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Perks are gone. They cannot take spouses to dinners the drug cos are having or anything.
Reps bring samples to get the patients started on, or for the indigent, but in order to leave the sample, one of the drs has to sign, and if they can get more than one dr to sign, they can leave more.
They have to wait for the dr to get a min, because the dr is running on his time, not the reps time.
Im most cases, drs will put you on the med, if they feel it is nec. We have drug closet full of certain hbp meds that have to be thrown out, out of date, because they dont rx it, and we tell the reps not to bring it.
The dr will try you out on the sample, bring you back to see how it worked, write an rx if it worked for you. Sometimes, if we have samples, and you cannot afford the med, esp w something new, we will sample you.
Perks? pens, papers, calenders. Sometimes clocks or stethescope gadgets.
It is hard to get them as a patient or a doctors office? We had them at our office. As long as the med hadn't gone generic.
I think that sometimes the patients are afraid to ask for the samples, and they shouldn't be (as long as they really need them).
Depends what it is. Example - Bactroban used to be sampled frequently in the foil packets. Not any more. The new topical - a tad more liberal with samples. I've had (+) outcomes, so I'll consider using it. Cipro, Avelox, Levaquin - nada - and these meds in certain strengths are $$$$.
About the only statin we can get is Lipitor and occasionally Vytorin (which I don't use). Used to get more of the SSRI starter packs - very helpful, but again, not much LOL - I have patients with med cards call and ask for samples - no fear there - 'cause they don't want to pay the co-pay. Too Bad.
At my last doctors appointment I arrive 5-10 min. before the appointment time. I sat there in an empty waiting room for 45 min. to get in to see the doc. While waiting a saleman walked in and was allowed in to speak with the doctor before they called me in. That is nuts.
Did you ask about the delay? I certainly would have, regardless of how many were or weren't in the waiting room.
Depends what it is. Example - Bactroban used to be sampled frequently in the foil packets. Not any more. The new topical - a tad more liberal with samples. I've had (+) outcomes, so I'll consider using it. Cipro, Avelox, Levaquin - nada - and these meds in certain strengths are $$$$.
About the only statin we can get is Lipitor and occasionally Vytorin (which I don't use). Used to get more of the SSRI starter packs - very helpful, but again, not much LOL - I have patients with med cards call and ask for samples - no fear there - 'cause they don't want to pay the co-pay. Too Bad.
I used to call these companies and ask for a rep to come to the office if we didn't have the samples of med's we used a lot. We got the antibiotics, but not many of them. It's strange about the BP meds. We seemed to get those, but they went fast with the samples we gave patients to try before writing the scripts for them.
I know what you mean about patients with the card wanting the samples. We had that, too. We tried to save the samples for start up trial (two weeks worth to make sure it worked) or for the patients who had no insurance and not much money.
Samples can be great, but the Doctors still only use the med's they believe work best. We, too, threw away samples and refused more of the med's the doctors didn't use.
My girlfriend is the office manager for a dermatology practice, and they get free lunches and other perks all the time. The doctor at this office is very ethical, and he decides which reps to see, and turns away most. This is the way it should be; the doctor does his own research and decides which meds are best, and then forges a working relationship with that drugs local rep. However, for too many doctors these days, it works the other way around; they decide what meds to prescribe based on the perks and kickbacks from the rep.
The bigger part of this problem, is that doctors these days seem to get most of their ongoing education from drug reps, or big-pharma sponsored events. Even the medical journals are basically run by big-pharma these days. Take a look at any medical journal, and there are more pages with ads for drugs than there are pages with research studies. And most of those studies are sponsored and paid for by, guess who.... So what do you think the outcome of the studies are going to show?
It seems like a growing number of physicians are becoming nothing more than legalized drug dealers...they are the foot soldiers on the street, peddling dope for the big pharma king pins. Don't get me wrong, there are a ton of wonderful doctors out there who are doing amazing things every day, but my point is that it seems like every year, they slowly move towards becoming the minority in their profession.
