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This report in the WSj looks at the Silicon valley approach of pursuing rapid torrential growth at any cost. It shows the victims as investors looking for outsize returns to the point of turning their attention from the facts showing the products as highly hyped improperly as tech for WeWork or having health risks in alternative smoking products in the case of Juul Labs Inc. Both company CEO's were asked to resign. This discussion is on the the limited number of new ideas as the tech really creative stuff  peters out and the tens of billions of dollars pursuing a few ideas even if they as in the case of WeWork basically a real estate company subleasing space were not really tech. The neglect of top priorities in infrastructure, in priorities for health, education and other pressing needs are a result of the misallocation of capital by capital markets structures of funds, banks and investors. Juul started at Stanford University and quickly raised $14 billion. Soon three million high schoolers in the U.S. were using the vaping product as e-cigarettes causing alarmed parents to bring up the issue and the Food and Drug Administration to look into it. As the tech boom results in fewer new ideas practices fail to change in the allocation of capital and wasted capital, resulting in gross neglect of priorities for infrastructure, health and education, wide gaps in income.   ...

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The use of Zyprexa in nursing homes, and Lilly's marketing of the drug as "requiring fewer skilled nursing staff hours", and "reduced caregiver stress." The lawsuit alleged that this meant it was " an effective chemical restraint for demanding, vulnerable and needy patients." Zyprexa has the risk of life-threatening infections like pneumonia and of heart failure in elderly patients. Lilly also marketed the use of Zyprexa to treat disruptive children, even though there are side effects of severe weight gain and metabolic disorders. The case is being prosecuted by the US Attorney's Office of the Eastern District of Pennsylvania. In the negotiations Lilly agreed to pay $1.2 billion to 31,000 Zyorexa plaintiffs. This is the biggest case and settlement of its kind.

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Yuka Hayashi describes the remarkable comeback of prime minister Shinzo Abe in Japan, his "Japan is Back," strategy and its personal overtones. He describes a visit- by Japanese known for taking that second or third chance and making it work through difficulties- to the prime ministers residence for discussion on the theme of "the second chance." The premier tells the visitors that Walt Disney would never have been heard of if he had not tried the sixth time after five failures, and not succeeded in Japan, which has a risk and failure averse business environment. Encouraging risk taking to setup new ventures and open up new frontiers and markets is part of the growth strategy for Japan. His personal struggle with ulcerative colitis during the period of his first term as prime minister, and the new drug discoveries that made it possible for him to recover, give Abe a fresh burst of energy this time. His story and Japan's story now coincide. Abe says the mission of the new LDP is to make sure that talent now flows from mature industries to the industries of the future....

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Th cost of cancer drugs Avastin and Erbitux and the need for putting life savings at risk for a few months of treatment create tension among families, doctors and treatment providers. A course of Avastin could run $56,000 and take 90 days for reimbursement by meicare or pricate insurance, and a 20% co-pay comes to $11,200.

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Research by Allen Roses, director of Duke University's Deane Drug Discovery Institute, and continuing research on the ApoEgene that has aclose link with Alzheimer's. In 1993, Dr Roses's research showed that people who have avariant of the ApoE gene have an unusually high risk of developing Alzheimer's. THese studies have been repicated by other scientists. In research presented at the international conference of Alzheimer's deisease in Vienna, Dr Roses and this team show that they have found a gene linked to ApoE called TOMM40. This gene had mutations that involved a small number of extra copies of aparticular building block of DNA in some individuals and alarge number of extra copies in others. Individuals with alarge number of extra copies- knownn as the "long repeat" version of TOMM40- coupled with ApoE3 develop ALzheimer's an average of seven years earlier- at about 70 compared to the individuals have the "short repeat" version.

