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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.

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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. ...

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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.

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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.

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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. ...

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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....

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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."  ...

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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

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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.

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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."       ...

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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.

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At this point in May (May 22, 2026) a glimmer of hope appears for settling both the crisis in Hormuz and the Ukraine war. Pakistan, Turkey and China following DJT visit to China may be pushing Iran to lower the scale of the conflict. China's first priority was to be accepted by the US at the Beijing meeting as an equal power with the US, and keen to show its willingness to bear responsibility for peaceful resolution in conflict zones as a sign of its maturity as a world power. Much of this is not shown in the media as it is mostly done behind the scenes in communications that the media knows nothing about. Note that even in the depths of the Cold War during the Hungarian revolution of 1956 and Soviet action in Budapest, the US and the Soviets when their economies were not intertwined as the US and China are today, were still talking to each other to limit the conflicts to low level conflict. Hong Kong takeover, China's actions near Taiwan, China's presence in Latin America, Chinese cooperation with Iran, and Russia on Ukraine, China's economic competition in rare earths, are relatively smaller levels of friction considering 1950's Soviet's and the US. At the same time China and the Us are aware of a new bloc emerging in Oslo in May, where India is merging its economy with the Nordic economies of Sweden, Denmark and Norway, and of the European Union and Germany, creating a new bloc of 2 billion people that can only grow rapidly with India's potential to exceed growth rates of 20% in the 600 million Eastern region for a decade. EU would make the shift to strategic partnership with India displacing the vital role the European Union has played in China's growth and economy. This would create new pressures for Russian president Putin to decide it is time to listen to a friend India and de-escalate lower the level of conflict with an initial peace deal that would lead to more talks on a final settlement. Because Russia would have a harder time tackling both India and Germany at the same time. NYT shows on the same day May 22 a report on Russia and a report by the Swedish Foreign Minister Maria Sonegard that say the elites in Russia and Putin were by January 2026 having very serious discussion to change the administration, bring Igor Sechin as negotiaor to end the Ukraine conflict before serious, possibly irreversible damage, to the Russian economy. Sweden's Sonegard says that between 2020 and 2024 Russian economy declined by 8%, not grew by 13% as official figures show, inflation is much higher than 5% as official figures show, and credit is tightening, bankruptcies expected, growth even with oil prices up down to 0.4% for 2026. During 20 years running Russia Putin's No. 1 priority, his life's mission was to restore, then exceed by a large margin the living standards of the Russian people. Having at such great cost accomplished the goal of gaining recognition as a Northern Power in Europe, having gained much of Russian speaking eastern Ukraine, Putin could wisely with self respect wind down Ukraine conflict for good. The US gains something similar to Northern Power status for Russia in its recommitment to the Monroe Doctrine, with Russia withdrawing from any involvement- and China tacitly doing the same-  in the western hemisphere. With that the US can tackle its own losses that match Russian losses in lives- loss of more American lives than in the Korean and Vietnam and WWI combined to drug smuggling from Mexico, Venezuela, Colombia, and restoring rule of law in Cuba, Venezuela, and through drug cartel free Mexico good governance in Mexico.  ...

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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. 

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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. ...

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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.     ...

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Does the ICC, the International Criminal court have jurisdiction over US policy in the Western Hemisphere? The ICC was founded in 1998 with the Rome Statute which was signed by US president Clinton but never ratified. President Bush unsigned for the US and Congress passed the ASPCA American Servicemen's Protection Act to protect Americans in the armed forces from prosecution by ICC. The US sees the ICC as infringing on its sovereignty. As most UN institutions with members from 125 (ICC) or 193 countries (UN) the tendency or bias is to be critical of the US in a "anti-imperialist" sense and for European states that practiced colonialism to also have the same tendencies. For instance the Monroe Doctrine was to keep European colonial powers out of the western hemisphere, out of Latin America, so that institutions modeled on the US and the UK including democratic representation, courts and rule of law could thrive. In today's context it is for the US to keep drug trafficking gangs and crime out of the western hemisphere. The ICC easily ignores the lack of rule of law, drug trafficking, and millions of of refugees, in favor of single incidents where violation has not caused massive harm to tens of millions of people and enormous deaths such as the Mexican drug trafficking that has cost more lives from fentanyl than the Korean, Vietnam and World War 1 combined.  In fact without the US and the UK on which US institutions are modeled, much of the framework of civil liberties, rule of law, independent court, democratic representation would be lost.  The ICC is part of institutions that are answerable to no one and made up of the many independent states emerging from the colonialism of Europeans in the 20th century that have little experience in such institutions that are with science and industry the achievements of the modern world, and in many cases these new and numerous states are proof of egregious violations. It took many centuries for the UK to develop these institutions from the 16th century and the US from the 18th century, and it is American and UK institutions that are the foundations for protecting the rights of citizens and of the people in the modern world. ...

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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....

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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.”   ...

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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.

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Thre drug companies are placing bets on the vaccine business. Johnson and Johnson paid 302 million euros for 18% of Dutch biotech company Crucell NV, to jointly develop vaccines. Abbott Labs says it will acquire a unit of Belgian conglomerate Solvay SA for 4.5 billion euros in adeal that includes a vaccine business. And Merck obtained the marketing rights for a seasonal flu vaccine from Australia's CSL Ltd. This follows Pfizer's Wyeth acquisition. Low prices, high costs and fear of lawsuits made most drug makers to exit the business in the 1980's and 1990's. Now vaccine sales are growing faster than other prescription drugs and are largely protected from generic competition. And government agencies here in the USA and around the world are reliable buyers of vaccines as they seek to stockpile medicines that could be needed in aflu outbreak. Merck never exit the vaccine business and now makes 8 of 10 vaccines recommended for adults. Flu and other vaccines are especially attractive for entering drug markets in Brazil and China and developing countries. Governments lke the idea of lowcost prevention at $10 adose, and with this new relationships are developed in these countries. And even at price of $10 or $20 a dose they provide asteady stream of revenue.Vaccines are estimated to generate $21.5 billion in revenues by 2012 according to Sanofi-Aventis SA, which is a leading vaccine maker....

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Pfizer's aggressive promotion of Chantix an antismoking drug. Article by Steinberg and Foulds in the Annals of Internal Medicine, suggesting treating smoking not like alcoholism but like diabetes with lifelong taking of medication like Chantix to curb craving for nicotine after cessation of smoking. The article may have been intended to promote Chantix to insurance companies to cover its use as a drug for treatment of diabetes type lifelong disease. It costs $100 a month for Chantix. The drug can cause depression and psychological disorders so the FDA is considering putting a black box warning on the drug for patients to take due care in using it. Chantix had USA sales of $680 million in 2007.