Generic Drug Prices Run AMOK!

And you probably thought you could still afford those ‘cheap’ generic drugs…

You may have noticed recent increases in generic drug prices. More than 85% of all prescriptions are for generic drugs. What is a generic drug? According to the FDA, generic drugs are copies of brand-name drugs and are the same as those brand name drugs in dosage form, safety, strength, quality, performance characteristics and intended use. And they have always been much cheaper than brand name drugs.

Truthfully, I had not paid much attention to this, although I saw some of the reports. But when it hit close to home… I have used a generic prescription ointment to treat my eczema. In October 2014 the retail cost of my prescription was about $47, and with my copay I paid much less. In January 2015 when I went to refill the prescription, I was told the retail price was now $500! That’s a 1,000% increase.

So I was off to Google to find out what’s going on. No problem—there were hundreds of articles, surveys, editorials and even an inquiry by The House Committee on Oversight & Government Reform, (created in 1816). You know we’re in good hands when you hear, “We’re from the government and we’re here to help you.”

Reports in The New York Times and an article in Slate Magazine titled Drug Bust, laid out some of the sad facts. It seems that in the past couple of years, many generic drugs have increased in price by 1,000%, 5,000%, or even 8,000%! 

Why, pray tell, is this happening? It seems there are several reasons, sort of. There have been shortages of some generic drugs and that always pushes prices up. With generic drugs the research and development costs have long since been recovered. I’m thinking that greed, a good thing according to Gordon Gekko, may also be a factor. But that’s just a cynical guess on my part.

Many common and necessary drugs are included in the long list of large price jumps. In addition to the 1,000% increase in my clobetasol, other increases include:

Digoxin, used since 1785, for heart failure and irregular heartbeat, has increased in price by 884%.

Albuterol Sulfate, used to treat asthma, has increased in price by more than 4,000%.

Pravastatin Sodium, used to control high cholesterol, has increased in price by more than 500%.

Doxycycline Hyclate, an antibiotic, has increased in price by more than 8,000%! There are many, many more examples.

What are the implications for consumers (like all of us)?

1 Individuals without drug coverage will be (and are) paying higher and higher prices for these formerly ‘cheap’ drugs. Some people will be priced out of even getting their prescriptions—not a good situation.

2 While the copays may still be small (mine, for example, is $8 for tier one meds) the insurance companies must now pay for the huge increase in generic drug costs. For those of us who have insurance and drug coverage, our copays and premiums are bound to go up and there will likely be higher insurance costs for all consumers.

3 There are no indications that the trend of rising generic drug prices will end soon.

Bottom Line

Your guess is as good as mine and I haven’t heard of any plan to resolve the situation. This is a serious situation that could have a major health impact on all of us.

axman

Preventing Cancer: How Hard Can It Be?

Maybe a lot harder than you think!

 

For many years we have believed that genetics and lifestyle factors were the major cause of our cancers. We all know that we should NOT smoke, we should NOT get too much sun, we SHOULD exercise, and we SHOULD manage our weight. These are proven ways to help prevent some cancers. So if we do these things we are unlikely to get cancer, right? Well, not exactly. It turns out that about two-thirds of all cancer is caused by plain old Bad Luck, according to:

A study published in the January 2, 2014 issue of SCIENCE magazine came to that conclusion. Johns Hopkins University researchers statistically analyzed the genesis of common cancers based on stem cell divisions of 31 cell types. Of the millions of stem cell divisions in the human body, a small percentage are disparate, or do not divide correctly. According to the researchers, the majority of cancers are caused by “random mutations arising during DNA replication in normal, noncancerous stem cells.” Of course, many mutations do not lead to cancer‑‑ but some do.

This sounds a little discouraging but one of the researchers, Christian Tomasetti, further said: “If two-thirds of cancer incidence across tissues is explained by random DNA mutations that occur when stem cells divide, then changing our lifestyle and habits will be a huge help in preventing certain cancers, but this may not be as effective for a variety of others.” (Basically, keep on keeping on and it will help some) The cancers they identified that were influenced by lifestyle factors include colon, lung, and skin (no surprises here).

 

An important conclusion of this study is that there has to be a greater scientific emphasis on early detection.