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What do you say to something like this:
Full article is in Wall Street Journal. There is another article in the NY Times
Genentech to Limit Avastin Availability
Use of Cancer Treatment
For Eye Ailment Hurts
Sales of Targeted Drug
By JACOB GOLDSTEIN and MARILYN CHASE
October 12, 2007;*Page*B6
Genentech Inc. said it will stop making its cancer drug Avastin available to certain pharmacies in a bid to curb its use in treating eye disease -- which has cut into sales of the company's high-priced eye drug.
Although regulators haven't authorized Avastin's use against eye disease, it is chemically similar to Lucentis, which was approved last year to treat wet macular degeneration, a leading cause of blindness in the elderly. Compounding pharmacies, which are licensed to mix and repackage drugs, put Avastin into syringes that contain a once-monthly dose of the drug for use in the eye and cost about $40. A once-monthly dose of Lucentis costs about $2,000.
In the first six months of this year, U.S. sales of Avastin were $1.1 billion, and Lucentis sales were $420 million.
What do you say to something like this:
Full article is in Wall Street Journal. There is another article in the NY Times
Genentech to Limit Avastin Availability
Use of Cancer Treatment
For Eye Ailment Hurts
Sales of Targeted Drug
By JACOB GOLDSTEIN and MARILYN CHASE
October 12, 2007;*Page*B6
Genentech Inc. said it will stop making its cancer drug Avastin available to certain pharmacies in a bid to curb its use in treating eye disease -- which has cut into sales of the company's high-priced eye drug.per the article's authors?
Although regulators haven't authorized Avastin's use against eye disease, it is chemically similar to Lucentis, which was approved last year to treat wet macular degeneration, a leading cause of blindness in the elderly. Compounding pharmacies, which are licensed to mix and repackage drugs, put Avastin into syringes that contain a once-monthly dose of the drug for use in the eye and cost about $40. A once-monthly dose of Lucentis costs about $2,000.
In the first six months of this year, U.S. sales of Avastin were $1.1 billion, and Lucentis sales were $420 million.
Translated, means "off-label" use of the drug and someone probably saw the similarities and took a chance and tried it out on a patient with good results. Yes, I agree it sucks, but on the other hand, all it would take is ONE person to experience some freak reaction to its use for MD, and the prescribing MD/NP/PA, compounding pharmacist, and the company would be sued and they wouldn't have a snowball's chance! Notice the authors don't mention that aspect - it won't attract readers or sell papers - would you have bothered to quote the article if the title read: Genentech to Limit Avastin Availability Use of unapproved Cancer Treatment For Eye Ailment risky What will probably happen is a re-formulation, a few FDA- trials, and a re-release of Avastin with a new approved indication, at about the same price as Lucentis......
Location: Lots of sun and palm trees with occasional hurricane :)
8,293 posts, read 16,155,259 times
Reputation: 7018
Quote:
Originally Posted by mm_mary73
Translated, means "off-label" use of the drug and someone probably saw the similarities and took a chance and tried it out on a patient with good results. Yes, I agree it sucks, but on the other hand, all it would take is ONE person to experience some freak reaction to its use for MD, and the prescribing MD/NP/PA, compounding pharmacist, and the company would be sued and they wouldn't have a snowball's chance! Notice the authors don't mention that aspect - it won't attract readers or sell papers - would you have bothered to quote the article if the title read: Genentech to Limit Avastin Availability Use of unapproved Cancer Treatment For Eye Ailment risky What will probably happen is a re-formulation, a few FDA- trials, and a re-release of Avastin with a new approved indication, at about the same price as Lucentis......
The problem is that the non FDA approved use of Avastin for macular degeneration IS just as good as the $2000 Lucentis and it can be used more frequently, if necessary, because MOST patients CAN and will find $50 to save their eyesight, and if they need it but cannot afford it, the physicians will much more readily do it for free, as many times as necessary.
With Lucentis, because it is so expensive, everybody thinks about it more than twice. The insurance carriers don't want to pay either and it takes 6 or 7 months to collect anything, even with preauthorized HMO's.
I am in Florida and the Florida Medicare carrier, First Coast, after reading all the literature, actual results, reviewing data not just from Florida but from across the nation, ended up APPROVING Avastin for wet dry mac use.
Avastin is already FDA approved for colorectal cancer and it is "approved" for other, off label, uses (one of them being eyes).
