Push for name-brand drugs

first_imgMore than a third of U.S. physicians responding to a national survey indicated they often or sometimes prescribed brand-name drugs when appropriate generic substitutes were available simply because patients requested the brand-name drug.“Since generics are from 30 to 80 percent cheaper than the brand-name versions, that would represent a significant source of unnecessary health costs,” said Eric G. Campbell of the Mongan Institute for Health Policy (MIHP) at Massachusetts General Hospital (MGH), who led the study.Survey respondents who had marketing relationships with pharmaceutical industry were more likely to fulfill such patient requests than were those without those relationships. The report from investigators at the MIHP and Harvard-affiliated Massachusetts General Hospital will appear in JAMA Internal Medicine and has been released online.“The good news is that 63 percent of physicians indicated they never or rarely prescribed a brand-name drug instead of an equivalent generic simply because of a patient request. However, our data suggest that a substantial percentage — 37 percent or about 286,000 physicians nationally — do meet those requests,” said Campbell, a professor of medicine at Harvard Medical School (HMS).In 2009, the survey of medical professionalism was sent to 3,500 physicians — 500 each in internal medicine, family practice, pediatrics, cardiology, general surgery, psychiatry, and anesthesia — and almost 1,900 responded. One of the survey questions asked physicians to indicate whether during the previous year they had “prescribed a brand-name drug when an equivalent generic was available because the patient asked for the brand-name drug specifically.” The available answers were “never,” “rarely,” “sometimes,” and “often,” and about 40 percent of the respondents answered “sometimes” or “often.”Physicians who had been in practice more than 30 years were significantly more likely than those in practice for less time to report filling patient requests for brand-name drugs, as were physicians in solo or two-person practices. Doctors in internal medicine and psychiatry were the specialists most likely to honor such requests. Receiving industry-sponsored food or beverages in the workplace and receiving free drug samples — both of which are common marketing practices of pharmaceutical companies — were associated with a greater likelihood of prescribing brand-name drugs, although no association was seen with industry-paid speaking or consulting or with receiving industry gifts or reimbursement of travel expenses.“While we cannot prove a cause and effect between industry marketing activities and prescribing practices, at the most basic level these data suggest that industry marketing works,” said Campbell. “Our results also raise serious doubts about the desirability of meeting with drug company representatives to ‘stay up to date.’”The authors note that measures to reduce unnecessary brand-name prescribing should include efforts to educate patients — who are targeted by drug-company advertising — as well as physicians about how wasteful the practice can be. Hospitals and health systems could require drug samples to go through their pharmacies, instead of directly to prescribing physicians, and could ban industry-provided food and beverages from their premises. Another option would be making the decision to prescribe a brand-name or generic drug the primary responsibility of pharmacists — as is currently the case in the U.S. Veterans Health Administration — while allowing physicians to stipulate a brand-name drug for special circumstances.“Reducing or eliminating this practice represents low-hanging fruit in terms of reducing unnecessary spending in medicine,” said study co-author Christine Vogeli, an investigator with MIHP and an assistant professor of medicine at HMS. “However, doing so will likely be unpopular with some patients, physicians, and certainly with the drug industry.”Additional co-authors of the JAMA Internal Medicine research letter are Genevieve Pham-Kanter of the MIHP and the Edmond J. Safra Center for Ethics at Harvard University, and Lisa Iezzoni, director of the MIHP. The current study and overall survey were supported by a grant from the Center on Medicine as a Profession at Columbia University.last_img read more

