Friday, January 15, 2016

One more example why government support for ALL drug and medical device research should be the norm

Up until now a spectacular argument for government taking over all drug and medical device research has been the example of Sovaldi: the Hepatitis C cure. We all know the story.
Now, for the first time ever, all three million Hep C sufferers can clean the virus from their system — for only $300 billion dollars ($100,000 each) with 84 pills that costs $1 each to manufacture.
Seems the gov did the original (read: risky) research but once the researchers smelled money (er, uh, a cure) the law allowed them to continue with private funds and then make as much profit out of it as can be bled.
Hep C — PS: 30% more likely to come down with Parkinson’s — and who knows what else. Jingle, jingle, jingle goes the cash register.
Now we have a story supporting gov research from the opposite angle — if you ask me anyway.
Until now, heart failure has been progressive and surely terminal. In 2012 a trial or an innovative medical device in England with 20 patients ended with 25% cured and everyone else improved. It involved a balloon like cuff wrapped around the upper aorta that aided pumping — and apparently allowed the less strained organs to heal.
Now, a much bigger trial on two continents is being arranged (hopefully) but may potentially fall apart for lack of private funding.

Link to very long — what I can only call a — prospectus below

    [cut and paste]
Sunshine Heart develops the C-Pulse device for HF (Heart-Failure) patients. C-Pulse showed outstanding clinical results in the US feasibility study, and EU study, including improvement in HF condition, and recovery.
Heart Failure is poorly treated, resulting in 5 year mortality rate of 60%. C-Pulse targets a huge unmet market of 5.2 million patients in relatively progressed HF stages.
Slow enrollment in the US pivotal trial (the equivalent of an FDA phase III trial), and circumstantial pause and resumption of trial enrollment have lead to dwindling cash.
SSH share price fell rapidly, fueled by panic, tax purposes selling, inability to raise additional cash, fears of approaching bankruptcy, and a poison-pill mechanism preventing an otherwise likely take-over.
Sunshine Heart basically has no other option but pursuing a strategic move soon, that is explored in this article, and can result in substantial gains in the next 6 months.
Heart Failure condition overview
HF (Heart Failure) is a terrible disease , but unfortunately is very common. It is currently poorly treated, and is one of few diseases that increase in mortality YoY. More than 7 million HF patients exist in the US, with more than 800,000 new HF cases every year. The number of HF patients is expected to exceed 10 million by 2030. The HF increase in prevalence is driven by the epidemics of obesity, diabetes, and high blood pressure. Additionally, 7-10% of the aging population above 65 years old suffer from HF.
The outcomes of HF are very poor: 5 year mortality rate is higher than 60% – worse than many types of cancer. There are 1 million hospitalizations per year due to HF in the US. HF accounts from more hospitalization-days than any other disease. HF is the number 1 cause for readmission within 30 days – higher than 20% re-admission rates. The current annual cost of HF to the US economy is a huge $31B, with annual cost projected to reach $70B by 2030.
Figure 1 shows the poor outcomes of patient hospitalizations due to heart failure, as reflected by high mortality rates at 30 days, 12 months, and 5 years, and high rate of hospital readmissions. Figure 2 shows the poor and deteriorating median survival time after every HF hospitalization. Kidney failure accounts for more than 50% of mortality, as the kidneys heavily depend on sufficient blood pressure, and blood flow for their operation, which is obviously affected by HF.
PS. The insertion procedure is minimally invasive and there is no risk of clots as with other pumping aids, the whole device being outside the bloodstream.

Headline:  Drug shortages in American emergency rooms have increased more than 400 percent
"Of the nearly 1,800 drug shortages reported between 2001 and 2014, nearly 34 percent were used in emergency rooms. More than half (52.6 percent) of all reported shortages were of lifesaving drugs, and 10 percent of shortages affected drugs with no substitute."
"It seems simple enough: If companies produce more drugs, more drugs will be available to ERs. But given that the majority of drugs on shortage in emergency rooms are sterile injectables with low profit margins, don't expect that to happen anytime soon."

