Promo cost for drug with Million-Dollar Potential: $12.00-18.00

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That $12-18 figure, while it hardly represents the total a pharmaceutical company might spend to promote a new drug, it does, according to Medicare’s Open Payments data for 2013, represent the amount actually spent during information-sharing lunches where doctors heard from big pharma reps about for specific medications.

The information, which came to light in a study reported last month in JAMA Internal Medicine, was a compilation of data on 279,669 doctors who received 63.524 payments relative to one drug to lower cholesterol, two to address symptoms of hypertension (high blood pressure), and an antidepressant.

Any given doctor might, over the course of a medication’s life, prescribe it thousands, if not tens of thousands of times. Collectively, doctors often do prescribe a medication enough times to make it worth millions of dollars, if not tens of millions, to its maker.

The $12-18 figure represents what pharmaceutical reps typically spent on lunch for doctors at those information-sharing sessions. Certainly a modest enough sum, when the potential benefit to the drug’s maker is taken into consideration.

Yes, many patients also benefit from drugs doctors first learn about over lunch with a big pharma rep.

Yet the fact remains that, according to the above-cited study, doctors are significantly more likely to prescribe a lunch-promoted drug than an alternative – even when the alternative might cost the patient (or his/her insurer, or Medicare) considerably less.

Dr. R. Adams Dudley, a professor of medicine at the University of California, San Francisco, the lead author of the study, decried this “system of education for doctors” in a New York Times article on the study.

“The cost of an alternative system of drug education would be paltry,” he said.

What’s ‘Good’ For You? Or ‘Healthy’? It Depends Who You Are/Who You Ask!

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One of several New York Times charts symbolizing the healthy/not healthy issue.

When it comes down to it, Americans don’t have a firm grip on the concept of ‘healthy’ versus ‘not so healthy’ foods. And, sadly, because of conflicting advice from assorted vested interests, most people are far from approaching the level of understanding of why this food, while it may supposedly be ‘good’ for you in ‘this’ way, is far from good for you in another way.

The New York Times devoted a great deal of time and resources to researching this subject and, sadly, came away with head-scratching concerns on top of confusion why the what’s-good-for-you subject is so, well, incomprehensible.

The USDA doesn’t help: It recently came out with a revised standard for nutritional information on packaged food labels and the supposedly-improved ones truly aren’t – leaving consumers, as they have been for years, trying to make sense of terms and quantities they can’t comprehend.

An excellent explanation of why the U.S. has so resisted going totally metric – many domestic industries already employ that system exclusively – is laid out in this Time Magazine article from 2014. Some of the stated reasons may have made a certain amount of sense at one time, but they no longer do – just as, except for its currency, the British have been all-metric since the late 1970’s.

(I happened to leave, after five years there, as the change-over was starting. The thing that amazed me most was how quickly and adeptly lovers of Fahrenheit and other non-metric units switched over.  Yet even today, when I discuss something involving a measurement with a friend there, I have to do an electronic [or old-fashioned, paper-based] conversion to get ‘on the same page’ with them.

Our auto industry is all-metric. So is the military. So is the industry producing wine and ‘hard’ alcoholic beverages : 5ths and quarts disappeared some years ago, replaced by .75 liter (litre) and liter bottles. Beer producers are switching, too, albeit more subtly : Incrementally, they are making the percent-of-a-liter ID larger than the old standard ‘ounce’ measure on their bottles.

But because, except in a limited number of instances, it is impossible to produce a food package of a size that can be converted from ounces to milligrams/milliliters or vice versa in whole numbers, and because manufacturers insist on measuring sizes in quantities only vaguely approximating what people call a serving, comparisons of the value Brand A to Brand B  are, at best, an exercise in futility.

So, regardless of whether Brand A or Brand B is ‘healthier’ or ‘better for you,’ it’s pretty hard to tell from packaging and serving sizes.

The Times report noted that a survey of “hundreds” of nutritionists – members of the American Society for Nutrition – revealed “a surprising diversity of opinion, even among experts.”

Dariush Mozaffarian, dean of the Tufts Friedman School of Nutrition Science and Policy, told the paper, “Twenty years ago, I think we knew about 10 percent of what we need to know” about nutrition, “and now we know about 40 or 50 percent.”

The Times report is long, detailed and, sadly, will leave many readers none the wiser – or not much the wiser, anyway – after they’ve plowed through the entire thing.

And when reading any such report, one has to keep in mind that it refers to ‘healthy’ and ‘good for you’ foods for ordinarily healthy people. To a concerning extent, though, the findings of such studies are meaningless for ‘special needs’ people like me: I have Stage 4 Chronic Kidney Disease (CKD), meaning many things that are ordinarily good for healthy people – things such as tomatoes, potatoes, beans and nuts – should seldom if ever pass my lips.

Diabetics have their own dietary issues, of course.