Professors debate America’s right to build a border wall, immigration ethics

first_imgProfessors Jason Brennan of Georgetown University and Christopher Heath Wellman of Washington University in St. Louis participated in a debate Thursday evening surrounding the ethics of immigration. During the event, entitled “Do we have a right to build the Border Wall?” the two academics clashed over whether or not states have a right to restrict immigration.Brennan advocated a position of open borders. Noting it would strike the average person as unethical to ban certain Americans from living elsewhere in the United States, he said this same logic should apply to people born abroad.“Imagine that the people of northern Virginia get together and decide they have a bill they want to pass through their various county legislatures,” Brennan said. “And the bill says the following: ‘Whereas white people from West Virginia and black people from east D.C. commit crime at high rates, use drugs, have low wages, low employment and low educational attainment; and to protect our distinctively high-achieving culture, our community, our schools — which are some of the best in the country — and our exceptional welfare services and way of life. … We the people of northern Virginia hereby forbid them from moving here.”Such a move, Brennan said, would strike the average person as wrong.“Suppose [northern Virginia] did that,” Brennan said. “How would you think about that? What sort of word would you use to describe that kind of bill? Probably think ‘classist,’ maybe think ‘racist’ … something kind of nasty. Nevertheless, these kinds of arguments are precisely the arguments that nation-states use for excluding foreigners for these very same kinds of reasons. So what’s the difference? What’s the magic of a border of a nation-state that’s different from the magic of the border of a town, or a county, or a state?”Brennan enumerated what he saw as the numerous benefits of immigration, noting that researchers estimate free movement would lead to a global economy that is 100% larger than it is now.“A number of current economists — libertarian economists, left-wing economists, socialist economists, conservative economists — there’s surprising agreement: it seems to be that restricting immigration is the single most inefficient thing that countries can do around the world,” Brennan said. “… Immigration restrictions are so inefficient they cut world production in half.”Given immigration’s myriad benefits, Brennan said there would need to be a compelling reason for countries to severely restrict the inflow of people. In his view, such a reason does not exist. He said newcomers enhance the host country’s culture, it would be easier to “build a wall around the welfare state, not the country” and that immigrants commit crimes at lower levels than native-born citizens.“Places where you do not have a lot of immigrants are cultural wastelands,” Brennan said. “Think about the places that are cultural centers in the United States: Los Angeles, New York, Miami. Probably not South Bend, Indiana, probably not … New Hampshire. They’re places with lots of immigrants.”Brennan concluded with a discussion of the self-determination issue, arguing that it is not a sufficient reason to restrict immigration.“Why would a right of self-determination, or a right to decide who associates with a country, simply imply a right to exclude foreigners? Why would it also not imply other kinds of rights?” Brennan said. “Why not say, ‘We have a right to self-determination, that means the country can decide to engage in eugenics if it wants. We have a right to engage in self-determination, so we can force people to use birth control. We can have censorship, religious control. We can have a command economy.’ The puzzle here is if there is a right to self-determination, why does it specifically say the right to exclude, and not all of this other stuff? Because if you’re a liberal like I am, you definitely tend to think countries do have some sort of right to self-determination, but only within very well-defined borders. They can’t decide everything.”Wellman responded with arguments in favor of a right to self-determination. While he did not dispute Brennan’s points about the benefits of immigration, he said the question of who to let in should be left to individual states.“I think as the discussion goes on you’ll see there’s a lot of agreement between Jason and me,” Wellman said. “But I’d like to start by unapologetically defending the claim that legitimate states have a right to design and enforce their own immigration policy.”Wellman encouraged the audience to imagine a scenario in which he had the right to get married, but his father got to choose his partner. Without being able to say no, Wellman said his freedom would be curtailed.“My father is much wiser than I. He might choose better than I. My life might go better, if he got to choose my marital partner,” Wellman said. “But it seems unquestionable that my freedom of association is denied in a very important sense, and my self-determination is restricted in a very important sense. If I’m not the one who gets to decide whether or not I want to marry someone … the important thing is unless I’m in a position to decline a prospective suitor … I don’t have freedom of association.”Wellman built on this logic by stating “legitimate” states should be able to say no to prospective immigrants, if they so desire. He defined a legitimate state as one that protects the rights of the people who live there, citing Norway as the “paradigmatic” example.“Norway seceded from Sweden in I believe 1905,” Wellman said. “Imagine that Sweden said ‘we miss you, let’s get back together.’ Norway says ‘well, we’ll think about it.’ They have a debate, they have a plebiscite and they decide ‘no thank you.’ Do you think Sweden gets to forcibly annex Norway? I don’t. And I think if you agree with that the best explanation is ‘well, Norway, in virtue of being a legitimate state, enjoys political self-determination, one important component of which is the freedom of association. As we saw in the marital case, that includes the right to decline to associate, if they want to.”Wellman applied this logic directly to immigration.“A lot of teenage, young Swedes go to Norway for the summer because they can make so much more money in Oslo because the economy in Norway is stronger than in Sweden,” Wellman said. “Imagine a Swede says … “let’s stay here permanently. Let’s be a part of this union. I think that just as Norway can’t force a Swede to come over and join the union, the Swede can’t unilaterally insert herself into the political community.”However, Wellman did say that rich, legitimate states do have an obligation to help those in need. Nevertheless, he argued states cannot be obligated to take in people they don’t want. Instead, he advocated building institutions in struggling countries so people can have opportunities in their own land while expressing qualms with the current immigration model.“Let me be clear: I’m not a defender of the status quo, which I take to be a moral abomination,” Wellman said. “I’m not saying that Norwegians get to close the door, put guns at the door, turn their backs and say, ‘… it’s their fault, not my problem.’ My claim is that they probably do have much more demanding duties than they’re currently discharging. But that doesn’t mean there’s only one thing they can do, which is open their borders.”Tags: ethics, Immigration, Norway, open borderslast_img read more

