Cost of Prolia

Prolia is a drug used to treat osteoporosis. I was recently prescribed Prolia. It is an injection delivered every six months. Prolia is an expensive drug and in the past, my insurance covered an appreciable amount.  I am not sure what changed but the last time I had the injection at my doctor’s office, we received a bill for over $7,000.

The insurance form had the standard explanation about how “they” had worked with the hospital to bring the cost down so that we owed only about $4,000. Curious, I went online to see exactly how expensive this drug is. I found coupons for Prolia from numerous pharmacies for about $1,000, sometimes a little more, sometimes a little less. It occurred to me there was no way it could cost any hospital $6,000 to administer a single injection.

My doctor was as appalled as I was and was open when I suggested different approach.

Before you can have the injection, you need to be tested to measure the amount of calcium in your system. My doctor wrote lab slip for the blood draw which I would took to the lab I usually go to for this kind of thing. Then, after the doctor received the results and all was well, she wrote the prescription for Prolia and submitted it to a pharmacy, one which offered a coupon. When the prescription was filled, I collected it and then had a health professional administer the injection on my own time.

There are two points I want to make. The first is that one must be vigilant in looking over charges from hospitals. We all know of instances when mistakes were made, like the man who was charged for a pap smear. We also need to be mindful of costs. In addition to mistakes, some of the charges are simply way out of whack. Ice packs for $40.00 dollars, for instance. (Bring your own).

The second point is that it is incumbent on us to take further charge of our health care. My experiment saved us over $5,000, which is substantial. It took work on my part to set this up. Getting the blood work was standard, but then I had to talk to several people about exactly how this was going to work and it also took some time to get all the parts moving in the right order. But I did and I got the prescription filled and the injection given.

Health care costs a lot and we often feel helpless in the face of that, but there are things we can do.

Ask what things cost. You would be surprised at how many people who work in healthcare have no idea what anything costs. Insist they find out.

Check your bills and insurance claims. Mistakes do happen and they are rarely in your favor. If they are, you can be sure the insurance companies will let you know. Similarly, you should let them know when the mistake is in their favor and that you are due a refund.

Participate with your healthcare team to figure out the most cost effective way of receiving your healthcare. Do your own research and come prepared to discuss options.

Horton, in Horton Hears a Who, got all the little voices to speak together in order to be heard and save their community. Likewise, all our voices speaking together about the obscenely high costs of particular medical treatments can make a difference. We need to make sure that hospitals and insurance companies know that we are paying attention.

Posted on 11 Nov 2016, 13:26 - Category: Health Care

Broadpoint's misleading advertisement program

We want to believe that we can trust the community around us to be honest with us, especially as it pertains to issues regarding our health and the health of our children. Sadly, that honesty is not often forthcoming, or even worse, is deliberately circumvented, so as to obfuscate the truth. Indeed there are companies devoted to doing just that. Recently we saw an example of this in the Portsmouth Herald’s Sunday (9-18) medical section; Tip of the Day. The tip, as it were, touted the safety of BPA, an element found in many plastic household products. The takeaway was that BPA is perfectly safe. The text and its presentation were designed to give the impression that this was an actual news item. But this was not the case and in fact, the information presented was, to put it kindly, of questionable nature. This article was submitted to the paper by a marketing company called Brandpoint.

I did a little checking into Brandpoint; who they are and what they do. I found, on their website, a special section dedicated to the pharma industry, called An Advertising Solution for Pharma Companies (

On this page, Brandpoint says that their “native advertising initiative” is of great benefit, specifically, to pharmaceutical and chemical companies because Brandpoint can create “a piece of branded content that mimics a news article.” That is to say, they will write and submit articles promoting products of pharma companies that sound like legitimate news stories as opposed to advertisements.

They go on to say that this “mighty” tool helps companies that are “usually bogged down with legal red tape” to tell anecdotal stories that are presented as proof of a chemical’s efficacy and safety. Brandpoint goes on to remind its clients that  “FDA regulations aren’t going away any time soon. Pharma companies will still have to include their hefty disclaimers, their less-than-enticing side effects and whatever else the FDA requires of them.” Heaven forbid that potential consumers should have to know about those pesky side effects.

In the “article,” Brandpoint does not mention that it is because of BPA’s that they tell you not to microwave food in a plastic container. In 2009, the FDA banned makers of baby bottles and sippy cups from using BPA’s in their products. And yet,  BPA was still used in the making of containers that held baby formula. The FDA got around to banning that in 2013.

