949.734.7446 A Private Internal Medicine Practice

Drug Makers Buy Pricey Vouchers to Speed Products to Market

“We are all seeing skyrocketing pharmaceutical costs these days.  This article highlights one of the many culprits in this tainted industry.  Clearly, much reform is needed.  If you haven’t reached your deductible yet OR are paying cash for your prescriptions, make sure you ask my staff to help you find our best cash price and/or physician-approved alternatives.  It’s a jungle out there, but we’ll do everything in our power to advocate for your health care needs.”  – Dennis Jordanides, M.D. Sanofi and Regeneron beat Amgen to market with their drug, Praluent, even though Amgen applied for approval of its own PCSK9 drug first. Photo: Mark J. Terrill/Associated Press   There is a new price surge in the pharmaceutical industry—not for medications, instead for a limited number of government-issued vouchers that drug makers, including AbbVie Inc. ABBV -0.61 % and Sanofi SA, SNY -1.49 % are buying to speed products to market. Legal provisions enacted in 2007 and 2012 require the U.S. Food and Drug Administration to issue “priority review vouchers” as rewards to developers of drugs for rare pediatric conditions or tropical diseases, such as malaria. Congress intended the vouchers to encourage more research into underfunded diseases. Companies receive them when the FDA approves their drug for sale and can redeem them to speed FDA consideration of a subsequent drug for any disease. The vouchers require the FDA to shorten its decision deadline to six months from the standard 10 months—potentially giving companies an extra four months’ worth of sales. The voucher doesn’t guarantee the FDA will approve the drug. Because companies can also sell the vouchers, a lucrative...

California Gov. Brown Signs Aid-in-Dying Bill Into Law

“Yesterday, Governor Brown gave all Californians the right to end their own life.  It is important to remember though that there are many, many other options available to you before we even think about this one.  Issues surrounding comfort and fear can be overwhelming, but know that I am your advocate and will always be available to help find the right path for you.” – Dennis Jordanides M.D. Calif. Gov. Jerry Brown (Photo by Justin Sullivan/Getty Images)   California Gov. Jerry Brown signed landmark legislation Monday, allowing terminally ill patients to obtain lethal medication to end their lives. In a deeply personal statement, Brown wrote that he read opposition materials carefully, but in the end was left to reflect on what he would want in the face of his own death. “I do not know what I would do if I were dying in prolonged and excruciating pain,” the former Jesuit seminarian wrote. “I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn’t deny that right to others.” Brown, who is a Democrat, had been silent on the issue before Monday’s signing statement. If he had not signed the bill, it would have become law later this week. The new law requires two different doctors to determine that a patient has six months or less to live before prescribing the drugs.  The patient must voluntarily submit two oral requests at least 15 days apart, as well as a written request to the attending physician. And patients must be physically able to swallow the medication themselves,  have the...

Presidential Candidates In Fantasy Land Over Health Care

 “Regardless of your party affiliation, pay close attention to this presidential election –  lots more healthcare changes are in the works both with the current president and variations with each of the candidates.   At a time when our entire US system is struggling to provide care for everyone, finding high quality can be challenging.  We are here if you ever have a question about any health care provider or related health care service .  And, we have developed a proprietary network of fully vetted, best-in-class providers.  Our mission is to help you navigate a system that is growing ever more complex.” – Dennis Jordanides M.D.   Andrew Harnik/AP   Presidential candidates from both parties are full of sound and fury about various aspects of the U.S. health care system, but unless we as a nation get serious about big money in politics, all the noise will ultimately amount to nothing. Every one of the Republican candidates has pledged to repeal and replace the Affordable Care Act. But I’m not sure they realize that the interests of the insurance and pharmaceutical industries,  as well as hospitals and physicians,  were considered first and foremost as the law was being drafted. Yes, Obamacare has brought some needed reforms to the insurance marketplace and has enabled millions of previously uninsured Americans to finally get coverage. But health insurers have not only thrived since the law was passed, they are more profitable than ever, and that has made their executives and investors happy—and richer. The stock prices of the five largest for-profit insurers have tripled and in some cases quadrupled since the law was passed....