SEE  ALSO  (long):

Tuesday, December 8, 2015



TITLE:  It's the labor market, stupid (us) -- AND the psychology

Forget monetary and/or fiscal policy — it’s the labor-market policy, stupid (to borrow a familiar phrase from somewhere).

As long as ownership monopsony unopposed by labor union monopoly is able to mercilessly squeeze wages and benefits down …

… squeezing what is squeezed to the top who cannot spend it as fast as we shovel it to them — THINK $100,000,000 QBs, $20,000,000 CEOs, ETC., ACTUALLY REDUCING DEMAND …

… squeezing so much out of the bottom that too many (very many) lives become less well educated, less healthy, LESS PRODUCTIVE, or even so dysfunctional we have to spend heavy on police and jailers to chase some around ...

... or squeezing so much out of wages of former middle class jobs that people end up on the bottom because they refuse to work AT ALL for “chump change” wages: think me, American born former taxi driver (okay I’m too old now — but I wouldn’t if I could) who won’t work for $500 a week (if they do that well today) for a job that used to pay $800 a week for 60 grueling hours.
 * * * * * *
This last takes a little development. Today’s Chicago gang bangers would gladly labor for the equivalent of $200 a week -- in 1915. Because, that would have been all the less productive economy of that era could have paid them. Today’s 100,000 Chicago gang bangers (out of my guesstimate 200,000 Chicago gang age, minority males) wont work for $400 a week for jobs that today’s economy should be able to pay $600 to $800 a week for (e.g., super market clerk).

At my old Teamsters Union local 804 (Gimble’s furniture warehouse) we spent half the day breathing hard and wet with sweat for $800 a week — in 1970; when per capita income was 66% of today’s level. Today’s 804 UPS drivers do $1200 a week, “breathing hard” — the market still demands a lot from them but they at least can demand commensurate pay -- commensurate in 2015.

The beauty of collective bargaining -- much the better if under-girded by centralized bargaining to keep the balance between monopsony and monopoly fair --  is that it informs you that you have squeezed out the last penny the ultimate consumer is willing to pay — so you have that natural incentive to give your work all you’ve got.

A lot of it seems to be the psychology too, stupid (just to use a familiar phrase :-] — see snake head) especially on the dysfunctional side of town.
 * * * * * *
Until the American labor market is rescued from it’s pathological union-free condition there will be no change in direction from the gradual descent into more demand stagnation and greater human dysfunction -- and of course progressive political corrosion for the disempowered majority).

Easy-to-rescue: just start in most progressive states, moving to less progressive states of the union, treating labor market muscling and manipulation as seriously as we sanction every other form of unfair market warping: MAKE UNION BUSTING A STATE FELONY, backed by RICO prosecution for persistent abuse.  Could it be easier?

The laws are already in place; the issues presumably long settled; the laws are curiously missing one thing: dentures. :-)

It’s really just a matter of freedom, isn't it — free to chose to collectively bargain? 

Thursday, October 8, 2015


Sovaldi: Hepatitis C can be wiped out for $300 billion (that's a "b") -- the same amount we now pay for all other prescriptions. Cost to manufacture: half a billion dollars.

Now comes: "Amgen scores a victory for PCSK9, halving cardio risks after one year"  " ... new [cholesterol] drugs could eventually add as much as $150 billion to the national health-care bill." 

[how much will we be willing to pay to cure the incurable?]

"Of the 2,644 patients, eight exhibited signs of dementia. Two were younger than 65, five were aged from 65-74 and one was aged between 75-84."
"for the first time in human subjects, our notion that calcineurin inhibition has a protective effect on the development and possible progression and even reversal of Alzheimer's disease,"

C-Pulse - a cuff that wraps around the aorta and pumps blood from the heart around the body - has proved effective in reversing [formerly incurable] heart failure, even in some patients with severe cases.

[the list of potential pharma rent collectors grows by day]

"And they also found that azoramide greatly improved blood glucose levels in obese mice and mice with type 2 diabetes. They showed this improvement was the result of two things: better functioning of insulin-producing beta cells and greater insulin sensitivity in tissues." 

