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The Inexplicable American Consumer Revolts Against Prescription Drugs
Wolf Richter www.testosteronepit.com www.amazon.com/author/wolfrichter
Anecdotal evidence has been coagulating into numbers, and these numbers are now beginning to weigh down corporate earnings calls. It appears the toughest creature out there, the one that no one has been able to subdue yet, the ever wily and inexplicable American consumer, is having second thoughts about prescription drugs. And is fighting back. A paradigm shift.
We’ve already heard from some companies, such as drug maker Pfizer, whose revenues in the US plunged 18%, largely due to the collapse of its flagship drug Lipitor that is losing its battle with much cheaper generics. But the direst indications came from Express Scripts, the largest pharmacy benefit manager in the US—and perhaps one of the best gauges of spending patterns for prescription drugs.
During the earnings call, CEO George Paz, who ominously was “not prepared to provide 2013 guidance,” embarked on a dark speech. The company’s clients had “unprecedented concerns about our country’s economic outlook,” he said. Unprecedented concerns! So even worse than 2008-2009. He went on:
Our health claim clients are expecting membership reductions in 2013. Large employers have pulled back on hiring plans, using contractors and part-time employees when necessary. Mid to small employers are cutting back or postponing health care coverage decisions while waiting for more clarity on Health Care Reform. And we continue to see low rates of drug utilization as individuals deal with uncertainty at the household level.
He lamented “the current weak business climate and the unemployment outlook” and was worried about the “challenging macroeconomic environment.” Shorts must have felt a certain frisson. Remains to be seen whether the dive that Express Scripts shares performed is a buying opportunity that will add to a cushy retirement or one that will slice off your fingers.
But beyond the company’s fate, he’d pointed at what ails the US economy, including a shift to part-time workers and contractors often without healthcare benefits, and smaller employers who, in their struggle to survive, are cutting back on healthcare benefits. As these workers—the inexplicable American consumers—are left to their own devices, they have to make their own decisions about what prescription drugs, if any, to blow their scarce money on.
Express Scripts has seen this trend in another area. Its Drug Trend Report, which dissected prescription drugs sold to its members in 2010 and 2011, sketched the beginnings of the paradigm shift: in 2011, specialty drugs sales increased 17.1%, down from a 19.6% increase in 2010; traditional drugs only eked out a gain of 0.1%, the lowest increase since it began tracking the data; and spending on all prescription drugs combined rose only 2.7%, also a record low. That was for 2011.
But the report didn’t include insights into the buying behavior of the 48.6 million uninsured Americans who’re even more reluctant to spend money they don’t have on prescription drugs they can live without. And it didn’t include the trends of 2012, which as Paz phrased it, are cause for “unprecedented concerns.”
Whatever the reasons, whether prescribing behavior by doctors or buying behavior by consumers, lack of insurance or lack of money, or the growing prevalence of generic alternatives: spending on prescription drugs, long considered recession-proof, seems to have bumped into a wall for the first time ever.
Healthcare costs in the US, around $2.6 trillion a year, or 17.9% of GDP, may be reaching a level beyond which the various players in the economy cannot go, or refuse to go, a market-based barrier of sorts. And the inexplicable American consumer may be on the forefront—not only those who don’t have insurance, but also those who have high-deductible plans.
In 2012, plans with deductibles of $1,000 or more made up 19% of employee-sponsored health plans. Families covered by such plans, for better or worse, are cutting back medical spending ... by 14%, according to a study last year. They’re making medical decisions where at least one part of the equation is their own money. And they’re accomplishing what no one has been able to accomplish so far, namely taming the untamable healthcare expense monster.
That the US has too much debt is no longer a controversial statement. Some may believe other problems are more urgent, or that we need to grow our way out rather than slash spending. But the debt-to-GDP ratio must decrease if we are to have a stable, prosperous economy. Read... One Chart Explains Why Government Debt Is Dragging on the Economy.
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I gave you an up arrow for tact and restraint. Well done.
Fact of the matter is that BigPharma has even less tact and restraint. And, thanks to sellout motherfuckers in our worthless POS cum belching gov't..........it's totally legal.
ya no rs, i like the way ya fuckin think. Kudos.
As earlier posters have suggested, these drugs will kill you. They give you a prescription to ease one ailment that leads to another ailment requiring further medication that causes another ailment and so on and so on.
I stopped taking all medications about 3 months ago, and have never felt better. I know I'm dying, everybody does it. But the Pharmaceutical industry wants you to believe you'll live forever, and that your menopausal wife really looks forward to that erection.
