Sunday, December 2, 2007

Virginia Tech Hokies-Orange Bowl and Oklahoma Sooners-Fiesta Bowl



Virginia Tech won the ACC Championship over Boston College and are headed to the 74th Annual FedEx Orange Bowl. The Hokies will face the Kansas Jayhawks on January 3, 2008 in Miami and tickets go on sale early this week.


University of Oklahoma won the Big 12 Championship over Missouri and are headed to the Tostitos Fiesta Bowl. The Sooners are the first team in Big 12 history to win consecutive titles and will face West Virginia on January 2, 2008 in Glendale, Arizona.

It will be an exciting football Bowl Season.
Go Sooners! Go Hokies!

Friday, November 30, 2007

Odd Anniversaries - Health/Wellness, Rare Disorders, Insurance, Money and MS

Yesterday was an anniversary of sorts as is tomorrow.

Two years ago on Thursday, December 1, 2005, I took my newly acquired supply of Copaxone to the Neurology Center for injection training. It was both a big deal and not a deal big at the same time. Nurse Carol suggested injecting after a shower when the skin is warm and clean, skipping the alcohol swabs (alchohol on the skin burns on injection!!) It went fairly smoothly but I did develop a largish lump around the injection site.

Nowadays, injections are not a big deal at all. I just do it and go. No ritual. No extra prep. Just do it.

Now more interesting to me is the Saturday after Thanksgiving 2 years ago. I received a phone call from Shared Solutions (Teva's patient front) giving me the good news and congratulations. Below I discuss this particular pivotal point in my personal life, but first...

This year the Saturday after Thanksgiving I received an unexpected call, this time from Dr. Eric Berg, the chiropractor who I discussed previously on this blog. It seems that beyond becoming aware of my blog, he basically had a few things that he wanted me to share with me. One being the concern that an unidentified individual who had communicated to me was in fact under investigation for fraudulent claims. Investigation, that's an interesting word. A scientist may investigate the efficacy of a new drug or I may investigate the cause of my cat's persistent meowing from somewhere near his food bowl. That word alone doesn't indicate much. More information would be needed to supply the context.

Although, congratulations is an odd word to hear after you've recently been diagnosed with multiple sclerosis, your insurance will not pay for the prescribed medication, and you've been left hanging for six weeks after submitting an enormously personal application form to verify your lack of income or resources with which to pay for said medication.

Congratulations!!! You've been approved for 50% by NORD
(National Organization for Rare Disorders).

Yeah!! Wait....50%? What does that mean?

NORD has approved your application and awarded you 50%.

Huh?

You will be receiving six months of medication from NORD and will only need to pay a $100 shipping/handling fee for each 3-month supply.

What happens after six months?

You will need to pay for your medication.

But I don't have that kind of money. I can't afford that.

You can appeal for more assistance, if your financial situation
changes.

So I can appeal in the Spring after I've completed my taxes and have more recent information?

Yes.

(Whew! Okay. I'm alright for now. Now when does that med
arrive?)

Fast forward. Appeal denied!! "You still earned too much at $26K to qualify for additional $10K worth of meds. And you still have some money in the bank. Sorry." I'm paraphrasing, of course. But same result. I ended up spending $16K in medical costs while earning less than $20K.

Okay, finally I'm under that magical 200% Federal Povery Level and I was approved for 100% assistance from NORD this past March.

But the story's not over (is it ever?)

Tomorrow is the last day which I can conduct any banking activity which will not be represented in next spring's application. You see, NORD requires three months of statements from every financial institution which has any of my money. And if it looks like I am able to accumulate any significant amount, I risk forfeiting the opportunity for assistance in the coming year. Yuck!!

That means that I CAN'T take advantage of opportunities to increase investments such as that craziness which is occurring with Questcor's stock. I can't conduct business such as to maximize my own earning power. I basically can't be overtly successful. I just have to ride this out and smile gently each time Nurse Carol asks, "so when is that boyfriend of yours going to propose and ya'll get married? Marriage has benefits you know." Yes, it does, one of which is access to his company-sponsored health insurance which is pretty doggone good.

