularly during ages of transition such as 2 to 3 or the teenage years where the child uses defiance in an attempt to assert himself. Children who are tired, hungry, or upset may be defiant. Oppositional defiant behavior is a matter of degree and frequency. Children with Oppositional Defiant Disorder display difficult behavior to the extent that it can interfere with learning, school adjustment, and, sometimes, with the child's social relationships.

Common behaviors seen in Oppositional Defiant Disorder include:

-Losing one's temper


-Arguing with adults


-Actively defying requests


-Refusing to follow rules


-Deliberately annoying other people


-Blaming others for one's own mistakes or misbehavior


-Being touchy, easily annoyed


-Being easily angered, resentful, spiteful, or vindictive.


-Speaking harshly, or unkind when upset


-Seeking revenge


-Having frequent temper tantrums

Many parents report that their ODD children were rigid and demanding from an early age.

-Diagnosis

The diagnosis of ODD is not always straight forward and needs to be made by a psychiatrist or some other qualified mental health professional after a comprehensive evaluation.

If you feel your child may have ODD, there is a quick ODD Screening Test at http://addadhdadvances.com/ODDtest.html

-Causes

It is not clear what causes Oppositional Defiant Disorder. There are currently two theories.

The developmental theory suggests that ODD is really a result of incomplete development. For some reason, ODD children never complete the developmental tasks that normal children master during the toddler years. They get stuck in the 2-3 year old defiant stage and never really grow out of it.

The learning theory suggests that Oppositional Defiant Disorder comes as a response to negative interactions. The techniques used by parents and authority figures on these children bring about the oppositional defiant behavior.

-Co-morbidity

Oppositional Defiant Disorder usually does not occur alone.

50-65% of ODD children also have:

-ADD ADHD


-35% of these children develop some form of affective disorder


-20% have some form of mood disorder, such as


-Bipolar Disorder or anxiety


-15% develop some form of personality disorder


-Many of these children have learning disorders

Any child with Oppositional Defiant Disorder must be evaluated for other disorders as well. If your child has ODD it is imperative to find out what are the co-existing problems. This is the key to treating the condition, as we shall soon discuss.

-Prognosis

So what happens to these children? There are four possible paths.

-Some will grow out of it. Half of the preschoolers that are labeled ODD are normal by the age of 8. However, in older ODD children, 75% will still fulfill the diagnostic criteria later in life.


-The ODD may turn into something else. 5-10% of preschoolers with ODD have their diagnosis changed from ODD to ADHD. In some children, the defiant behavior gets worse and these children eventually are diagnosed with Conduct Disorder at http://addadhdadvances.com/CDtest.html. This progression usually happens fairly early. If a child has ODD for 3-4 years and he hasn't developed Conduct Disorder, then he won't ever develop it.


-The child may continue to have ODD without any thing else. This is unusual. By the time preschoolers with ODD are 8 years old, only 5% have ODD and nothing else.


-The child develops other disorders in addition to ODD. This is very common.

-Treatment: Medical Intervention

There have been some recent studies that have examined the effects of certain medications on Oppositional Defiant Disorder. All the research is preliminary and just suggests that certain treatments may help.

One study examined the use of Ritalin to treat children with both ADHD and ODD. This study found that 90% of the children treated with Ritalin no longer had the ODD by the end of the study. The researchers skewed the results a bit because a number of children were dropped from the study because they wouldn't comply with the treatment regimen. Still if these children are included as treatment failures the study still showed a 75% success rate.

There have been two studies examining the effect of Strattera on children with both ADHD and ODD. One study showed that Strattera helped with ODD, one study showed it did not help.

There was a large Canadian study that showed that Risperdal helped with aggressive behavior in children with below normal intelligence. It did not matter if the child had ADHD or not.

There was study showing that 80% of children with explosive behavior improved when given the mood stabilizer, divalproex.

There was another pilot study examining the use of Omega-3 oils and vitamin E in ODD children. Both helped the ODD behavior to some degree.

-Treatment: Psychological Intervention

Parent management training is still viewed as the main treatment for Oppositional Defiant Disorder. Our program, How to Improve Your Child's Behavior, located at http://addadhdadvances.com/betterbehavior.html which is available online, or some other parent training program is still considered essential if you want to help your child. Also, the younger your child is when you enroll in such a program, the better the results.

-Conclusion: Advice to Parents

Currently, there is still far too little research on this very common disorder.

Medically, the most important consideration is to treat other disorders that come along with ODD. Considering that Ritalin may help alleviate the problem in 75-90% of ODD children who have ADHD, and considering that most children with ODD also have some degree of ADHD, I feel that it is very worth your while to try your ODD child on Ritalin unless you know for sure that he does not have ADHD. The other treatments may also be worth a try depending upon the nature of your child.

