BRAND NAMES VS GENERICS IN MEDICINES

 

RELIEF FOR THE COMMON MAN: HIGH PRICED DRUGS TO BECOME AFFORDABLE

"The patent cliff is over. That’s great for large pharma, but that also means the opportunities theoretically have dried up for generics."

Kim Vukhac, Crédit Agricole.

            For the past fifty years or more, dispassionate and money hungry manufacturers of drugs for life-threatening diseases have fleeced the needy by charging up to and over 50 times the actual cost of making that drug. Their greedy days are about to end soon, as 2012 has seen landmark decisions in permitting registered pharmaceutical companies to produce and sell those drugs at their actual market price plus a fair margin. The volume of products sold to the needy will provide them their profit.

            Legally speaking, a generic drug must replicate the same constituents as the original drug. According to the U.S. Food and Drug Administration (FDA), “generic drugs are identical or within an acceptable bioequivalent range to the brand-name counterpart with respect to pharmacokinetic and pharmacodynamic properties. By extension, therefore, generics are considered (by the FDA) identical in dose, strength, route of administration, safety, efficacy, and intended use.” In all cases, generic products are available to the public at large when the patent expires. In such a case, market competition leads to much lower prices for both the high-priced exclusive branded product and the generic forms.

            Consider the case of Statins. Cardiac specialists were enticed into recommending Statins to supposedly regulate the bad Cholesterol in a patient’s cardio-vascular system. The gullible proletariat ended up paying hard earned money that could be considered extortion. Today, many Cardiologists do not prescribe Statins, perhaps 10 mg a day. This contrast is not obvious in terms of US$. In India, the price has dropped from Rs. 56/- a pill to Rs. 2.40/- Chemotherapy is now within reach of the common man. 

            Things can only improve with time. Bye, shyster!

The Truth About Hedy Lamarr-Hollywood's Most Popular Glamour Girl

  Hedy Lamarr-Actually Hedwig Kiesler

In 1933, a beautiful, young Austrian woman took off her clothes for a movie director. She ran through the woods ... naked. She swam in a lake ... naked. Pushing well beyond the social norms of the period, the movie also featured a simulated orgasm.

The most popular movie in 1933 was King Kong. But everyone in Hollywood was talking about that scandalous movie with the gorgeous, young Austrian woman.

Louis B. Mayer, of the giant studio MGM, said she was the most beautiful woman in the world. The film was banned practically everywhere ... which of course made it even more popular and valuable. Mussolini reportedly refused to sell his copy at any price.

The star of the film, called Ecstasy, was Hedwig Kiesler. She said the secret of her beauty was "to stand there and look stupid." In reality, Kiesler was anything but stupid. She was a genius. She'd grown up as the only child of a prominent Jewish banker. She was a math prodigy. She excelled at science.

As she grew older, she became ruthless, using all the power her body and mind gave her.

Between the sexual roles she played, her tremendous beauty, and the power of her intellect, Kiesler would confound the men in her life ... including her six husbands, two of the most ruthless dictators of the 20th century, and one of the greatest movie producers in history.

Her beauty made her rich for a time. She is said to have made -- and spent -- $30 million in her life. But her greatest accomplishment resulted from her intellect ...And her invention continues to shape the world we live in today.

You see, this young Austrian starlet would take one of the most valuable technologies ever developed right from under Hitler's nose. After fleeing to America , she not only became a major Hollywood star ... her name sits on one of the most important patents ever granted by the U.S. Patent Office.

Today, when you use your cell phone or, over the next few years, as you experience super-fast wireless Internet access (via something called "long-term evolution" or LTE" technology), you'll be using an extension of the technology a 20- year-old actress first conceived while sitting at dinner with Hitler.

At the time she made Ecstasy, Kiesler was married to one of the richest men in Austria . Friedrich Mandl was Austria 's leading arms maker. His firm would become a key supplier to the Nazis.

Mandl used his beautiful young wife as a showpiece at important business dinners with representatives of the Austrian, Italian, and German fascist forces. One of Mandl's favorite topics at these gatherings -- which included meals with Hitler and Mussolini -- was the technology surrounding radio-controlled missiles and torpedoes.

