miércoles, 22 de mayo de 2019

Forbes The World’s Largest Public Companies 2019 Ranking / Pharma

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VENEZUELA: Practicar la medicina en medio del caos.

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When the Venezuelan infectious disease specialist Oscar Noya started his career almost four decades ago, he treated about 20 patients with malaria a year. Last year the number was 3500. He expects the number to be higher this year. In the past five years economic policy has left his formerly upper middle income country beset by poverty, violence, corruption, hyperinflation, and chronic scarcity of basic goods, leading to a humanitarian disaster.


Recently, a patient visited Noya with textbook symptoms for malaria: high fever, tremor, and chills. The young man, small and wiry with an odd indifferent look, had a good idea of what was ailing him—he’d already had many bouts of malaria in his lifetime. He was Noya’s third patient of the day to show malaria symptoms. In the dark and windowless waiting room, 10 other patients sat in silence.



“Before, it was one patient a month, or two at most,” Noya told The BMJ during a break. “Now it can be 50 a day.” 
Noya usually sees 15 to 30 patients or more a day in his small office in the Tropical Medicine Institute of Venezuela’s Central University in Caracas, most of them with malaria. A large painting of his mentor, former Venezuelan health minister Arnoldo Gabaldón, sees all.(...)


In the midst of the western hemisphere’s worst economic crisis in recent history, the health system that used to provide Noya’s patients with affordable care and access to drugs has crumbled. Around 22 000 physicians left between 2012 and 2017,1 leaving many hospitals with vacancies that were never filled. There are not enough medicines, and those that can be found are unaffordable.

“Malaria is just one indicator,” Noya laments. “We have epidemics of a large number of diseases, which means the entire health system has collapsed.”


Dr. Oscar Noya
Noya’s working day lasts from 7 am to 5 pm. He doesn’t accept money from his patients, who have little or none. He himself is living off savings. His own hospital salary of $20 (£15; €18) a month—when he gets it—couldn’t support him.

The economic crisis forces children and adults to work in rural areas where there is much standing water that serves as breeding grounds for mosquitoes, and catching malaria isn’t hard. 




Patients come to El Clínico from other parts of Venezuela because there’s a shortage of drugs nationwide, says Noya, as he carefully counts out 21 tablets of the combination treatment artemether with lumefantrine.

Drought of drugs

The cost of a full round of treatment, when available, is just a couple of US dollars. Most of the drugs Noya prescribes today are provided by international organisations, not the state. “We had to resort to donations to continue working,” Noya explains. Even so, they’re running out of the chloroquine they prescribe to pregnant women with malaria.

Drug shortages began in 2014. Last year his institute spent five months without any drugs at all. On days when Noya has no antimalarials for his patients he can only tell them to go home and rest. “This is what angers me most,” he says.

The Federation of Venezuelan Pharmacies, a trade group, estimates that only 15-20% of the necessary drugs are available in the country. Daily medicines to treat diabetes or hypertension are almost impossible to find. Antibiotics are practically non-existent. And the drugs that are available are prohibitively costly. Some treatments can surpass the monthly minimum wage of 18 000 bolivars, the equivalent of $4.50.

For more than three years President Nicolás Maduro has denied the existence of a humanitarian crisis and blocked foreign aid. In early April the Red Cross was able to deliver its first shipment of humanitarian medical aid: power generators, 5000 L of distilled water, and three surgery equipment kits.

Noya’s ability to do research has changed dramatically. His laboratory lacks supplies ranging from diagnostic tests to ordinary paper. 
The rooms are full of empty chairs, as colleagues and students have joined three million other Venezuelan emigrants fleeing hunger, disease, and crime. The laboratory is a graveyard of damaged equipment: the people who could repair them have left. The postgraduate programme Noya led has closed for lack of funding.

More than half of the university’s staff have gone. “We are living with a very serious brain drain,” Noya says. “This is the problem that worries us most: the staff are leaving, and we can’t train new people. It’s a chain of events that makes it difficult for us to continue doing research.”