My $500 Pill Revealed -- Revlimid -- by Kevin Drum

[just a sample of monopoly possibilities; more -- surely -- to come] 

Potential target for future Huntington's disease treatment discovered
"... MNT reported on a study that confirmed an activating protein called Rhes plays a pivotal role in Huntington's disease. This protein could become a drug target in future treatments.  

PLEKHA7 -- puts brakes on cancer -- better get ready to sell the Statue of Liberty back to France
"He notes this is like a speeding car that has a lot of gas (E-cadherin and p120) but no brakes (the PLEKHA7 complex), and concludes:"By administering the affected miRNAs in cancer cells to restore their normal levels, we should be able to re-establish the brakes and restore normal cell function. Initial experiments in some aggressive types of cancer are indeed very promising." 

[just another day for potential new drug monopolies -- we will all owe our souls to the corner drug store]

Why Insulin Costs So Much
July 19th, 2015 by David Mendosa
"Dr. Hirsch reviewed the cost of insulin from 1921 when Drs. Frederick Banting and Charles Best discovered it. “In a generous gesture that unfortunately didn’t start a trend, they sold the patent for $1 so that cheap insulin would quickly become available.
"By 2005, people worldwide were spending more than $7.3 billion for insulin. “But no one could have predicted what would happen over the next decade,” Dr. Hirsch said. By 2013 we were spending $21 billion for it.
"Between 2005 and 2015 the cost of a lispro vial went up 264 percent, while a vial of insulin glargine went up 348 percent, and a vial of NPH went up 364 percent. That’s a lot, but other insulins went up even more.
"The cost of an aspart pen rose in this 10-year period by 389 percent. And the cost of a vial of U-500 regular insulin jumped a staggering 508 percent.
Price Fixing?
"Dr. Hirsch noted that one year ago Sanofi increased the price insulin glargine 16.1 percent. “And literally the next day, Novo Nordisk increased the price of insulin detemir (Levemir) 16.1 percent. In fact, this pattern repeated six months later, and this has actually happened 13 times for these two products that have total U.S. sales of $11 billion.” 

[Such an collection of greed-driven price bleeding that I cannot encapsulate it -- yet.]

Drug Goes From $13.50 a Tablet to $750, Overnight
Andrew Pollack   The New York Times|finance|headline|headline|story&par=yahoo&doc=103012076&ref=yfp 

That Guy Who Is Price-Gouging AIDS Patients (see just above) Also Did It to Kids with Kidney Disease

"The former hedge fund manager whose pharmaceutical company has come under withering attack for allegations of  egregious price-gouging on life-saving medication (just above) ... and it turns out he once tried a similar price hike scheme ... During Martin Shkreli's tenure as CEO of Retrophin ... the company increased prices on a decades-old kidney medication by about 20 times its original cost ... ."
"Drugonomics is not Adam Smith’s invisible hand. It is Gordon Gekko’s visible middle finger."

[One Washington Post story]

The drug industry wants us to think Martin Shkreli is a [unique] rogue CEO. He isn’t [unique at all].

Plant used for gout 3,000 years -- in pill form since 1800s.  Pharma somehow got exclusive rights (normal apparently) -- price shot up from 9 cents a tablet to $4.85.
2013 increase in price of brand name drugs (higher every year): 12.9%.  That approaches 200% added (300%) every 10 years.
Tetracycline, 1948 drug: 5 cents a capsule until 2013 -- now $11.
Clomipramine, 1960s antidepressent, 22 cents a pill up to 2012 -- now $8.17.
In Australia, 2010, Amedra Pharmaceuticals bought the rights to abendazole, off patent, intestinal parasite drug selling for $6 a day -- raised to $120.

[Another day, another drug]

Nitropress, generic blood pressure drug went for $44 a vial way, way back in the year 2013.  Now sold by Valeant Pharaceuticals for $806. 

According to a spokesman, no one will ever be denied this medication: “These are drugs that are only used by hospitals — they are not sold in pharmacies — in accordance with specific surgical procedures. This means that whenever the protocol calls for use of these drugs, they are used.”

[$2,000 in far away Canada -- $20,000 for us in the US]

"The price of a 30-milligram injection of the drug, according to the bill, was $19,827.90. Because at least four shots would be needed, they were looking at pharmacy charges approaching $80,000 and nearly $16,000 in copays.