Wireless weapons offered far greater ranges than the wire-controlled alternatives that prevailed at the time. Kiesler sat through these dinners "looking stupid," while absorbing everything she heard ...

As a Jew, Kiesler hated the Nazis. She abhorred her husband's business ambitions. Mandl responded to his wilful wife by imprisoning her in his castle, Schloss Schwarzenau. In 1937, she managed to escape. She drugged her maid, snuck out of the castle wearing the maid's clothes, and sold her jewelry to finance a trip to London .

(She got out just in time. In 1938, Germany annexed Austria . The Nazis seized Mandl's factory. He was half Jewish. Mandl fled to Brazil . Later, he became an advisor to Argentina 's iconic populist president, Juan Peron.)

In London , Kiesler arranged a meeting with Louis B. Mayer. She signed a long-term contract with him, becoming one of MGM's biggest stars. She appeared in more than 20 films. She was a co-star to Clark Gable, Judy Garland, and even Bob Hope. Each of her first seven MGM movies was a blockbuster.

But Kiesler cared far more about fighting the Nazis than about making movies. At the height of her fame, in 1942, she developed a new kind of communications system, optimized for sending coded messages that couldn't be "jammed."

She was building a system that would allow torpedoes and guided bombs to always reach their targets. She was building a system to kill Nazis.

By the 1940s, both the Nazis and the Allied forces were using the kind of single-frequency radio-controlled technology Kiesler's ex-husband had been peddling. The drawback of this technology was that the enemy could find the appropriate frequency and "jam" or intercept the signal, thereby interfering with the missile's intended path.

Kiesler's key innovation was to "change the channel." It was a way of encoding a message across a broad area of the wireless spectrum. If one part of the spectrum was jammed, the message would still get through on one of the other frequencies being used. The problem was, she could not figure out how to synchronize the frequency changes on both the receiver and the transmitter. To solve the problem, she turned to perhaps the world's first techno-musician, George Anthiel.

Anthiel was an acquaintance of Kiesler who achieved some notoriety for creating intricate musical compositions. He synchronized his melodies across twelve player pianos, producing stereophonic sounds no one had ever heard before. Kiesler incorporated Anthiel's technology for synchronizing his player pianos. Then, she was able to synchronize the frequency changes between a weapon's receiver and its transmitter.

On August 11, 1942, U.S. Patent No. 2,292,387 was granted to Antheil and "Hedy Kiesler Markey," which was Kiesler's married name at the time.

Most of you won't recognize the name Kiesler. And no one would remember the name Hedy Markey. But it's a fair bet than anyone reading this newsletter of a certain age will remember one of the great beauties of Hollywood 's golden age -- Hedy Lamarr. That's the name Louis B. Mayer gave to his prize actress. That's the name his movie company made famous.

Meanwhile, almost no one knows Hedwig Kiesler -- aka Hedy Lamarr -- was one of the great pioneers of wireless communications. Her technology was developed by the U.S. Navy, which has used it ever since.

You're probably using Lamarr's technology, too. Her patent sits at the foundation of "spread spectrum technology," which you use every day when you log on to a wi- fi network or make calls with your Bluetooth-enabled phone. It lies at the heart of the massive investments being made right now in so-called fourth-generation "LTE" wireless technology. This next generation of cell phones and cell towers will provide tremendous increases to wireless network speed and quality, by spreading wireless signals across the entire available spectrum. This kind of encoding is only possible using the kind of frequency switching that Hedwig Kiesler invented.

This came to me in an email and is reproduced verbatim

TIT FOR TIT

TIT FOR TIT

The recent brutal killing of two Indian soldiers by Pakistani troops on Indian soil, then the Indian government's protests and the Pakistani government's denials, etc etc has left me pondering and reminiscing about the good old days.

I have had three postings in J&K, and I distinctly remember three incidents that took place around NW Kashmir during my first posting at Uri in 1976-77:

Incident 1: A Maratha Light Infantry battalion was newly inducted in a sensitive sector. On the very first night when the rear party of the previous battalion finally moved out and the main body of Marathas newly moved in, Pakis fired 2" mortar shells on a Maratha forward post. (This has been the usual way to welcome newly inducted Indian Army units by the Pakis for ages.) As soon as day broke, a Major on the Maratha post climbed a tree with an RL (Rocket Launcher, for my civilian friends) slung on one shoulder and two rockets slung on the other, and simply blasted two bunkers of the Mujahid post across the LOC. 

