Monday, April 9, 2007

Adapting to Change: Globalization and USC Pharmacy

When one reads about change and modernization in academia, the word globalization inevitably appears as one of the principle elements of change. Unfortunately, globalization has been a relevant term for over 25 years, yet it is more commonly referred to as a new phenomenon rather than the underlying force in our political and economic theory. It is for this reason that I propose the USC Pharmacy School adapt changes in their program that go beyond adapting to the minor changes of globalization has brought, and instead employ some for principle aspect of globalization. The first principle may seem self evident but more often than not is forgotten in academia; a useful integration into the global pharmaceutical market. The industry today is widespread, with many drugs being produced in Europe and Africa, and research is conducted in Asia and the U.S. The USC Pharmacy program can adjust their curriculum to integrate these elements of the industry by teaching students how and where their products come from, allowing them decide whether they would be interested in entering one of these markets overseas. Additionally, the USC Pharmacy School should consider opening a research facility overseas or perhaps in Canada. Although studying overseas is appealing for any student, pharmacy school graduates from USC would have a distinct advantage for any job if they can claim to have treated patients or conducted primary research in a foreign country. The second element of globalization that should be utilized by the school is integration with foreign pharmaceutical companies, allowing for students to work overseas, which is again a huge advantage USC pharmacy students will have over other competitive students. Other than globalization, a key change that should be implemented is the shortening of the entire curriculum. Currently, the pharmacy school is a four year program, which is on average a year longer than most other courses. Shortening the program to three years will draw more students to the program, allowing for the pharmacy school to choose the most qualified students. Additionally, the feasibility of a joint degree program will increase, for example, if a student pursued a joint degree program in which he would graduate with a Pharm D. degree and a MBA degree, that student would be in school for five years, although this isn’t a drastically long time period, it does not offer a competitively short time frame. Thus it is reasonable to assume that some students who wish to have a MBA would not pursue pharmacy become of the length of the program, and would pursue programs with shorter time frames. On the other hand, USC may be losing students to other pharmacy schools because of this same issue; for example, the only other pharmacy school in Los Angeles is Western University, which has a three year program. Additionally, the pharmacy school should also allow for more rotation time for students. This would give the students more experience under the guidance of USC while allowing them to discover what fields within pharmacy they would like to pursue once they graduate. Now if the USC Pharmacy School adopted all of these changes the experience of getting a degree in pharmacy would be significantly different; students would work and study overseas, while finishing in a shorter time period, allowing them to get a foothold in the industry sooner. However, one may argue that students cannot receive proper instructions outside of the U.S. due to language issues, but this brings us back to the problem of academia we addressed earlier, which is that reluctance to accept the ways in which globalization has changed the political, economic, and ultimately academic environment.