"A 30-mg dose of Lupron Depot is available from Canadian pharmacies for under $2,000, according to the website"

 Ever elongating list grows from here.

[$250,000 a year breakthrough cystic fibrosis drug -- and more]

"A breakthrough new drug, Orkambi, for patients [with cystic fibrosis, a life-threatening genetic condition that causes severe damage to lungs] — along with sticker shock, at an annual price tag of more than a quarter million dollars. 

"[A]t more than $300,000 a year, Kalydeco costs even more than Orkambi ...  Both Orkambi and Kalydeco are made by Vertex, a Boston-based pharmaceutical firm ... "

[Post Script]

Is it too late to recount the tale off a sleeping pill whose name I forget, but which cost $10 a month in 10mg dose -- and $200 a month in a lower 5mg dose: a "new drug"; trials having shown that some patients do better on the half dose.  That's how today's law is written. 

 How the US Congress Hands US Corporate Taxes To Europe
02/08/2016     Jeffrey Sachs

" The present case of Gilead is even more absurd. The company owns the patent on blockbuster drug Sofosbuvir, the cure for Hepatitis C. The company bought the drug from the drug developer Pharmasett, which did all of its R&D in the United States. Yet the intellectual property on Sofosbuvir is claimed by Gilead to be in Ireland for tax purposes. When Gilead fleeces the U.S. government by charging $1,000 for a pill that costs $1 to manufacture, and the money is paid by the U.S. government to pay for treatment of a U.S. citizen in the U.S., Gilead has the chutzpah to book the U.S. profits in Ireland. And they get away with it.

" You can't make this stuff up.

" But here's the further twist. The European Governments are seeing how the U.S. companies are getting off without paying taxes. So now the European tax authorities are stepping forward to collect taxes on the profits earned by U.S. tech companies in Europe. And the companies are indeed settling with the European tax authorities for billions of dollars in tax payments -- taxes that should be paid, not to Europe, but to the U.S. Treasury.

"As I said, you can't make this stuff up.

" So the bottom line is as follows. In their interest to garner favor with U.S. companies (mainly in search of campaign funds), the U.S. Congress has allowed these companies to escape U.S. corporate taxes by magically declaring that their IP is located in some foreign tax haven. Yet instead of the money remaining with the U.S. companies, as Congress intended, it is increasingly going into the European tax coffers. "

Monday, April 21, 2014

My $15 an hour minimum wage/centralized bargaining "Magnum Opus" :-)

If average Walmart nonsupervisory pay were raised to $100 an hour, the price of $10 items would only rise to $15.  Walmart labor costs are 7%.  Nonsupervisory workers average $12 an hour. $12 X 8 = almost $100. One of the $12s is there already.  7x7% = 49%.

Double current Walmart nonsupervisory pay to $24 hourly, throw on 25% for benefits to make it $30 and prices rise about 10%.

Somebody challenged me that raising Walmart prices 10% (at $30 -- only 3.5% at $15 min wage) would charge low income consumers $26 billion more a year ($260 billion sales).  I pointed out they could take it out of the $560 billion raise they would get from a $15 minimum wage.  

A $15 minimum wage would shift about 3.5% of income from the 55 percent of the workforce who garner 90% of income to the 45% who scratch only 10%.  $8,000 average raise X 70 million (45% of 140 million + 5% at minimum now) = $560 billion out of $16,000 billion GDP.  BTW, 45% of workforce not going to be sent home over a 3 1/2 percent shift in income share.

100,000 out of (my estimate) 200,000 gang age, Chicago males are in street gangs – I say because they wont work for a minimum wage several dollars below LBJ’s 1968 minimum wage ($10.95) after per capita income about doubled.  A $15 an hour minimum wage might actually put American born workers back to work at America’s McDonald’s.
 * * * * * * * * * *
”Denmark has no minimum-wage law. But Mr. Elofsson’s $20 an hour is the lowest the fast-food industry can pay under an agreement between Denmark’s 3F union, the nation’s largest, and the Danish employers group Horesta, which includes Burger King, McDonald’s, Starbucks and other restaurant and hotel companies.”