I take aspirin and vitamin D (natural source) and kelp (for all that radiation out there), what else do you need?
If your menopausal wife is not looking forward to your erection then whose erection is she looking forward to?
tons of vitamin C! it's the best!
I hear you.
Started to sleep better and feel better after I got off those damn "anti"-depressants.
I may as well have been taking Valium and Speed at the same time and drinking a fifth of gin a night the way that crap made me feel.
My libido, my smooth skin, and my hair recovered as soon as I got off that fucking cholesterol lowering crap that made me feel 20 years older.
I'm going to die of a heart attack? Good! It's better than the alternatives!
Nailed it again, eb.
People just feel bad when they take that stuff, so they just stop taking it. And who needs a drug to make eyelashes longer? Seriously?
we've all got depressive sides, it's (essential) human nature, it's the flip side needed for us to have euphoric moments
the solution is understand what makes you depressed, it's usually something simple in fact. Many times it's worries that you never face head on and just address, make steps to solve, that grind you down. Deal with worries, don't let them worry you
that's the mental side. the other issue for me is daylight, if ii don't get enough i switch the lights on in the evening, it keeps me 'up'. And finally 'up' music. Music is a drug through your ears, better than valium etc, great music keeps you mentally lifted even when you're tired or down
the Drugs industry would rather you lived on a drug dependency than understood yourself and solved your own problems naturally, intelligently
Take regular baths with epsom salts. Magnesium is readily absorbed through the skin.
Also, high-dose niacin therapy is supposed to work great for depression.
One suggestion, a non-brand name multivitamin. There are many manufacturers and each has several formulations, each for a slightly different purpose. An ounce of prevention and all...
Nowhereman, I'm sorry, I'd do the same though.
This report is no surprise; Big Pharma is a heartless machine designed for one thing and one thing only:
Big Profits
They use TV ads to promote drugs directly to the public and heavily incentive doctors to gladly write the prescriptions.
Doctors routinely prescribe drugs that while not necessarily needed may mitigate malpractice suits. They're covering their asses.
Consumers are figuring this out and are trying to cover more & more expense with less & less income. Something's gotta give and needless prescription drugs fill the bill.
IMHO we need a total overhaul of our health care system resulting in something like single-payer. And deals like Billy Tauzin cut with Big Pharma so they wouldn't be required to negotiate prices with the government (just before he quit Con-gress and was hired on at Big Pharma) should result in prison time.
the great masses of U.S. citizens are tapped out.
In 2000 Kieser was in angst predicting Healthcare to be 12.5% of the GDP by 2002. Now in 2012 per this article were are appraching 17.5%.
Extrapolate that trendline...
100% by 2040 per my reconing..
Gimme a hit man.
Don't expect Big Pharma to take this laying down. Expect Congress to 'protect' the American public by passing new legislation forcing them to buy more high-cost drugs. There is a reason why the US has the most expensive (= profitable) health care system in the world.
Who needs 'new legislation'? Obamacare is already working GREAT, as designed:
'Our health claim clients are expecting membership reductions in 2013.'
Feeling ill yet? Take two aspirin and call Nancy Pelosi.
yes but just as CONgress legislates to 'protect' jobs and loads costs on business and sends the jobs abroad their grubby fingers trying to enforce a monopoly in healthcare will just send Americans abroad for treament
consumers are just not as stupid as they once were with the speed of information (and enlightenment) across the web
Fuck those assholes.
I would rather die than fund their BMW or their Golf Club Membership or their trophy Wife's plastic surgery.
Fuck off and die you parasitic gutless souless assholes; fuck off and die.
Morphine is cheaper than projectile vomiting, dizziness, and the shit you hawk.
musn't laugh but you've got it in for the medical profession (like i have for the lawyers:)
I agree funding Doctors trophy wives plastic surgery is a waste of money, you should get your own trophy wife that way you get to 'enjoy' her when she's not under the knife
I would say that price certainly plays a big role. Another would be that most, if not all of the newer meds are merely maintenance drugs for chronic conditions.
With the internet, the AMA cloak is being pulled back and people are learning how to actually take care of themselves.
I have a PDR at home which I look up any drug that is pushed on friends and family. I am also in the drug industry so I am well aware of the side effects and limited efficacy of most medications.