Thereafter, not one bullet was fired by the Pakis on the Maratha paltan for as long as they stayed there.

Incident 2: Pakis observed that Gorkha soldiers in their OP (Observation Post) just left the LMG (Light Machine Gun) un-attended for 2 to 3 minutes while they went out of the OP for a pee. One summer day at about 11 o' clock in the morning, in a daring raid, two Paki soldiers sneaked in and ran back with the LMG. 

Four hours later, which is normally siesta time and security is lax, a team of Gorkha soldiers raided the Pak post and came back with the Paki CO's 15 years old daughter. (Pakistan Army's officers-lot is super privileged. They even stay on border posts with their families.) The Gorkhas did not harm the child, they just made her sit on a chair on top of the OP bunker. Soon enough, a bunch of Paki jawans came up to the LOC with a white flag and the Gorkhas' LMG, and a neat and clean exchange took place.

Incident 3: This incident happened when Naga Regiment was newly raised in the Indian Army and Pakis had no clue what material the Nagas were made of! (Those with a weak stomach may please skip reading this incident further.)

The Nagas were also given the customary welcome on their induction, but they did not retaliate. Then, for the next two consecutive nights, a couple of Paki soldiers would cross over to the Indian side, lob hand-grenades at the Naga post and run back. On the third night, a few Naga soldiers laid an ambush and caught 2 Pakis. They brought the Paki soldiers back enough to be hidden from the Paki OP sights. They tied the Pakis to a tree, lit a fire and performed a traditional Naga dance! Then they chopped a leg off one of the Paki soldiers and literally barbecued it over the fire. Both the Paki soldiers were let off the next morning, but not before the were made to hear this dialogue between a Naga Havildar and a Sepoy:

Sepoy: "Ustaad, inko rakhte hain, bilkul chicken jaisa taste hai."

Havildar: "Nahi re, inko jaane do, yeh dono bahut kamjor hain. Ab yahan 3 saal rehna hai; tu tension mat le, aur bahut mote tagde milenge."

This news spread like wildfire, and the Pakis (Baluch Regiment) across the LOC were thereafter not to be seen even through binoculars, till the Naga battalion was replaced by another unit after 3 years.

Now-a-days, the only reason Pakistanis keeps blatantly bullying us Indians is because we allow them to do so.

How I miss the good old days. Jaane kahan gaye woh din!

END THE NEGLECT OF THE MILITARY

The Pakistan Army’s strategy in near future will be based primarily on two perceptions. First, it believes that the ‘Kashmir’ issue is dying down, fading away from international focus and ‘Kashmir’ is slipping from Pakistani control. Second, internal turmoil in Pakistan is seriously threatening its territorial integrity as it dodders on the verge of becoming a totally dysfunctional state.In this situation, GHQ Rawalpindi headed by General Kayani has two choices. If India attacks Pakistan, the country under an ‘anti-India’ sentiment will unite once again. However, New Delhi is not likely to oblige. In India’s perception, Pakistan is falling apart in any case and war, unless imposed by Pakistan, makes little sense. In such an eventuality, it would be prudent on the part of Kayani to hold his flock together, needle India in Kashmir thus enabling Pakistan to regain a degree of unity and simultaneously bring back ‘Kashmir’ onto the center stage of its international agenda.

The Western forces led by America require Pakistan’s assistance to ensure a smooth and honourable exit through Karachi port. Withdrawing forces would need to be escorted by the Pakistan Army to obviate the possibility of ambush by the local militia. Therefore, New Delhi is not likely to receive support against Islamabad from the international community till US withdrawal from Afghanistan is complete. General Kayani will utilise this opportunity to further Pakistan’s agenda against India.