Monday, April 2, 2007

Dr. Raymond Damadian; A Great yet Unknown Inventor

With graduation approaching, the search for a candidate to be awarded with an honorary degree from USC is underway. My Candidate is Dr. Damadian. In picking a nominee for this essay I found it difficult to decide exactly to what degree an individual must embody the qualities that form the foundation of an honorary degree. My problems were soon over when I read about the achievements of Raymond Vahan Damadian, the inventor of the MRI machine. Born in 1936 in Melville New York, Dr. Damadian attended the University of Wisconsin and the Albert Einstein School of Medicine. Dr. Damadian faced great adversity in his life, while at the same time always advocating that people should strive to help individuals. Dr. Damadian should be awarded an honorary doctoral degree in science due to his outstanding achievements in science, chiefly in creating the Magnetic Resonance Imaging (MRI) machine which is used worldwide to detect certain cancers in the human body. Dr. Damadian contribution to society cannot be overstated; however, he has faced much controversy in his life.
The most obvious issue is the fact that although Dr. Damadian invented the MRI machine, he does not have a patent on the production of MRI machines, instead, large overseas companies produce MRI machines while paying no royalties to the original inventor, whose prototype still remains on permanent display in the Smithsonian Institution’s Hall of Medical Sciences. The injustice Dr. Damadian faced was the result of a belligerent and dishonest interpretation of the relevant facts by the presiding judge in the 1982 trial disputing the patent rights of the MRI machine. Despite the fact that a grand jury found Dr. Damadian deserving of the patent, the trial judge overturned the decision of the jury six weeks later and denied Dr. Damadian his rightful patent. Another equally insulting injustice Dr. Damadian had to face was the denial of the Nobel Prize. The simple fact is that the MRI machine has helped countless people live longer and healthier lives, yet the inventor of the MRI has been this award ever since its invention in 1977, and to add insult to injury, the 2003 recipients of the Nobel Prize in Medicine, Paul C. Lauterbur and Sir Peter Mansfield, were awarded the Nobel “for their discoveries concerning magnetic resonance imaging.” The blatant denial of the Nobel to Dr. Damadian is preposterous, but to award the Nobel for same machine to two people did not invent it is unforgivable and casts a long and disgraceful shadow on the entire Nobel Foundation. It is partly for this reason that USC should without recitation award Dr. Damadian an honorary doctoral degree in science.
The MRI machine is without a doubt one of the most important breakthroughs in medical science and its applications have grown far and wide, helping physicians in order fields diagnose and treat myriad diseases. Additionally, throughout all the insults and hardships Dr. Damadian has had to face he has maintained his composure and dignity, upholding the virtues that USC hold dear, he has been faithful to his work, and was courageous and ambitions to attempt to create the MRI machine, which at the time was said to be impossible to make. Dr. Damadian’s contribution to society is without a doubt far beyond what most of us can hope to achieve, and it would be to USC’s benefit to have his name written in our halls. Hopefully, one day Dr. Damadian’s achievements will be properly recognized, however, if they are not in our lifetime, at least USC could be have the honor of recognizing it before most others. Dr. Damadian would encourage all graduates to persue theirs goals without resitation and to ignore their critics.

Wednesday, March 21, 2007

This I Believe: A New Way to Protect Life

In the world of medicine we find many challenges. According to the This I Believe website, one must can openly express their views, I would like to discuss the problems facing modern medicine. The most frustrating challenge I believe is the simplest; the inability to be effective in healing people from whatever medical conditino they have. In other words, modern medicine cannot help everyone get well, the human body and its systems require far more advancements in technology in order to make significant progress. It is for this reason that I believe pharmacy represents a great opportunity for science to apply itself to medicine. I can remember when my grandmother was in the hospital and I was pleading with the doctors to tell of all the ways in which we could help her, but they said that our options were limited and the best thing we could do was to help the body help itself. Luckily my grandmother turned out be healthy, but countless people require more proactive medicine in order to get well.

Pharmacy can be the vehicle to deliver the best of what medical science has to offer in a proactive manner. Unfortunately, I believe that we face a fundamental dilemma in medical science; the human body is the product of billions of years of evolution, and despite the immense understanding of human physiology the scientific community has amassed in the last thousand years, I feel that the human body is far more complicated than we would like to admit. In my own personal studies of medicine and human physiology, I find that the more I understand about the human body, the more lost and disconnected I feel as I only come to realized how vast and complicated our bodies truly are.
In order to put this into perspective, one could imagine if the world’s top electrical engineers, computer programmers and physicists were asked to build a robot that could perform half of the functions a human adult can, reading, writing, driving a car, playing basketball, while at the same time requiring only simple food and water, both commonly found of course, and emitting no pollution which is uncommon for man made machines, capable of automatically maintaining itself, and so on. The task would be impossible; even if someone gave me 100 billion dollars and asked me to build a robot that could effectively do any of those things I’d give the money back and say it cannot be done. Now with this in mind, imagine trying to improve upon the human body itself, the task seems immense, but I am confident that progress can be made, and it is through pharmacy that we can best apply our scientific knowledge. The commercial value of the pharmaceutical industry is undoubtedly growing. I mention ethics because the growing industry represents another important opportunity in medicine. Although the practice of pharmacy is as old as medicine, the new applications of pharmacy provide an opportunity for medicine to lay new ethical and moral standards by which all should health industries can abide. As pharmaceuticals become increasingly more powerful and effective, especially in the field of nueropsychotics, we must review our ethical standards and possible adjust them to accommodate the new applications of many drugs.