Disclaimer 1: Some scientists dispute this conclusion. Watch for further developments

Disclaimer 2: Prostate and breast cancer were not included in the study. The researchers did not find a consistent rate of stem cell division. Maybe in the next study…

Disclaimer 3: I am not suggesting that because “life ain’t fair” we should blandly accept our fates. To quote Dylan Thomas, “Do not go gently into that good night.”

Bottom Line

Cancer sucks, it is sneaky and devious, and while our doctors and scientists search for answers, we can live the best, most active, most rewarding, and most loving life possible. Research like this tells us how far we have to go. Life is an unpredictable mystery and that’s just as it should be.

axman

A Brief History of 2014

1-I'm Still Alive! Is that brief enough?
2-My prostate is still gone (since 2003) and is unlikely to grow back.
3-My PSA is remaining low--my medications seem to be working. For the cost, I should be cured.
4-Hormone therapy side effects are still alive and well and help bring out my 'feminine' side.
This part of the update has been about the same for a few years now.

2014 additions and challenges...
1-I discovered a new side effect in February. It's called Radiation Induced Bladder Cystitis. Nine years after radiation therapy no less. It is not easily treatable so many of us who had radiation before or after prostate cancer treatment are now living with bleeding and clotting in our bladder. Annoying but not life threatening.
2-A pesky mole on my back turned out to be cancerous-a
Melanoma. The surgeon got it all, put in 33 stitches and that was that...except for some other moles that will also need to be biopsied.
3-With each passing year I get slower, forget more, and spend more time getting injected, inspected, bled, scanned, and being told that, "You're doing pretty good for someone your age."

Conclusion
Life is good and I intend to make the most of it.
Enjoy

axman

Movember Results and other Tidbits

Movember is over for 2014, after raising another $70 million worldwide. Pretty good. Movember makes fundraising and giving almost fun. Tens of thousands of men all over the world grow, or try to grow, a mustache for the month of November. It has worked. Hopefully all that money will improve and expand prostate cancer research, support, and educational programs.

I joined the fray, donated, and didn't shave or trim for more than a month. Unfortunately, I didn't look much scruffier at the end than at the beginning. Maybe I'll let it grow for another year and see if it looks better then.

Private donations for cancer research, such as the Movember program, seem to be on the rise (that's good) as  public funds diminish (not so good). Add to that low participation in cancer clinical trials, the slow process of clinical trials, and the high cost of medications of the successful meds, and you have  a mixed result. At best, two steps forward and one step backward. Sometimes it seems more like one step forward and two steps backward.

More men with prostate cancer are surviving longer with a better quality of life--I'm one of them. That's a direct result of research, clinical trials, and good medical choices. I'd still like to see a cure. Maybe more of us should grow a mustache next Movember.

axman

Is it Movember? Yes it is!

So what is Movember? Well, it's a rather new world-wide movement to improve prostate cancer awareness and raise money for prostate cancer research and programs.

It started with 30 guys in Australia in 2003, has grown to more than four million members worldwide, and has raised more than 400 million dollars!

Men pledge NOT to shave during the month of November to raise awareness, save on razors, and impress women and other men (my take on it). Men become a Mo Bro and women can join as a Mo Sista.

Mo is short for mustache in Australia, November is the month chosen for awareness and fundraising, so Movember it is.

You, too, can join, have fun, and help raise money,  awareness, and hope. Just go to the Movember United States site and it's all explained for you.
axman

One Cancer is Not Enough (tongue in cheek)

One never knows

Not only does cancer suck, but did you know that having any cancer puts you at higher risk for developing another cancer?

Incurable cancers tend to spread to various parts of your body but it is still called the name of the original cancer. For example, prostate cancer can spread to your bones, lymph nodes, and lung and it is still called prostate cancer.

Sometimes, however, you can get a new and unrelated cancer. In my case the new cancer started as a small flat mole, shaped roughly like Antarctica, and sporting several bland colors. It was located just below my right shoulder, near my modest and tasteful axe tattoo. My wife suggested a doctor visit, the doctor suggested a biopsy, and the report came back labeled melanoma. Bummer! Melanoma is the BAD skin cancer, but the report also said early stage and that the biopsy may have been big enough to take out the whole thing. 