The FDA still considers BPA to be more or less safe for the general population, but there are studies done with laboratory animals that suggest BPA may not be so safe after all. In 2006, a panel of medical experts met in Chapel Hill, NC, to discuss the matter and in their summary said that “BPA at concentrations found in the human body is associated with organizational changes in the prostate, breast, testis, mammary glands, body size, brain structure and chemistry, and behavior of laboratory animals.” (S. Vogel, "The Politics of Plastics: The Making and Unmaking of Bisphenol A 'Safety'". American Journal of Public Health. 99 (S3): 559–566.)

I suppose I should not be surprised that companies like this exist and that their goal is to mislead for the purpose of padding their clients’, and consequently, their own, pockets. But such maneuvers tear at the fabric of our community, which is built on trust. Perhaps we trust too much and have become complacent. Finding out about this company (and I’m sure there are others) reminds me that we must remain vigilant and speak out when we uncover attempts to mislead and put us, and our children, in harm’s way. While we probably cannot influence companies like Brandpoint to not present misleading advertising, we can insist that our local purveyors of the news, like the Portsmouth Herald, not be a party to such misdirection. Let them know that it is not socially responsible to print an item as news when it is, in fact, an advertisement.


Native advertising, and the MAT release in particular, is one of those solutions. A MAT release (or master of aligned type, for all you 1950s marketing geeks) is a piece of branded content that mimics a news article. It presents factual information in the form of a narrative, distilled into about 500 to 700 words (minus the disclaimers) and distributed to several newspapers, as well as traditional and digital marketing outlets. And there lies the greatest opportunity for pharma companies.

The mighty MAT release is helping brands usually bogged down with legal red tape to use their most compelling asset: patient stories. These stories of patients, their ailments and their recoveries make these companies truly unique, and this form of native advertising offers the perfect medium. Just like any other story, the best kind is about a person with a specific malady that your product or service helps alleviate, with a clear beginning, middle and end. And just like that, you’ve got a piece of content that is genuine, unique and versatile, whether it’s used as part of an ad, PR or social currency.

FDA regulations aren’t going away any time soon. Pharma companies will still have to include their hefty disclaimers, their less-than-enticing side effects and whatever else the FDA requires of them. But these brands can utilize the MAT release and its narrative structure to tell patient-centric stories and create a lasting impact on a massive audience. We should know. We’ve written a few thousand of them. It’s perhaps a little more complicated than the minimalist, less-is-more examples you see in those timeless VW ads (and yes, those disclaimers and ISI info still need to be a part of the release), but it’s an incredibly effective means for pharma companies to detach from the visual and focus on the patient to tell the story.

No matter your industry, Brandpoint’s Mat release services don’t stop at writing. We also handle editing and provide access to one of the largest distribution networks in the country. Check us out for more information.

(Copied from Brandpoints page entitled An Advertising Solution for Pharma Companies.)

The key conclusions of the report included expression of some concern over the potential for developmental toxicicty for fetuses, infants, and children. And this was based primarily on evidence from animal studies that would suggest that there might be effects on the development of the prostate gland, and the brain, and also for the potential for behavioral effects. There was also a lower level of concern, minimal concern, expressed over potential for changes in the development of the mammary gland and also for the age at which females attain puberty. There was also a level of minimal concern expressed for workers exposed in occupational settings. But with the exception of that, exposures to adults were considered to be not particularly risky for exposures to BPA.

The fact that there are so many levels of uncertainty make it very difficult for us to make any kind of overall recommendations as to how exactly the U.S. public should view bisphenol A right at this point, but it clearly has also identified a number of research areas that we think need to be followed up on in great detail to give us a better handle and reduce some of these uncertainties and allow a clearer picture of exactly what we should be doing as a society with regards to exposures to BPA.(2008, the National Toxicology Program )

In 2006, the US Government sponsored an assessment of the scientific literature on BPA. Thirty-eight experts in fields involved with bisphenol A gathered in Chapel Hill, North Carolina to review several hundred studies on BPA, many conducted by members of the group. At the end of the meeting, the group issued the Chapel Hill Consensus Statement,[52] which stated "BPA at concentrations found in the human body is associated with organizational changes in the prostate, breast, testis, mammary glands, body size, brain structure and chemistry, and behavior of laboratory animals."[53] The Chapel Hill Consensus Statement stated that average BPA levels in people were above those that cause harm to many animals in laboratory experiments. It noted that while BPA is not persistent in the environment or in humans, biomonitoring surveys indicate that exposure is continuous. This is problematic because acute animal exposure studies are used to estimate daily human exposure to BPA, and no studies that had examined BPA pharmacokinetics in animal models had followed continuous low-level exposures. The authors added that measurement of BPA levels in serum and other body fluids suggests the possibilities that BPA intake is much higher than accounted for or that BPA can bioaccumulate in some conditions (such as pregnancy).[52]  (Chapel Hill bisphenol A expert panel consensus statement: Integration of mechanisms, effects in animals and potential to impact human health at current levels of exposure)