Odds & Ends: Megan Hilty Tapped for BrainDead & More

first_img Here’s a quick roundup of stories you may have missed today and over the weekend. Megan Hilty Tapped for BrainDead Opposite Aaron TveitBroadway.com has confirmed that 2016 Tony nominee Megan Hilty will appear in the premiere of CBS’ BrainDead as a cable television news anchor. The D.C.-based series about politics and extraterrestrials, headlined by your Broadway boyfriend Aaron Tveit, also stars Tony winner Nikki M. James and Fun Home’s Beth Malone. It’s perhaps no surprise that Main Stem faves have landed roles in the series…showrunners Michelle and Robert King are theater fans and previously took charge of (and gave lots of stage faves employment with) The Good Wife. BrainDead is scheduled to start airing on June 13, the day after this year’s Tony Awards.Andy Karl-Led Groundhog Day Cast SetWe now know who will be joining the previously reported Tony nominee Andy Karl and Carlyss Peer in the Broadway-bound Groundhog Day. The ensemble cast at London’s Old Vic from July 11 will include Leo Andrew, David Birch, Ste Clough, Roger Dipper, Georgina Hagen, Kieran Jae, Julie Jupp, Andrew Langtree, Vicki Lee Taylor, Emma Lindars, Antonio Magro, Carolyn Maitland, Kirsty Malpass, Lisa Mathieson, Eugene McCoy, Jenny O’Leary, Leanne Pinder, Mark Pollard, Damien Poole, Jack Shalloo, Andrew Spillett and Spencer Stafford. The production is set to begin Great White Way performances on January 23, 2017.Carmen Cusack & More Enlisted for MTC Gala2016 Tony nominees Carmen Cusack (Bright Star), Danielle Brooks (The Color Purple), Danny Burstein (Fiddler on the Roof), Adrienne Warren (Shuffle Along) and Christopher Fitzgerald (Waitress) are just some of the talent tapped for Manhattan Theatre Club’s annual spring gala. The swanky event, one of the highlights of Tony season, will be hosted by Tony winner Sarah Jones and is scheduled to take place on May 16 at Cipriani 42nd Street.Charlie Stemp Lands Half a SixpenceSchool of Rock’s 2016 Tony nominee Julian Fellowes has a new theater project in the works, a collaboration with mega-producer Cameron Mackintosh. Half a Sixpence will play the U.K.’s Chichester Festival this year, starring Charlie Stemp as Arthur Kipps, Devon-Elise Johnson as Ann Pornick, Ian Bartholomew as Chitterlow, Emma Williams as Helen Walsingham and Vivien Parry as Mrs. Walsingham. With this team, next stop the West End?The SpongeBob Musical Extends Out of TownA good sign for the Broadway-aimed The SpongeBob Musical; the production has extended its world premiere engagement in Chicago by a week and will now close on July 10. The new tuner is set to begin performances on June 7 at Broadway in Chicago’s Oriental Theatre, led by newcomer Ethan Slater in the title role. As previously reported, he will be allowed to be human and is not set to don a puppet type outfit as seen in Times Square. We’re going to depart today’s Odds & Ends before we start making jokes about Bikini Bottom and getting ourselves into trouble! View Comments Star Files Megan Hilty(Photo: Bruce Glikas) Megan Hiltylast_img read more