Noya’s hospital is typical. Syringes, needles, gloves, and sewing thread are not available across the country. The National Hospital Survey found that all public hospitals experience shortages. Half have damaged x-ray equipment. In 95% the tomographs don’t work. And operating rooms are closed in 53% of hospitals. (Más)

martes, 21 de mayo de 2019

PWC: Global Consumer Insights Survey 2019

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 "Parece evidente 
que el papel de la tienda física 
ha evolucionado 
y que ya no tiene 
un rol puramente transaccional. 
Esta circunstancia, 
unida al aumento del uso 
de los canales digitales, 
va a hacer que sea 
cada vez más difícil 
discernir en qué momento 
se toma la decisión de compra". 
Roberto Fernández Humada 
Socio responsable de Retail en PwC











PwC’s survey shows that consumers are increasingly willing to engage in nontraditional activities online. 
This trend is especially noticeable in healthcare, where almost two-thirds of our global sample said they’re willing to access services through companies not typically associated with health, such as Amazon, Apple and Facebook.


And why not? Consumers are already using their mobile phones for health information: Almost 75% of survey respondents who use healthrelated apps said they have as many as three fitness, healthcare or wellness apps on their mobile devices

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Web for Healthcare professionals

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The report is based on an independent study conducted in August 2018 with three global stakeholder groups – healthcare professionals (HCP), pharmaceutical companies (pharma) and third party service providers. In combination, their insights indicate that: 

For HCPs, websites are the most important and frequently used of communication channels in clinical practice, while pharma still places more value and budget with other channels including scientific meetings and company representatives. 

HCPs turn to pharma websites for brand awareness, however for disease awareness they prefer to use independent websites and expect industry to support the provision of these. Pharma however, prefers to use its own websites for both brand and disease awareness, and most companies have internal policies to favour investment in their own websites. 

Pharma’s primary objectives for digital activities are to provide real value, improve trust and grow audience reach. To do this, focus is on creating the types and formats of content that HCPs prefer. Creating this content is a major challenge that pharma largely outsources to overcome. The potential of this content to achieve pharma’s objectives is then limited by placing it on their own websites. 

While multichannel activity is a major area of focus and challenge for industry, the channels that pharma adopts to engage HCPs are not being effectively integrated with websites or successfully used to raise awareness of them. Likewise, data collection and use is a key area of focus but also a major challenge, with pharma struggling to extract meaningful insight or measure real-world impact currently. 

Pharma is collaborating with third party providers in the areas that it finds challenging internally due to perceived lack of expertise, but research indicates pharma preference would be to keep most digital activity internally driven and resourced (Más)

domingo, 19 de mayo de 2019

Sexo analgésico...

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El sexo es como la aspirina: bueno para el corazón, para las dolencias musculares... y para las migrañas. Según una investigación de la Universidad de Münster (Alemania), el sexo puede ser el antídoto más eficaz contra esta dolencia, uno de los pretextos más clásicos para no mantener relaciones sexuales. ¿Quién no lo ha puesto alguna vez?

«Las excusas son tantas y tan creativas como las personas», cuenta Diana Fernández, terapeuta sexual y de pareja de la Asociación Estatal de los Profesionales de la Sexología (AEPS).

Echarle la culpa a un dolor de cabeza para no irse a la cama con la pareja no es solo una cuestión de mujeres, aunque según los expertos son ellas quienes más la usan. Lo cierto es que el estudio hecho por el departamento de Neurología de esta universidad encontró que mantener relaciones sexuales puede mejorar parcial o completamente el dolor. 

No importa si es con su pareja o en la soledad de las sábanas. Fernández dice que «durante la excitación y el orgasmo, ya sea en compañía o con la masturbación, se liberan endorfinas que actúan como analgésico natural, inhibiendo la sensación de dolor. Al igual que los analgésicos, su efecto puede cambiar en función del momento y la persona».

Los resultados del estudio son contundentes y alentadores. Más de un tercio de las personas con migrañas tenían experiencia practicando sexo durante un momento de dolor y de estos pacientes, casi dos de cada tres informaron de una «mejora de su migraña».

