Doctor Eclectic

Doctor Eclectic
Doctor Eclectic

Tuesday, March 11, 2014

Lethal Injection

Execution room - California prison
A week ago or so, I found myself in conversation with a couple attending a Pharma meeting in Chicago.  It wasn’t hard to find subject matter as at least three Pharma issues were in current news: Lethal Injection, changes in copayment for seniors as a result of the ACA, and CVS stopping cigarette sales.

My knowledge base for at least one of these was improved: Lethal Injection.

I had assumed that the decision to cease import of two of the drugs in the “cocktail” used for execution was political; based on the fact that the United States is one of only two developed countries that still allow Capital Punishment.  Not so!  The decision was, as most business ones are, financial.  There are increasing legal challenges that the drug combination was not working properly: the desired effects of the barbiturate, paralytic, and heart stopper, in that order, should put the prisoner to sleep, stop all evidence of pain, and stop the heart. When the process took too long, or when there was evidence of pain response, lawsuits ensued.

The profit margin for a limited sales model was too small to justify continued production.

The states turned to U.S. compounding pharmacies who, working without a prescription, have had very mixed results, with stayed executions and further lawsuits.  Now the compounding pharmacies are reconsidering whether they want in the game.

As for the controversy over the value of death as a deterrent over the value of life in general, Saint Augustin sided with the deterrent people.  As for me, I’m ambivalent about the morality of executions, but I feel the “cruel and unusual punishment” argument is overblown.  I say, bring back the guillotine; it was quick and effective.

More and more states are abolishing capital punishment with the main arguments centering around wrongful deaths, deaths of children and the mentally challenged, and the long appeals process with its ensuing costs.

So much for that topic!

On the issue of who should bear the cost of Pharmaceutical R&D and the shareholder profit, I was surprised to find that four of the top ten manufacturers are still in the US: Pfizer, Bayer, J&J, and Abbott.  I was not surprised to see that 80% of legal drugs taken to control chronic health problems are consumed in the United States, and seniors take most of those.  I am not unusual in taking five prescribed pills a day to control blood pressure, cholesterol, and gout. While the Federal government has used its might, to ratchet down the cost of these, many, particularly new and non-generic drugs are very expensive.  With the increase in population receiving support from the ACA, patients will have to bear more of the cost burden.  So, I think we consuming Americans should rightfully pay for our consumption.

The ACA can also be blamed, if that is an appropriate word, for the CVS decision to stop cigarette sales. Wellness is all over the law and those insurance companies who are participating in the Exchange all have Wellness programs in their design.  Prevention is cheaper than treatment, especially when you cannot adjust rates for previously existing conditions.  Also, since physicians are limited, health plans are forced to contract other healthcare providers who can legally perform services.  Pharmacies are not only dispensing drugs, they are also providing vaccinations and immunizations.

It gives the wrong image when they are also dispensing unhealthy product.  Cigarettes today; perhaps soda and alcohol tomorrow.
In my next post I will share how watching August, Osage County made me think of Mary’s family and other related and relative issues.  Come check that out!

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