Arcapta Inhaler Approved for COPD

Pushing Western medicine with fear in India

An advertisement from pharmaceutical giant Abbott, which appeared in a newspaper ad in India earlier this year, is shown in this image taken July 7, 2011. QUALITY FROM SOURCE

Credit: Reuters/Stringer

By Frederik Joelving

NEW YORK | Thu Jul 7, 2011 2:51pm EDT

NEW YORK (Reuters Health) - If you sleep less than six hours a night, you're increasing your risk of developing or dying from heart disease by 48 percent. At least, that's what U.S.-based pharmaceutical giant Abbott would have 1.2 billion people in India believe.

But doctors say the grim message, which appeared in a newspaper ad in India earlier this year, is baseless.

In fact, they worry Abbott's marketing campaign may be the bigger threat, scaring healthy people into buying potentially harmful sleeping pills they don't need -- such as the company's own drug Zolfresh.

"They are implying that taking sleeping pills may help you live longer, whereas the data shows that taking sleeping pills is associated with increased mortality," said Dr. Daniel F. Kripke, a psychiatrist at the University of California, San Diego.

Industry insiders say the ad points to a bigger problem: According to Benjamin England, an attorney formerly with the U.S. Food and Drug Administration (FDA), drugmakers have lower standards for how they operate in emerging markets like India and China, where government oversight is poor.

"You already feel like you are in the Wild West," said England, founder of the international consulting firm FDAImports.com. "There is not likely to be anybody who is going to take them to task."

"If there is nobody paying that much attention to what people are saying about the product, then they'll push the envelope and say things they would not have gotten away with here," he told Reuters Health.

And it doesn't matter that Abbott refrains from mentioning drugs directly, which would have been illegal in India, said another lawyer formerly with the FDA.

"I would argue that if the company making the claim has a sleep product for sale in India, then this is an implicit ad for the product," the lawyer, who spoke on condition of anonymity, told Reuters Health.

"In the U.S., companies cannot put out a scare notice without substantiation simply because they do not mention their product in the communication."

CREATING A NEW MARKET

With soaring incomes, expanding insurance coverage and more and more chronic disease, India has become a big draw for global drugmakers. According to one McKinsey report from last year, the country's drug market will be worth $55 billion by 2020.

Promoting sleeping pills, a staple of Western medicine, is one way to tap into that potential. Last year U.S. doctors prescribed the drugs nearly 60 million times, with sales exceeding $1.9 billion, according to the research firm IMS Health.

In India, a pack of zolpidem -- the generic form of Abbott's Zolfresh -- sells for just a couple of dollars. Despite the low price, getting just a small fraction of the large population to buy sleeping pills could mean a sizable profit for drugmakers.

"Insomnia is an area where you will find a huge untapped market," said Ram Bala, a marketing expert at the Indian School of Business in Hyderabad, who has consulted for companies like Johnson & Johnson and AstraZeneca.

He said drugmakers appear to be stepping up their efforts to win over emerging markets, although it's an uphill battle as many Indians still prefer herbal remedies or are largely unaware of modern medicine.

"There is a lot of public resistance to treating insomnia, because they don't think it is such an important condition," Bala told Reuters Health. "If you bombard them with enough information about insomnia, maybe they may at some point decide, 'Hey, you know what, there are so many people telling me that insomnia is important, maybe I should go to the doctor and check it out.'"

Indeed, Abbott's ad encourages readers to see their doctor if they can tick off just one of 10 statements, including "I feel sleepy during the day" and "I have a feeling that my sleep is unrefreshing."

"This is so dramatic and ridiculous," said Dr. Adriane Fugh-Berman of Georgetown University in Washington, D.C., who runs PharmedOut, a think tank that studies drugmakers' influence on prescribing.

"It is really advertising, but it is disguised as education," she told Reuters Health. "Industry calls it disease awareness, those of us who are public health advocates call it disease-mongering -- making people believe that they are sick when they are normal."

Abbott declined to discuss the purpose of its campaign.

But McKinsey's India report bolsters Fugh-Berman's point: "The acceptability of modern medicine and newer therapies will increase due to aggressive market creation by players," it notes. "Investments in increasing patient awareness and education will impact diagnosis and treatment levels ... In addition, patients will show greater propensity to self-medicate."