The Centers for Disease Control (CDC) says that some 29 million Americans have Type 2 Diabetes. That’s roughly 9.3% of the population.

Another 10% of adults have CKD.

So, right off the bat, close to one-fifth of the American population falls outside the ‘good/not good’ – ‘healthy/unhealthy’ measurements of most nutrition surveys. And that doesn’t count those with special dietary needs because they are way under-, or over-weight.

If you are fortune enough to in the larger group that can choose what you eat based on common measurements like those surveys and ‘experts’ produce, consider yourself fortunate. But keep in mind, it wouldn’t take a lot to push you into one of the ‘endangered’ classes!

Olive, Alive Oh: A Tree’s Genome Has Been Sequenced in Spain

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Credit: Manuel Sánchez (RJC-CSIC)

The more that is known about a plant, the better the chances are for modifying its behavior and improving its product – be it a fruit, a nut or, as an example, a kind of fruit called an olive.

Researchers in Spain recently sequenced the complete genome of a 1000-year-old olive tree, and it is widely expected their work will – in time, but hardly soon – enable improvements in genetics improvement for production of olives and olive oil, and possibly also lead to advancements in protecting olive trees from attacks from the bacteria Xilella fastidiosa and the fungi Verticillium dahlia – something not accomplished anywhere to date.

A report on this breakthrough, which was several years in the making, appeared in the July 4 issue of New Food magazine.

The reason it will be some years before many significant result from the sequencing concerns the fact that olive trees grow very slowly. Very very slowly. That may have something to do with why they can live to a ripe old age of 3000-4000 years!

“Without a doubt, [the sequenced tree] is emblematic, and it is very difficult to improve plant breeding, as you have to wait at least 12 years to see what morphological characteristics it will have, and whether it is advisable to cross-breed,” says Toni Gabaldón, ICREA research professor and head of the comparative genomics laboratory at the CRG.

(“ICREA, the Catalan Institution for Research and Advanced Studies, is a foundation supported by the Catalan government and guided by a board of trustees. An institution without walls, ICREA works hands in hand with Catalan universities and research centers to integrate ICREA research professions in the Catalan research system. The foundation offers permanent, tenured positions to researchers from all over the world interested in coming to work at Catalonia. Over the years, these positions have  become a synonym of global academic excellence,” the Foundation’s website says.

(The Centre for Genomic Regulation (CRG) “is an international biomedical research institute of excellence, created in December 2000. It is a non-profit foundation funded by the Catalan Government through the Departments of Economy & Knowledge and Health, the Spanish Ministry of Economy and Competitiveness, the ‘la Caixa’ Banking Foundation, and includes the participation of Pompeu Fabra University,” CRG’s website says.)

Pablo Vargas, who coordinated the three-year research effort to sequence the olive tree’s genome, says this about the research: “There are three phases to genome sequencing: first, isolate all of the genes, which we published two years ago. Second, assemble the genome, which is a matter of ordering those genes one after the other, like linking up loose phrases in a book. Last, identify all of the genes, or binding the book.”

Clearly not a simple, get-in-done-by-next-Tuesday project!

While the researchers didn’t say as much in the New Food article on their work, it would appear obvious that it won’t just be Spanish olive trees to benefit from their efforts. How, and how much, will come to light when it does – to scientists, researchers and olive-growing/processing specialists a decade or so from now.

Cutting Down On Pasta? Don’t! It Could Be Good For You

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‘Think pasta is fattening? Think again. A new study reported this month in the journal Nutrition and Diabetics indicated that moderate levels of pasta consumption contributes positively to a good BMI (Body Mass Index) and with “better adhesion to the Mediterranean diet.”

Put another way, pasta consumption balances well with “a diet of a type traditional in Mediterranean countries, characterized especially by a high consumption of vegetables and olive oil and moderate consumption of protein, and thought to confer health benefits; Researchers [have] found that people who eat a Mediterranean diet have lower odds of having a heart attack,” a Wikipedia article says.

George Pounis, the first author of the Italian study – the one cited above – sums up the results this way: “Our data show that enjoying pasta according to individuals’ needs contributes to a healthy body mass index, lower waist circumference and better waist-hip ratio.”

Previous research has touted the heart-healthy benefits of the Mediterranean Diet, which is a way of eating rather than a specific meal plan. It emphasizes fruits, vegetables, grains, beans, peas and olive oil plus fish and poultry.

However, little was known about how pasta — also a staple in the Mediterranean region — affected health, the researchers behind the new study said. This finding fills that gap, they believe.

“We have seen that consumption of pasta, contrary to what many think, is not associated with an increase in body weight, rather the opposite,” Pounis added in a journal news release.

Many people have shunned spaghetti, noodles and other types of pasta in recent years because of concerns they were fattening. The new study could potentially cause Americans and others to revise their views.

The Italian study covered thousands of people surveyed in several ways over several years.