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A New Paradigm for Drug Reps, or, "M-I-C…K-E-Y…"

Posted by Howard Brody on February 3rd, 2012
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Jonathan D. Rockoff wrote a little while ago in the Wall Street Journal online:
http://online.wsj.com/article/SB10001424052970204331304577142763014776148.html
--that while people like me were paying attention to other issues at the medicine-Pharma interface, and ignoring our old friends the drug reps, a paradigm shift may have begun to occur in that field.

First off, Rockoff updates us on a trend that was just beginning at the time HOOKED came out, that from a peak in 2007 of 105,000 drug reps in the US, industry has been trimming steadily down to a present force of about 72,000. The firms had decided that too many reps were tripping over each other and duplicating effort.

But the real paradigm shift is what these reps are now supposed to do, at least according to the picture Rockoff paints (focusing on a particular Eli Lilly rep who peddles neurological and psychiatric drugs in North Carolina). Instead of the old hard sell where reps were trained to "close the sale" and push their docs to promise that they'd write the next 5-10 prescriptions in that class for the company's drug, reps are being urged to use a softer and friendlier technique, do more listening, and try harder to find out what the physicians think and want and better meet their needs.

Hence my subtitle--as Rockoff reported, "Lilly's most recent national sales meeting, held at Disney's business training institute in Florida in February, was devoted to customer service, not product training. Sales representatives watched how Animal Kingdom workers greeted families at the gate and answered questions around the attractions."

Now, here's the most serious aspect of the paradigm shift: "In the wake of costly settlements by other drug makers over illegal marketing practices, British drug giant GalxoSmithKline PLC stopped evaluating salespeople based on the number of prescriptions written. Instead, companies are considering how well physicians rate their representatives." Whoa-- bonuses for reps no longer based on sales volume pure and simple? That's huge.

Not, you understand, that companies have changed how they see the rep's job--just that you can catch more of the proverbial flies with proverbial honey: "'Increasing physician satisfaction, it turns out, is a much better way to promote a pharmaceutical agent than simply telling them to write more prescriptions or what the benefits' are, said David Ricks, president of Lilly's global business unit."

The new generation rep, says Rockoff, is more ready to admit the downside of the company's drug and give docs useful information about side effects. For example, the "new" rep Rockoff profiles, Michaelene Greenly, helped one of her physicians troubled by a patient's weight gain on the Lilly antipsychotic Zyprexa, recommending a special Lilly-sponsored nutrition program. (What drugs the patient might have been switched to besides an antipsychotic appears not to have been part of the conversation.)

As an example of how this goes over with the physicians, Rockoff tells us about Dr. Carey Cottle, Jr., a psychiatrist on Ms. Greenly's circuit:

Before the change in tactics, psychiatrist Carey Cottle Jr. says he was more likely to write prescriptions for a competing antidepressant like Pfizer Inc.'s Effexor over Cymbalta, because Lilly representatives had a "high-pressure, car sales-type approach, and it was just not appropriate." Fed up several years ago, Dr. Cottle called their Lilly manager and complained that the reps' visits were "wasting our time."

Now, Ms. Greenly's service has lifted the bias he had against prescribing Lilly medicines, Dr. Cottle says. When he had a patient who was breast-feeding, she supported his conclusion that it would be safer if the woman took the antipsychotic Risperdal instead of Lilly's Zyprexa because Risperdal had more safety data on that point.

Let's talk about this for a minute. First, it's a great step forward that the rep would actually suggest a rival company's drug due to a safety issue--even though, once again, one has to ask whether the patient truly needed an antipsychotic, given how much evidence we have of massive overprescribing of psychoactive drugs.

On the other hand, personally, as a patient, I would not want to be treated by a physician who used not to prescribe a certain company's drugs because he did not like their rep, and now prescribes that company's drugs because the rep is nicer. Whatever happened to the quaint idea of prescribing the drug that you think, based on the available scientific evidence, is really best for this particular patient? Or are you really saying that the choice of a drug is like Tweedledum and Tweedledee, and that you might as well toss a coin anyway based on the scientific data, so why not go with the company that sent their reps to Disney? Somehow I don't think that's what even the "new" reps tell the physicians, even though in many drug categories it's probably true.