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Here are the 10 drugs with their negotiated prices for one-month supply: Januvia treats diabetes. The negotiated price is $113 (£103), down 79%. Fiasp, Fiasp FlexTouch, Fiasp PenFill, NovoLog, NovoLog FlexPen, NovoLog PenFill: These are insulin medications, treat diabetes. The negotiated price is $119, down 76%. Farxiga treats diabetes, heart failure and chronic kidney disease. The negotiated price is $178.50, down 68 %. Enbrel treats rheumatoid arthritis, psoriasis and psoriatic arthritis. The negotiated price is $2,355, down 67%. Jardiance treats diabetes, heart failure and chronic kidney disease. The negotiated price is $197, down 66%. Stelara treats psoriasis, psoriatic arthritis, Crohn's disease and ulcerative colitis. The negotiated price is $4,695, down 66%. Xarelto prevents and treats blood clots and reduces risk of coronary or peripheral artery disease. The negotiated price is $197, down 62%. Eliquis prevents and treats blood clots. The negotiated price is $23, down 56%. Entresto treats heart failure. The negotiated price is $628, down 53%. Imbruvica treats blood cancers. The negotiated price is $9,319, down 38%. ...

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Questions raised about Dr Pazdur's decisions at FDA for anemia drugs made by Amgen and Johnson and Johnson. Dr Pazdur is head of the FDA office that regulates oncology drugs, all cancer drugs. Dr Pazdur's review process and decision shows how reviewers are human and their own experience helps determine what they see prominently. His experience with his father who suffered severely from the side effects of steroid drugs would make him aware of the the other effects of drugs. He is an oncologist, his wife is an oncology nurse, and some relatives have died of cancer, so he has lived with cancer patients. It appears from close associates that he like open communication and hears all sides but makes the final decision himself. He had an experience with a drug for lung cancer Iressa made by Astra -Zeneca, which the FDA approved based on testimonials, but not enough statistical evidence, which later failed and approval had to be withdrawn. This may have made him more inclined to look for strong results and statistical evidence before concluding on the safety and effectivenes of a drug. An approach evident with Amgen's anemia drug. It also appears that the FDA is not clear on whether the drug's effectiveness is to be judged by what result, is it whether it prolongs life only that counts, or whether the effectiveness in relieving significantly the symptoms of a patient even if life is not prolonged. There is the controversy surrounding the FDA's rejection of a drug by Genta Inc Genasense that relieved patient symptoms for leukemia but did not prolong their life. These and other questions continue to give sleepless nights to people at the FDA and outside as the drug review process faces difficult balancing act between what to give importance and what direction to take with a drug in patient's interests. In Dr Pazdur's case this is made more difficult as he thinks every day of his father who died in 1979 and suffered from the side effects of steroid drugs, went blind when Dr Pazdur was only a teen, and had pulmonary fibrosis and diabetes. He is described by doctors who trained under him as gentle but did meet a patient's eyes and tell him that he had to come to terms with his disease. ...

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Unorthodox cabinet nominees- Kash Patel at FBI, Tulsi Gabbard at Intelligence get nominated. Others where the nominee is supported broadly by moms and parents, and many senators Rand Paul and Ron Johnson who are highly enthusiastic, are RFK Jr. for Health Secretary who still faced questioning from Republican Kennedy and other Republicans. All of them get nominated by Feb 15, 2025. Republicans in Congress stay together, Democrats do the same strangely opposing everything on the other side, including action on obesity and chemicals in food, drug industry practices they have been railing against for years that are RFK's agenda.  By tapping into different ideas just because they are good, make common sense, and not worrying too much about whether it is from the opposing Kennedy clan, and willing to take some risk with Patel and Gabbard, try youngsters such as Pam Bondi at Justice Department, Elise Stefanik at the UN and Kate Leavitt as Press Secretary, a woman Kristi Noem in the toughest job there is today at Homeland Security, DJT and Chief of Staff Susie Wiles have put forward a different set of people highly motivated, more than a bit rambunctious and boisterous, to get things done on immigration zero illegal migrants, zero fentanyl deaths, and zero deindustrializing technology transfers to the Nation's competitors, and zero play except on a level playing field in trade and business. ...