Best thing you could do to avoid the need of these drugs:
http://www.drfuhrman.com/
pods
Well, there's no money in actually curing diseases. Maintenance drugs are totally the way to go. Patient takes them for life for a "disease" that wouldn't have killed them anyway, and if they stop taking the drug they go crazy or their dick falls off. Brilliant.
The industry has successfully put laws in place to limit mark to market pricing in the USA for medicare and medicaid.
Time for us to expand the war on drugs in the us to include big pharma who wish to evade the laws of nature regarding counter party risk and true competition.
the "War on Drugs" has failed ..miserably, expensively and completely
Druggies 80+ years of next to zero pprblems vs. Govt slaughtered for 80+ years
when the front of a major newspaper in Britain, The Times an upmarket read not known for anything radical, runs War on Drugs Lost on its Front page as I saw 3-4 weeks ago you know the end is near. That follows a UN report a few years back that said the same thing
the war on drugs we need is a Free Market attack and end the endless monopolism and public-private protection rackets that make everything, not just drugs and healthcare, so extortinate.. and both sides of the Pond.
Au contraire! The "War on Drugs", "War on Poverty", "War on Terrorism", and all the other "War on ..." programs of the goverment were great successes. They all allowed the government to expand its size and funding.
War on => Freedom off.
Of course, if drugs, poverty and terrorism went away, all those government programs would also have to go away and all those high-paid government employees would be out of jobs. Can't have that! The economy would collapse.
Interesting tidbit: of the 10 US counties with highest median income, 7 are within commuting distance of Washington, DC.
Absolutely agree, from the angle of expanding the Govt Empire most "War on...?" are a license to print money and siphon money into crony businesses (Solyndra?)
The War on CO2 is another humdinger, the conflicts of interest between MP's on Green Co's boards or payrolls as consultants and also promoting the hysteria in Britain has got beyond a farce. Toffy-nosed Tory landowners raking it in with windfarms on their land as well
and the witchunt for Osama Bin Hiding cost $80bn a year for 8 years in Afghanistan ...a nice $5m Bounty for some ex-secret service SAS/Seals and he could have been zapped in 1 year. Without shadow of a doubt this was the most extortinate bill to round up a few terrorists in history, they should be in jail for this scandal of price-for.prize cost effectiveness
Washington property values holding up very nicely isn't it while the rest of Americas stock tanked past 6 years. Let them eat cake
richest county in the world? http://www.forbes.com/sites/nathanvardi/2012/04/24/americas-richest-coun...
the market is so much more 'open' with mail order and internet as well as the information flow you don't have to buy expensive patent drugs, there's generics out there at a 3rd the price very often
it's the same with 'Medical Tourism' ....why pay $350 at home when you can pay $120 in Prague or New Delhi ...and get a holiday in :)
Why don't insurance companies jump on this. Could you drop the cost of a bypass operation by shipping someone to New Delhi India first class flight, putting the family up in a 5 star hotel with some spending money too boot, fly them back and save a a couple million rupees?
The sacred cow will not allow this.
The AMA will not allow this. They are too protective of their divine greatness. If the AMA is your sacred cow, then you have nailed it.
you just have to find your own way around these expensive dinosaur monopolies ...where there's a will there's a way ...you can usually just web-search and you'll get a price list pretty quickly on Doctors in places like India, South Africa, Eastern Europe etc and select your favorite holiday destination
Side effects may include: Erections lasting more than 4 hours, depression causing suicide, liver failure, kidney failure, and remember Bitchez: City water is recyled piss water with meds in it...
Cheers!
