Denninger on Price-Fixing In the Drug Marketplace

All Karl below:

Time to stop being nice.

America, you’re being raped.  Flat-out raped.

15 USC Chapter 1 makes clear that price-fixing is illegal.  When it comes to drugs, which are physical commodities, Robinson-Patman (15 USC Chapter 1, Section 13) also makes discriminatory pricing illegal for buyers of like kind and quantity.

(a) Price; selection of customers It shall be unlawful for any person engaged in commerce, in the course of such commerce, either directly or indirectly, to discriminate in price between different purchasers of commodities of like grade and quality, where either or any of the purchases involved in such discrimination are in commerce, where such commodities are sold for use, consumption, or resale within the United States or any Territory thereof or the District of Columbia or any insular possession or other place under the jurisdiction of the United States, and where the effect of such discrimination may be substantially to lessen competition or tend to create a monopoly in any line of commerce, or to injure, destroy, or prevent competition with any person who either grants or knowingly receives the benefit of such discrimination, or with customers of either of them

It is illegal for a pharmacy to charge you $10 for a drug and someone else $100.  Or, for that matter, to charge one person $2.15 million and another a $100 copay.

It is illegal for a hospital to do the same thing.

Things like “GoodRX” and similar are flat out facial violations of the law.

So are “varying” co-pays for the same drug in the same quantity.

So, for that matter, are bribes on a differential basis for the same thing (Section 13 c, d and e)

So, for that matter, are inducing such practices or benefiting from same (Section 13 f)

An insurance company is never a consumer of the drug.  A person is.  Such practices as conspiring with pharmacies and hospitals to vary the price you pay is illegal and has been since the 1930s.

Never mind the first few Sections of 15 USC Chapter 1 which make any scheme to fix prices or lessen competition irrespective of upon whom the price injury falls, or even whether it occurs (proof of same is not required in the statute) a criminal, 10 year in prison, felony.

Drug prices in particular, since drugs are commodities, fall under Robinson-Patman.  There is no exception found in the statutes for drugs.

Source: Prison Or Gallows: Pick One – The Market Ticker

Well worth your time to read the whole thing.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com

 

Interval Training Beats Continuous Exercise for Fat Burning

From JAMA Network:

Exercisers can burn slightly more body fat with interval training than moderate-intensity continuous training, according to a recent systematic review and meta-analysis in the British Journal of Sports Medicine. Although the differences in fat loss weren’t huge, the interval workouts were shorter, which could make it easier for people to adhere to them.

Source: For Fat Burning, Interval Training Beats Continuous Exercise | Lifestyle Behaviors | JAMA | JAMA Network

I discuss both types of training in my book.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com

Memories: Sense of Smell Must Be Wired Directly Into the Hippocampus

Have you ever smelled something that instantly brought back a strong memory?

Whenever I smell wax-leaf ligustrum blossoms in the spring, it takes me back to my childhood in Houston, TX.

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Here’s to you, Uncle Hank

I thought I’d try a whisky less expensive than Jamesons, so I brought home a bottle of Jim Beam Kentucky Straight Bourbon Whiskey. The first whiff immediately transported me back to age 12, Baytown, TX, and thoughts of my favorite uncle, Hank Tarski.

I don’t know what Hank drank, but I’m guessin’ Jim Beam.

Hank was quite a guy. I loved him. He was Polish and worked as a chemist at one of the petroleum plants in Baytown. Was he a fighter pilot in WW2, or did I imagine that? He had a beautiful huge mustache, smoked a pipe, had a waterfront house on Black Duck Bay. Hank’s laugh was infectious, and got louder the more he drank.

One of my strongest memories of him was when he took me and his sons fishing in a small boat on one of the local waterways. I still remember catching catfish and croakers; they were small but that doesn’t matter to an adolescent boy.

I also remember falling asleep upstairs with my siblings and cousins while Hank and Kay and my parents downstairs stayed up late talking and laughing, sometimes shouting! We could only imagine the muffled topics of adult conversation. This was the 1960s.

Hank died of pancreatic cancer ten or 15 years ago. I miss him very much.