'DANGEROUS' MARKETING

Of course, Western medicines like antibiotics and vaccines have helped countless people across the globe. But in the case of Abbott's sleeping pills, doctors say the company has gone too far.

In the ad, a smiling Bollywood actress is seen standing next to the words, "Hard Work Never Kills. Lack of Sleep Can."

It continues, "Research shows that sleeping less than 6 hours at night leads to 48% increase in developing or dying from heart disease."

Dr. Francesco Cappuccio, whose research Abbott cites, did not answer requests for comments. But his work, like other research, only demonstrates an association -- not that a lack of shuteye is at the root of heart problems.

"They can't make any claims about the cause," said Dr. Ana C. Krieger, who directs the Center for Sleep Medicine at Weill Cornell Medical College in New York. "We don't know if people who sleep four to five hours are environmentally stressed because they work multiple jobs, and then get anxiety and insomnia, or because they are sicker to begin with."

This may seem like a technical nuance, but it makes all the difference.

"A patient that comes to the office, for instance, saying, 'I have insomnia and I need my Ambien so I don't die of heart disease' -- that just doesn't fly, we can't justify that," Krieger told Reuters Health. "It's really an extrapolation, which can be kind of dangerous because there are side effects for any medication that we give to people."

Those side effects include sleepwalking -- risking falls and other accidents -- as well as impaired memory and driving skills.

According to the FDA, the drugs may also cause bizarre behaviors like "sleep-cooking" and "sleep-driving." The latter rose to national attention in 2006, when then-Representative Patrick Kennedy crashed his car into a barricade on Capitol Hill in the middle of the night.

Kennedy had been taking Sanofi's Ambien, the same chemical that Abbott sells as Zolfresh in India, as well as an anti-nausea pill that also acts as a sedative.

Krieger said she does prescribe sleeping pills to a few of her patients, but only for short periods of time and when changing their behavior doesn't help.

"We want people to naturally increase their sleep," she explained. "We don't know if an unnatural sleep, like what the medication would do, would really be beneficial for them."

In fact, people taking sleeping pills turn out to have a higher risk of death than those not on the drugs, even after taking into account other diseases they might have.

While that doesn't prove the medications kill people, the science hints at it, said UCSD's Kripke, a long-term critic of sleeping pills.

"The use of sleeping pills, including zolpidem, is associated with higher mortality, and there are 18 studies that show that," he told Reuters Health.

And the extra rest patients get from the medications, recorded through brainwaves and eye movements and other objective tools, is modest at best. Pooling the available research, one 2007 study estimated zolpidem and similar drugs add just 11 minutes of total sleep time per night.

REGULATION ON THE BACKBURNER

Abbott's ad includes a link to a website showing a picture of Zolfresh, despite the fact that direct-to-consumer advertising is illegal in India.

The company would not discuss its marketing activities over the phone and declined to comment on its claims.

"Abbott and other health care companies support disease awareness education programs for health conditions where there is an unmet need and where awareness about these conditions is low," spokesman Scott Davies said in an emailed statement.

He noted that the campaigns "commonly incorporate education on lifestyle factors such as diet, stress and exercise," although there was no such information in the ad that Reuters Health found.

The firm also said it follows the local regulations wherever it runs campaigns.

However, not even the FDA regulates what drugmakers can and cannot say in the name of disease awareness. And in emerging markets like China and India, experts say marketing claims are unlikely to be put under the microscope.

"Only in the United States and in more developed regulatory markets do we have the privilege to worry about what you said," FDAImports.com's England told Reuters Health. "In China, they are like, I don't care what you said, just don't sell something that has melamine in it!"

England would not comment on the legality of Abbott's marketing, but noted that the ad is clearly meant to promote the company's sleeping pills.

"This is just the beginning of the marketing," he said. "It's the door opener."

Resentment no, Disappointment yes!

by Nameless
(Caregiver)

Considering the mom has lived with my husband and I for about 15yrs after selling her house. The usual Doctor's appointments, healthcare decisions along with the mountain of other tasks has mounted up over the years.

Taking time off from a full time job, changing jobs frequently to find one that permits telecommuting and flex time is a blessing.