Health insurance really isn't a good reason to get married in my opinion, but trying to start a family before I turn 40 is. Wait...I think we just passed the point at which it is possible to have a child before I'm 40 next year. Oh well. In the meantime, tomorrow's the last day for any private banking decisions.

Maybe, I'd better investigate the opportunity to maximum the benefits of our relationship.

Rob, sweetie, if you are reading this....I love you and thank you for spending our 30-month + 1 week anniversary on Thanksgiving in Oklahoma with those energetic but adorable nephews of mine!

Questcor's 'REAL' Strategy creates Huge Opportunities for PROFIT!!

UPDATE: I have to admit that when I wrote the following, I was rather annoyed by statements I was reading on the Yahoo Financial Message Board discussing Questcor's rising stockprices. My sense of calm logic was spread thin indeed.

[some content deleted]

Well, I'm no expert and I certainly don't get paid for my opinion.

If you are a biotech investor or a pharma industry commentator or even a health policy expert, you are most likely aware that a little company called Questcor has created quite a stir since the summer.

Initially news focused on the non-approval of their sNDA for Acthar Gel's indication for Infantile Spasm, a rare pediatric epilepsy disorder. Then the President and CEO, James Fares, resigns in May.

"Oh...no...we're in trouble!!!," the board seems to say and upgrades one of their own to Interim President to figure out this mess. It's like they are saying, "we're doomed without the FDA on own side."

So what happens? Three board members resign in July, including the Chairman of the Board of Directors, Albert Hansen. Interestingly, the Senior Vice President of Strategic Planning and Communications, Eric Liebler who worked at Questcor for less than one year, resigns three weeks before the Board announces their 'NEW STRATEGY' after which Questcor loses another board member, Gregg Lapointe.

Now, it sure does seem like former CEO James Fares screwed up and jumped ship, but he wasn't the first to resign. [I don't really know the reasons Fares resigned, but I have doubts that strategy suddenly changed after his departure.] In March, Craig Chambliss, Vice President of Sales and Marketing, resigned...the first big player to do so since James Fares 'took the helm' in February 2005.

James Fares, Steven Cartt (Executive Vice President of Commercial Development), Craig Chambliss, and George M. Stuart (Vice President Finance and CFO) have connections to each other from dealings with Elan and Xcel pharmaceutical companies. This is not surprising since new folks in charge will understandably want familiar faces to work with.

Eric Liebler, former Senior Vice President, Strategic Planning and Communications, was hired in October 2006. No doubt in relation to his expertise as Treasurer and Trustee of American Academy of Neurology Foundation. After resigning his position at the end of July, Liebler is staying close by as a consultant.

David Young was appointed to the Board in September 2006. No doubt in relation to his expertise as a PharmD, researcher, and frequent presenter to the FDA. Young became Chairman of the Compensation Committee in July, replacing Virgil Thompson who replaces Albert Hansen as Chairman of the Board.

Just wait.... the shuffle is not done!

Gregg Lapointe was appointed to the Board in July 2005 primarily due to his position as COO for Sigma Tau Pharm (in US-Gaithersburg, MD office) which is a HUGE investor/owner of Questcor. In fact, Paolo Cavazza of Italy owns Sigma Tau and the other affiliated companies which also collectively own no less than 20% of Questcor. Lapointe was also quite useful due to his connections with National Organization for Rare Disorders (NORD), Child Neurology Foundation, and Kidney Cares Partners.

NORD is an organization which administers pharmaceutical assistance programs for many companies who don't want to do it for themselves. They serve as a buffer between the patient and the company. NORD holds the keys but they are not responsible for the contents. [NORD prides itself on being objective, but it has 'run out of funds' a number of times during the past two years...so has said my neurologist. Being denied sufficient assistance, I paid $16,000 for meds last year on an income of $19,500.] Lapointe resigned in August just after the 'new strategy' was announced and the NORD program was beefed-up. You better bet that he made the transition go much more smoothly. Job done...now you can go.