«Podríamos decir que el placer erótico favorece una vivencia corporal menos dolorosa. Hay diferentes estudios que también hablan de la afinidad e interacción de las zonas cerebrales vinculadas a placer y dolor, apuntando que las experiencias positivas y negativas puedan anularse unas a otras», insiste Fernández.

La investigación se realizó con una encuesta anónima a 800 pacientes con migraña y 200 con dolor de cabeza. Encontró que más de la mitad de quienes padecían migrañas y que tuvieron relaciones sexuales durante un episodio de dolor sintieron mejoría en sus síntomas.

Uno de cada cinco encuestados en este análisis quedó sin ningún tipo de dolencia, mientras que los pacientes masculinos incluso usaron el sexo como una herramienta terapéutica.

Los neurólogos de la universidad alemana concluyeron que más del 90% de los participantes en el ensayo, sintió alivio moderado por completo al tener un orgasmo en un episodio de dolor, pero un 50% manifestó menos efecto en casos de dolor extremo. (Más)

sábado, 18 de mayo de 2019

ANIS 2020: No pudo ser...no llegamos.

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 Ver

Desde esta semana (y hasta 2.020) PHARMACOSERÍAS en la Vicepresidencia de ANIS...



Este era el mandato...




Por razones diversas, por imponderables no pudimos terminar el período establecido. 

Seguiremos, desde cualquier trinchera, luchando por ello.

viernes, 17 de mayo de 2019

Ratón de biblioteca: Viñetas biográficas de un médico y humoradas peregrinas de medicina / Rafael Muci-Mendoza


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Biblioteca Nacional Venezuela

En la octava década de mi vida al fin de me decidí… Por largo tiempo había abrigado el deseo de ¨colgar¨ una página en la red que pudiera albergar mi producción intelectual de tantos años y en la cual mi familia, amigos, alumnos e interesados pudieran encontrar el producto de mis desvelos… 

Un blog (Dr Muci-Mendoza blog) como un libro, cualquiera que sea su asunto, considero que es también una autobiografía del autor, pues en él se conjugan hechos aislados, aconteceres y pareceres que muchas veces parecen una colcha de retazos; y si esta manta tiene alguna coherencia reflejará los avatares de la vida del autor. 

He sido y soy médico de vocación forjada en el contacto con los enfermos, inicialmente de un hospital público y luego de la conjunción armoniosa del trabajo con un hospital privado. Ello me ha permitido entrar y estar en contacto con las penas de los poderosos, pero también con las miserias de los que nada tienen. Sobre ese tema he escrito mucho, aunque me temo mis palabras no han tenido la trascendencia necesaria. 

El común de las personas no queremos conocer ni sentir como en carne propia las desgracias de otros menos afortunados. Mis editoriales del Boletín Virtual de la Academia Nacional de Medicina tienen mucho que ver con la esencia del ser médico pero también del ciudadano comprometido con enseñar lo que cree que a otros podría interesar.(...)

Siendo el creador de un segmento intitulado ¨Perlas de observación clínica¨, actividad que propuse en el seno de la Academia Nacional de Medicina de Venezuela mostraré aquellas que han sido publicadas en el seno de la Corporación.

Quiero mostrar pues el latido de mi vida personal como médico, ciudadano, profesor universitario y académico siempre agradeciendo la presencia y ayuda efectiva de mi esposa Graciela inseparable compañera en la aventura de mi vida labrada con trabajo, seriedad y honestidad.

Mis libros, ¨Primum non nocere, primero no hacer daño, vivencias de un médico del Hospital Vargas de Caracas¨ (2004) y ¨Viñetas biográficas de un médico y humoradas peregrinas de medicina¨ (2015)



En PHARMACOSERÍAS...orgullosos de aparecer en las páginas de este libro.

Ver:
Todo sobre Dr. Rafael Muci-Mendoza en PHARMACOSERÍAS

H.A. "Una bomba que se activa" así que "pasen" 40 años...

