LyrArc Article Gist
Brian Deese and other economists remind us that the government is still not able to negotiate the prices of drugs with pharmaceutical companies something that government was instructed not to do under a Republican administration with a George W. Bush administration rule that has hurt millions of Americans since 2003. In fact December 3, 2003 may be a day of ignominy for Americans who face high cost of pharmaceutical drugs, and actions that send money from the pockets of government that would go into fixing aging infrastructure, and from pockets of ordinary Americans that would go into meeting the cost of living to improve ease of living. President Biden without the needed majorities in Congress was able to only specify certain drugs on which negotiation could take place. There is a need to cut pharmaceutical costs for the American public, there is a need to be like everybody else in the community of nations in Europe and Asia that pay only so much for pharmaceuticals not many times more. Making the US worse off than Indians and Chinese who can access these drugs and find it affordable for most of the people of 3 billion in these countries. The contrast makes one question what is a developed and a developing country as what has happened in the last 3 decades in America has turned this  question on its head- with irresponsible presidents and irresponsible Congress. ...

LyrArc Article Gist
Jeanne Whalen on the Two Speed Economy in the US September 2025- diverging paths of low and high income Americans. With the new administration in 2025 priorities shift to immigration and what to do about 14 million illegal migrants from Latin America and other places, war on fentanyl and drug trafficking gangs with hundreds of thousands of lives lost to fentanyl and drugs in the US, crime and safety which includes the unprecedented illegal movement of drug trafficking in the Nation, and to a bold posture on using US advantages of its huge market to get European Union, Japan, South Korea, and China to level the playing field on trade bring jobs home.The Biden administration had already conceded to DJT's approach in its one term presidency by shifting on uncontrolled illegal migration but not fast enough, by not removing DJT's tariffs, and failing to take an aggressive posture on fentanyl and drug trafficking. Of the DJT plan US has tariff based revenues of 10--15% for all countries imports into US can that it redirect to groups to soften any effects of tariffs. DJT administration oil transition policy of stretching out the transition to give middle class and lower classes cost of living relief was also accepted by the Biden administration and is now the policy of Democrat run California state government.  The US economy was slowing in 2024 under the Biden administration. What has changed in 2025 is that the US stock markets are responding to steps taken by the DJT Republican administration to lower the cost of doing business by softening regulations, and giving US business the upper hand in different industries, and rebuilding the manufacturing sector with calls for EU and Japan/South Korea to invest more in the US as a quid pro quo for market access. This has led to increase in the value of market portfolios of the income earners above 250,000, or 10% of American households. As this happens the process of trade renegotiation has introduced some uncertainty in 2025 and businesses are looking for more clarity before increasing investment and slowing job hiring which hurts younger people entering the job market and lower income Americans. Were things better under Biden? Government Covid assistance and payouts in the early years 2020-2021 helped lower income workers, as this faded and the cost of living autos, housing increased sharply under Biden in 2022-2024 the situation deteriorated. The situation today is similar to the situation in 2024 with the difference in 2025 that inflation is coming down just as government help is receding. And added factor is the DJT administration plan to tackle head on the increasing cost of Medicaid to about $1 trillion by adding new requirements and reducing subsidies. The federal workforce had a disproportionate share of black workers and the policy changes to reduce the federal workforce have increased black unemployment from 6.1% under Biden in August 2024 to 7.5 % a year later. Hispanics have seen slight improvement in unemployment to 5.3% in 2025, and the middle class incomes also have held up and are holding steady. Meantime Bloomberg points out that one third of people in the top 10% are living paycheck by paycheck because of high cost of housing, university education for children, and inflation.     ...

LyrArc Article Gist
Britain's National Institute for Health and Clinical Excellence (NICE) says Glaxo's drug Benlysta for lupus is not "good value for money." The drug is priced at 10,000 pounds a year in the U.K. ($15,600) and much higher at $35,000 a year in the U.S. Benlysta is covered by insurers in the U.S. and some European state run health systems according to Glaxo. NICE also rejected a new multiple sclerosis drug Gilenya, which costs 19,000 pounds a year in the U.K. ($29,700), and $48,000 a year in the U.S.