Serious allergic reactions
Swelling of the face, lips, tongue, and/or throat
Difficulty breathing
Difficulty swallowing
Anemia
Decreased levels of potassium
Decreased levels of sodium
Dizziness
Excessive bleeding (sometimes fatal)
Facial flushing
Fainting (syncope)
Fast heartbeat (tachycardia)
Heart attack
High blood pressure (hypertension)
Increased levels of potassium
Low blood pressure (hypotension)
Low blood cell counts
Palpitations
Perpetual erection (priapism)
Postural hypotension
Slow heartbeat (bradycardia)
Thrombosis (clotting)
BONE
Side Effects
COMMON:
Bone loss
Bone pain
BRAIN
Side Effects
COMMON:
Amnesia
Dizziness (vertigo)
Seizures
Speech disorder
Stroke
Transient ischemic atychosis
Worsening of epilepsy
GASTRO-INTESTINAL
Side Effects
COMMON:
Abdominal pain
Colitis
Constipation
Diarrhea
Dry mouth
Dyspepsia
Intestinal bleeding
Nausea
Rectal bleeding
Stomach bleeding
Stomach pain
Upset Stomach (indigestion)
Vomiting
INTERACTION
Side Effects
COMMON:
Drug and drug interactions
Food and drug interactions
LIVER/ KIDNEY
Side Effects
COMMON:
Acute kidney failure
Chronic kidney failure
Hepatitus
Jaundice
Liver damage
LUNGS (Pulmonary Side Effects)
COMMON:
Cold symptoms
Cough
Flu-like symptoms
Lower respiratory infection
Fluid in the lungs (pulmonary edema)
Pulmonary thrombosis
Shortness of breath (dyspnea)
Sore throat
Upper respiratory infection
top of page
MENTAL
Side Effects
COMMON:
Aggression
Agitation
Anxiety
Confusion
Depression
Hallucinations
Hostile
Hyperactive
Impulsive
Irritable
Panicky
Personality disorder
Overly excited
Severely restless (akathisia)
Sleeplessness (insomnia)
Suicide
Weakness (asthenia)
MUSCULAR
Side Effects
COMMON:
Back pain
Leg cramps
Muscle pain
Shakiness (tremor)
Spasm
Tiredness
Swelling of legs and feet
Unexplained muscle pain
Weakness
OTHER DRUG
Side Effects
COMMON:
Diabetes mellitus
Hair loss
Frequent urination
Hyperglycemia
Ketoacidosis
Loss of appetite
Pancreatitis
Urinary tract infection
Weight gain
Weight loss
PAIN
Side Effects
COMMON:
Abdominal pain
Bone pain
Breast pain
Chest pain (angina)
Headache
Heartburn
Joint pain
Leg cramps
Painful menstruation
Vaginitis
SENSES
Side Effects
COMMON:
Blindness
Blurred vision
Colored vision
Ringing in the ears (tinnitus)
Tingling sensation (paresthesia)
SKIN
Side Effects
COMMON:
Allergic reaction
Itching
Skin rash
Severe skin reactions
Sweating
funny thing is, our sewage plants in europe have filters which remove most of these chemicals. :-D
one million dutch are on anti-depressants (of a population of 17 million). in Belgium 1 million on a total of 11.
that's a HUGE amount.
I didn't think of this until this morning: Our economic depression, The Second Great Depression which the Boobalings call a recovery from the Great Recession has had a massive impact on suicide rates in the states.
http://www.psychopathiceconomics.com/DavosEconomicForum/
For the first time I’ve been alive: More Americans committed suicide than died in car crashes. Deaths from suicides rose 15 percent and deaths from poisoning rose 128 percent, the latter are often when intentional overdoses get classified as.
The only thing economically I’ve been wrong on so far is this: Celente said, “when people lose everything—they lose it.” I optimistically thought he meant pitchforks and torches and not suicide.
The suicide rate during Great Depression of the 1930s was 22 in 100,000 people, today we’re at 10 in 100,000.
37,000 suicides in 2009, 31,000 poisonings.
+1 nevertheless Big Pharma is constantly telling us europeans that we should take much, much more anti-depressants. they go as far as claiming that one third of all europeans have untreated depressions. our total consumption of psychodrugs is still way lower than in the US, but picking up rapidly in the UK, Ireland, the BeNeLux countries and Scandinavia.
I was/am having episodes where a grey fog comes over my eyes. Lasts about two or three seconds and fades off. (yes, I'm an old fuck) I'm not a pill taker, never have been, I'm border line high BP and have a prescription for pills but have 'forgotten' to take for at least six months.
Anyway...eyes were fogging over and health insurance sent me to some Dr for a checkup. First thing I noticed was that he was a bioethisist...a big shot bioethesist (however the fuck you spell that) with awards all over his office. My reading of these assholes is they're perfectly fine with cloning dolphins and humans, experimenting on viable embryos, aborting post natal infants (up to any age)...these are the modern Dr. Mengele's; educated in euthanasia and propgandized by Midge Sanger.
So I go through the routine, with all the fancy hand-held computer shit, where he enters my information to copy, manually, into the main computer in the room (was a few years ago). He turns around and says I'm in depression and I need to take these fuckin' pills.