So in some ways the paradigm seems really to be shifting, but in the most basic way, it hasn't. The challenge to docs is still: do you want to get your information about drugs from a person who was sent to your office specifically with one mission, which is to represent a company and try to maximize their sales?

The Health Risks of a Desk Job

Posted by Sharon on February 2nd, 2012
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This article, The Health Risks of a Desk Job, was originally published at Natural Health Ezine.

ComputerMany people assume that working at a computer all day long is less detrimental to your health than, for example, hard, physical labor. However, if your work regularly includes spending a few hours a day at the computer, you are putting your health at risk.

As someone who spends a considerable amount of time working at my computer, I am well aware of the actions I should be taking to prevent long term effects on my health. However, putting it all into practice is often a different story! Here’s how a computer can affect your health – and the remedies you should be taking to minimize your health risks.

Common Health Problems Associated With Computer Work

There are many health problems that can arise when you spend a considerable amount of time working at a computer; these include:

What You Can Do to Remedy Computer Health Problems

It might sound simple, but many people do not put into practice a few simple rules that would help to minimize some of the above health problems. These include:

  • take a break from the computer screen approximately every 15 minutes
  • walk around the room and do simple stretching exercises (see below)
  • make sure that your desk and chair are set at the optimum level for your comfort and eye line
  • treat “tired” eyes with an aromatherapy eye pillow at the end of your work day.

Simple Exercises for Computer Related Problems

If you simply can’t avoid spending long periods of time each day at your computer, here are a few simple exercises that might help with problems such as eyestrain and neck, back and shoulder pain (source: Office Yoga, Darin Zeer).

  • eye strain – give your eyes a rest each hour by closing them and let your face “soften”; this also helps to release tension (and associated headaches) in your face
  • neck pain – roll your head around in circles several times
  • shoulder pain – place one arm behind your back and grab your wrist with the other hand; repeat on the other side
  • back pain – lie on the floor and pull your knees to your chest; wrap your arms around your knees and stretch. Relax and repeat several times.

Daily Routine  for Computer Problems

In addition to the quick exercises listed above that you can practice throughout your work day, you can also make sure that your daily routine includes the following activities to help your health stay in good shape:

  • take a brisk 15 minute walk
  • make time to relax at the end of your work day
  • take a hot bath
  • get enough sleep at bedtime.

Computer Health Problems of Tomorrow

Computer related injuries are on the rise which is no surprise given the technological society that we live in today; tomorrow’s aging generation will suffer from many problems that arise from having a career related to computer work, a problem that earlier generations have not experienced.

Exact statistics on computer related injuries are difficult to pinpoint but some of the most common computer injuries include back pain and carpal tunnel syndrome. However, with a little bit of good health practice and common sense, it is possible to minimize the risk of pain and injuries sustained while working at a computer all day long – and help protect your health for later life!

Photo by Pcora

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More on Journal Reviews Paid For by Pharma

Posted by Howard Brody on February 2nd, 2012
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A little while back I posted this commentary/summary of an item from Marilyn Mann's Blog:
http://brodyhooked.blogspot.com/2012/01/peddling-useless-drugs-paying-journals.html

At the time, I drew some unflattering conclusions about the journal (Reviews in Cardiovascular Medicine) and its editor and authors, based only on the review of a single article. Making up for my sloppiness and laziness now comes Kevin Lomangino in a guest post on the Health News Review blog:
http://www.healthnewsreview.org/2012/02/readers-may-be-snared-in-heart-journals-tangled-web-of-conflicts/

Mr. Lomangino took the time to dig into a number of articles this journal printed, and to compare the conflicts of interest disclosed in the journal to information now available on the ProPublica "Dollars for Docs" database. Not surprisingly, he found a lot of people writing enthusiastically about drugs for companies with whom they had significant financial ties, and often not reporting same in the journal article.

The conclusion Mr. Lomangino leaves us with is the impression that I had on reviewing the single article on fibrates, only now backed up by more searching--which is that Reviews in Cardiovascular Medicine is basically what's known in medical jargon as a "throwaway" journal. A throwaway journal is a journal that's not peer reviewed and generally not indexed in the National Library of Medicine's Medline/PubMed system. It's advertising pure and simple. The articles are generally written by spokespersons for the companies; they are lavishly illustrated with nice color graphics; and the journal is sent free to physicians. Such journals are totally funded by industry.