LyrArc Article Gist
CEO Ryan at CVS/Caremark. An unassuming man with a sharp focus on things, joined CVS right out of pharmacy school at University of Rhode Island. At 29, CVS owner Stan Goldstein gave him the chance to run pharmacy operations for CVS, then a regional drugstore chain in the eastern USA. Over the years CVS has made a number of successful acquisitions, the latest being the acquisition of Longs Drug store chain on the west coast, and it is now one of the largest chains in the USA. It has nearly 7000 stores and more than 50 million users of its CVS loyalty card in the US. As the pharmaceutical business evolved pharmacy benefit management (PBM's) companies like Caremark, Medco, and Express Scripts, came into being to manage burgeoning prescription costs. PBM's work with companies to save money, by filling recurring prescriptionsin 90 day quantities through the mail at reduced per pill cost. Now drug store chains instead of competing with PBM's are either creating or acquiring these larger PBM's. THe result is that a company like CVS which acquired PBM Caremark in 2007 for $27 billion, now has extensive computerized databases with patients information and drug usage histories. Ryan's clear focus is on these IT records as a distinct advantage, if he can use it to help the Obama administration's efforts to control health costs of chronic diseases like diabetes and arthritis, and back or neck pain, high blood pressure, and others, that end up clogging the hospital system and raising health care costs. By using these IT records to flag when a patient is not compliant or taking his medications and call the patient, Ryan can increase drug sales, get more visits into drugstores if the drugs can also be picked up at CVS stores, and increase sales through ancillary purchases during visits. This is now his strategy. It also includes setting up more clinics at stores and at corporate locations that divert the patient flow for small care like sore throats, flu and the like. As this is the way health care costs can be controlled, Ryan sees himself as helping achieve national goals while keeping CVS in the sales and profit picture for the US, even as health care as we know it goes through a complete transformation that removes the waste and unnecessary cost, and improves effectiveness and health. He sees CVS/Caremark right where it wants to be with its large patient drug database from about 1 billion prescriptions it fills each year, and as the largest single buyer and dispenser of prescription drugs in the country. ...

LyrArc Article Gist
How Integrative Medicine, changes in lifestyle and diet, yoga and exercize, meditation, no smoking habits, can add up to changes in the nation's health that work more effectively than new drugs to prevent or delay the onset and progression of chronic diseases like diabetes, asthma, heart disease and of obesity, etc that consume 75% of the costs in the $2.1 trillion spent on medical care in the USA. Shockingly 95% of these costs are incurred after the onset of the disease, proving that prevention is simply not an important part of the equation.

LyrArc Article Gist
How the Drug Industry and Drug Companies will go through a complete change and look nowhere near what it looks like today. Huge changes are overtaking the Drug industry and old ways of doing things will go out the window. Patent expirations for blockbuster drugs, safety issues, increased regulation, rise of generics drugs, cost issues, outsourcing of manufacture and testing and some R&D, changes in marketing practices, slimming down of marketing and sales force personnel, new approaches to R&D- Novartis emphasizing science, Glaxo breaking up into smaller teams, and the growth of emerging markets. All this happens as the public in the USA looks at healthcare in anew way and the demand for healthcare expands quickly in growing developing countries of Asia, Africa and Latin America and Eastern Europe.

LyrArc Article Gist
George Bush's administration passed healthcare legislation that allowed private pharmaceutical companies not to have to negotiate with Medicare on cost of drugs. It also passed the so called Medicare Modernization Act that created a huge opportunity for profits through Medicare Advantage Plans. The chart in WSJ shows profits it calls a bonanza. What it means is that instead of reducing the costs of providing medical care to elderly Americans it has increased the cost leaving less and less money for infrastructure for roads and bridges and airports that are dilapidated in the US, and less money for essential services in education and health care, transportation, housing. This has reduced the standard of living and quality of life in America. For healthcare it is providing less for higher cost when compared to China, India, Germany, France and the UK. George W Bush administration put America into 2 wars in Asia and the Arab world which also drained resources contributing to a lack of investment in the country in essential infrastructure and services. ...

LyrArc Article Gist
Copies with slight changes to extend drug life with new brand names- Clarinex for Claritin, Nexium for Prilosec, Paliperidone for Risperdal being the latest in this new marketing strategy of drug companies to extend the life and sales of a successful drug. The drug companies try to market the copy drug as a significant improvement, which is what J&J is doing with Paliperidone. Experts are skeptical. Pricing of the generic versions of Risperdal or its copy will be much less expensive. Cost is a sensitive issue. About 15% of Risperdal's $1.35 billion sales were from Medicaid, generic substitutions offer potentially large savings. Meantime J&J did not do clinical tests between Risperdal and Paliperidone, the tests with 1600 patients compared Risperdal with a sugar pill. A psychiatry Professor at Duke and another professor at NYU are skeptical of J&J claims for Paliperidone. United Health shows savings of $150 million by using generics instead of Nexium, so managed care payors will tread carefully....