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Hoy, Día Mundial de la Hipertensión Arterial, mi memoria retrotrae recuerdos de Caracas (1979).

Producto Manager en Sandoz, lanzamiento de Visken (Pindolol), betabloqueante, un gran simposio...

Eminentes coordinadores que representan, al completo, los centros académicos del país: Dres. Otto Lima Gómez, Francisco Suarez Torres, Francisco Fragachán y Frank Pérez Acuña
Invitados extranjeros: Dres. Roland Gugler (Außerplanmäßiger Professor, Alemania), Dra. Julia H. Hauger-Klevene (Argentina). 
Los más reconocidos líderes nacionales: Dres. Manuel Velasco (Caracas), Dídimo Rubio (Maracaibo), Kepler Orellana  (Barquisimeto), José L. García Zozaya y Gregorio Riera (Valencia)

El "Who is Hu" de la Hipertensión arterial en Venezuela...

Un lugar de prestigio: Hotel Caracas Hilton (el genuino)

Una imagen: "referente" a un doloroso atentado terrorista en Barcelona (España)




Un lema motivacional: 

Hipertensión 

Una bomba que se activa con el abandono de la terapia. 

Sigue vigente...

jueves, 16 de mayo de 2019

USA: The Big Pharma Conspiracy / Precios..."en genérico"

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By Heather Murphy May 11, 2019

Leading drug companies including Teva, Pfizer, Novartis and Mylan conspired to inflate the prices of generic drugs by as much as 1,000 percent, according to a far-reaching lawsuit filed on Friday by 44 states.

The industrywide scheme affected the prices of more than 100 generic drugs, according to the complaint, including lamivudine-zidovudine, which treats H.I.V.; budesonide, an asthma medication; fenofibrate, which treats high cholesterol; amphetamine-dextroamphetamine for A.D.H.D.; oral antibiotics; blood thinners; cancer drugs; contraceptives; and antidepressants.

“We all know that prescription drugs can be expensive,” Gurbir S. Grewal, the New Jersey attorney general, said in a statement. 
“Now we know that high drug prices have been driven in part by an illegal conspiracy among generic drug companies to inflate their prices.”

In court documents, the state prosecutors lay out a brazen price-fixing scheme involving more than a dozen generic drug companies and just as many executives responsible for sales, marketing and pricing. The complaint alleges that the conspirators knew their efforts to thwart competition were illegal and that they therefore avoided written records by coordinating instead at industry meals, parties, golf outings and other networking events.

Más





Ver: 
Todo sobre precio en PHARMACOSERÍAS

El sexo es como la aspirina: bueno para el corazón, para las dolencias musculares... y también para las migrañas.


El sexo es como la aspirina: bueno para el corazón, para las dolencias musculares... y para las migrañas. Según una investigación de la Universidad de Münster (Alemania), el sexo puede ser el antídoto más eficaz contra esta dolencia, uno de los pretextos más clásicos para no mantener relaciones sexuales. ¿Quién no lo ha puesto alguna vez?

«Las excusas son tantas y tan creativas como las personas», cuenta Diana Fernández, terapeuta sexual y de pareja de la Asociación Estatal de los Profesionales de la Sexología (AEPS). 

Echarle la culpa a un dolor de cabeza para no irse a la cama con la pareja no es solo una cuestión de mujeres, aunque según los expertos son ellas quienes más la usan. Lo cierto es que el estudio hecho por el departamento de Neurología de esta universidad encontró que mantener relaciones sexuales puede mejorar parcial o completamente el dolor. 

No importa si es con su pareja o en la soledad de las sábanas. Fernández dice que «durante la excitación y el orgasmo, ya sea en compañía o con la masturbación, se liberan endorfinas que actúan como analgésico natural, inhibiendo la sensación de dolor. Al igual que los analgésicos, su efecto puede cambiar en función del momento y la persona».

Los resultados del estudio son contundentes y alentadores. Más de un tercio de las personas con migrañas tenían experiencia practicando sexo durante un momento de dolor y de estos pacientes, casi dos de cada tres informaron de una «mejora de su migraña».