The problem with Reviews in Cardiovascular Medicine is that while it seems to walk, talk, and quack like a throwaway journal, it is disguised as a real journal. They have somehow concocted some sort of peer review process, and the journal as I noted before carries the imprimatur of the American College of Cardiology. And the journal is listed in PubMed.

Physicians have traditionally known exactly what to expect from "throwaway" journals, but that doesn't mean that they don't read them. The articles are generally much more snappily written than the stodgy pages of real medical journals (who can't afford to hire professional writers), and the pictures look pretty, and the information is often fed to docs in highly useful nuggets for the busy practitioner. Again, a very smart and profitable industry doesn't waste money on marketing that doesn't work. So I suspect that Reviews in Cardiovascular Medicine is widely read in the field despite having all the distinguishing marks of advertising pure and simple. (If anyone attached to this journal is trolling the web for mentions of their product, and wants to comment on or rebut these statements, be my guest.)

Celebrity Shills for Pharma

Posted by Howard Brody on January 31st, 2012
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I was kindly asked by The Scientist to submit an opinion for their blog regarding recent news that Paula Deen, who I gather is a celebrity chef sort of person who has tended to advocate high-fat diets, has acknowledged having Type 2 diabetes and has shown up as a celebrity spokesperson for a diabetic drug for Novo Nordisk. So I figured why write two blog posts when I can write one:

http://the-scientist.com/2012/01/30/opinion-celebrities-pushing-drugs/

5 Best Natural Health Books

Posted by Carol on January 30th, 2012
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This article, 5 Best Natural Health Books, was originally published at Natural Health Ezine.

BookI thought today I’d share my top 5 natural health reference books. Of course this is just a sampling of what is on my shelf, and I refer to a lot more than this; but these 5 will give you an idea of what to look for in several categories.

Rosemary Gladstar’s Family Herbal

This book is packed full of helpful information for the entire family. Gladstar not only shares information on staying healthy, but herbal formulas that treat many common ailments. The chapters include “Taming Stress and Anxiety,” “Home Remedies for Everyday Ailments,” and ones for children, women, men, and elders. A practicing herbalist for over 35 years, Gladstar founded the California School of Herbal Studies, Sage Mountain Herbal Retreat Center, and United Plant Savers(an organization “dedicated to the conservation and cultivation of at risk North American medicinal plants”)  I have used several recipes from this book with great success and recommend it highly.

The Green Pharmacy

Dr. James A. Duke is one of my favorite herbal authors. I started with this book and went on to purchase several of his others. An ethno-botanist retired from the USDA, Dr. Duke arranged The Green Pharmacy by ailment. Want to know what to do for canker sores? Go to page 114. He offers a brief discussion of each ailment and a list of herbs that may help the condition. His other books include The Green Pharmacy Herbal Handbook and Dr. Duke’s Essential Herbs.

The Encyclopedia of Natural Medicine

With a 3rd edition due out in July, this wonderfully scientific book was written by Michael Murray, ND and Joseph Pizzorno, ND. Like The Green Pharmacy, it is arranged by ailment. Murray and Pizzorno however, discuss symptoms, diagnoses, and treatments from a medical perspective. They also cover diet, nutritional supplements, and herbal treatments—complete with dosages. One of my first natural health volumes, I still refer to the Encyclopedia of Natural Medicine often.

Prescription for Nutritional Healing

With similar content as the previous book, Phyllis A. Balch, CNC and James F. Balch, MD wrote Prescription for Nutritional Healing for a layman to understand. Also arranged according to ailment, they give a comprehensive discussion of the condition, nutritional, herbal, and dietary recommendations, as well as lifestyle considerations. It also contains the section “Understanding the Elements of Health” which includes nutrition, vitamins, minerals, amino acids, enzymes, etc. Sporting 776 pages of natural health wisdom, this volume is the most dog-eared and tattered on my shelf.

Nourishing Traditions

I often vacillate about where to keep this book—in the pantry with the cookbooks or on my shelf of health related volumes. In Nourishing Traditions, Sally Fallon challenges every politically correct nutritional dictum you have ever heard. This book contains chapters that explain the truth about fats, carbs, proteins, milk, salt, and a lot more. Be prepared, you will not read in this book to eat margarine for your heart disease, to cut back on your salt for high blood pressure, or to abstain from animal products for anything. Categorically a cookbook, Nourishing Traditions earns its place in my list because of the wealth of information in its introductory chapters and on the sidebars of every page.