I feel that using Omega-3 supplements and a vitamin E supplement should be tried in all children. This is because most children are deficient in these nutrients. Even if it does not help with the ODD, it should make your child healthier.

Parent training is still the most effective means of dealing with Oppositional Defiant Disorder. The two main drawbacks of most of these programs are the expense and the availability.

Some practitioners charge $100 or more per visit and considering the program will take several months costs add up. Insurance usually will not pay for such programs. Many parents complain to me that they can not afford the program that their child so desperately needs.

In addition, these programs are not available everywhere. Over the years, numerous parents have told me that where they live there are no programs for Oppositional Defiant Children.

I created How to Improve Your Child's Behavior to address these two problems. It allows parents to help their children regardless of where they live and at a cost that is less than one office visit. Even though it was an experiment to try to administer such a program online and to date no one else is doing this, over the past two years How to Improve Your Child's Behavior has proven time and again to help parents gain control of their defiant children.

Get more information on Oppositional Defiant Disorder- ODD Help at http://addadhdadvances.com/betterbehavior.html

It is tough to live with children who have ODD. However, if you make sure that your child has his other problems addressed and you improve your parenting skills by enrolling in a parent training program, you can do a great deal to improve your child's condition and his future.

Anthony Kane, MD


ADD ADHD Advances


http://addadhdadvances.com

Anthony Kane, MD is a physician and international lecturer. Get ADD ADHD Child Behavior and Treatment Help for your ADHD child, including child behavior advice and information on Oppositional Defiant Disorder, the latest ADHD treatment. Sign up for the free ADD ADHD Advances online journal. Send an email to: subscribe@addadhdadvances.com?subject=subart

Oppositional Defiant Disorder Treatment

About a year ago I wrote an article on Oppositional Defiant Disorder discussing the condition, symptoms and treatment options. This article is an update describing what is new.

-Introduction

Oppositional defiant disorder (ODD) is a psychiatric behavior disorder that is characterized by aggressiveness and a tendency to purposefully bother and irritate others. These behaviors cause significant difficulties with family and friends and at school or work.

-Description

Oppositional defiant children show a consistent pattern of refusing to follow commands or requests by adults. These children repeatedly lose their temper, argue with adults, and refuse to comply with rules and directions. They are easily annoyed and blame others for their mistakes. Children with ODD show a pattern of stubbornness and frequently test limits, even in early childhood.

These children can be manipulative and often induce discord in those around them. Commonly they turn attention away from themselves by inciting parents and other family members to fight with one and other.

-Behavioral Symptoms

Normal children occasionally have episodes of defiant behavior, particularly during ages of transition such as 2 to 3 or the teenage years where the child uses defiance in an attempt to assert himself. Children who are tired, hungry, or upset may be defiant. Oppositional defiant behavior is a matter of degree and frequency. Children with Oppositional Defiant Disorder display difficult behavior to the extent that it can interfere with learning, school adjustment, and, sometimes, with the child's social relationships.

Common behaviors seen in Oppositional Defiant Disorder include:

-Losing one's temper


-Arguing with adults


-Actively defying requests


-Refusing to follow rules


-Deliberately annoying other people


-Blaming others for one's own mistakes or misbehavior


-Being touchy, easily annoyed


-Being easily angered, resentful, spiteful, or vindictive.


-Speaking harshly, or unkind when upset


-Seeking revenge


-Having frequent temper tantrums

Many parents report that their ODD children were rigid and demanding from an early age.

-Diagnosis

The diagnosis of ODD is not always straight forward and needs to be made by a psychiatrist or some other qualified mental health professional after a comprehensive evaluation.

If you feel your child may have ODD, there is a quick ODD Screening Test at http://addadhdadvances.com/ODDtest.html

-Causes

It is not clear what causes Oppositional Defiant Disorder. There are currently two theories.

The developmental theory suggests that ODD is really a result of incomplete development. For some reason, ODD children never complete the developmental tasks that normal children master during the toddler years. They get stuck in the 2-3 year old defiant stage and never really grow out of it.

The learning theory suggests that Oppositional Defiant Disorder comes as a response to negative interactions. The techniques used by parents and authority figures on these children bring about the oppositional defiant behavior.

-Co-morbidity

Oppositional Defiant Disorder usually does not occur alone.