Revival of Tom Stoppard’s Tony-Winning Travesties Circling Broadway

first_imgTom Hollander in ‘Travesties'(Photo: Johan Persson) View Comments The acclaimed London revival of Tom Stoppard’s Tony-winning play Travesties is eyeing a transfer to the West End and Broadway. Led by Tom Hollander, the Daily Mail reports that the production could move from the buzzy Menier Chocolate Factory (where the Tony-winning revival of The Color Purple originated) to the West End early in 2017 followed by Broadway in the fall. Directed by Patrick Marber, the production is running at the Menier through November 19.Hollander’s extensive theater resume includes The Judas Kiss on Broadway, along with A Flea in Her Ear, The Threepenny Opera, Tartuffe and The School for Scandal. Screen credits include Doctor Thorne, The Night Manager, Mission: Impossible—Rogue Nation, The Riot Club, Muppets Most Wanted, The Invisible Woman, Valkyrie, Elizabeth: The Golden Age, Pirates of the Caribbean: At World’s End, A Good Year, Pirates of the Caribbean: Dead Man’s Chest, Pride & Prejudice, Enigma, Maybe Baby, Ambassadors and The Life and Adventures of Nicholas Nickleby.Stoppard’s dazzling comedy of art, love and revolution features James Joyce, Tristan Tzara and Lenin as remembered—and misremembered—by Henry Carr (Hollander), a minor British diplomat in Zurich 1917. When Gwendolen and Cecily wander in from The Importance of Being Earnest, Henry’s mind wanders too. He knows he was Algernon in a production in Zurich. But who was the other one?Along with Hollander the cast includes Clare Foster as Cecily, Freddie Fox as Tristan Tzara, Forbes Masson as Lenin, Peter McDonald as James Joyce, Amy Morgan as Gwendolen and Sarah Quist as Nadya.Travesties opened at the West End’s Aldwych Theatre in 1974, directed by Peter Wood, and played on Broadway the following year, winning the Tony for Best Play. It has never been revived on the Great White Way.  last_img read more

Weekend Pick: Rocktown Beer and Music Festival

first_imgThe Rocktown Beer & Music Festival begins at 2:30 p.m. this Saturday, April 26 at the Turner Pavilion in Harrisonburg, Virginia.Tickets are $34 and are selling out fast! Plan for a day of fun and entertainment presented by Harrisonburg Downtown Renaissance, sponsored by Blue Mountain Brewery, Jack Brown’s, and Vision Studios.Headlining music acts include Bronze Radio Return, The Kelly Bell Band and The Deadmen.For festival information please e-mail aaron@rocktownfestival.com or call 540-432-8922. Find them on Facebook!1519835_590317697704643_2126035249_olast_img read more

Toned calves? 5 signs teams don’t trust

first_img continue reading » ShareShareSharePrintMailGooglePinterestDiggRedditStumbleuponDeliciousBufferTumblr I know, I know, you’re scratching your head, wondering what in the world toned calves have to do with trust. You see, when teams don’t trust…Well, think about it like this.You’re At The GymSweat is trickling down your forehead as the bass bounces off the brightly colored walls and thumps in your chest. It’s emanating from a darkened room across the way where people who you’re certain possess more motivation (read: psychosis) than you are doing some ridiculous workout that promises they’ll resemble a Greek god 91 days from now.Whilst the greek-gods-in-training continue their assault on Mount Olympus in the other room, one particularly large bead of sweat — you know the one — is making its way from your sweet, 80s-inspired sweatband down toward your eyebrows. Once there, it will no doubt traverse the terrain between the aforementioned eyebrows, slide down that short distance just to the side of the bridge of your nose, and then roll precariously — but almost intentionally, it seems — toward your quickly blinking eye.last_img read more

