Monday, March 21, 2016


The ever more moronic and inept little temporary leader of the "B" team is attempting to assist the big Pharmaceutical Companies to dismantle New Zealand's unique and much admired internationally, Government drug buying agency, Pharmac. Something he and his allies have railed about as they attempt to get some traction from their opposition to TPP.

The people charged with the protocols in Pharmac have an unenviable task and will sometimes be easily portrayed as heartless in their gyrations around funding new drugs that too often have an eyewatering price tag and with the limited resources available, leave others to suffer when alterations are made to the "schedules" of part and wholly funded drugs.

Back in the day pastoral farmers were almost bereft of viable remedies to cope with internal parasitic worms in the gut of increasingly vulnerable livestock as more intensive management systems were gaining momentum.
After many 'Dr Hook' remedies, many home made,  along came a drug, Phenothiazine, that was almost without compare.
It came as a liquid or a large bolus and was very effective but had a propensity to cause serious staining of wool from spillage and urine.
Then Merk Sharpe and Dohme produced Thiabendazole, equally effective if not more so, without any wool stain but accompanied by a serious step up in costs.
The old "costs of research and development" meme was trotted out and was accepted by many as reasonable until some years later when I had become involved inside the stock and station industry and blundered into a staff room meeting of merchandise reps being primed by a regional sales rep of a company releasing a latest wonder drug to be marketed to farmers. The merch agents were being schooled in what was a seemingly disproportionate cost that was going to probably create a backlash from their clients and they would need to be prepared to meet it. Put simply the drug company had spent considerable resources in establishing the highest cost that could be charged using cost benefit, safety, ease of use, longevity and effectiveness, the hoary old chestnut of escalating costs of R & D was only to be employed as a backstop to come when all else had failed and fear of no more new drugs could be used to combat the inevitable resistance  problems. That lesson dismantled any residual acceptance that high drug costs were actual costs, yes naivety expired that day for me.
Pricing had moved to "what the market could meet".

National made a grievous error when they politicised 'Herceptin' and the moronic Little Claytons leader has made the very same error in spades over Keytruda.

On the periphery of my social circle there is a young person with advanced melanoma, married with a couple of little ones facing life without a parent.
This pt has spent  savings, had fundraisers on  behalf, including a 'give a little' to access Keytruda and it has worked.
Last spring was told by oncologist to put affairs in order with a prognosis said pt would not make Christmas.
Chest cavity invaded with tumor growth that was impeding breathing.

Keytruda was accessed in late spring and now after a series of  treatments at the cost of $9 000 to cleared in the suppliers bank before issue of drugs every three weeks has that Pt miraculously symptom free although I have very sketchy evidence of prognosis and equally little evidence of current actual Pt condition but we are well clear of the Xmas date with destiny and on what I understand as current status, any such date is not an issue for now.
 That Pt has funding for another year and a half and I am sorry but I have no knowledge as to what the situation will be then, either prognosis, cure or hope, as I said the Pt is three social steps from my immediate association .

Sunday program last night alluded to the manipulations of big Pharma over supply of the treatment for Hepatitis C and how the drug barons are permitting drug creation in third world countries where their assessed cost structures will be meaningless in the prevailing poverty of say Bangladesh.

Anecdotal evidence of drug barons seeking out "victims" and advising on ways to lobby, bring pressure to bear and innovative ways to raise the funds to pay the costs of lifesaving drugs were bad enough until the now not so secret dinner for The Little Man with several big pharma leaders was revealed as a background to his sudden rising to expert status as a consultant to Pharmac.
The mountain of unknown background knowledge on matters of alternative treatments and the true effectiveness of Keytruda are what Pharmac must consider in their job, A job  that I and most others would not want to go near, yet apparently the "B" team will not be impeded.

Find another vehicle Little Wonder to reach tonights infotainment hour, as getting into the emotionally charged and too often disgusting manipulations of Big Pharma as they pursue their macabre goals of misery money should be beneath even your crass and cringeworthey abilities.


Anonymous said...

Advertising veteran Mike Hutcheson agreed something needed to be done.

"At a point where they don't respond to any kind of voluntary request then I think the chief censor should come in. Because some of those slogans are downright offensive and they've just overstepped the mark," said Mr Hutcheson.

"I mean it's a fuzzy line but they've overstepped it and I reckon it's about time they get reined in."

Adolf Fiinkensein said...


You must be still asleep.

All goods and services are charged at what the market will bear.

If you want a 'cost plus' economy just dig Muldoon out of his grave.

macdoctor said...

There seems to be a meme that the political decision to fund Herceptin has paved the way for the ludicrous call to fund Keytruda. This is not the case. Pharmac had already funded Herceptin but only for a 9 week course instead of 12 months. While there was good evidence that Herceptin was effective, the evidence that 9 weeks was as good as 12 months was very flimsy. It was therefore a poor decision by Pharmac and Oncologists across New Zealand were saying so. It was therefore the right decision to fund it for 12 months until there was sufficient good evidence to use it for a shorter period.

Keytruda is very different. Oncologists agree with Pharmac that the additional benefit that Keytruda provides is not worth the large extra expense over conventional treatment. Of course, this decision, whilst correct, is not helped by anecdotal reports of "miracle cures". Like all biologics, Keytruda sometimes works spectacularly well. Sadly, this response is not easily predicted. We would have to spend tens of millions with mediocre results to get one "miracle". There are better things to spend that money on.

gravedodger said...

Thanks macdoctor, good summary as to what I believe.

With what I attempted above I am somewhat conflicted in my information and the sources but alarmed at the clear moves by Merck with assistance from the little people to attack Pharmac.