Taking up the position as Rare Disease expert, Robert J. Rubin joined the Board in September just before reports of the successfulness of the 'new strategy.' Rubin is a professor at Georgetown and served as Assistant Surgeon General and Assistant Secretary of HHS in 1981-1984 and in 1987-2001 was president of The Lewin Group, "a premiere national health care and human services consulting firm" in Falls Church, VA (just 3 miles from my home. I wonder if they ever have lunch meetings over at 2941 Restaurant...hmmm.)

Then Questcor appoints Stephen Farrell to the Board as Chairman of the Audit Committee just after releasing the 3rd Quarter results. Followed by upgrading, Don M. Bailey to full-time President and CEO.

Now, I've read some interesting comments that Bailey came in and turned this sinking ship around (hmm..mixed metaphor) 180 degrees. However, it really seems that Fares should be given credit for creating the huge buying opportunity at $0.21 a share this summer to yesterday's closing price of $6.02.

Do the math....that's insane!!

And it's all based on Questcor's dire financial straights as evident from the 2006 annual report where they reported huge, I mean HUGE, losses.
Baloney!! Phaloney!! Rigatoni!!

And today the stock is establishing a new support level at around $5.40.

So what, you say.

Well, just think, one investor Paolo Cavazza purchased 326941 shares between Oct 1-Nov 13 around $1.93-$2.059 a share at a cost of $667,518 which at today's opening was worth $1,961,646. Not bad for a few days of work. Through Sigma Tau and affiliated companies, Paolo Cavazza has owned significant percentages of Questcor since March 2002. Just looking at the shares purchased between March 2002-December 2006, Cavazza could potentially have close to $100,000,000 value of stocks from about $21,000,000 investment, assuming that no profits had been taken during that time.

I also read estimates that former CEO, James Fares, owned around 1,500,000 shares in March 2007 and had over 800,000 vested stock options valued at $0.44 when he resigned in May. I wonder if he exercised those options or did a little purchasing on his own after the stock dropped so low. Nobody could convince me that he didn't exactly know what would occur later this year.

In case any readers think that this is really cool investor stuff, just remember that Questcor has created this dog-and-pony show by exaggerating income losses (IMO) and outrageously increasing the price of their cheaply acquired ($400,000?) Acthar Gel to over $23,000 per vial.

Increase price 15x - Increase revenue 12x = create stock flurry - take profits

That's it folks. Our innovative U.S. healthcare system thriving.

Who cares about the little folks who are being passed the expense?!!

Wednesday, November 28, 2007

Multiple Sclerosis Community and Resources

Here you will find links to news and research, information and support, foundations and forums, ranters and ravers...

...real people and real stuff about Multiple Sclerosis.

This collection is still under construction, please pardon any mess.

MS Journals and collected Articles Online:
International Journal of MS Care (CMSC, IOMSN, RIMS)
Neurology - American Academy of Neurology (AAN)
Selected Neurology Articles (AAN)
New England Journal of Medicine (NEJM)
Archives of Neurology - American Medical Association (AMA)
MedlinePlus - National Library of Medicine (NIH)
HealingWell
Sage Journals
WebMD

MS News:
Acclerated Cure Project
Medical News Today
NYT Health News

MS Advocacy and Support:
National Multiple Sclerosis Society (NMSS)
MS World - "Patients Helping Patients"
Multiple Sclerosis Association Of America (MSAA)
Multiple Sclerosis Foundation (MSF)
Acclerated Cure Project for Multiple Sclerosis
Multiple Sclerosis Trust (UK)
Society for Neuroscience (SFN)

MS Support and Foundations:
Atlas of MS
Face of MS
MS Means...
MS Moms
MS World
MyMS MyWay
Brain & Spine Foundation
Job Accommodation Network
MS Cooling Foundation
MS Crossroads Connections
Multiple Sclerosis Mobility Foundation (MSMF)
Multiple Sclerosis National Therapy Centres
Multiple Sclerosis Resource Centre (MSRC)
The Race to Erase MS
Trish Multiple Sclerosis Research Foundation (Australia)

MS Forums:
BrainTalk ~ Computer Literate Advocates for MS (CLAMS) ~
Fight MS ~ Friends with MS ~ HealingWell ~ MS for Kids ~ MS for Teens ~ MS for Parents ~ MS Center - MS-CAM ~ MS Discuss ~ MS Log ~ MS Means... ~ MS Support Network ~ MS Watch ~ MS World ~ Neurology Channel ~ OzMS ~ This is MS ~ WebMD