If you’re just starting to build a natural health library, I hope this list gives you a place to start. There are so many books published, I know it can get overwhelming. Or, perhaps, you’ve already got a great library and have a few suggestions to share. Please do in the comment section below.

 Photo by Daniel Y. Go

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Ritalin: Is Drug Shortage or Drug Excess the Problem?

Posted by Howard Brody on January 29th, 2012
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Today's New York Times features an opinion piece by Dr. J. Alan Sroufe, emeritus professor of psychology at the University of Minnesota and expert on child development:
http://www.nytimes.com/2012/01/29/opinion/sunday/childrens-add-drugs-dont-work-long-term.html

Dr. Sroufe starts by noting that the news has lately been full of reports of serious drug shortages, leaving frantic parents and teachers worried that kids with attention deficit disorder will be unable to get their Ritalin (methylphenidate). Dr. Sroufe then offers the argument that instead of worrying that these kids might not be able to get their meds, we should be worried that far too many kids are getting medicated for ADD despite good evidence that any benefit from drugs is probably limited and short-term.

The piece basically falls into two parts. One addresses the actual evidence about the benefits of stimulant drugs like Ritalin in ADD. The other discusses the likelihood that ADD is not an inborn chemical imbalance and may be at least partly environmentally triggered, suggesting that a more complex approach is needed rather than just prescribing drugs. (Since psychiatrists tend to prescribe drugs for behavioral problems and psychologists tend to downplay the value of drugs and suggest various other forms of therapy and prevention, I fully expect to read angry psychiatrists attacking Sroufe's article in coming days.) And Dr. Sroufe defends his bona fides by noting that early in his career, he did research on Ritalin and helped show that it seemed to have benefit. Anyway, the first part of the article is what I choose to focus on as most pertinent to this blog's agenda.

Basically Dr. Sroufe disputes the initial claims that ADD kids have messed up brain chemistry because of an inborn problem, so that stimulant drugs have a paradoxical effect on them and settle them down instead of revving them up. There's no paradox, he says--anyone given stimulants, and then assigned to do boring, repetitive tasks (presumably like much schoolwork is) will be able to do the tasks better. The real issue is whether in the long run ADD kids improve on Ritalin, in terms of learning or life adjustment, and he claims that long-term studies show no difference and that any presumed benefit to stimulants disappears after a few years as the body develops tolerance. Because the body develops tolerance, kids do worse when the drug is stopped, so studies showing worsening of ADD symptoms on drug withdrawal hardly support the actual benefits of the drugs.

What these assertions have to do with our concerns is:


  • Stimulants, like many drugs used in mental health, look very good so long as you do your study for a 4-8 week period, and never look at long term outcomes. For this reason it is increasingly worrisome that so many studies of psychoactive drugs are roughly 4-12 weeks' duration. From an industry viewpoint this is good for two reasons--such studies are cheap and quick, and as noted their outcomes are much more likely to be positive. The rest of the world (the FDA included) needs to take note that such studies are also virtually uninformative about any drug intended to be used chronically.

  • To repeat a basic theme, drug marketing does not simply try to sell us drugs. Marketing tries to sell both physicians and the general public a way to think about drugs. We have recently discussed the popularity as well as the scientific defects of the low-serotonin theory of depression (http://brodyhooked.blogspot.com/2012/01/npr-forget-serotonin-theory-of.html). Telling guilty and frazzled parents and teachers that the child has an inborn brain disease is reassuring, while saying that something in the environment may be making them act that way just ramps up the guilt. So the public (and the physicians trying to reassure them) readily grab for a biochemical story to tell about ADD. So long as that story sells pills, Pharma wants to be sure we keep believing it, even if the science refuses to accommodate them.