The Pakistan Army comprises the regular conventional army and the irregulars or guerrilla forces under the jihadi flag, the likes of Hafiz Sayeed. On completion of withdrawal by US and NATO forces from Afghanistan, the Pakistan Army plans to let loose the irregular forces such as the Afghan Taliban to capture large territories inside Afghanistan. The residual US forces may not even be allowed to ultimately retain a toe-hold in Kabul. Subsequently, attacks on the Union of India will be mounted from Talibanised Afghanistan and Pakistan.

Couple this threat with the principal challenge posed by authoritarian China in cahoots with Pakistan. Besides claiming 90,000 sq km of Indian territory, the Chinese, with the help of Pakistani regular and irregular forces, will attempt to obtain a stake in mineral-rich Afghanistan. The long term objective of the Chinese is to open up the route to Central Asia, gain a sizeable presence in the Indian Ocean by positioning themselves at Gwadar port, replace US influence in Asia and eliminate completely, the Indian footprint in Afghanistan.

The Union of India is in turmoil and transition. The internal circus in the name of governance continues owing to dearth of visionary and honest leadership. The Maoists, who control 40 per cent of Indian territory, will increase their influence primarily due to the inept civil administration which is failing on all fronts. On the one hand, external threats mount due to contradiction between dictatorial regimes in the neighbour- hood and the Indian multi-cultural democracy. On the other, corrupt and failing instruments of the State are creating massive internal instability. Obviously, there is a connect between the external adversaries and the internal dissidence which makes the situation explosive.

Primarily therefore, the country is held together by its military and in particular by the Indian Army. The internal charade in the name of governance is only possible so long as the invincible Indian Army along with the Indian Air Force and the Indian Navy continue to secure the nation.

Due to neglect by the state for decades, Indian military power is in decline and its capabilities are shrinking. Though India is densely populated with 65 per cent of its population below 35 years of age, the huge shortages in manpower defy logic. The Indian Army has a deficit of nearly 10,000 officers. Surprisingly, despite the large population and high unemployment rate, the Indian Army is short of over 30,000 soldiers. There is a shortfall of approximately 2,000 officers and 15,000 sailors in the Navy. The Air Force is deficient of nearly 1,000 officers and 7,000 airmen. Shortfall in Young Officers in the Army is creating havoc with the traditional cohesion and bonding between the officers and soldiers. This state of affairs can be attributed primarily to lack of incentives and unattractive terms and conditions of service in the armed forces.

Similarly, the equipment held on the inventory is ancient and archival. Yet, the military is expected to successfully defend the borders of the country. New Delhi’s neglect of its military over decades is gradually but surely, destabilizing the ‘final’ instrument of the State with morale plummeting to the lowest levels since independence. To add insult to injury, the budgetary cut of Rs 10,000 crore imposed recently by the finance ministry will adversely impact the much-needed military modernization. China and Pakistan must be delighted at the move by the Indian Finance Ministry that will degrade the Indian military.

Meagre budgetary allocation for defence and the bureaucratic red tape involved in the acquisition process have placed the defence services in a tight spot. In such a milieu compounded by acute scarcity of equipment and human resources, plummeting morale in the armed forces is not surprising. Today, India is in no position to deal with threat from China or fight a two-front war if imposed on it after the withdrawal of Western forces from Afghanistan.

The harsh reality is that if the Indian Army is incapable of protecting the borders, the Union of India will disintegrate within no time. Another issue of concern is that the police and the CRPF cannot successfully counter the Maoist onslaught. Sooner or later, and somewhat unfortunately, the Army will be called in to take charge of the operations against the Maoists. By arming Maoists, Beijing and Islamabad want to ensure that Indian Army’s attention is diverted from the borders to handle the growing internal turmoil. This will further stretch the military which is already under considerable pressure on account of capability degradation owing to the callous apathy of the political leadership.

In order to avoid the collapse of the Union, the military capability in its entirety needs to be refurbished on a war footing. Foremost, integrate the Service Headquarters with the Ministry of Defence by posting serving officers in the Ministry to increase efficiency and knowledge base. Integrate the armed forces through the appointment of the Chief of Defence Staff and create theatre commands with integral army, air and naval elements to optimise the military punch and avoid duplication of effort and resources. Strange that New Delhi should find it a herculean task to bring about a tri-Services integration along with its MoD to enhance India’s war-fighting capability even as China and Pakistan boast of a combined military strategy against India!