MS Patient Support Groups or Centers:
2008 BP MS 150 Bike Tour, Houston to Austin (Lone Star Chapter)
Familia Unida Living with Multiple Sclerosis (Los Angeles, CA)
Montgomery MS Center (Rockville, MD)
Multiple Sclerosis Association of King County (Seattle, WA)
Multiple Sclerosis Resource Network (Toronto)
OZMS Peer Support (Australia)
Rotarian Fellowship of MS Awareness (RFMSA)
Southcook MS Support (Chicago, IL)
Us Against MS (Timonium, MD)
Youth Against MS (YAMS in Los Angeles, CA)

Active MSers
Multiple Sclerosis Sucks
This is MS

MS Professionals:
Consortium of Multiple Sclerosis Centres (CMSC)
International Multiple Sclerosis Genetics Consortium (IMSGC)
International Organization of MS Nurses (IOMSN)
Multiple Sclerosis International Federation (MSIF)
Multiple Sclerosis Coalition (CMS)
Rehabilitation in Multiple Sclerosis (RIMS)
American Academy of Neurology (AAN)
American Neurological Association (ANA)
European Multiple Sclerosis Platform (EMSP)
National Institute for Clinical Excellence (NICE)
National Library of Medicine (NLM-NIH)

More About Multiple Sclerosis:
Diagnosis and Management of Multiple Sclerosis (AAFP)
Historical Information about MS
Multiple Sclerosis Research (MSR)
Multiple Sclerosis Sucks
National Institutes of Health (pdf file)
National Institute of Neurological Disorders and Stroke (NINDS)
Veterans Affairs Multiple Sclerosis Centers of Excellence (VA-MSCoE)
Neuroland (NL)
Neuroscience for Kids
New York Online Access to Health (NOAH)
Understanding Multiple Sclerosis
BUBL LINK: Multiple sclerosis

MS Alternatives:
MS-CAM (Complementary-Alternative Medicine at Rocky Mtn Center)
Multiple Sclerosis and the Diet Alternative
"Coping and Prevailing with MS" - Thomas Bayuk
Diet and Research into Cause and Treatment of MS (DIRECT-MS)

MS Treatment Centers:
Mayo Clinic - Diagnosis and Treatment Options (MN)
MS Center at Holy Name Hospital (Teaneck, NJ)
Partners MS Center (Brigham and Womens Hospital)
Rocky Mountain MS Center (Denver, CO)
The Cleveland Clinic: MS Learning Center (Cleveland, OH)
The Heuga Center (Colorado)
The Maryland Center for Multiple Sclerosis (College Park, MD)

MS Research and Clinical Trials:
North American Research Committee on MS (NARCOMS)
Accelerated Cure Project for Multiple Sclerosis
Duke Center for Human Genetics
Johns Hopkins Multiple Sclerosis Center
CenterWatch Listing of MS Clinical Research Trials
ClinicalTrials.gov for MS Clinical Research Trials
Medical Research Council (MRC)
Multiple Sclerosis Center of Oregon
Multiple Sclerosis Genetics Group (MSGG)
Multiple Sclerosis National Research Institute (MSNRI)
Multiple Sclerosis Rehabilitation Research and Training Center
Multiple Sclerosis Research Australia (MSRA)
Multiple Sclerosis Research Center of New York (MSRCNY)
Multiple Sclerosis Research Unit at Bristol General Hospital
Myelin Repair Foundation (MRF)
The Myelin Project - Research & Education
Sylvia Lawry Centre of MS Research (SLCMSR)