Monday, March 5, 2007

Pharmcy Robberies: An Unexpected Side-effect of OxyCotin

A recent but unfortunate trend of pharmacy robberies has been taking hold nationwide. The assailants are holding up pharmacies in order to access popular drugs such as OxyCotin, which are only available through a prescription. Pharmacies make easy targets for several reasons; firstly, they usually do not undertake the regular security precautions that other high risk vendors employ; such as the bullet-proof glass found in many gas stations and banks. Secondly, the nature of a pharmacy entails a relaxed and unsuspecting environment, with easy access to the public; this fact gives robbers the element of surprise. Another element adds to the problem of pharmacy hold ups, the suspects are not usually from the municipality where the pharmacy is located; they commonly travel from poorer neighborhoods. It seems as though the criminals are avoiding local pharmacies because they would have more active and passive protective measures against robberies. The most common active protective measure is a weapon, such as a firearm or chemical spray.

However, the problem lies not only in prevention of the robberies, but in avoidance of those factors that lead individuals to commit such crimes. Morphine and OxyCotin are some of the most widely abused prescription drugs, so much in fact that the FDA released a 63 page report on the abuse of OxyCotin. In my opinion, the prevention of drug addiction is a better method of addressing the issue. However, it must be stated that much is already being to in order to help prevent the abuse of OxyCotin and drugs of the sort. One of the best possible methods to prevent such abuse is to monitor the use of these drugs to patients who have legitimate prescriptions. More often than not, users become dependent while they are using it with a valid prescription. However, when the prescription runs out, users find they are addicted, and search for new means to access the same drug. Some individuals claim that they have lost their supply, and request more, others buy it illegally on the black market, and some take the extreme measure of robbing suppliers, such as pharmacies or even hospitals. On the other hand, it can be argued that an individual willing to commit armed robbery is immune to any prevention methods available, and that the nature of that individual renders him helpless. Honestly, I cannot think of a strong counterargument other than to say that modern science is incapable of correctly diagnosing an individual as “beyond help” and thus we must as a fair society treat all members in danger of drug addiction or violence as being within the bounds of aid. Unfortunately however, I believe that modern pharmacies and government agencies are ignoring abuse-prevention, and instead are focusing their energies on robbery prevention.

Monday, February 26, 2007

Prescription Drug Advertisements: How Many are Too Many?

The two blogs I focused on this week were pertaining to misperceptions of pharmaceutical products by the consumer. The first blog discusses the finding of a recent UCLA study illustrating advertising techniques for prescription drugs. The blog analyzes the finding of the study, and highlights some key evidence that demonstrates the subtle nuances of marketing strategies for pharmaceuticals on television. The second blog reflects on an article published by the Washington Post highlighting “low health literacy.” The blog relates the finding of the Washington Post to an article discussed in the authors Health Law Class citing the importance of a lucid understanding of health products and their accompanying literature.

Comment on Blog I

I believe that this is an important blog because it highlights those points of the UCLA study that make a case against the dishonest advertising techniques of many pharmaceutical companies. Additionally, I feel that the blog may be lacking in its consideration of alternative causes for the high degree of pharmaceutical ads, such as a lack of government regulation, and the relative ignorance of the consumers. Also, I believe that the blog could have made a stronger case against the pharmaceutical companies if it argued that the advertisements exploited consumer’s ignorance of health literature.

Comment on Blog II

I feel that this blog brings up an important issue in the U.S. health industry, and that the lack of understanding may cause confusion for the average consumer. However, I feel that this blog suffers because it does not have certain elements that Blog I did, mainly an attempt to illustrate false marketing techniques by the major drug manufactures. This blog could have been stronger if it gave some possible explanations for why Americans have such low health literacy other than their overall literacy skills, which are approximately at the 8th grade level.

Wednesday, February 21, 2007

American's Appetite: Demanding the Worst and Hoping for the Best

The centers for Medicare and Medicade Services realeased a report predicting future health care costs up to the year 2016 demonstrates the possible outcomes of the current national health trends. What is paramount to this issue is the combination of a sedentary lifestyle, as seen in the chart illustrating the increasing cost of healthcare in the U.S., and an increasingly unhealthy diet. When one considers the fact that a staggering 65% of the U.S. population is overweight or obese, it is not surprising that the federal government is forecasting health care costs to rise to approximately $ 4.1 trillion a year, or about 16% of the GDP. Another factor is the increasing age of the overall population, as baby boomers near retirement. The general trend for the elderly is the onset of health problems, generally dealing with the cardiovascular or circulatory systems, such as diabetes of heart disease, along with a wide range of other health problems. In addition to age, unhealthy eating habits also contribute to the ever worsening health condition of the average American.