Posted on 22 Sep 2016, 11:40 - Category: Politics

Trump's Tower of Lies by D. Allan Kerr

I found this article especially interesting and straightforward. I appreciate the honesty of D. Allan Kerr

Posted on 25 Jul 2016, 14:02 - Category: Politics

Heroic Greek Girl

While recently in Athens, Greece, I attended an exhibit of photographs documenting the arrival of Syrian refugees, on display at the Benaki Museum Annex. Different photographers provided images for the exhibit, and at the same time, assisted the refugees. Their images provide an opportunity for many people from all over the world, visiting Athens and this museum, to gain insight into the refugee experience. As good art should do, these images give voice to those who have had their voice taken away.

The images showed both extreme kindness and heart-breaking pain. A number of people going through the exhibit needed to leave the gallery on occasion in order to collect themselves, dry their tears and repress the anger welling up in them, that in this world, desperate families still need to leave the homes where their families have lived for centuries, because they are no longer safe in their own countries.

Many of the images showed the kindness of the Greek people as they ran into the Aegean Sea, grabbing infants and toddlers from the arms of exhausted parents, helping them to the safety of the shore. There were images of futile attempts to resuscitate small children who had drowned.  There were images of police comforting the refugees as they processed them into the country and directed them towards shelter and food.

A Greek scholar, born in Canada, raised in South Carolina, who moved to Greece to return to her roots, told me that Greek people know what it is to be refugees and that is why they are so open to helping any way they can, even in the face of Greece’s economic difficulties.

At the end of the exhibit, there was a photo of a young Greek girl, 8 years old, standing on a plaza in front of her home with the sea behind her. She stands strong with both sneakered feet planted firmly on the ground, looking directly at you. These are the words she gave the photographer, her story:

“I volunteer because I cannot see people being wet while I am just comfortably sitting. Our house is on the sea and refugees arrive every day. Recently, a boat arrived with 45 people and many babies. I got into the sea, grabbed babies and put them in our home. We turned the radiator on and we gave them milk. I put socks on them and gave them diapers.

The other day I took sea urchin spines off the foot of an adult, they had arrived with their boat behind our house on the rocks and as they were about to arrive at the coast, he stepped on a sea urchin. These people are not familiar with the sea. My teacher gives me thumbs up for helping but tells me that I also need to pay attention to my classes. The other kids at school make fun of me. They tell me I will get sick. What makes me angry is that several adults come by just to steal the engines of the boats and leave the people helpless.

It is just five of us who help here. At school we have history and religion classes and we are told to love and help our neighbor. But here no one comes to help.” (Hermione Koyimani, 8 years old).

If any one asked me who deserved the Nobel Peace Prize, I would give it to Hermione in a heartbeat. When I hear proposals to ban all Muslims, including the tens of thousands of refugees  seeking a safe place, I am deeply ashamed and offended. There is nothing American or great about such heartlessness. Indeed, it is a level of immorality I had hoped never to see in the United States. My America does better by those who are in need. We forget that many of us are here because at one time, we were in need. America has always been there for those seeking sanctuary. Around the world, Americans are respected because when things get tough, Americans show up to help. I am sick to death of attempts to malign and destroy what is the essence of being American. We are in danger of losing our moral compass and God forbid we let ourselves be lead down the road of ignorance and intolerance. We have a sea urchin spine that we need to pull out of our own foot.


Posted on 24 Jun 2016, 13:00 - Category: World Issues

Lack of Ethnics in the NH Legislature

How incredible that a member of the New Hampshire House of Representatives has been charged with intent to commit aggravated felonius assault against a 14 year old girl. He is also facing felony charges for drug possession with intent to sell.

How does someone like this get elected to the NH Legislature? We need to work together to make sure that we elect people that we can count on to be ethical, honest and return respect and dignity to the office of State Representative.

Posted on 18 May 2016, 17:07 - Category: NH Legislature

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