Sponsored Patient Support:
MS Clinicaltrials (Novartis)
Avonex (Biogen Idec)
MS Active Source & Avonex (Biogen Idec and Elan)
MS Patients for Choice (Tysabri)
MS Advances (American Outcomes Management of New York)
MS Friends (VisionWorks Foundation - Bayer HC Pharmaceuticals)
MS Gateway International & Betaferon (Bayer Schering Pharma)
MS Lifelines & Rebif (EMD Serono and Pfizer)
MS Network & Rebif (Serono International)
MS Pathways & Betaseron (Bayer Healthcare Pharmaceuticals)
Shared Solutions & Copaxone (Teva Neuroscience)
Understanding MS (Healthology and Biogen Idec)
Multiplesclerosis.com - Living With Multiple Sclerosis (Bayer HC Pharma)
BUPA (UK): Multiple sclerosis

International MS Societies:
Argentina ~ Australia ~ Western Australia ~ Austria ~ Bailiwick of Guernsey ~ Belgium ~ Brazil ~ Canada ~ Canada - British Columbia ~ Canada - Calgary ~ Colombia ~ Croatia ~ Czech Republic ~ Denmark ~ Egypt ~ Finland ~ France ~ Germany ~ Hungary ~ Iceland ~ India ~ Ireland ~ Israel ~ Italy ~ Latvia ~ Malta ~ Netherlands ~ New Zealand New Zealand - Auckland ~ Norway ~ Pakistan ~ Peru ~ Poland ~ Portugal ~ Romania ~ Saudi Arabia ~ Scotland ~ Slovakia ~ Slovenia ~ South Africa ~ South Korea ~ Spain ~ Switzerland ~ Sweden ~ Taiwan ~ Turkey ~ United Kingdom ~ United States ~ Ukraine

MS Blogs and Personal Websites: (hattip to Brain Cheese)
A Personal Account of MS
A Short in the Cord
A Stellarlife
Access Denied - Living with MS
Angst on a Shoestring
Behind Blue Eyes
Brain Cheese
Brass and Ivory
Broken Clay
Bubbie's Blog
Camille's MS Adventures
Can You Hear Me Now?
Caregivingly Yours
Chris has MS
Cyndee, Family, and Living With MS
Dancing with MS
Danieldoo
Deborah Does Navel-Gazing
Defeating Illness
Diary of MS X
Disabled Not Dead
Dissonance
Down the MS Path*
Electrical Disturbance
Erik's MS & Lyme Blog
Friday's Child
Funky Mango's Musings
Gandksmom
Health Central Group Blog
Hop Bloody Hop
It's Not All in my Head...
James S. Huggins' Multiple Sclerosis Pages
Jeff's MS Protocols
Jenn's Journey with MS
Jooley's Joint (MSWebPals)
Judi B's Blog/The MS Recovery Diet
Know Multiple Sclerosis
Lazy Dog Public House
Libbi's MS Journey
Life on Cripple Creek Column
Life with MS - Trevis Gleason
Living Life as a Snowflake
Living with MS
Living with MS - My Tysabri Diary
Living with Multiple Sclerosis
LJ Users with Multiple Sclerosis
Looking Forward with Multiple Sclerosis
Maggsbunny
Managing MS with Tai Chi
Managing Multiple Sclerosis
Marciarita
Maybe I'm Just Lazy
MS Activist
MS Caregivers
MS Maze
MS Musings
MS My Way
MS News and Notes
MS Not Just a Diary
MS Pipeline
MS Toolkit
MSB Podcast
Multiple Sclerosis - Real Life Stories and Issues
Multiple Sclerosis Blog
Multiple Sclerosis Blog and News
Multiple Sclerosis Sucks
Multiple Synchronicities & Sclerosis
My Autoimmune Life
My Demyelination
My Journey - Living Well with MS
My Journey with MS
My MS Journal
Newly Diagnosed with MS
No Time for MS
Now We Are Six
One Crazy Chick
One Life - Living Large with MS!
One Life - Old
OUCH!
OzMS Bloggers
Post Cards of my Life
Reality Check
Reality Chick
Say It Isn't So
Self-injecting Chinese Hamsters since 2007
Shoester
Silver Lining
Sunshine and Moonlight
Surviving MS in Alaska
The BS of My MS
The Jaws of My Life
The Life and Times of Sancho Knotwise
The MonSter ate my branes!
The Multiple Sclerosis Companion
The Perseverant Pincushion
The Zen Pretzel Trick
Travels with Lucy
Troy's Multiple Sclerosis Experience
Tryin' to Imagine Bliss
Vicki's Blog
Victoria Plum - Technician!
Wendy's Multiple Sclerosis Site
White Lightening Axiom: Redux
Wind Among the Reeds
Word Salads, The Demyelination of Me
WTF - Intent, Context and Perception
Yoda Mamma MS & More


