Tuesday, June 21, 2016

How About a Little Our-Brand-Name-Pharmaceutical with Your Sandwich, Doctor?

Way back in 2009, I argued that "gimme" pens, cups, T-shirts, lunches, and all the rest were a bad idea in the medical industry (and others, too, for that matter). (Full post, here) At the time, I wasn't sure that something so small as a pen could affect a doctor's purchasing decision, but even the appearance of being so influenced was bad.

It turned out, of course, that doctors could be influenced by something so small as a pen. (Another 2009 post, here)

I wrote about it again in 2012 (here) and 2014 (here) and probably a bunch of other places that I haven't found in a quick scan.

And... here we are again.

Today's New York Times has a "Well" blogpost from Nicholas Bakalar (article, here) that reports, depressingly but not surprisingly, that "...[a] free lunch may be all it takes to persuade a doctor to prescribe a brand-name drug instead of a cheaper generic, a new study suggests."


And, of course, "[the] more meals doctors had, the more likely they were to prescribe the promoted drug."

The full article on which Bakalar's post is based is from JAMA Internal Medicine, and can be found online, free, here.

None of us like to think of ourselves as this susceptible, but study after study has shown that we are. So why are we still OK with this system?

Thursday, May 12, 2016

West TX: Still What a Regulation-Free Universe Looks Like

Three years ago, an explosion at a fertilizer plant in West TX leveled the building, destroyed or damaged hundreds of homes, killed 15 (10 of whom were volunteer firefighters or other emergency responders trying to contain the disaster, and wounded hundreds.

A year later, the US Chemical Safety Board released preliminary findings, stating that the fire and explosion were entirely preventable, and that part of the responsibility for the death and destruction lay in the fact that there is no state fire code, and that "counties under a certain population are prohibited from having them."

Something like 50 tons of ammonium nitrate was stored in wooden bins in a wooden warehouse that had no sprinkler system (ammonium nitrate was used in the Oklahoma City bombing in 1995). As New York Times reporter Manny Fernandez wrote then, "Federal investigators have determined that a lack of oversight and regulations at the local, state and federal levels contributed to the deadly fertilizer plant explosion that devastated ...(West TX)." (Fernandez' article, here)

And as I wrote at the time (full post, here): Ya think?!?

The full and final responsibility for the fire and explosion has gotten murkier, as the Bureau of Alcohol, Tobacco, Firearms and Explosives has just released the results of its investigation: the fire was deliberately set.

In an article in today's Times, Fernandez writes, "All accidental and natural fire possibilities were tested and eliminated..."

As a result, the case is now being pursued as a crime, and officials announced a reward of "up to $50,000 for information leading to the arrest of those responsible."

A senior ATF official was quoted as saying, "It required extensive scientific testing to determine the cause of this... We took our time because we knew we had to get this right. For a fire of this size, I wouldn't say this is unreasonable."

If the West TX disaster was a crime, how can I continue to say that "this is what a regulation-free universe looks like"?


The crime was as "successful" as it was because of lax regulation. Fernandez's story today reminded me that the explosion "left a crater 93 feet wide and 10 feet deep." Just think about that for a moment.

More than a quarter of the town's homes were destroyed or severely damaged. Fernandez also noted that "three schools, a nursing home and a 50-unit apartment complex were destroyed or heavily damaged."

A key contributing factor to the extent of the disaster? "The nearest cluster of houses was about 370 feet from the plant's property line and most of those injured were within 1,500 feet of the blast."

What does that say to you? To me, it says that the Chemical Safety Board was right: lax regulation and oversight. Who would allow houses to be built that close to a warehouse that stores a potential explosive? Who would allow a potential explosive to be stored in a warehouse with no sprinkler system? Who thinks no fire codes are a good idea?

None of these failures has been addressed.

Meanwhile, a civil suit against the West Fertilizer Company and the ammonium nitrate supplier, filed three years ago, is slowly wending its way through the justice system. The suit, according to a 2013 Waco Tribune article, seeks "unspecified damages".


Wednesday, April 27, 2016

Good News Shouldn't Be So Rare, But Let's Celebrate Anyway

It's been a while since I've posted anything, for a variety of reasons. Among them -- the business news has been depressing: how many times can I write, Trust and Transparency?!?

So I'm happy to pass on a little bit of good news, the story of an entrepreneur who realizes that it's not all about me, Me, ME.

A little more than ten years ago, Hamdi Ulukaya, founded Chobani Greek yogurt, buying a shuttered factory in upstate New York and turning an $800,000 Small Business Administration loan into a wild success. The company, still privately held, is currently valued at several billion dollars.

What has Mr. Ulukaya done? He's turned around and given a 10 percent stake in the company to his 2,000 full-time employees (the longer you've been with Chobani, the larger the number of shares you've received).

New York Times reporter Stephanie Strom, in an article in today's paper, quoted one long-time employee: "It's better than a bonus or a raise. It's the best thing because you're getting a piece of this thing you helped build."


Ulukaya said the same thing: "I've built something that I never thought would be such a success, but I cannot think of Chobani being built without all these people."

The only depressing thing about this news is how rarely it occurs. I wrote a piece six years ago about Bob Moore's gift of his company, Bob's Red Mill, to his employees (full post, here), but I can't think of another recent example.

Strom notes that the Chobani employees will be able to sell their shares "if the company goes public or is bought by another business, neither of which seems imminent. Employees can hang onto the shares if they leave or retire, or the company will buy them back."

Given the current hot-button political issue of income inequality, this is particularly good news. And especially for upstate New York which has struggled for many years.

Not to mention -- given another hot-button political issue -- that Ulukaya is a Turkish immigrant to the United States.