LyrArc Article Gist
The Trump Accounts for children born 2025-2028 and the Dell $6.5 billion expansion to include earlier born children may be one of the single biggest actions to rebuild the bank accounts of the next generation. It looks at the shrivelled bank accounts of today's older generation with lack of enough savings for a medical crisis and says it has got to be different from now on. The median bank account of Americans over 65 and over is $13400 which means there is little for medical health emergencies and little for needs of older Americans. Median means half have less and half have more than $13400. This is astounding for the wealthiest nation at a time when the total wealth is the highest ever in history. This report by WSJ unfortunately does not mention this at all and dwells on how this is an opportunity for banks and investment companies to get in the door to get your business. DJT as US president with a mandate from lower income Americans has designed this so that it shows the value of careful investments of small seed money. With $1000 to begin with from the government, added amounts from parents and grandparents and invested in a mutual fund that tracks the S&P 500 it will grow with the economy for 18 years, doubling two to three times on the way. It would provide funds for education increasing enrollment in higher education, increase financial literacy by showing how money grows in broad S&P 500 type index funds such as Vanguard type funds. Much of the shriveling of bank accounts for the shocking figure of $13400 median for American 65+ year olds is a result of job losses, high health care costs, wage decline  with factories outshored, hits from 2009 financial crisis caused by bank irresponsible behaviour, drug epidemics and fentanyl allowed to pour into the country, covid pandemic and stock bubbles, decline in higher education enrollment, other. The US president DJT is seeing his mandate as one that reverses these adverse situations one by one to take America back to post war prosperity and rising incomes, rising bank acocunt savings and rising hopes and aspirations for the next generation. ...

LyrArc Article Gist
How gaps in the medicare program Part D for drugs is affecting seniors by imposing additional financial burden for drugs. And without the governments ability to negotiate dug prices with companies the cost of drugs is rising and medicare coverage has gas in it and premiums for additional coverage are also rising rapidly.67

LyrArc Article Gist
The FDA sets a pathway for developing "biosimilar" drugs in the U.S. Biosimilar drugs are cheaper versions of higher cost biotech drugs. Europe has moved further ahead in this area.

LyrArc Article Gist
Starmer's visit to China and the result being halving of tariffs- it comes 8 years after Theresa May's visit 2018.  Starmer is following his intution  to set an independent course for Brtian's foreign policy. It makes sense as the US is using common sense in coming back to basics, to getting its own hemisphere policies right. How could there be a situation like that in Venezuela and Mexico as with the drug cartels operating as states within states- what would Teddy Roosevelt say about this? So we now have the Monroe Doctrine, the return of the Panama Canal, the restructuring of the oil industry in Venezuela, and other action. This also means Canada and UK, India, European Union can pursue policies that are common sense. It means for Britain a new openness with China after 8 years inward looking with Austerity, Brexit and Covid. For a smaller economy it makes sense for Britain to have agreements on trade as it signed with India, and now with China. Carney, Starmer and soon Merz will have worked out relations with China on trade and exchanges. For Europe and the US over concentration of making goods in China can be corrected while still engaging with China. For the EU the visits Germany's Merz made to the kite festival an India and Leyen/Costa of the EU following up with trade agreements are all part of common sense to not just reduce over concentration in China, but also to build a new partnership with India to form a 2 billion people market. All of which happened suddenly as European nations realized how to work out new arrangements following the war with Russia over Ukraine and China's support for Russia, taking up the cues from DJT common sense action in its backyard. "I'm a pragmatist, a British pragmatist, applying common sense," the prime minister tells BBC on the plane and says he wants to "make Britain face outwards again."  ...

