Healthy Life Journal

With results from the Iowa caucuses coming tonight, two Big Pharma CEOs seemed unworried about how the drug industry will fare this election year.

Despite the uncertainties, Schering-Plough CEO Fred Hassan struck an upbeat tone when asked about politics at Morgan Stanley’s “Pharmaceutical CEOs Unplugged” conference. The drug industry, he said, is in “50% positive territory in terms of our favorable standing with the American public, and that has a big effect on the way politics develop.” (We were surprised by that figure and asked Schering-Plough for more information. No word yet.)

Both Hassan and Merck CEO Richard Clark, who also spoke at the conference, said the Medicare drug benefit has been successful. Hassan said, for instance, that efforts to give the government power to negotiate drug prices for the program have “died down.” That’s because of seniors’ high satisfaction with the program, he said.

Hassan also said the industry is doing a “more effective job at working both sides of the aisle.” For his part, Clark added that Merck has “always worked on a bipartisan basis with Republicans and Democrats.” Clark, who takes over as chairman of the trade group PhRMA this year, said he hopes the industry will be able to offer recommendations on health reform, especially around the uninsured.

For an indicator of that bipartisan spirit, take a look at drug industry contributions to the donkeys and elephants, as Dow Jones Newswires reminded us this morning.

Still, the public optimism from the CEOs today clashed with some of the chatter on the Health Blog about the presidential race. We couldn’t help but remember readers’ comments in defense of Big Pharma to this post about a proposal by John Edwards to replace patents with prizes for new drugs. Or a broadside from Hillary Clinton that we’d read in the New York Times on New Year’s day: “I’ve taken on the drug companies,” Clinton said. “I’ve taken on the health insurance companies; I’ve taken on the oil companies, and I intend to keep doing it.”

Update: Our curiosity piqued, we did find some recent data on how Americans view drug makers. Harris Interactive polled more than 2,500 adults in October and found that Big Pharma tied with Big Oil at 53% as the industry that respondents said is most in need of additional regulation. When asked which industries are “generally honest and trustworthy,” only 11% said pharmaceuticals fit the bill. Supermarkets topped the trustworthiness chart at 32%.

Lewis Maharam only ran one marathon, and that was to get a free turkey for Thanksgiving (more on that later). But he’s been the medical director of the New York City Marathon for a dozen years now, and on race day this Sunday he’ll be responsible for the work of 2,500 medical volunteers and the health of 38,000 runners.

Maharam (pictured) practices sports medicine in New York, and talked with the Health Blog this morning. Here are the highlights.

How did you get into this line of work?

I went into sports medicine because I was always watching ball or playing ball. Running wasn’t my big thing. When I was in medical school at Emory, my friends saw that the Atlanta marathon had a deal where if you finished, you got a turkey. So my friends said, “OK Mr. Sports Medicine, go run a marathon.” I finished.

What was your time?

I don’t want to talk about it. I was a back-of-the-packer.

What do worry about as medical director?

People can have a heart attack. Running the race could be their stress test that they don’t pass.

And hyponatremia is something we always look for because it’s something that we can readily fix. It’s where the salt level [in the blood] is too low. First people get nauseous and weak. They may get confused. They can progress to fainting and then to seizure and death. The basic recommendation is to drink for thirst, so you don’t over-drink or under-drink. Over-drinking is what causes this. You don’t want people drinking at every water station.

How many runners have have died while you’ve been medical director?

Globally, one in 50,000 to one in 75,000 marathoners dies [during a race]. But, knock on wood, we have not had a death at the ING New York City Marathon since 1994.

Where will you be on race day?

At a tent in the middle of Central Park [where the race finishes]. It looks like air traffic control–we have a map of the event and push-pins where all of the ambulances are. Every ambulance for the City of New York is on standby for this event. When someone needs an ambulance on the course we have an ETA of three minutes.

How many ambulance calls will you have on Sunday?

There are hundreds of calls for ambulances over the course of a race like this. The calls aren’t all serious things. We’ll have at least 50 of them on Sunday for runners bending over tying their shoe or lying down to rest. People call in and they go, ‘Runner down,’ and you have to get somebody to them.

Any tips for runners?

You shouldn’t get a massage within the first two hours of finishing a race. Your muscles build up lactic acid, and if you get a massage you move the lactic acid around and get more muscle soreness. Better is to go back to your hotel or go back to your home and either take an ice bath or a cool shower, because that calms down all the inflamed muscles and ligaments.

First timers will say, “I feel awful; I feel terrible. Is this normal?” I say, “You just went 26.2 miles, how do you think you’re supposed to feel?”

Merck’s diabetes drug Januvia has been approved by the FDA for use in combination with older diabetes medicines, but stiffer warnings have also been added to the Januvia’s label.

The instructions now say allergic reactions and cases of a rare skin called Stevens-Johnson syndrome have been reported in some patients taking the drug. An FDA spokeswoman told the WSJ “the level of concern is not great.” And John Buse, the American Diabetes Association’s president for medicine and science, called the additional label information “par for the course.”

Still, Stevens-Johnson can be devastating for patients and is a particularly vexing problem for drug makers. A consortium of big drug makers said last month they’d be teaming up to look for genetic clues to better understand who might be at risk.

The reports of Stevens-Johnson and other skin reactions in patients taking Januvia also call to mind Novartis’s Galvus, a drug in the same class as Januvia that’s been delayed by the FDA in part because of skin reactions in monkeys. But John Amatruda, Merck’s VP of clinical research, said Merck hadn’t seen such reactions in its trial of Januvia, and added that there is “no evidence at all” that reactions in Januvia patients are related to those events.

The new approval says Januvia can now be prescribed with the diabetes drug metformin and a class of diabetes medicines called sulfonylureas.