What Denmark does have – along with most of continental Europe and French Canada and Argentina and Indonesia -- is a labor market setup called centralized bargaining where every employee doing similar work (e.g., retail clerk) negotiates one common labor contract with all employers doing similar business (e.g., Safeway, Best Buy, Walmart).

$20 an hour + benefits: it’s the centralized bargaining/truly-free market!  Supemarket workers (think Walmart gutted two-tier contracts) and airline employees (think regional pilots making $500 a week) would kill for centralized bargaining. 
The only practicable way to re-unionize -- by law.  Only way to reconstitute political democracy as well. 

Check out Only One Thing Can Save Us by Chicago labor lawyer Tom Ghegeogan.
 * * * * * * * * *
I am not talking about collective bargaining alone — you understand I am talking about every employee doing the same kind of work negotiating one common contract with every employer doing the same kind of business (in the same geographic locale unless nationwide is appropriate). I’m not sure that is we are both talking about the same.
Well, imagine you are running for Congress and you want to support putting some real teeth into the right to organize. Whatever that would mean has got to be real complicated and unfortunately in a country that has forgotten about collective bargaining not a real hot topic.
OTH, centralized bargaining promises to improve so many employees lot (everybody’s lot?) so simply and quickly that it would make a very exciting — and very novel (as in big fun) — issue. Come to think of it polls show 50% want to unionize so maybe its just a matter of the right kind of union issue — and this might be the real killer app. Democrats taking a pasting because they aren’t making anything any better as our world goes down the drain — might be just what they need.
- See more at:
I am not talking about collective bargaining alone — I am talking about every employee doing the same kind of work negotiating one common contract with every employer doing the same kind of business (in the same geographic locale unless nationwide is more appropriate).

Imagine running for Congress and you want to put some real teeth into the right to organize.  Modifying current labor law could be off-putting complicated -- unfortunately in a country where collective bargaining has become a forgotten topic. 

OTH, legally mandated, centralized bargaining promises to improve so many employees lot (everybody’s lot?) so simply and quickly that it would make a very exciting — and very novel (as in big fun) — issue.  The political "killer app."  As I always say supermarket workers and airline employees would kill for centralize bargaining. 

We have socialists, we have Austrian economists and every flavor of economic/political opinion in between.  Where are America's "centralized bargain-ists" (should be a movement all over the world even in labor organized countries) -- pushing the one labor market system that, world-wide for three-quarters of a century (starting with the Teamsters Union in Detroit in the 1930s), has consistently delivered fair and balanced economies and societies?

Everybody better get together to come up with something real soon -- or else:
If the top 1% income continues to receive all the economic growth, then, by the time the output per person expands 50% (25-30 years?) the top 1% income will “earn” half of a half-larger economy (25% + 50% = 75% of 150%). By the time output per person doubles (typically 40-50 years) the equation will read 25% + 100% out of 200% = 62.5% of a twice-as-large economy.


double-indexed is for inflation and per capita income growth:   

yr  per capita    real     nominal  dbl-index   %-of
(2013 dollars)

68    15,473    10.74      (1.60)        10.74      100%
69-70-71-72-73     [real, low point- 8.41]
74    18,284      9.47      (2.00)        12.61          
75    18,313      9.11      (2.10)        12.61
76    18,945      9.44      (2.30)        13.04        72%
77                                                    [8.86]
78     20,422     9.49      (2.65)        14.11
79     20,696     9.33      (2.90)        14.32
80     20,236     8.78      (3.10)        14.00     
81     20,112     8.61      (3.35)        13.89        62%
82-83-84-85-86-87-88-89               [6.31]
90     24,000     6.79      (3.80)        16.56  
91     23,540     7.29      (4.25)        16.24        44%
92-93-94-95                                    [6.51]
96     25,887     7.07      (4.75)        17.85
97     26,884     7.49      (5.15)        19.02        39%
98-99-00-01-02-03-04-05-06          [5.97]
07     29,075     6.59       (5.85)       20.09
08     28,166     7.10       (6.55)       19.45
09     27,819     7.89       (7.25)         9.42        40%
10-11-12                                          [7.37]  