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The major provisions of the Republican House healthcare bill that passed by a vote of 217-213 are- 1. To help people buy insurance coverage the bill offers $2000 to $4000 a year, upto $14,000 a year in credits based mainly on age, reducing them for families making $150,000, individuals making $75,000. 2.  Under the Affordable Care Act insurers cannot charge older Americans more than 3 times for same coverage they offer to younger people, the new bill makes this 5 times. This would increase premiums for older Americans and reduce it for younger Americans. This is the most controversial part of the bill. Older Americans supported the Republican party in the presidential election. 3. The new bill ends Medicaid as an open ended entitlement and places this on a budget with cuts of $880 billion over 10 years. 4. To mollify conservative Republicans a provision allows state to opt out some provisions of the ACA that requires minimum benefits such as maternity care and emergency services. It retains coverage for pre-existing conditions to mollify moderate Republicans. The bill provides states with $138 billion over 10 years to subsidize premiums, provide coverage for pre-existing conditions, mental healthcare and drug addiction. 5. The bill removes the taxes imposed under the Affordable Care Act (ACA) on high income people of about $300 billion over 10 years by repealing a payroll tax increase and tax on investment income. This bill and the ACA offer 2 competing visions on healthcare, both bills passed only by a margin of 4-5 votes in the House. The ACA overlooked the impact on premiums causing discontent among middle income Americans. The new bill lets premiums rise for older Americans in order to keep premiums down for other Americans. This shows the many tradeoffs involved and choices being made, and the lack of a consensus on the issue of healthcare in the U.S., becoming a highly politicized issue instead of the way it is treated in western Europe.     ...

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India's new bankruptcy law is a big step forward in letting credit markets function normally and drawing in new capital. The new law says the bankruptcy should be completed in 180 days after a default. Indian banks hold about $105 billion in non-performing or bad loans, according to the Reserve Bank of India. It is essential that India cope with the bad debt to attract new capital investment and increase growth. Asset reconstruction company being formed by Ambit and J.C. Flowers & Company was approved in late 2016 by the Reserve Bank of India, India's central bank. So far Indian banks have showed unwillingness to take a loss on the loans and take a big discount. Only $3 billion in asset reconstruction has taken place in 2016 through selling bad loans, according to Credit Suisse. Indian industry has relied heavily on bank loans and sale of stock for capital investment as the corporate bond market is undeveloped. This is about to change to finance growth, with the bankruptcy law and transparency as a first step. Larger foreign firms are teaming up with local partners to tackle distressed debt and bad loans, with locals knowledge of risks making it easier to profit from capital invested. ICICI bank won the first ruling of the new bankruptcy law by the National Company Law Tribunal against Innoventive to recover assets, providing the first test of the law. In the past such action would drag on for years, showing India is now serious about getting rid of bad loans in the banking system, and to revitalize credit markets to finance new growth. ...

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Stricter warnings on Amgen's Epogen and Aranesp, and J&J's Procrit, Anemia drugs.

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US president Biden signs a broad executive order on July 9, that is directed at promoting competitive behaviour in the American economy, and taking action against companies that have anti competitive behaviours. It also aims to limit corporate dominance that then can lead to anti competitive behaviours. These types of behaviours puts consumers, workers and small compoanies at a disadvantage. The Biden plan stretches from the smaller items such as hearing aids and baggage fees, to the task of putting in place the first antitrust regulation on tech companies Apple, Google, Amazon and others. Industries Biden sees as needing help are agriculture, healthcare, shipping, transportation, technology, and labor practices that limit wages and mobility. In making the executive order the White House says it "will lower prices for families, increase wages for workers and promote innovation and even faster economic growth." As each step is taken by the Biden administration to help workers, families, women and children, the situation is a reminder of the actions taken by Franklin Delano Roosevelt at another period of crisis in the nation's history. The July 9 executive order will create a Competition Council as proposed by Tim Wu, special assistant to the president for technology and competition policy in the White House National Economic Council. The Compeititon Council task will be to get federal agencies to take action to promote competitive behaviours for the first time since the 1980's when Republican presidents Reagan, Bush, and Democratic presidents Clinton, Obama, allowed such behaviours in some industries to get entrenched. In Biden's own words "the rise of monopolies weaken labor." In each industry agencies will now have the task of pushing back against anti-competitive behaviours already put in place by companies. In agriculture it will help small farmers, in pharmaceutical sector it will help the American people deal with a problem that has no end in sight of high drug prices and practices that support this. In all areas of the economy the Biden plan is for a new coordinated effort across all the agencies of the government and under the leadership of the president, to restore the vibrant economy to what it was before the long deterioration through anti-competitive behaviours. ...