Sheldon Silver Found Guilty in Month-long Corruption Trial

first_imgSign up for our COVID-19 newsletter to stay up-to-date on the latest coronavirus news throughout New York Former New York State Assembly Speaker Sheldon Silver (D-Manhattan), one of the most powerful men in Albany over the last two decades, was found guilty of all seven counts against him at his corruption trial in Manhattan on Monday.Silver, 71, resigned as speaker after surrendering to federal authorities in January but he remained in Albany representing Manhattan’s Lower East Side. Now, under state law, he will also lose his Assembly seat. Silver faces up to 130 years in prison when sentenced.The month-long trial centered around $4 million in illicit profits Silver collected—a sizable income the former speaker failed to report in his annual state disclosure forms. Federal prosecutors said Silver used his powerful position to “secretly direct” a half-million dollars in state funds to a doctor researching mesothelioma. In exchange, the doctor referred asbestos cases to the law firm Weitz & Luxenberg, where Silver worked as a private attorney, prosecutors said.In a separate scheme, Silver, who became speaker in 1994, used his power to convince two real estate developers conducting business with the state to retain a real estate law firm controlled by Silver’s ex-counsel in Albany. State lawmakers are not prohibited from earning outside income but they are required to report such earnings in annual disclosure forms.“Today, Sheldon Silver got justice, and at long last, so did the people of New York,” said Preet Bharara, US Attorney for the Southern District of New York, in a statement.Former Assembly Speaker Sheldon Silver leaving the federal courthouse in downtown Manhattan after he was found guilty in his corruption trial. (Timothy Bolger/Long Island Press)The case against Silver comes as Bharara is single-handedly trying to weed out corruption in the state’s capital. Silver’s former counterpart, ex-state Sen. Majority Leader Dean Skelos (R-Rockville Centre), is in the midst of his own corruption trial, which is taking place in the same federal courthouse in downtown Manhattan where Silver was convicted.“Politicians are supposed to be on the people’s payroll, not on secret retainers for wealthy special interests they do favors for,” Bharara said during a news conference on the January day when Silver surrendered to the FBI. “These charges, in our view, go to the very core of what ails Albany: Lack of transparency, lack of accountability and lack of principle joined with an overabundance of greed, cronyism and self-dealing.”Bharara, during the very same press conference, sent a now-infamous warning shot—“stay tuned,” he teased—to other lawmakers potentially scheming the system. Five months later, Skelos and his son Adam were both arrested for allegedly manipulating legislation to pad his son’s pockets. Skelos’ trial resumed Monday following a break for the Thanksgiving holiday.Silver, Skelos, and Gov. Andrew Cuomo were once part of an exclusive group dubbed “the three men in the room,” which maintained a stranglehold on New York State politics. Silver ruled the Democratic-dominated Assembly, while Skelos controlled the state senate, where his party has the edge. Cuomo, a Democrat, split the difference.The arrests of Silver and Skelos sent a shock wave through the system.Most likely, Silver’s conviction will have no bearing on Skelos’ trial, but it does signal a clear victory for Bharara, whom many observers believe staked his reputation on his crusade against Albany’s culture of corruption.Silver told reporters as he left the courthouse that he was “disappointed” in the verdict, which his attorneys are expected to appeal.last_img read more