«Podríamos decir que el placer erótico favorece una vivencia corporal menos dolorosa. Hay diferentes estudios que también hablan de la afinidad e interacción de las zonas cerebrales vinculadas a placer y dolor, apuntando que las experiencias positivas y negativas puedan anularse unas a otras», insiste Fernández.

La investigación se realizó con una encuesta anónima a 800 pacientes con migraña y 200 con dolor de cabeza. Encontró que más de la mitad de quienes padecían migrañas y que tuvieron relaciones sexuales durante un episodio de dolor sintieron mejoría en sus síntomas.

miércoles, 15 de mayo de 2019

Cannabinoides: strategies and tactics in pharma marketing.

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The strategies and tactics in pharma marketing are highly applicable in medical cannabis. Most of our marketing and sales team comes from pharma.


Amanda Daley, VP, medical sales and education, Canopy Growth, recently joined MM&M’s executive editor Marc Iskowitz on MM&M’s Transforming Healthcare webcast, which offered a sneak peek into some of the cutting-edge educational content in store at May 8’s Transforming Healthcare event. 
The following interview has been condensed and edited.

Marc Iskowitz: As VP medical sales & education, for Canopy Growth and Spectrum Cannabis, you oversee the commercial medical strategy for Canopy, including the medical sales team, and the creation and implementation of CME programs. Lay some context on that.


Amanda Daley: I’m responsible for the Spectrum Cannabis commercial business in Canada. Spectrum Cannabis is Canopy Growth’s international medical brand. It’s our healthcare professional and patient-facing identity in medical markets in Canada and around the world. Spectrum Cannabis is focused on the simplification of healthcare interactions, and my role is to oversee the team efforts around the work we do with the healthcare community, patient and professional organization partnerships in addition to overseeing our Customer Care function that we provide to our medical clients here in Canada.

Canopy Growth, for anyone who isn’t familiar with us, is a world-leading diversified cannabis and hemp company, offering distinct brands and a collection of cannabis varieties in a variety of product forms—presently dried, oil and softgel capsule forms. We’re listed on both the Toronto and New York stock exchanges and have operations in 15 countries across five continents along with 10 licensed cannabis production sites with over 4.3 million square feet of production capacity, including over 1 million square feet of GMP certified production space.

Iskowitz: In Canada, is “medical sales” the equivalent to our “medical science liaisons” here in the U.S., which typically sit under medical affairs along with CME and scientific communications?

Daley: Not quite. Our medical sales function consists of our field team who are developing relationships with healthcare practitioners and providing support and education to help these medical professionals navigate the complexities of medical cannabis. We do have a CME team involved in medical education through partnerships with clinical experts and scientific organizations, and the intent is to expand our medical affairs team in the near future in order to continue to meet the needs of HCPs and the medical community.

The way doctors learn 
about medical cannabis 
is very different 
compared to other medications.

Iskowitz: Your background includes 15 years in the pharma industry, including a decade at Pfizer Canada. Why, and how, did you transition from pharma to the cannabis industry?


Daley: It was about five years ago when new regulations were introduced in Canada that allowed for companies like Canopy Growth to participate in the medical cannabis industry. What was missing at that time was the ability to deliver evidence-based education for doctors, which is something I had many years of experience in at Pfizer. I had worked in the field of pain and after doing my own research, medical cannabis seemed like a promising space. It felt like it was time for a change and I decided to make the leap into cannabis.

Mas

USA: Pharma´s lobbying 2000-2018

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As Washington aims to rein in soaring drug prices, the lobbying spending by drugmakers has reached a 10-year high.

The spending by the industry’s main trade group and seven key drugmakers has climbed to a level not seen in a decade

Ver

domingo, 12 de mayo de 2019

Ida Vitale*: Poesía como terapia


 "La poesía busca sacar de su abismo ciertas palabras que puedan constituir el tejido de cicratización en el que todos andamos sin saberlo" 

(*) Ida Vitale 
Premio Cervantes 2019
Alcalá de Henares 23.04.2019