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Unbranded drug advertising is becoming popular as it takes advantage of a loophole in the FDA rules, that if an ad doesn't directly name the drug, it doesn't have to include areading of the possible side effects. Pfizer used this method in an ad for antismoking drug Chantix during NBC's coverage of the Beijing Olympics. The 60 second commercial instead of naming the drug says go to site Mytimetoqyit.com to find ways to kick ahabit a woman is shown to have on the tV screen.

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Lilly is suspending two studies for its blood thinning therapy drug called prasugrel. It could be because of safety concerns, dosages and bleeding risks.

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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.

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Two of Amgen's drugs that treat anemia in cancer and kidney-failure patients have questions raised about their safety and marketing. The two anemia drugs Epogen and Aranesp generate about half of Amgen's sales. THey now have ablack box warning placed on them by FDA requirements.

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Just as the drug industry is more getting more dependent on the government with the medicare drug benefit raising the retail drug purchases paid by government to 34% in 2006 from 28% in 2005, the industry is facing more governmental scrutiny, from the FDA, from Congress from the public, and during this election campaign. Rep .Rosa DeLauro, who heads the House appropriations subcommittee that has oversight over FDA funding compares the drug industry to the tobacco industry saying that it requires the same amount of scrutiny. At the same time the drug industry is aware of the changes in the public mood and the recent controversies over drug studies, such as the one on Vytorin and other controversy. It is initiating some voluntary changes, registering clinical trial results, submitting commercials to the FDA before they air, and under pressure from medical journals registering trials before they are performed. A new law will requires and its not clear whether the drug industry is dragging its feet and then making changes when there is increasing public pressure. This is the feeling of the medical journals like the Journal of the Medical Association and the New England Journal of Medicine. JAMA's editors will be keeping up this pressure as they have more articles showing how the drug industry manipulates data and the need for public skepticism of information that comes out of the drug industry. The New England Journal editors expressed the need to publish information that helps doctors get all the available information, and not just the information from the drug industry that makes the drug look better than it really is, such as the information and analysis it provided on antidepressant medications. The chairman of the energy and commerce investigations subcommittee Rep. Stupak, finds the advertising for drugs contains information that cannot be backed up and not true ethically, medically, or legally. As this reflects the public mood look for more investigations in Congress and investigative research by the journals. On the issue of importation of drugs from Canada there is bipartisan support as both Senator McCain and Senator Clinton support importation. Clinton supports legislation that allows the FDA to approve new generic versions of biotech drugs which would lower prices of biotech drugs. And with the US consumer budget facing strains in a recession there will be increasing pressure and demands for relief in the area of drug prices, especially for the elderly and uninsured and from corporate payors. ...

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Teva Pharmaceutical plans to acquire the generic drug business of Allergan in 2015. Teva's sales of generics were $9.1 billion in 2014, according to EvaluatePharma, over 50% of its total sales, and 12% of global market. Alergan had $6.6 billion in generic sales in 2014. Allergan's strategy is to move up the market to branded drugs because of price competition from India in generic drugs. Teva's strategy is to increase the size of its generic business to better tackle pricing issues.

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The pharmaceutical companies are reducing the size of their sales forces, but increasing the number of MSL's or Medical Science Liaisons. The drug companies are using the MSL's to discus the science behind a particular drug, and how the drug can have increased applications. Pharmaceutical companies are barred by the FDA from promoting unapproved drug uses, or "off-label" use.

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German drug company Boehringer has applied for FDA approval for a drug that treats low female sexual drive for premenopausal women. A staff report by the FDA recommends not approving the drug. An FDA advisory panel meets this week to vote on whether the FDA should approve it. Meanwhile Boehringer is setting up a marketing campaign for the drug, including a website, Twitter feed, Discovery Channel documentary and a publicity tour by Lis Rinna, a soap opera actress. Boehringer's R&D designed the drug to treat depression but it did not work. Along the way Boehringer discovered that this drug, flibanserin, taken for weeks restores female sexual drive. It works by reducing the brain chemical serotonin and increasing dopamine. Results for this drug in a medical conference report show that the increased self-reported "sexually satisfing events" to 4.5 a month on average, and this compares to 3.7 a month on a placebo, and 2.7 for women not taking any pill. Critics at Georgetown University say this shows how drug companies are medicalizing normal conditions, and working on the insecurities and psychology of people. ...