  • We are also seeing here more signs of the worries raised in Robert Whitaker's controversial but probably mostly-on-target book, Anatomy of an Epidemic (http://brodyhooked.blogspot.com/2010/05/whitakers-anatomy-of-epidemic.html). Whitaker paints a bleak picture of modern psychopharmacology, while admitting that for the small population of people with really severe psychiatric symptoms, drugs are far better than no drugs. He claims as a general point about psychoactive drugs that the human body seeks to restore homeostatis, a fancy way of saying that if you give a drug that (say) raises your serotonin, the body thinks this is making things go out of kilter and sooner or later tries to lower its own serotonin production in response. If you then go off the drug for a while, you are left with a brain that is producing serotonin at even lower levels than normal, and you might well see withdrawal effects, which psychiatrists interpret as more evidence that you really need the drug and dare not stop it. So the bottom line is that we've gone way overboard in prescribing drugs that have dangerous and often unknown long-term consequences for people who have such mild symptoms that they would be much better off with no drug treatment--Sroufe notes that we now prescribe 20 times more stimulants for ADD than we did 30 years ago.

The Best Flowers For Romance

Posted by Sharon on January 26th, 2012
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This article, The Best Flowers For Romance, was originally published at Natural Health Ezine.

RosesMany flowers have traditionally been associated with romance throughout the centuries. Rose is perhaps the most well known of romantic flowers. However, did you know that there are several species of other flowers which are also associated with romance – and which also have therapeutic benefits?

Herbs Which Were Used in Weddings

Today we might not associate herbs with weddings and romance but historically several herbs were used in weddings as part of bridal bouquets or bridal crowns. Herbs such as rosemary (Rosmarinus officinalis), marjoram (Origanum marjorana) and lavender (Lavandula angustifolia) were used in traditional Greek and Roman weddings.

These type of herbs were prevalent in the Mediterranean region so were probably used in weddings as people had easy access to them. However, these herbs also had therapeutic benefits. Rosemary was traditionally used for respiratory, digestive and nervous disorders, in addition to muscle aches and pains; rosemary is also an aphrodisiac. Marjoram was used for similar complaints, although interestingly marjoram is listed as an anaphrodisiac by Julia Lawless in The Illustrated Encyclopedia of Essential Oils.

Therapeutic Benefits of Orange Blossom for Brides

Orange blossom (Citrus aurantium var. amara), also known as Neroli, was a plant that was native to the Far East but became adapted to the Mediterranean climate once it was naturalized in the region. Orange blossom flowers are white, fragrant flowers that belong to the bitter orange tree.

Orange blossom flowers have a number of therapeutic benefits; with regard to romance, the flowers are aphrodisiac and help to calm the nerves. Traditionally, orange blossom flowers were used in bridal bouquets in order to calm the bride before she walked down the aisle. They were also used to calm the nerves before the newly married couple spent their first night together in the marriage bed.

Ylang Ylang Flowers for the Marriage Bed

Ylang Ylang (Cananga odorata) is a tropical tree with large, yellow, fragrant flowers. The tree is native to tropical Asia and traditionally the flowers of ylang ylang were spread out over the marriage bed of newly married couples.

Ylang ylang flowers are also aphrodisiac, in addition to being sedative and anti-depressant. Therefore, they are an ideal flower to initiate romance and calm the nerves! However, ylang ylang flowers can also be intoxicating and may cause nausea and headaches if used in excess.

Roses for Romance

Rose (Rosa damascena) became popular in Europe when it was brought to the European countries from its native Orient. There are many different species of roses, some of which are fragrant and some of which are not fragrant.

Fragrant roses, such as Rosa damascena, have therapeutic benefits that include aphrodisiac, anti-depressant and sedative. Roses were used in excess by the Romans who lavishly used rose petals in banquets. Today, brides commonly carry roses in bridal bouquets and the rose is regarded as the traditional flower of love.

Flowers For Your Loved One

Flowers come in many colors, shapes and scents. However, some flowers do possess actual therapeutic benefits so if you are looking to instigate some love into your life you might want to consider some of the above mentioned flowers! In addition, flowers such as lavender are calming, so if you have an important date planned you might want to consider combining flowers, such as lavender, with aphrodisiac flowers, such as rose. The scent of flowers is more powerful than many realize – so be careful which flowers you choose for your loved one next time it is her birthday or special occasion!

References:

  • Lawless, Julia, The Illustrated Encyclopedia of Essential Oils
  • Lawless, Julia, The Aromatherapy Garden
Photo by  Robo Android

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Another Planet Heard From: Sunshine Law is Useless

Posted by Howard Brody on January 24th, 2012
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I had not heard recently from Dr. Thomas Stossel of ACRE fame (see for example http://brodyhooked.blogspot.com/2010/04/federal-settlements-acre-perspective.html). However, the redoubtable Dr. Stossel now appears on the op-ed page of the Wall Street Journal ("Who Paid for Your Doctor's Bagel?" January 23, p. A17; subscription required), to inform us that the Sunshine Act provisions included in the Affordable Care Act, due to take effect later this year, are "toxic" and "inverts reality."