13     28,829     7.25       (7.25)       19.32        38%

Sunday, June 2, 2013

My minimum wage worksheet

double-indexed is for inflation and per capita income growth

yr  per capita    real     nominal  dbl-index   %-of
(2013 dollars)

68    15,473    10.74      (1.60)        10.74      100%
69-70-71-72-73     [real, low point- 8.41]
74    18,284      9.47      (2.00)        12.61          
75    18,313      9.11      (2.10)        12.61
76    18,945      9.44      (2.30)        13.04        72%
77                                                    [8.86]
78     20,422     9.49      (2.65)        14.11
79     20,696     9.33      (2.90)        14.32
80     20,236     8.78      (3.10)        14.00     
81     20,112     8.61      (3.35)        13.89        62%
82-83-84-85-86-87-88-89               [6.31]
90     24,000     6.79      (3.80)        16.56  
91     23,540     7.29      (4.25)        16.24        44%
92-93-94-95                                    [6.51]
96     25,887     7.07      (4.75)        17.85
97     26,884     7.49      (5.15)        19.02        39%
98-99-00-01-02-03-04-05-06          [5.97]
07     29,075     6.59       (5.85)       20.09
08     28,166     7.10       (6.55)       19.45
09     27,819     7.89       (7.25)         9.42        40%
10-11-12                                          [7.37]  

13     28,829     7.25       (7.25)       19.32        38%

 * * * * * *  

An added thought: By the year 2013 some could speculate that a $20.20/hr minimum wage might not be a realistic expectation evidenced by double indexing alone because the fabric of the economy might have changed so radically over 45 years.  Might be an outside possibility, but, LBJ's 1968 minimum wage would have morphed to more than $14/hr with double indexing by only 1978.  Can anyone explain how the economic fabric might have changed so radically in a mere 10 years?

Saturday, February 4, 2012

DIRECT AID TO ISRAEL SINCE 1970 (millions of dollars)

DIRECT AID TO ISRAEL SINCE 1970 (millions of dollars)
Year------ Nominal------- Adjusted-------------------- Total

1970---------- 93.6--------- 530.00
1971--------- 643.3------- 3,489.70
1972--------- 430.9------- 2,264.00
1973--------- 492.8------- 2,438.47
1974------- 2,621.3----- 11,681.53
1975--------- 778.0------- 3,177.07
1976------- 2,337.7------- 9,026.23
1977------- 1,762.5------- 6,389.79
1978------- 1,822.6------- 6,141.49
1979------- 4,888.0------ 14,791.92-------------- 59,930.02
1980------- 2,121.0------- 5,655.14
1981------- 2,413.4------- 5,833.05
1982------- 2,250.5------- 5,123.66
1983------- 2,505.6------- 5,526.91
1984------- 2,631.6------- 5,564.61
1985------- 3,376.7 ------ 6,894.62
1986------- 3,663.5------- 7,343.71
1987------- 3040.2-------- 5,879.68
1988------- 3,043.4------- 5,885.87
1989------- 3,045.6------- 5,656.11-------------- 59,363.36
1990------- 3,034.9------- 5,377.16
1991------- 3,712.3------- 5,988.20
1992------- 3,100.0------- 4,854.38
1993------- 3,103.4------- 4,178.46
1994------- 3,097.2------- 4,591.46
1995------- 3,102.4------- 4,472.42
1996------- 3,144.0------- 4,402.40
1997------- 3,132.1------- 4,287.37
1998------- 3,080.0------- 4,050.36
1999------- 3,010.0------- 3,969.37-------------- 46,171.58
2000------ 4,131.85------- 5,144.00
2001------ 2,876.05------- 3,569.88
2002------ 2,850.65------- 3,481.31
2003------ 3,745.15------- 4,471.79
2004------ 2,867.25------- 3,334.75
2005------ 2,612.15------- 2,938.50
2006------ 2,534.5--------- 2,762.05
2007------ 2,500.2--------- 2,649.75
2008------ 2,423.9--------- 2,474.59
2009------ 2,550.0--------- 2,611.82-------------- 33,438.44