According to the Forbes article, the effects of the increasing healthcare costs in the U.S. on the pharmaceutical industry will affect both health providers and suppliers of pharmaceuticals and also "U.S. prescription drug spending should reach $497.5 billion by 2016, more than double the expected level for 2006." Federal expenses on prescription drugs are expected to grow at a faster rate (8.6%) than the growth rate of overall healthcare spending (6.9%). The higher rate of pharmaceutical spending is due in large part to the increasing effectiveness of drugs and the change in the role of pharmacists from a position of supplier to that of primary healthcare advisor, almost on par with a physician. Thus, we see that unhealthy eating habits, coupled with age and an inactive lifestyle have necessitated increases in national healthcare spending. Additionally, the expansion of the role of the pharmaceutical industry in providing healthcare to the average America explains the higher rate of spending for pharmaceuticals.

One only needs to travel as far as his local supermarket to see how poorly the average American eats. For example, a recent product released by a major American food producer, Jimmy Dean, illustrates just how severe the disparity is between what Americans are willing to purchase and what foods are actually healthy. The product in question is a sausage wrapped in a chocolate chip pancake, on a stick. Now the nutritional value of the product is beyond question negligible, anything wrapped with a chocolate chip pancake, or “on a stick” is most likely unhealthy, not to mention that sausages are mostly made from animal by-products. The thing to keep in mind is that Jimmy Dean expects this product to sell; they expect consumers to either be completely ignorant of the health risks associate with the product, or to disregard them altogether, either way; the existence of such an unhealthy snack on the market makes a statement about the health standards of the average consumer. And this is the big picture, Americans no longer demand healthy foods from the market, and nor do they expect a healthy lifestyle from themselves.

When one accepts these ideas as the truth it is easy to understand why health care costs will double in less then ten years, and why heart disease kills almost a thousand people a day.

Monday, February 12, 2007

The Nuances of Pharmaceutical Safety: Two New Arguements

For as long as modern medicine has existed, there have been concerns over the validity and effectiveness of drugs. A recent article published in the United Kingdom highlights this issue and what can be done about it. In an ideal world, all drugs would have randomized, double blind, placebo controlled testing done by creditable institutions prior to be released into the market. Unfortunately, this is not possible nor is it heavily pursued. On the contrary, we have two general classifications in the United States regarding the validity of a given drug, FDA Approved, and unapproved. The existence of this system baffles the mind when considering the complete openness and accessibility of none FDA approved drugs to the market. The availability of unapproved drugs is staggering and reflects on the true lack of government regulation of the health care industry. In a nutshell, an individual could turn a pine cone into powder form, bottle it, and sell it on the open market as a weight loss drug, while only having to take on precaution, labeling the so-called medicine as none-FDA approved.

The first blog highlights the underlying problem in faulty pharmaceutical drugs, which is a lack of quality testing. This issue however, is far more complicated, and he blog does an excellent job of addressing these issues. To begin with, there is a inherent disparity between the goals of an pharmaceutical provider and the means by which quality medicine is produced. Large pharmaceutical firms, like Pfizer, are publicly traded companies, and therefore, the CEO’s have a responsibility to the shareholders to produce the maximum profit possible. This constitutes the ability to rapidly respond to the demands of the market, and in my opinion, control the demands of the market. Unfortunately, almost all of what science stands for, and what ethics demand in the production of quality medicine, is the dismissal of all factors except for the validity of evidence. Pharmaceuticals are obviously complicated in their production, and thus conflict with the goals of the corporations that produce them.

The second blog discusses, among other things, the nuances of the FDA’s approval practices, and the inherent dangers of the seemingly open and unregulated pharmaceutical industry. The major classification between FDA approved and none-approved truly reflects on the capitalistic underpinnings of policy federal government regulation. One can argue that citizens have the “freedom” to choose between approved and none-approved drugs, but the reality is the market is cluttered with medicine that has not passed adequate scientific standards. Despite the fact that an ideal, randomized, double blind, placebo controlled testing process is not possible for every drugs, as discussed in the first blog, we should demand that the production of pharmaceuticals be guided by the highest professional and scientific standards.

Monday, February 5, 2007

Prescription Drug Legislation: How Much Can We Change?