I have felt for some time that Dr. Stossel lives on another planet. On his planet everything is just fine between medicine and Pharma, at least so long as the evil government, and goody two-shoes folks like me, don't interfere. Docs get paid big bucks by Pharma. As a result they think fine thoughts and invent great new drugs. These great new drugs then make us all live longer and better. Eeveryone wins, and there's no downside. Dr. Stossel reports that medicine can today do wonderful things that we could not do when he graduated from med school in 1967--I didn't realize he was that old, I graduated in 1976 and feel pretty much fossilized myself--an assessment of progress with which I totally concur. He believes that all of it is due to the free enterprise business model that he advocates.

So what doesn't happen on Dr. Stossel's planet, that in my humble opinion happens on this one? First, drugs only help people and never hurt them, and companies never market potentially dangerous drugs to people who don't need them. Revelations such as Dr. Don Light's about the harm caused by prescription drugs apparently are irrelevant there: http://brodyhooked.blogspot.com/2010/08/how-many-new-drugs-are-lemons-ask.html.

But perhaps the most fascinating difference between the two planets is Dr. Stossel's claim, "Having failed to detect substantive corruption due to physician-industry relationships over a quarter century, [critics] will spend taxpayer-provided grant money" to keep searching for the supposedly non-existent corruption.

There's no "substantive" corruption because when the industry pays docs, it is always strictly on the up and up. Physicians are "compensated by royalties from useful inventions that they license to companies, or ...were paid consulting fees for advice concerning the optimal use of products, or for educating other physicians about products." On that other planet, docs are never paid bribes by industry to prescribe their drug or device, or to persuade their fellow physicians to do likewise. Funny how on this planet seldom a week goes by that I'm not blogging about some such corruption at the medicine-industry interface.

But then again, I suppose that the corruption that I have been blogging about all these years is not "substantive" enough. So just who "inverts reality"?

The Over-the-Top Prices for Cancer Drugs

Posted by Howard Brody on January 24th, 2012
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Our pal Merrill Goozner of GoozNews blog just posted this article in the Fiscal Times:
http://www.thefiscaltimes.com/Articles/2012/01/23/New-Cancer-Drugs-Affordable-by-the-1-Percent.aspx#page1

Gooz goes into the current problems caused by the high cost of new cancer drugs, relating facts such as:


  • 84% of oncologists report that treatment recommmendations are modified due to the patient's out-of-pocket costs

  • Despite decreasing incidence of cancer, the National Cancer Institute projects a 27% rise in the cost of treating the 29 most common cancers by 2020
Typical price tags:


  • Johnson & Johnson's Zytiga extends life in advanced prostate cancer by 5-16 months, costing $44,000 per year

  • Bristol-Myers Squibb's Yervoy improves 1-year survival rate in metastatic melanoma from 25% to 46%, costing $120,000 for a 4-month treatment course
Gooz notes that neither the Republican nor the Democratic proposals for health care system changes address in any serious way what to do about this problem.

Back in HOOKED, I discussed the high price of some cancer drugs, noting that these prices were determined by one factor only--what the company figures it can squeeze out of the market. The price has nothing to do with either manufacturing costs or research costs--in this area, the bulk of the research on breakthrough molecules continues to be done in academic and not industry labs.

Until now, the industry has figured that a patient with advanced cancer would pay any amount for even a few more months of life, especially if newer drugs, as many promise, are much less burdened with side effects than old-style chemotherapy. Gooz's account shows that even if the patient has good insurance, the out-of-pocket copays may be so high that the patient and family decide that it's just not worth it. So as much as people want to sound off about "government death panels," here we have rationing of cancer care based on the private marketplace.

You could make the claim that when a new cancer drug might extend life by only a few months, and a patient decides they'd rather leave that much money to their grandkids rather than buy the medicine, it's a perfectly rational choice, and a good system that allows it to be made. I worry however that when the drug offers more substantial benefits than that, it seems less fair that the luck of the draw that is today's health insurance system might determine whether the drug is affordable. On the other hand, I have steadfastly proclaimed in this blog that there's no good, solid "ethical" answer to how much drugs should cost.