Govt suspends Papuan seaport, airport operations to curb COVID-19 spread

first_imgShe warned people planning to visit the province in the near future to postpone their plan. Ferra went on to say that she hoped people would not join any mass gathering or meeting in regards of social distancing measures.Previously, the Papua provincial administration decided to close its ports and airports to passenger transportation as an effort to prevent COVID-19 from spreading by limiting people’s mobility.The decision was made on Tuesday by Governor Lukas Enembe along with the regional leaders’ coordinating forum (Forkompinda) and regents. The restriction took effect on Thursday.Read also: COVID-19: Jayawijaya cancels Baliem Valley Cultural Festival as health precaution As an effort to prevent COVID-19 transmission in the country’s easternmost province, the government has imposed limitations on passenger transportation to Papua in response to the provincial administration’s request to restrict people’s mobility from and to the region.The Transportation Ministry’s Sea Transportation Directorate General announced on Thursday a temporary closure of passenger ports in Papua, preventing passenger ships from entering them. Such access closure had been agreed to by the government, regional administrations and all maritime stakeholders.“As a form of prevention, control measurement and social distancing regarding COVID-19, we closed passenger ports from March 26 to April 9,” said Jayapura Port Authority Office head Ferra J. Alfaris in Jayapura on Thursday. The policy, however, only applies to human passengers as the transportation of goods would continue as usual, Lukas said.Transportation providers have started to follow the provincial administration’s policy.Low-cost Lion Air Group announced on Thursday a suspension of its flights from and to Papua from March 26 to April 9. The suspension is effective for all flights operated by the group airlines, namely Wings Air, Lion Air and Batik Air.“The suspension is in accordance with the notification [we received] from the Airport Authority for Regional Division X regarding the closure of passenger flights at airports in Papua. This is taken in an effort to prevent the spread of COVID-19,” Lion Air Group spokesperson Danang Mandala Printoro said on Thursday.Normally, the group operates 35 flights to and from Papua every day.Read also: https://www.thejakartapost.com/news/2020/03/27/indonesian-airlines-carry-out-layoffs-to-cope-with-covid-19-pressures.htmlThe Transportation Ministry’s Civil Aviation Directorate General’s spokesperson, Budi Prayitno, said there was no closure of airports across the province so far. However, the ministry had received a request from the provincial administration regarding restricting access for passenger flights.“There’s little chance for airports in Papua to be closed down because the airports also serve other purposes such as cargo and logistics flights, as well as medical and humanitarian,” Budi said.The directorate general was discussing the restriction plan with local airport authorities, as well as with the regional government, he said.The number of COVID-19 positive cases in Papua has increased in the past few days. As of Thursday, health authorities have confirmed seven positive cases – rising from only three the previous day.Topics :last_img read more

‘Zero tolerance’: Australian university, govt ‘aware’ of sexual abuse allegations against student

first_imgTopics : The University of Melbourne has stated that it has zero tolerance toward inappropriate behavior, a representative from the university said on Saturday in response to allegations against Ibrahim Malik, a student finishing his master’s degree at the university’s Melbourne School of Design who has been accused of sexual violence by at least 30 women in Indonesia.Read also: High-achieving UII student to be stripped of honors after 30 women report him for alleged sexual abuse“The University of Melbourne is committed to ensuring that all of its campuses are places where students, staff and visitors are safe and are treated with absolute respect and courtesy,” the university’s representative told The Jakarta Post through a written statement.Two female alumni from the campus had also reported Ibrahim for alleged sexual harassment to the university’s Safer Community Program, the university said.”The university takes all allegations of sexual harassment and inappropriate behavior extremely seriously and a senior staff member has contacted both women to check on their welfare and provide advice on the university’s student complaints process,” the representative stated, adding that the university had offered wellbeing support to the alumni, who currently live outside Australia. “The university has also contacted the male student and offered him support and assistance.”Read also: Pressure mounts for Australia to cancel scholarship of student accused of sexual abuseSeparately, a spokesman from the Australian Embassy said the embassy had been notified of Ibrahim’s alleged sexual misconduct.“We are aware of allegations of sexual misconduct by an Australia Awards scholar. The Australian Department of Foreign Affairs and Trade and its programs have a zero-tolerance approach to sexual misconduct claims,” he told the Post on Friday.“We take all allegations of this nature seriously and manage them in accordance with our policies and Australian law,” he continued, adding that the embassy was unable to provide further details due to privacy constraints.Two of the women who reported Ibrahim told ABC that Ibrahim had sexually harassed them during his time in Melbourne.last_img read more