As anyone who has a remote interest in politics has noticed, seems to being steering congress into a new direction, one thatthe new democratic leadership has not been seen for over twelve years. Case in point, the new Prescription Drug Bill which requires the Secretary of Health and Humans Services to negotiate with drug suppliers for lower prices. This bill reflects a new policy change in Congress, but according to some interest groups, the system remains flawed and vulnerable to private interests.
Interestingly enough, the bill was passed during the whirlwind of legislative activity known as the Democrats “First 100-Hours.” During this period (first 100 hours of official Democratic leadership) six major pieces of legislation were passed by the House, and now await the Senate’s decision.
This new bill could not have come at a better time for elderly in America. Two factors seem to be pushing the elderly farther into the margins our society. Firstly, the increasing cost of living vs. their fixed and hopelessly inadequate income. As many of us can see today, many senior citizens today rely almost solely on their social security checks, a role for which they were not intended to fill. As a result, many senior citizens live in scarcity, making for the acquisition of necessary medication difficult and uncommon. The second strain on senior citizens is the increasing strain on the system by one, the increasing age of the U.S. population, and despite recent events, the second factor is a trend toward privatization of the medicare industry.

Monday, January 29, 2007

The Private Pharmaceutical Industry

The Challenges Contemporary Small-Scale Pharmacies Face

As we enter the 21st century, we find ourselves succumbing to the controversial yet ultimately unstoppable trend of globalization and corporatization of previously small-scale markets, like the retail pharmaceutical industry. Although large retail pharmacy chains have existed since the 1940’s, which major retail stores such as Sav-on and Osco Drugs, there remains the persistent reminder in the back of one's mind that somehow the entire retail pharmaceutical will soon be nothing but a closed off market, guarded by an oligarchy of major pharmaceutical chains lording over the industry.

As the increasing age of the U.S. population is coupled with the staggering dietary habits of most middle aged and adolescent Americans the pharmaceutical industry will unfortunately get a boost in its sales. Perhaps it is because of this eminent growth in demand that corporations are attempting to seize as much of the market as possible, like sprint runners taking positions in anticipation of the blast from the starting gun. The proliferation of corporate pharmacies is coldly evident when one does a simple Google search with the following in the search for pharmacies in a given area, approximately fifty percent of the stores belong to national brands. Perhaps it is because small scale, mom & pop, pharmacies do not advertise with a Google supported publication, however, this represents an even greater problem. The issue here is not that advertisements for local, privately owned pharmacies cannot be found on a simple Google, but that small businesses cannot meet the demands of modern consumers.

The modern consumer demands quick access to all prevalent information, such as location, inventory, working hours, and drug production capabilities. Not only do most private pharmacies lack the efficiency and resources of corporate pharmacies, but their location and accessibility (hours of operate, parking, space) is also inferior when compared to large corporate pharmacies. As we can see, the second store on our general search had a 24hr pharmacy. The amount of effort and capital required for a private pharmacy to maintain those hours would be staggering. Another advantage corporate pharmacies have is the prevalence of an almost infinite number of “pull factors” for consumers. The CVS pharmacy chain sells thousands of non-pharmaceutical products; they even have one of the world’s first disposable digital video cameras. When one critically compares private versus. corporate pharmacy retailers the results are extremely discouraging.

One of the few advantages private pharmacies may have in the future is the increasing role of the pharmacist in modern medicine by allowing greater to pharmactists and pharmaceuticals. The ever broadening capabilities of the pharmaceutical sciences are expected to propel the contemporary pharmacist into a position almost on par with that of a general physician. Private pharmacies would have some advantage in that their customer base would naturally be smaller and thus allow any given pharmacist working in the in a given area to have a more intimate relationship with the patient as they can more easily recognize their personal needs. Unfortunately however, modern business trends dictate that almost any market can fall prey to corporatization.

Another blow to the private pharmaceutical industry is the U.S. policy on retail pharmaceuticals. Essentially, U.S. policy favors pharmaceutical corporations, which results in extremely expensive pharmaceuticals compared with Canada. This has created an online market for drugs from Canada. The demand for low-cost drugs is evident in a simple search for a random drug used for ulcerative colitis. The drug is called Asacol, and in a simple search on, one can see that three of the five sponsored links are websites of Canadian pharmaceutical retailers.

Thus, it is evident that a combination of growing demand, corporatization, along with the increasing accessibility demands of the modern consumer are all contributing to the profitability and practicality of large-scale corporate pharmacies. Perhaps the changing role of pharmacists in the future will counter the decline in private pharmacies, but modern economic trends dictate otherwise.