The siblings live some distance away and with moms health decline requiring a home health aide(wonderful)the responsibility of everything is to the pint of exhaustion. I have relayed the information to siblings with the reply that "Do what's best for you". Never once have they offered to come for a week, or stay a few hours even to give me a break. They take vacations and spend time with their families which I can appreciate but when I ask for help all I get is their backs turned. Kind of like falling and raising your hand up for help up and there's no one there.

I get the "you should do this or that" but they haven't a clue as to what mom's capabilities are or are not and the best place for her currently is here with me.

Sadly, I don't think the siblings would look after her like I do.
Perhaps it's the way I am put together and I would like for moms last years to be in comfort and stability but it becomes a daily challenge.

My marriage and relationships have suffered yet I push on. I figure if folks don't want to hang with you during the ruff times they might not be worth having around anyway.
Well per usual I hear some rustling around and I need to go tens to what mom needs.

It's a thankless job most of the time but at least I know that I do not suffer alone and there are plenty of others walking this same path.
Good luck to all and may mercy shine on us when our time comes.

Plano Elderly Care

Posted in Assisted Living, Assisted Living Facilities, Elder Care, Elderly Care at 1:58 pm by admin

Plano, TX is home to more than two hundred thousand north Texans. It located just a short drive north of Dallas, but it provides plenty of excitement by itself. There are many attractions for a person looking for a place to retire, or for a senior wanting to move into a Plano elderly care facility. Here are a few of them:

Visit the popular Municipal Art Galleries of PlanoTake in a show at the Courtyard Theater in the Haggard Park Historical DistrictGo to a festival like the Big Tex Cat Show, the Fall Home and Garden ShowCheck out a concert at Picnic in the Park Take a short drive to a park at Lavon Lake, and catch some bassDrive to the Dallas metroplex to take in a Mavericks game or one of the Dallas million other attractions!Enjoy the warmth of the weather and the north Texas culture!

[ad#ad-1]
The world of elderly care has changed considerably in recent years. Elderly care used to be synonymous with nursing homes. But that is far from the truth today. Now, we have a wide scale of elderly care homes available to seniors, from full time nursing facilities to assisted living communities to hands-off independent living communities, and everything in between.

So, how do you know what type you need? Just consider a few basic questions.

1) Does your loved one have a major medical problem that requires constant oversight? Than you definitely need skilled nursing care. But if not…

2) Does your loved one require help doing things that the rest of us do by ourselves? I’m talking about basic Activities for Daily Living? Do they need a hand putting on their clothes in the morning, or bathing, or moving in and out of their bed? If so, don’t think “nursing home” right away. Rather, think assisted living. Plano Assisted Living homes are designed for those types of seniors exactly: people who aren’t necessarily in bad shape from a medical standpoint, but who need help with daily life. Who cannot live alone. These are communities that generally offer help with any of those activities, plus things like housework, transportation, and cooking. Most of them offer three meals a day in the common dining room, and they encourage interaction through social events throughout the week. In short, you can be independent without being alone.

3) If your loved one does not need help with basic activities, and wants independence, then a retirement community or a continuing care facility would be great. Independent living is a standard retirement community where seniors have help nearby if they need it, and they are secure. A continuing care community goes one step further and allows the senior to transfer their living situation to a place with more care if the time comes when they need it. This allows the medical community to adapt to the needs of the senior as the senior’s life changes.

Plano elderly care has plenty of senior care facilities no matter what kind of care you are looking for. To find the housing that fits your needs, put your information in the box at the top of the screen and start searching for retirement or assisted living homes in your area today!

Permalink

View the original article here

Fun-Raiser at Sweet Tomatoes, March 9, 2011 from 5-8 pm.

*** NOTE: (You must present the?Sweet Tomatoes Donation Form when you pay for your meal. Be sure to download this form and bring it with you).

Sweet Tomatoes is located at:?39370 Paseo Padre Pkwy?(corner of Paseo Padre and Walnut Avenue) in?Fremont. ?For directions to the restaurant visit: sweettomatoes.com

Moved to Help Mom

by Shelley
(Santa Maria)

I moved back to my hometown with husband and child to take care of my grandmother, then father, and then mother.