—Steve

PS. I almost named my son Henry, and we’d have called him Hank.

Nobody Gets Out Alive: Sugary Beverages Increase Risk of Death

From JAMA Network:

Question:  Is the consumption of sugary beverages (ie, sugar-sweetened beverages and fruit juices) associated with an increased mortality risk?

Findings:  In this cohort study of 13 440 black and white adults 45 years and older observed for a mean of 6.0 years, each additional 12-oz serving/d of sugary beverages was associated with an 11% higher all-cause mortality risk, and each additional 12-oz serving/d of fruit juice was associated with a 24% higher all-cause mortality risk. Similar associations were not observed for sugary beverage consumption and coronary heart disease mortality.

Meaning:  These results suggest higher consumption of sugary beverages, including fruit juice, is associated with increased mortality.

Source: Association of Sugary Beverage Consumption With Mortality Risk in US Adults: A Secondary Analysis of Data From the REGARDS Study | Cardiology | JAMA Network Open | JAMA Network

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com

Avoid Ultra-Processed Foods to Help With Weight Management

From Cell Metabolism:

We investigated whether ultra-processed foods affect energy intake in 20 weight-stable adults, aged (mean ± SE) 31.2 ± 1.6 years and BMI = 27 ± 1.5 kg/m2. Subjects were admitted to the NIH Clinical Center and randomized to receive either ultra-processed or unprocessed diets for 2 weeks immediately followed by the alternate diet for 2 weeks. Meals were designed to be matched for presented calories, energy density, macronutrients, sugar, sodium, and fiber. Subjects were instructed to consume as much or as little as desired. Energy intake was greater during the ultra-processed diet (508 ± 106 kcal/day; p = 0.0001), with increased consumption of carbohydrate (280 ± 54 kcal/day; p < 0.0001) and fat (230 ± 53 kcal/day; p = 0.0004), but not protein (−2 ± 12 kcal/day; p = 0.85). Weight changes were highly correlated with energy intake (r = 0.8, p < 0.0001), with participants gaining 0.9 ± 0.3 kg (p = 0.009) during the ultra-processed diet and losing 0.9 ± 0.3 kg (p = 0.007) during the unprocessed diet. Limiting consumption of ultra-processed foods may be an effective strategy for obesity prevention and treatment.

Source: Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake: Cell Metabolism

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com

Higher HemoblobinA1c Levels Linked to Cognitive Decline Over Time

HgbA1c (hemoglobin A1c) is a blood test that reflects average blood sugar levels over the previous three months. From a 2018 study:

In this community-based population, we observed a significant trend for cognitive decline over a 10 year period among individuals aged ≥50 years with normoglycaemia, prediabetes or diabetes at baseline. Additionally, HbA1c levels were linearly associated with subsequent cognitive decline in memory and executive function (but not orientation) irrespective of diabetes status at baseline.

Source: HbA1c, diabetes and cognitive decline: the English Longitudinal Study of Ageing | SpringerLink

h/t to Jan at The Low-Carb Diabetic

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Click the pic to purchase at Amazon.com in the U.S.

Don’t Confuse MY Ketogenic Mediterranean Diet With Others

I don’t know Dodie’s Doodles but she reviewed a competitor to my KMD: Ketogenic Mediterranean Diet at Amazon.com on May 30, 2018. She gave it two stars out of five. Here’s her review in toto:

This book, by Robert Santos-Prowse, a dietician, is not what you want. It’s a little over 180 pages, and the first 50 PAGES are how your digestive system works. Seriously, from the fact that your teeth chew your food all the way down your intestine, as if that’s why you bought the book. Yawn. No offense, but stick with the original by Dr. Steve Parker, who also has an acclaimed cookbook, and I recommend that. He’s the one you want and he has an author’s page here on Amazon.

The book Dodie reviewed is The Ketogenic Mediterranean Diet: A Low-Carb Approach to the Fresh-and-Delicious, Heart-Smart Healthy Lifestyle.

For a free taste of my Ketogenic Mediterranean Diet, click here. For the full monty and to support this blog, click the pic below.

Steve Parker, M.D.

Probably under $13 at Amazon.com in the U.S.