LyrArc Article Gist
See Tim Walz's full speech at the Democratic National Convention in Chicago, August 21, 2024 in his video from CBS News. Lyrarc has selected excerpts from Tim Walz's speech above showing what the Trump Republican party plans to do that will gut Social Security and Medicare, and kill the Affordable Care Act, gut efforts to lower exaggerated cost of medical drugs and healthcare. This excerpt shows what Harris will do to build a better life for workers and families and people across all 51 States, in education, childcare, healthcare, cost of living, and housing costs- "We’ve got something better to offer the American people. It starts with our candidate, Kamala Harris. From her first day — as a prosecutor, as a district attorney, as an attorney general, as a United States senator, and then our vice president — she’s fought on the side of the American people. She’s taken on the predators and fraudsters. She’s taken down the transnational gangs. And she’s stood up to powerful corporate interests. She has never hesitated to reach across that aisle if it meant improving your lives. And she’s always done it with energy, with passion and with joy. Folks, we’ve got a chance to make Kamala Harris the next president of the United States. But I think we owe it to the American people to tell them exactly what she’d do as president before we ask them for their votes. So this is the part — clip and save it, and send it to your undecided relatives so they know: If you’re a middle-class family, or trying to get into the middle class, Kamala Harris is going to cut your taxes. If you’re getting squeezed by prescription drug prices, Kamala Harris is going to take on Big Pharma. If you’re hoping to buy a home, Kamala Harris is going to help make it more affordable. And no matter who you are, Kamala Harris is going to stand up and fight for your freedom to live the life that you want to lead, because that’s what we want for ourselves, and it’s what we want for our neighbors."       ...

LyrArc Article Gist
Pharmaceutical companies in the US will be required to provide rebates to buyers if they increase prices above the inflation rate. This is one of the provisions in the Inflation Reduction Act of 2022 also called the Climate and Tax bill. Medicare recipients total out of pocket costs for drugs will be capped at $2000 under the Biden bill.

LyrArc Article Gist
Rep. Jake Auchinloss of Massachusetts views of breakdown in social order through lack of access to housing, childcare, automobiles, and groceries at affordable prices. Congressman Jake Auchinloss of Massachusetts talks about the need for order-the need for care, fairness, authority, and loyalty as a form of social order. Reference to the cost disease that makes housing, health care, automobiles, the basics less accessible than in the period 1960-1990. The symptoms of a breakdown of social order visible when such basics are missing. The cost of child care and the mental health issues created by social media add to the burden on parents and young people. The breakdowns at the border and drug trafficking, monopolies in tech with other priorities than the Nation's, and lack of resolute action, add to the anxiety of people about the social order fracturing. 

LyrArc Article Gist
Changes Novartis CEO Daniel Vasella is making in the pharmaceutical business. He has hired Joe Jimenez, who is running Novartis's consumer health care business to be the new pharmaceutical division chief. Jimenez previously worked at packaged goods companies including H.J. Heinz Company. Jimenez is cutting 25% of the jobs at pharmaceutical division's headquarters in Basel to reduce bureaucracy and costs. In March he promoted Trevor Mundel and Andrin Oswald, 2 young executives, to head the drug developmet group which puts drugs through human testing and submits them for regulatory approval. This group had become too bureaucratic and slow to move and take initiative. To improve its functioning Jimenez is organizing it into small teams with each team assigned an experimental drug in Novartis's pipeline. Each team of 8 people including physicians, experts in regulatory affairs and marketing and toxicologists work together to spot potential safety issues early and discuss them with regulators to determine whether to put the drug through expensive clinical trials. Each team takes the responsibility to take its drug to the market. The pharmaceutical unit is also being organized to be more nimble. It solicits health systems early on whether its willing to pay for drugs. And Jimenez has startd 4 pilot projects in tough markets to improve relationships with payers, including the Pacific Northwest where Novartis has offered to train an HMO's nurses in aspects of heart disease. Vasella supports the generics division of Sandoz because the growth is in generics, with generics commanding 60% of the prescription volume in Germany and USA, and sales for generics up 25% this year in the generics division. And Novartis paid $39 billion for Alcon, a eye care company. Its also working aggressively in the vaccines business, which like generics enjoys double digit growth. ...

LyrArc Article Gist
US president Biden's 2024 Budget places great emphasis on aid to workers and families in the US and shores up the Medicare hospital-insurance trust fund. He will do this by raising taxes on the wages, investment gains and self-employment income of people making more than $400,000 a year. Additional savings come from increasing the drugs on which Medicare can negotiate prices from 20 to 50 drugs.  Childcare- families making less than $200,000 a year will get subsidized child health care, the lowest income families paying nothing. Housing- Building and preserving 2 million housing units. Series of tax credits to make buying homes more affordable. College education- Reducing the cost of going to education with $12 billion allocated for this. Offering tution free community college. Family and Medical Leave- Federal paid family and medical leave program. Retirees- a $2000 cap on out of pocket cost of prescription drugs for retirees. Reduced taxes for under $400,000 income households- This would be done without increasing the deficits to extend the tax reduction from the 2017 tax cuts to households making less than $400,000 a year.     ...