I'm thinking, well fuck, maybe so...it's 2003, the 100k a year CFO job I had was immediately shut down by the events of 9/11...and I'm trying to get my legitimate CPA license in the failed State of California by working at a CPA firm for $8 an hour only to find out seven months later that they never do audit work...son's been in Afghanistan for his first of ten fucking years.. (almost shot a ten year old holding a plastic gun pointed at him his sixth month there)..<so far>...retirement savings took a hit in 2002 when same son spent a year in Germany using my account believing he was making $18 an hour while he was being paid $8. Maybe I was depressed, after all. What the fuck is depression, anyway? I still don't know what it is.
So I get prescribed pills. Pharmacist (personal friend) tells me..whatever you do, once you start taking this shit, never miss a dose. I was like ok, waving her off, it's no big deal.
Took'em for 30 days and ran out. Forgot to renew...had better things to do.
I ran out on a Tuesday evening. Went to work Wednesday at 7 am. By 10 am I was telling my bosses that something wasn't right and they needed to call my wife to come get me. The last thing I remember was sitting down in the chair at the front where they had helped me walk.
A week fucking later I came to myself. According to my wife I tried to kill her by putting her head into a vice...(major problem, the vise wasn't attached to anything and would only expand to about six inches) <I think that's creatively awesome, she thinks different>, she says I spent two days believing I was a fish and swimming all over the house, shitting everywhere <some would think of a 60's flashback>. I then spent the remaining time playing some casino game where I racked up more than the national debt.
Have no memory of this shit, but she apparently delighted in calling various people over to watch me perform.
Moral: Don't do drugs.
They'll fuck you up worse than what you problem was when they were prescribed.
Oh, yeah, eyes still go grey.
Thanks for the story, OP.
I just went and threw away all my frikking Alka-Seltzer.
Dang.
Is coffee OK? I really want to keep the coffee.
scary story, OldPhart
it reminds me (I do suffer from depressions) what my medical friends tell me: many doctors start to treat you before they really know what the hell is not ok. and this has a lot to do with the Placebo Effect and how people react positively as soon as they feel treated. most people expect doctors to start "treating" them immediately
my take: do try to find out why your eyes go grey
I never "treated" my depressions, I see them as part of me - including my taste for depressing facts - hence my avid fanship of Tyler Durden's ZH
medicine is an art..many times we do the text book right thing but end up with poor outcomes for the patient..diseases of the the MIND, treated never cured, with lethal outcomes..from inducing Diabetes and heart disease to suicides such as columbine hs killers..and as recently voters who reelect mad men.
antidepressants, antipsycotics,ADHD,benzodiazepines, have great dangers when not used wisely,, we mainly focus on the outcome of a patient, not on the outcome to society: such as the mind fogged voters lead to the disintegration of western culture ..bad drugs used widely impact our society ..control and the NWO, go hand in hand.
remember the war on street drugs that just expands the use it should be named the expansion of street drugs program. there is a reason it is so..to sedate the populations who are the victims of the "elite reptiles"
see "They LIVE" for what I mean.
There is a Dutch proverb "If the sky is blue today it will be gray tomorrow" maybe that explains it.
Well they still have Heineken to get throught the grey days...
No wonder they're depressed.
In my Dutch family, we have a saying about our women: "Built like a Dutch plough; heavy where the pin goes in."
Sad. "Civilization" just thinks it is civilized. Rerverse osmosis filters have been used in the states, the yield is signifigantly less than the total and the cost is astronomical.
While water is the most abundant substance on the planet (it covers 71 percent of the globe), 97 percent of it is too salty for consumption. Only 3 percent of the world’s H2O is fresh, and most of that is frozen: just 0.3 percent of it is accessible and clean enough for people to use.
And what does "civilization" do with that 0.3 percent? Pisses meds into it.
I have a water filter for the house cost $2000, I have a water filter (reverse osmosis) for my kitchen $900. Total $2900 for clean water. I clean / replace the house filters and trust me...the water they pump to our house is nasty.
People from 'the city' complain that my well water smells/tastes funny. They get their water from well fields in the same county shipped through 60 miles of decades old piping and mains made of steel and concrete. It's flouridated and chlorinated but even so with main breaks they have at least one boil water alert a year. Then it hits their house plumbing which is mostly 50 year old galvanized or brand new PVC, both of which have questionable leachates in my opinion. Then it arrives at their tap and they swill it thinking it's pure water...what a joke. I wouldn't wash my dog in that stuff without filtering...
In the early 2000's befor we moved our old neighbor worked for the local cities water authority. He told me that the pipes in the city were so old that many were asbestos.
Produces 'firm' and healthy fish.