Yes, for the past 22 years I have been caring for a nearly bed-ridden relative. I do this working full-time and with them paying for helpers to come 3 times a day (13 times out of the 21 times) a week. I do shopping, weekends and Thursday evenings. I deal with any repairs or emergencies.

My sister, who lives 3,000 miles away is the power of attorney, and executor. My grandmother willed me half her house and I paid my mother for the other half - so that I could stay in town.

Now, after caring for my mom for the last 14 years I find out that my sister is going to be willed all of my mother's house. That doesn't bother me as much as the attitude that this is fair. My family is the one who helps with the up-keep and yard-care.

My sister "visits" twice a year and doesn't lift a finger-won't clean, sort, help change a diaper. She will do laundry. My mother cannot afford to pay for more care and I know she is lonely and that I give her the best care. I am ready to walk away from it(a reverse mortgage?), but you know I can't - my heart won't let me.

So, I am so sad to think of my selfish sister and how her family treats my children (You have to live with the decisions you make - is what they are telling them.) This is the same sister, that when my father died, I received none of his personal belongings (I wanted a cowboy plate he had) - my nephew received it.
I am heart-broken.

Medicaid improves health and budgets of poor

A patient waits in the hallway for a room to open up in the emergency room at a hospital in Houston, Texas, July 27, 2009.

Credit: Reuters/Jessica Rinaldi

WASHINGTON | Thu Jul 7, 2011 2:12pm EDT

WASHINGTON (Reuters) - Medicaid, a government health insurance program designed to help the poorest of the poor, is giving people unprecedented access to doctors and also improving their finances, a study co-authored by the Harvard School of Public Health has found.

The study, released on Thursday, showed that new recipients of Medicaid reported better physical and mental health and were less likely to go into debt to pay their medical bills.

The fate of Medicaid -- the health program for people and families with low incomes and resources -- has been hotly debated for its role in the ballooning U.S. deficit. The Obama administration's healthcare overhaul passed last year requires all U.S. states to extend eligibility to millions more people by 2014.

The study followed health outcomes a year after a 2008 Medicaid expansion in Oregon, where 10,000 uninsured low-income adults won coverage through a lottery.

The results show that Medicaid helps poorer Americans well beyond the default safety net options that exist for people without coverage, according to the researchers from Harvard, the Massachusetts Institute of Technology, the National Bureau of Economic Research and Providence Health & Services.

"Some people wonder whether Medicaid coverage has any effect. The study findings make clear that it does," Amy Finkelstein, professor of economics at MIT and co-principal investigator of the study, said in a statement.

"People reported that their physical and mental health were substantially better after a year of insurance coverage, and they were much less likely to have to borrow money or go into debt to pay for their care," she said.

The study found that newly insured Medicaid recipients sought healthcare "substantially and statistically significantly" more than those who did not get the opportunity to apply for the program.

The lottery winners also spent less on out-of-pocket medical expenses, had less medical debt, were more likely to follow doctors' recommendations on preventive care, buy medication and overall said they enjoyed better health.

An especially large impact was seen in broader access to care. Newly insured adults were 70 percent more likely to report regular clinic or office visits for primary care and 55 percent were more likely to say they visit a particular doctor.

Medicaid coverage also reduced the likelihood that participants would have to borrow money or miss paying other kinds of household bills to pay for their healthcare needs by 40 percent. The likelihood of having a medical bill sent to a collection agency dropped by 25 percent.

The researchers cautioned against extrapolating from their findings to estimate the broader impact of the new U.S. healthcare law given the relatively small sample population.

The study focused on 10,000 lottery winners and compared their outcomes with some of the 80,000 other applicants who were not selected for coverage. Oregon's total population of about 3.8 million includes about 650,000 uninsured and about 200,000 low-income uninsured adults.

Researchers said they will continue to follow Medicaid lottery participants for another year and directly measure health outcomes such as changes in cholesterol levels, obesity and blood pressure.

The research group also included Katherine Baicker, former member of the Council of Economic Advisers under President George W. Bush, and Jonathan Gruber, who helped the Obama administration design the healthcare law as a paid technical consultant.

(Reporting by Alina Selyukh; Editing by Michele Gershberg and Matthew Lewis)