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With Pfizer cutting back sales force, the rest of the industry may also cut back to reduce expenses and get more productivity from the sales force.

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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. ...

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Rumelt argues that efforts to induce aconsumption led recovery won't work in 2011-2012 because of the high debt to income ratio of American households, reminiscent of the situtation in the 1930's as America went into World War II. It took a long period of over a decade to bring debt to income ratios down during the 1940's to 20% for America to once again stage a consumption based recovery. Since the solution of war time engagment and lower consumer spending due to wartime rationing is not a feasible solution today, a lot depends on stimulating investment. Rumelt does not say how this would happen in practice as corporations invest to increase production in a consumer based economy. Corporations can invest on increasing production for growing emerging markets such as India, China and Brazil, and this is happening today. But this does not increase growth in the U.S. economy, except in the limited sense that some of the high end development work takes place in the U.S. Policies that stimulate investment would set the stage for a future recovery. ...

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In a major policy move India's Modi government makes major changes for foreign investment in India. In different sectors, pharmaceuticals, defense, civil aviation, and retail stores, the move is designed to attract investment and create new jobs. Foreign investors can now take 100 percent ownership in defense, civil aviation, and food products sectors with government approval. In pharmaceuticals foreign investors can take upto 74 percent ownership with no government approval needed. In retail stores, such as for Apple and Ikea, the rules offer new incentives. From now on the requirement that Apple and other companies buy 30% of their supplies locally for single brand retail stores will be relaxed with a 3 year exemption on local sourcing, which can be extended to 5 years if the products sold are "state of the art" and "cutting edge technology," according to a government announcement. The changes were made by executive order. Apple CEO Tim Cook visited India and lobbied for this change recently. In combination with a national GST goods and services tax to be passed in July 2016, which is to be instituted nationally to replace a old set of state by state requirements and taxes, the two changes could have a bigger impact than the 1991 reforms that moved India away from a socialist managed economy. Poor job report numbers may have increased the pressure for taking action. In the defense sector the earlier change to allow 49% ownership had resulted in few new proposals. The changes in foreign investment rules also follows the resignation of the head of the central bank, Raghuram Rajan. ...

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Christophe Weber, a Frenchman, is made the new CEO of Takeda Pharmaceutical in Japan.

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Abbott Labs acquisition of Piramal Healthcare for $3.7 billion gives it 7% of the Indian market. Acccording to IMS Health emerging markets drug sales for 17 countries went up from $42 billion in 2000 to 126 billion in 2009. Anlysts expect 70% of global growth to come from these areas in next 5 years.

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All sides joined the President at the White House, as part of his consensus building efforts, and to get aseat at the table in restructuring health care. The insurers and health care providers, including technology providers, all committed to cutting the cost of health care. New social insurance programs to cover 45 million uninsured Americans, and to make health care affordable for businesses and individuals, will be unworkable at currently projected rate of increase in health care costs of 6.2% a year for the next decade. The industry promised to reduce that by 1.5% through voluntary efforts, even though there is skepticism about whether they will deliver. The insurers are against a government sponsored health plan fearing it will drive them out of business. Insurers and health care providers are lobbying against the cuts in their Medicare payments, and insurers are fighting Obama's cuts to their private Medicare Advantage plans by a total of $176 billion over 10 years. Doctors are fighting a 21% cut in their Medicare fees scheduled to take place in January 2010. Pharmacuetical companies and makers of medical devices are concerned that new products will have to pass a cost-benefit test before being approved for coverage under Medicare. Its just that they all see the continued rise in costs as somehow unsustainable, especially in the current economic crisis, and share the feeling with business and the rest of the country that the system is broken. At the same time like the banks and bank executives, health care companies and their executives go on lobbying aggressively and doing things the old way, which raises questions about how well these systems that are broken can be put on the right path....

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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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The risks associated with a Glaxo diabetes drug after an independent doctor used results on Glaxo's own website to compute cardiac risk associated with Avandia.

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A report by top FDA officials said that the agency's commissioner, who resigned in January, was improperly influenced by calls from Congressmen, in approving Meniflex. This is a product of RenGen Biologics Inc., a C- shaped pad device to repair injured knees. This after scientists at the agency had rejected it because it was not considered effective or safe.

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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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Following Brexit on January 31, 2020, Britain's government led by Boris Johnson prepares to negotiate new trade deals with the U.S. and other countries. The freedom to negotiate these trade deals was a key part of the plan of Brexit supporters and Mr. Johnson. The Times, Britain's leading newspaper, looks at the prospects of trade deals with each country- the U.S., Australia, New Zealand, Japan. Facing re-election Mr. Trump is seen as favorably inclined to work out a trade deal that he can show during the campaign. Trade discussions have taken place between the UK and Australia, Japan. Mr. Morrison in Australia and Mr. Shinzo Abe want to see strong trading ties and investment with Britain. Japan or Australia could be the first countries that work out a trade deal with Britain as discussions are at an advanced stage.  Britain has a small deficit with Japan in trade. It has a small dollar surplus in trade with the Australia and New Zealand. With the U.S Britain has a large surplus, it exports 121 billion pounds and imports 76 billion pounds. The prospects of trade deals are enhanced by the similarity in outlook of the governments of the U.S., Australia, and Japan, which share views on jobs expansion, economic growth and are centre right in economic philosophy. They also share a strong connection with working class voters under Johnson,Trump and Morrison. Mr. Trump is seen as a strong deal maker so that any deal would involve some concessions from Britain that increase U.S exports, including farm exports. Difficult issues with the U.S. are -pharmaceutical drug imports that could increase Britain's NHS cost for drugs, the digital services tax from Britain on U.S.  companies such as Google and the Trump retaliatory threat to impose tariffs beyond the current 2.5% on car imports of $11 billion from Britain. On agricultural imports Britain's natural foods preference conflicts with imports of genetically modified (GMO) foods from the U.S. Experts say this could lead to a partial or Phase 1 deal that does not need approval from the U.S. Congress, similar to the Phase 1 trade deal with China which sidestepped the thorny issues on trade. This is something both sides can show their support base as a win. ...

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Criticism of the FDA's inability to exert pre-market quality control. Questions raised by a Professor of Pharmaceutical Sciences, about the FDA's inability to detect quality issues in manufacturing. After the J&J recalls for childrens Tylenol and other medicines, the FDA sent a warning letter to Perrigo, a company based in Michigan, that ships these children's medicines, about manufacturing violations. This includes ibuprofen tablets with metal shavings.

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The failure of mega deals like the purchase of Warner Lambert and Pharmacia by Pfizer for $178 billion to do much in the long run. Pfizer's share price has fallen 70% in a decade and its market capitalization is $95 billion. J&J and Abbott have made smaller acquisitions and J&J's acquisitions have generated stable revenues with branded health-care products.

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Abbott is placed on a five year probationary period by the U.S. Justice Department. This comes after the $1.6 billion legal settlement for aggressive marketing practices to sell the drug Depakote in nursing homes.

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

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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.