What Steve Jobs’ Death Teaches Us All About Our Own Health Care

“It is paramount during times of an acute health episode to have someone on your team to personally direct and guide your care, even better if it’s a well connected MD that you have rich history with.  It is always my goal to keep my patients from needing me, but when you do – know that I and my team are ready to jump into action.  From access to all of our pre-negotiated services to research for the Best in Class physicians tailored to your specific needs is what you can depend upon from me.” – Dennis Jordanides M.D.   Image by Getty Images via @daylife   Steve Jobs lived ahead of his time.  Tragically, that’s also how he died. It’s impossible to know for certain, but his early death may have been avoidable. Jobs likely hastened it significantly by making medical choices with the same decision-making style that created the world’s most valuable company and its transformative products: He went against the grain and trusted no one’s instincts but his own. I have been helping executives navigate the health care system for decades and commonly see this pattern in high achievers—accomplished CEOs, investors, entrepreneurs, physicians, professors, attorneys, research scientists. Unfortunately I often see the pattern do them harm.  Jobs, eventually, saw that too, but it was too late. Walter Isaacson’s recently published biography reports that Jobs regretted disregarding medical guidance to have surgery immediately after diagnosis, choosing instead diet, meditation, and other interventions at a “natural healing clinic” he found online. Jobs’ malignancy had been discovered serendipitously and early, which put him ahead of the curve in treatment...

Why Higher Drug Costs Are Consumers’ Biggest Cost Worry

“Generic drug prices are rising at a greater rate than I have ever seen in my 20-year career.  Price gouging in the specialty drug market is especially acute and outrageous. Make sure you ask my team to help you find the best prices – we have tons of pre-negotiated cash prices and resources at our fingertips.” – Dennis Jordanides, M.D.   The emerging issue in health care is drug costs — despite the fact that most people say they can afford their drugs and greatly value the role drugs can play in making their lives better. One likely reason this is the case: Drug costs are the first thing people think of when they think of the growing out of pocket costs they are paying for health care, at a time when their wages have been relatively flat. In our Kaiser Family Foundation polling in April, surprisingly, “making sure that high-cost drugs for chronic conditions are affordable to those who need them” emerged as the public’s No. 1 priority for President Barack Obama and Congress, with 75% of the public saying it should be a top priority, far ahead of various other Affordable Care Act issues. “Government action to lower drug prices” was No. 2, picked by 60 % of the public and by 51% of republicans. (Respondents could choose multiple top priorities.) Then, in our August polling, we asked which health costs people with health coverage find to be the greatest burden. As the chart below shows, deductibles led a closely bunched list, followed by premium payments, drug costs and doctor visits. Deductibles have been rising steadily each...

Let IM365 lead you there

The Patient Protection and Affordable Care Act (PPACA), commonly called the Affordable Care Act (ACA) or “Obamacare”, is a United States federal statute signed into law by President Barack Obama on March 23, 2010. It represents the most significant regulatory overhaul of the U.S. Healthcare system since the passage of Medicare and Medicaid in 1965. The ACA was enacted with the goals of increasing the quality and affordability of health insurance, lowering the uninsured rate by expanding public and private insurance coverage, and reducing the costs of healthcare for individuals and the government. It introduced a number of mechanisms – including mandates, subsidies, and insurance exchanges – meant to increase coverage and affordability. As of May 2014, approximately 20 million Americans had gained health insurance coverage under the ACA, and the percentage of uninsured Americans dropped from 18% in 2013 to 13.4% in May 2014. Although more Americans now have insurance coverage, there is no clear evidence that access to care has increased. Exchange enrollment was off to a rocky start, there was a reduction in health plan competition in the exchanges, narrow networks of doctors emerged, and the rate shock of higher premiums and deductibles all contributed to cascading failures accompanied by massive disruptions of existing coverage and care. Thus far, the ACA has delivered higher health insurance premiums, higher deductibles, and less competitive health insurance markets. This does not bode well for care delivery, particularly if it means increased waits, rationing of care, limited or no access, and poor quality of care. The ACA, although well-intended, may have the dramatic, unintended consequences of bringing about the demise of...