The foreign policy of a country is only as good as its military and economic power. Hence it is important that the military be part of the national decision-making process in strategic and security matters. What is astounding is that the professional advice of the military is not sought prior to shaping diplomatic strategy. The nation won the 1971 War as Indira Gandhi sought professional military advice of the Generals. However, if military officers had been a part of her delegation at the Shimla Summit, wily Bhutto would not have won on the negotiating table, the war he had lost.

In the 21st century, with wide ranging and attractive options for employment available to the youth, a career in the military is not really a priority. Also, with India constantly in conflict with her neighbours or insurgents, the youths shy away from a hazardous career in defence services. Therefore, it is vital for the government to provide extra-ordinarily lucrative package and incentives for the young to voluntarily put in five to seven years of commissioned service. Similarly, service conditions of soldiers need to be substantially improved.

It is an operational imperative to keep the military young. The color service of the jawan should be reduced to 10 years from the current 17. There should be lateral induction of the Short Service Commissioned Officers and the jawans into civil administration. This will beef up the civil administration, which in turn will help tackle groups like the Maoists. For example, an officer from Signals inducted into the civil, can not only help organise communication systems but also protect against and conduct cyber attacks effectively. With multiple professional skills acquired in the military, this exchange will beef up the civil administration and enhance civil-military interface.

In addition to human resources, no military can pack the extra punch unless it is equipped with the most modern weaponry. At the same time, a nation cannot be a great power unless it boasts of a fairly large defence industrial complex. The reason India is one of the world’s largest importers of defence equipment today is due to the fact that under the disguise of ‘self-sufficiency’ mantra, scarce and precious resources of the nation have been squandered largely due to the inefficiency of the Defence Public Sector Units. One of the main reasons for delay in the production of the Scorpene submarine is the fact that it took a huge effort for DCNS of France to upgrade and modernise the public sector shipyard Mazagon Docks!

Today, the war-fighting equipment held by the armed forces is in a dismal state and the state defence industries are in no position to correct the situation. The only way to equip the defence forces is to privatise the state defence units, bring in the private sector as tier-1 supplier, encourage collaboration and joint ventures between Indian and international defence industries with minimum 49 per cent FDI. In case of sunrise defence technologies, permit 100 per cent FDI. This will, in the next decade, create a large and modern defence industrial complex in India that will not only equip the Indian armed forces but also earn revenues for the state through exports.

It is unfortunate and demoralizing for a soldier to not even possess a reliable assault rifle to tackle the insurgent or terrorist equipped with the latest weapons. Therefore, at the initial stage by-passing the long-drawn acquisition process, it is imperative that the basic requirements are met with through quick imports. To save costs, an assault rifle should be selected to meet the requirements of defence services as well as para-military forces. In addition, transfer of technology to a designated private sector unit in India should be done simultaneously.

On the other hand, there is a dire need to eliminate cumbersome red-tape and indecisiveness. The tender in which six in-flight refueling aircraft were selected by the IAF, was cancelled due to a clerical mindset of the MOD. The irony is that in the tender re-floated, the same company has now been identified as the preferred bidder. This reflects unimaginative application of mind by the MOD causing huge delay. In view of the prevailing threat, timely provisioning of the required hardware for the IAF ought to have priority over procedural imperatives. Similarly, if companies continue to be blacklisted without cleaning up our own stables, it can only lead to disaster. For example, if five companies in the world make 155 mm artillery gun and three are blacklisted, it will kill competition and deprive the nation of getting the best value for money. The rules of engagement should be fair and consistent with international norms for India to succeed in creating its own modern defence industrial complex. With the rapid march of defence technologies it is not possible today to be entirely self-sufficient in the production of the complete spectrum of weapons. Therefore, India also should become a part of global supply chain of defence equipment by being one of the important hubs of research and development of a variety of main and sub-assemblies.

In the event of any future conflict, New Delhi’s political will and the capabilities of the Indian military should be such that China and Pakistan are hard-pressed to defend Tibet and Lahore respectively instead of threatening Arunachal and Kashmir. This is only possible, if we end the demoralisation of the Defence Services by perpetual neglect.