We all agreed (doctor, wife, and me) that it was wise to have a little larger area around the ex-mole removed just to be sure. So be it. I think we all caught it early and I will be as good as new (not an absolute value). 

Moral of story

Pay attention to your body. Cancer is sneaky and lurks in various and sundry places inside and outside your body. Pay attention to moles that are not the normal round, rough, brown kind. Moles that suddenly appear can be a risk. A doctor can tell you if a biopsy is needed. My biopsy didn’t even hurt and the peace of mind from knowing for sure is priceless.

axman

What’s in a name?

Drugs 101—pay attention, there will be a test later
 

There are many Prostate Cancer medications in current use (and approved by the FDA). New ones are approved as older ones become less effective and disappear. Part of the formula has to do with money. No drug manufacturer wants to produce and market a drug that won’t make a profit for them. After the patent runs out—usually 17 years from the date it went into effect‑‑the drug becomes generic and can be manufactured by just about anybody and will almost certainly be less expensive.

If you’re taking a prostate cancer drug you probably know its name (at least one of them). But did you know that every drug has three or more names? The name you know is probably the brand name. It also has a generic name, and a chemical name or formula, mostly impossible to understand. Sometimes the chemical name is abbreviated during the Clinical Trials stage, something like FUN-4U.For example, I take Zytiga, the brand name of a drug manufactured by Johnson & Johnson (aka Janssen). The generic name of the drug is abiraterone acetate, assigned by the FDA when it was approved, and the chemical formula is 3β-Acetoxy-17-(3-pyridyl)-androsta-5,16-diene. When a drug finally becomes available in generic form it may have yet more names. Confused yet?

You can find the names and history of your drug or drugs at the NIH prostate cancer drug site. You might discover that there is a much less expensive generic version of your brand name prescription drug. That is good. Generic drugs are required by the FDA to be exactly the same as the original brand name drug. Another personal example of this—I take prednisone along with my Zytiga. The prednisone, a generic drug, costs pennies a month. The Zytiga, a brand name drug, costs many thousands a month (before my Medicare Part D kicks in and reduces it to just many thousands a year).

Some men who need these very expensive drugs are not rich or do not have a health insurance plan that helps enough. This is also true of drugs for other cancers and many other medical conditions for both men and women. Sadly, life-saving treatment for some still depends on their ability to pay.

Oh, there is no test, you passed by just reading this far so you can relax.

axman

Being Aware of Prostate Cancer!

Every month I am aware of my prostate cancer, along with another two and a half million American men and millions more worldwide. There are many little hints to help us remember—scars, side effects of treatments, pills and injections, blood draws, scans, and endless medical appointments.

September is National Prostate Cancer Awareness Month (2014) and has been designated and proclaimed as a month to focus awareness, gain knowledge, and increase funding for research. A cure is still the goal and my personal preference.

Statistics can tell us a lot and help us understand the scope of prostate cancer. The median age for prostate cancer diagnosis is 66. So you’d think it is an old man’s disease. It is certainly more common in older men but many younger men are diagnosed and there are even several hundred young boys with prostate cancer (I was surprised, too).

Prostate cancer is the most diagnosed cancer in the U.S. with breast cancer in women a close second. But the most deadly cancer continues to be lung cancer, as it has been for decades.

Prostate cancer survival rates have increased greatly in the last 40 years. Thanks to research and the development of new and better treatments The five year survival rate after diagnosis was 66% in 1975, 88% in 1990, and is more than 99% today. I say Woo Hoo to that. I am sure that more than 99% of me has survived since my diagnosis in 2003.

Statistics don’t tell us everything. Statistics are averages, percentages, and points on a graph used to show information for a large number of people. Statistics can’t tell you what will happen to you. Any individual could be diagnosed at 35 or 95 or, most likely, not at all. If you are diagnosed and have incurable prostate cancer, you could have a very aggressive and deadly type, or a slow growing type that will never become a factor in your health. Remember, we are individuals‑‑not statistics.

Bottom Line

1 See your doctor, ask questions, listen, and mutually make a plan that works for you—it may take a few tries.

2 Talk to your friends and suggest they see their doctor. Early diagnosis really is the key to long term survival.

3 Participate in clinical trials if given the chance.

4 Donate a few bucks to prostate cancer research—it won’t kill you and just might help save somebody else.

axman