50-65% of ODD children also have:

-ADD ADHD


-35% of these children develop some form of affective disorder


-20% have some form of mood disorder, such as


-Bipolar Disorder or anxiety


-15% develop some form of personality disorder


-Many of these children have learning disorders

Any child with Oppositional Defiant Disorder must be evaluated for other disorders as well. If your child has ODD it is imperative to find out what are the co-existing problems. This is the key to treating the condition, as we shall soon discuss.

-Prognosis

So what happens to these children? There are four possible paths.

-Some will grow out of it. Half of the preschoolers that are labeled ODD are normal by the age of 8. However, in older ODD children, 75% will still fulfill the diagnostic criteria later in life.


-The ODD may turn into something else. 5-10% of preschoolers with ODD have their diagnosis changed from ODD to ADHD. In some children, the defiant behavior gets worse and these children eventually are diagnosed with Conduct Disorder at http://addadhdadvances.com/CDtest.html. This progression usually happens fairly early. If a child has ODD for 3-4 years and he hasn't developed Conduct Disorder, then he won't ever develop it.


-The child may continue to have ODD without any thing else. This is unusual. By the time preschoolers with ODD are 8 years old, only 5% have ODD and nothing else.


-The child develops other disorders in addition to ODD. This is very common.

-Treatment: Medical Intervention

There have been some recent studies that have examined the effects of certain medications on Oppositional Defiant Disorder. All the research is preliminary and just suggests that certain treatments may help.

One study examined the use of Ritalin to treat children with both ADHD and ODD. This study found that 90% of the children treated with Ritalin no longer had the ODD by the end of the study. The researchers skewed the results a bit because a number of children were dropped from the study because they wouldn't comply with the treatment regimen. Still if these children are included as treatment failures the study still showed a 75% success rate.

There have been two studies examining the effect of Strattera on children with both ADHD and ODD. One study showed that Strattera helped with ODD, one study showed it did not help.

There was a large Canadian study that showed that Risperdal helped with aggressive behavior in children with below normal intelligence. It did not matter if the child had ADHD or not.

There was study showing that 80% of children with explosive behavior improved when given the mood stabilizer, divalproex.

There was another pilot study examining the use of Omega-3 oils and vitamin E in ODD children. Both helped the ODD behavior to some degree.

-Treatment: Psychological Intervention

Parent management training is still viewed as the main treatment for Oppositional Defiant Disorder. Our program, How to Improve Your Child's Behavior, located at http://addadhdadvances.com/betterbehavior.html which is available online, or some other parent training program is still considered essential if you want to help your child. Also, the younger your child is when you enroll in such a program, the better the results.

-Conclusion: Advice to Parents

Currently, there is still far too little research on this very common disorder.

Medically, the most important consideration is to treat other disorders that come along with ODD. Considering that Ritalin may help alleviate the problem in 75-90% of ODD children who have ADHD, and considering that most children with ODD also have some degree of ADHD, I feel that it is very worth your while to try your ODD child on Ritalin unless you know for sure that he does not have ADHD. The other treatments may also be worth a try depending upon the nature of your child.

I feel that using Omega-3 supplements and a vitamin E supplement should be tried in all children. This is because most children are deficient in these nutrients. Even if it does not help with the ODD, it should make your child healthier.

Parent training is still the most effective means of dealing with Oppositional Defiant Disorder. The two main drawbacks of most of these programs are the expense and the availability.

Some practitioners charge $100 or more per visit and considering the program will take several months costs add up. Insurance usually will not pay for such programs. Many parents complain to me that they can not afford the program that their child so desperately needs.

In addition, these programs are not available everywhere. Over the years, numerous parents have told me that where they live there are no programs for Oppositional Defiant Children.

I created How to Improve Your Child's Behavior to address these two problems. It allows parents to help their children regardless of where they live and at a cost that is less than one office visit. Even though it was an experiment to try to administer such a program online and to date no one else is doing this, over the past two years How to Improve Your Child's Behavior has proven time and again to help parents gain control of their defiant children.

Get more information on Oppositional Defiant Disorder- ODD Help at http://addadhdadvances.com/betterbehavior.html

It is tough to live with children who have ODD. However, if you make sure that your child has his other problems addressed and you improve your parenting skills by enrolling in a parent training program, you can do a great deal to improve your child's condition and his future.

Anthony Kane, MD


ADD ADHD Advances


http://addadhdadvances.com

Anthony Kane, MD is a physician and international lecturer. Get ADD ADHD Child Behavior and Treatment Help for your ADHD child, including child behavior advice and information on Oppositional Defiant Disorder, the latest ADHD treatment. Sign up for the free ADD ADHD Advances online journal. Send an email to: subscribe@addadhdadvances.com?subject=subart