It's the pharmaceutical company that does not want to lose money by allowing a cheaper version of a drug that works just as well, because they had already pumped the investment and time into Lucentis. Because Lucentis got FDA approved, that's why it costs $2000 (and this amount is only about $50 above what Genentech charges the physicians for it).
Avastin is not any riskier because it is not FDA approved.
It's the generic version of the much more expensive drug, if you will.
Why would I want to pay extra if I can get the same results.
Look what happened with Viox. That was FDA approved. Do you really think Avastin is any riskier than Lucentis because one is off-label and the other is not? Lucentis has risks also and the doc can get sued just as easily. The Lucentis treated patients DO NOT show any significant improvement over the Avastin treated ones.
The problem is that the non FDA approved use of Avastin for macular degeneration IS just as good as the $2000 Lucentis and it can be used more frequently, if necessary, because MOST patients CAN and will find $50 to save their eyesight, and if they need it but cannot afford it, the physicians will much more readily do it for free, as many times as necessary. No argument from me there
With Lucentis, because it is so expensive, everybody thinks about it more than twice. The insurance carriers don't want to pay either and it takes 6 or 7 months to collect anything, even with preauthorized HMO's. Yep, agree
I am in Florida and the Florida Medicare carrier, First Coast, after reading all the literature, actual results, reviewing data not just from Florida but from across the nation, ended up APPROVING Avastin for wet dry mac use. and they'd be crazy not to - less they have to shell out to the provider/druggist/pt. but this is not the "approval" I mean
Avastin is already FDA approved for colorectal cancer and it is "approved" for other, off label, uses (one of them being eyes).The language is probably "may be effective in the treatment of..... which is not the same as "FDA approved for"
It's the pharmaceutical company that does not want to lose money by allowing a cheaper version of a drug that works just as well, because they had already pumped the investment and time into Lucentis. agree Because Lucentis got FDA approved, that's why it costs $2000 (and this amount is only about $50 above what Genentech charges the physicians for it). no, because so far, it's the only one of it's kind available for use. Same thing happened with Tagamet when it first came out. Now you can go to K-Mart
Avastin is not any riskier because it is not FDA approved. not a question of risk, necessarily
It's the generic version of the much more expensive drug, if you will. I'm not a chemist
Why would I want to pay extra if I can get the same results. which is why some providers use meds "off-label" and the really smart ones have developed consent forms for people to sign saying they know it's not approved
Look what happened with Viox. That was FDA approved. different drug, used in a manner not approved AND some other problems Do you really think Avastin is any riskier than Lucentis because one is off-label and the other is not? I don't Lucentis has risks also and the doc can get sued just as easily. agreed, but the chances of a successful defense goes down with the plaintiff attorney saying :So you were experimenting on this poor person...The Lucentis treated patients DO NOT show any significant improvement over the Avastin treated ones
Location: Lots of sun and palm trees with occasional hurricane :)
8,293 posts, read 16,155,259 times
Reputation: 7018
I am in Florida and the Florida Medicare carrier, First Coast, after reading all the literature, actual results, reviewing data not just from Florida but from across the nation, ended up APPROVING Avastin for wet dry mac use. and they'd be crazy not to - less they have to shell out to the provider/druggist/pt. but this is not the "approval" I mean
I know you mean FDA approved. However, the CARRIER for the Federal Government's Health Insurance plan, made a conscious decision to say Avastin was good enough for wet mac D, not just because it saves them money, because they will also pay for the FDA approved drug at an outrageous cost right now. We are depleting funds unnecessarily.
Yes, there are consent forms. There have to be. You are actually injecting a patient's eye. It's a surgical procedure.
Patients were not used as guinea pigs. It was just not under a FUNDED Clinical Trial.
There are also what Medicare calls "Advance Beneficiary Notice" where explain WHY a procedure/item may not be covered and the patient must choose Yes or No regarding paying out of pocket if Medicare doesn't pay. There are only three "approved" reasons why the service MAY not be covered - one of them being "investigational".
Non-Medicare patients are given a similar version of the form.
The forms are strictly for payment purposes and not for legal issues.
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