LyrArc Article Gist
India has 2.3 million of the 9 million tuberculosis (TB) cases reported annually. About 100,000 of these are drug resistant strains. Existing treatment methods do not work for drug resistant cases, actually exacerbating the conditions as the strains thrive if the antibiotics fail. Cases of drug resistant TB are reported in Mumbai, Bangalore and New Delhi. Experts say the $236 million India spends on TB treatment and control is not enough to deal with the problem. India lacks the machines that can detect drug resistant TB in 2 hours and patients with drug resistant TB wait for months taking treatments that fail before it is detected. The WHO provides these machines at a cost of $70,000 per machine and each patient test is $16. The first cases were detected in 2006, and India began building labs for this strain in 2008. So far 37 labs have been built treating 5000 patients. The WHO has tried to persuade India to get the diagnostic machines since 2010, which can do the work of detection for drug resistant strains much faster. These machines are in pilot programs and India will buy more if they work says Dr Kumar, head of India's TB program. Doctors at Hinduja Hospital in Bombay, including Dr. Udwadia, are not convinced and see the efforts as slow and bureaucratic. Dr Kumar says the government has focussed on regular TB which only costs $9 or 500 rupees to treat and cure compared to the $1800 or 100,000 rupees it takes to treat drug resistant TB....

LyrArc Article Gist
Connection between inflation and spending (fiscal stuff) by the government is misunderstood or misstated, say Wharton Prof. Smetters. Doug Holtz-Eakin former CBO budget director agrees.  Does higher growth mean higher inflation? It depends. The climate change action renewable energy subsidies are expected to increase growth by 0.2%, yet this should reduce fossil fuel costs, mitigating effect on inflation of government spending. Will higher deficits increase inflation? Again it depends. In 2021 direct financial help for households during the pandemic led to a third of the higher inflation in 2021, 2022 and first half of 2023. Inflation peaked at 9.1%. In 2023 the deficit is up significantly but it is mostly of the accounting kind with lower tax revenues by $278 billion from capital gains taxes due to a stock market slump in 2022, and higher interest costs of $136 billion.

LyrArc Article Gist
Climate change study from Potsdam Institute for Climate Impact Research in Germany published in Nature magazine retracted in December 2025. The study is an example of how such research when not done right can misrepresent situations leading to policy errors. Policy error under such misrepresentation can lead to errors such as a policy that excludes adjustments and a dual response to climate change and cost of living crisis attacking both on two fronts necessary today so soon after a disastrous pandemic and people living in scarcity not able to meet heating bills. What happened is that the study made predictions for 2100- which is impossible to do. Studied 1600 regions in the world. Showed decline of economic output by 62% in 2100. Did not mention that excluding Uzbekistan would make the reduction in growth 23%. It shows how overzealous work in one direction or the other can actually hurt the fight to address climate change and also tackle everday concerns like cost of living crisis. Recent reports in WSJ show how the approach of single focus has hurt economic growth in Germany and hobbled its industries. Other reports show how deprived and less deprived areas in the UK (also in the US) sit by side showing how decades of neglect of manufacturing and outshoring of factories have destroyed jobs and destroyed communities across Europe and the US, making them open to scourge such as fentanyl in the Nation's neighborhoods, and creating a climate of despair that feeds into other fears. Such as the fears of the surge of illegal migration promoted by traffickers and the influx of drug trafficking gangs in the Nation's neighborhoods. Such reports are then used by the World Bank and the Congressional Budget Office and central banks of 90 counties in the coalition Network for Greening of the Financial System, leading to distortions in policy actions, destroying the social consensus needed among wide sectors of the population in democracies in the EU and US and worldwide to address climate change and cost of living crises.  Leonie Wenz, from the Potsdam Institute for Climate Impact Research in Germany says-“We broadly agree with the issues raised, and have made corrections to the underlying economic data and to our methodology to address them. These changes are too substantial for a correction of the original article in Nature.”   ...