Seemingly Inactive Sites:
Doug's MS Journal
Journey through the MS Fog
Just above the Abyss
Happiness, Heartache and Hope
Life with MS - Seeking a Cure
MS Support Network Blog
My Complications
My MS Experience
Object of my Injection
Sharing Our Days
Splodge on the Blogscape
The Great NetXperiment!
This Sucks - MS101
Truth & Beauty
What is MS to Me

Sunday, November 25, 2007

Doctors are Human Too

How much influence does the pharmaceutical industry have over your doctor's prescribing habits?

Not only are we (patients) supposed to ask our doctors about such-and-such drug for such-and-such condition, drug reps are attempting to convince your doctor to prescribe such-and-such drug for such-and-such condition because it is supposedly more effective than the other such-and-such drug commonly used.

Today's New York Times Magazine has a wonderful article, "Dr. Drug Rep," written by Dr. Daniel Carlat. During a year of being paid to give talks to doctors about an antidepressant, a psychiatrist comes to terms with the fact that taking pharmaceutical money can cloud your judgment.
(via Over My Med Body!)

On a blustery fall New England day in 2001, a friendly representative from Wyeth Pharmaceuticals came into my office in Newburyport, Mass., and made me an offer I found hard to refuse. He asked me if I’d like to give talks to other doctors about using Effexor XR for treating depression.
[...]
How many doctors speak for drug companies? We don’t know for sure, but one recent study indicates that at least 25 percent of all doctors in the United States receive drug money for lecturing to physicians or for helping to market drugs in other ways. This meant that I was about to join some 200,000 American physicians who are being paid by companies to promote their drugs. I felt quite flattered to have been recruited, and I assumed that the rep had picked me because of some special personal or professional quality.
[...]
Regardless of how I preferred to think of myself (an educator, a psychiatrist, a consultant), I was now classified as one facet of a lunch helping to pitch a drug, a convincing sidekick to help the sales rep.
[...]
One of my most uncomfortable moments came when I gave a presentation to a large group of psychiatrists. I was in the midst of wrapping up my talk with some information about Effexor and blood pressure. Referring to a large study paid for by Wyeth, I reported that patients are liable to develop hypertension only if they are taking Effexor at doses higher than 300 milligrams per day.

“Really?” one psychiatrist in the room said. “I’ve seen hypertension at lower doses in my patients.”

“I suppose it can happen, but it’s rare at doses that are commonly used for depression.”

He looked at me, frowned and shook his head. “That hasn’t been my experience.”

I felt rattled. That psychiatrist’s frown stayed with me — a mixture of skepticism and contempt. I wondered if he saw me for what I feared I had become — a drug rep with an M.D. I began to think that the money was affecting my critical judgement. I was willing to dance around the truth in order to make the drug reps happy. Receiving $750 checks for chatting with some doctors during a lunch break was such easy money that it left me giddy. Like an addiction, it was very hard to give up.
[...]
I still allow drug reps to visit my office and give me their pitches. While these visits are short on useful medical information, they do allow me to keep up with trends in drug marketing.

Sunday, November 18, 2007

Measuring Big Milestones and Giving Thanks

I started this blog in mid-August, and so far...

42 posts -- not quite as prolific as Kevin, M.D., but certainly not bad for a layperson.

15 blog reactions (Technorati.)

33 visits and 55 page views on average per day (Sitemeter.)
971 visits and 1814 page views since October 9 (Sitemeter.)

129 clicks back to the site on 38 items since August 16 (Feedburner.)

and...

No.544 -- Honorable Mention on the Healthcare Top Blogs List.


Not bad I'd say for a professional musician without a medical, health policy, or journalistic background. Simply an individual patient with a little experience and some thoughtful opinion. For this I am thankful.

I'm visiting my three young nephews and will be silent during the week.

Have a great Thanksgiving!!