One point to note in pasing that as Gooz interviewed industry experts about why these drugs cost so much, one answer that came back is that the companies are trying to recoup their losses from so many blockbuster drugs like Lipitor all going off patent at about the same time, and that if you want to get this money back from cancer patients (there are reportedly about 887 new cancer drugs in some state of development), then you have to get as much of it as you can up front, because unlike patients taking Lipitor, these folks won't be around for that long. So the longer-term solution is likely to be refining the drugs and identifying the really promising compounds that truly keep these patients alive for a long time.

Cheddar Potato Soup Recipe

Posted by Carol on January 23rd, 2012
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This article, Cheddar Potato Soup Recipe, was originally published at Natural Health Ezine.

Cheesy Potato Soup RecipeNothing warms body and soul in January more than a simmering pot of soup. No wonder it has been dubbed National Soup Month.

Making a pot of soup involves more than haphazardly throwing a bunch of ingredients into a pot of water and hoping for the best. I carefully choose each ingredient. Texture and color matter. Taste and smell matter. Everything matters. My soup is art.

The Stock

Soup begins with a quality stock—never out of a jar, can, or box; and certainly not water with bouillon cubes added. To get healthy stock, you must simmer bones, with a little apple cider vinegar added, for several hours. The vinegar extracts precious minerals from the bones. I suggest you make your stock in big batches and freeze or can for future use.

The Meat

Most Americans eat soup with a chicken or beef base. I have made soup with venison and pork with great success. Whatever meat you choose, make certain you have a stock on hand that will complement the flavor. You wouldn’t want to put venison in turkey broth, for example. Start with meat from organically raised, grass-fed animals. Cut into bite-sized pieces and brown in a little butter or olive oil. Once seared on the outside, add your onions and garlic and continue until the onion turns clear. Then add your stock and vegetables.

The Veggies

The choice of vegetables for your soup depends on several factors: what you have on hand, what you are in the mood for, and what sounds good together. Soup is intuitive. Trust your feelings on this. But here are a few pointers to get the most health value out of your soup:

  • Don’t put in more than one brassica plant (broccoli, cabbage, cauliflower). It makes it too gassy.
  • Don’t mix beans with brassicas. Again, too much gas.
  • Add greens or cabbage just before taking the soup off the stove so they don’t turn to mush.
  • Mix the colors—eat the rainbow.
  • Add grains sparingly. They will swell and take over the pot.

Creamed Soups

If you are making creamed soups, like my favorite potato soup recipe below, do not boil after adding the milk. You could curdle it or risk scorching. Add the milk, heat to hot, and serve. If you want a thick base, rather than a watery soup, I used to add potato flakes. A healthier alternative is to scoop out some of the soup, blend in the blender, and return to the pot. Do this until your soup is the right consistency.

Fixing Mistakes

One last point—no one is perfect and mistakes with soup can happen.

  • If you add too much salt, peel and quarter a potato and add to the pot. The potato will absorb some of the salt. When the potato softens, remove and taste. If it is still too salty, add another potato.
  • If your tomato base is too acidic, add a whole carrot. The carrot will cut the acid. As with the potato, cook until the carrot is soft, remove and taste. If needed, add another carrot.

Now, for my favorite and famous (at least with my family)

Creamy Cheesy Potato Soup:

 Ingredients:

  • 5 pounds of potatoes, peeled and diced (This will feed a large family.)
  • 1-2 onions, diced
  • 1-2 carrots, diced (Sometimes I use broccoli, too.)
  • Salt and pepper to taste
  • Lots of grated cheddar cheese (If you use Extra Sharp Cheddar, less will be required to get the same flavor and therefore reduce the fat content of your soup.)

Directions:

  1. Prepare vegetables and put into stock pot with a thick bottom. Add enough water (or ham broth is good) to just cover the vegetables. Bring to a boil and simmer until potatoes are soft.
  2. In batches, remove a few cups of the soup and carefully blend in blender until smooth. Return to pot. Continue doing this until soup is desired consistency. We like a few potato chunks left.
  3. After blending, add enough milk to give soup a creamy look and taste. Return to heat until hot.
  4. Once hot, add cheese and stir until melted.
  5. Serve immediately with a fresh loaf of homemade bread.

Photo by 3liz4

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