First OpinionHow the not-for-profit Civica Rx will disrupt the generic drug industry Bottles of prescription drugs are filled at the central pharmacy of Intermountain Healthcare in Midvale, Utah. Intermountain is one of the founding health care organizations of Civica Rx, which aims to make essential generic medications accessible and affordable. George Frey/Getty Images About the Author Reprints A pharma exec raised the price of antibiotic by 400 percent — and the government can’t do much about it In response to high pharmaceutical prices and their harmful impact on American consumers, President Trump has proposed lowering Medicare drug prices by tying them to the lower prices that other industrialized countries pay for the same drugs. Sen. Elizabeth Warren (D-Mass.), a 2020 presidential contender, has proposed creating a government-run pharmaceutical manufacturer to mass produce generic medicines in order to lower prices. Tags pharmaceuticals They also know what constitutes a reasonable cost. That means they can make commitments in advance to purchase specific amounts of medications from Civica Rx at predetermined prices long into the future. Not a penny of profit will be paid out. Any excess funds will be invested back into the organization to perpetuate its not-for-profit mission. Within three to five years, Civica Rx expects to offer its member hospitals up to 100 generic medicines.The company will operate on a membership model, with several levels of membership that will allow access for all hospitals, regardless of size. Members will range from small community hospitals of fewer than two dozen beds to the largest hospital systems in the nation.This membership system will ensure that Civica Rx’s long-term volume commitments will let it lock in prices that are both reasonable and transparent. The same price per unit will be offered to each hospital, and no hospital will be able to scoop up the supply.Locking in prices will ensure stability and consistency in both drug availability and cost. It also allows Civica Rx to commit to supplying its partners with the volumes of medications they need over the long term. That’s the key to enabling the company to produce specific drugs. With many health systems working together, we have the capacity to inject competition into the generic drug marketplace, an injection that is long overdue.Marc Harrison, M.D., is president and CEO of Intermountain Healthcare, based in Salt Lake City, a governing member of Civica Rx. Here’s an idea that won’t cost taxpayers a dime: a not-for-profit generic drug company that will shake up the marketplace and benefit the American people. That’s the idea behind Civica Rx, a not-for-profit company formed by three philanthropies and numerous health care organizations that represent about 800 U.S. hospitals. One of the founding health care organizations is Intermountain Healthcare, where I am president and CEO. Martin VanTrieste, the former chief quality officer for Amgen, is serving without compensation as the CEO of Civica Rx.advertisement Elizabeth Warren has a new way to lower drug prices: have the government make medicines In 2015, Turing bought the rights to Daraprim, the trade name of generic pyrimethamine, and raised its price from $13.50 a pill to $750, which boosted the cost of a normal course of treatment from about $1,350 to $75,000. An internal Intermountain Healthcare analysis indicated that a not-for-profit manufacturer can produce and sell pyrimethamine for $3.50 per tablet, which is less than 0.5 percent of the price of Daraprim after it was acquired by Turing ($750) and 25 percent of the price before the acquisition ($13.75).Two main things allow companies like Turing and Nostrum to jack up their prices: limited supplies of the drugs and the ease with which a pharmaceutical company with deep pockets can undercut anyone who’d consider investing in a competitor by drastically reducing the price long enough to put them out of business. Civica Rx’s not-for-profit model will correct that situation.With the clout of its large volume commitments, Civica Rx is creating its own market. The participating institutions know how much of each medication they need, and have records that reveal it with great precision. Marc Harrison Related: @MarcHarrisonMD The generic drug industry should cause prices for medications to drop. But lately it has been engaging in price gouging and making it difficult to obtaining some vital medications.You’ve heard the stories: a 5,000 percent increase by Turing Pharmaceuticals for one tablet of generic pyrimethamine, which is used to treat toxoplasmosis, a rare infection; a 2,800 percent price increase in a single year for digoxin, a commonly prescribed heart medication.The chief executive of Nostrum Laboratories, a generic pharmaceutical company, even argued there is a “moral requirement … to sell the product at the highest price,” as he defended a 500 percent increase in the price of nitrofurantoin, a generic drug used to treat bladder infections that is on the World Health Organization’s list of essential medicines.advertisement By Marc Harrison March 14, 2019 Reprints Related: Our company has a different moral requirement than that of Nostrum and many other generic drug companies: to put patients and their needs first.Unlike for-profit companies, Civica Rx is a public asset whose mission is to ensure that essential generic medications are accessible and affordable. These are drugs that have emerged from the patent-protection period and are in the public domain. The company will work to ensure they remain that way.Civica Rx will draw on the collective volume of commitments from its member health care organizations to serve the public good. It will initially focus on 14 hospital-administered generic drugs and expects to have its first products on the market this year.Shortly after the launch of Civica Rx in September 2018, more than 120 health organizations that represent about one-third of the nation’s hospitals contacted the company and expressed their commitment to the venture or interest in participating with it. Civica Rx is also collaborating with the U.S. Department of Veterans Affairs, which could bring its considerable buying power to the table and would likewise benefit greatly from less-expensive generic medications.The challenge is clear. Take the example of nitrofurantoin. Nostrum Laboratories raised the price of a bottle of the drug from $474.75 to $2,392, according to Elsevier’s Gold Standard Drug Database. In an interview, Nirmal Mulye, Nostrum’s chief executive, defended the quintupling of the price, saying, “We have to make money when we can. The price of iPhones goes up, the price of cars goes up, hotel rooms are very expensive.”FDA Commissioner Scott Gottlieb responded on Twitter:1/2 Regarding @FT story today @bydavidcrow; there’s no moral imperative to price gouge and take advantage of patients. FDA will continue to promote competition so speculators and those with no regard to public health consequences can’t take advantage of patients who need medicine— Scott Gottlieb, M.D. (@SGottliebFDA) September 11, 2018
250 Young People for Flames of Freedom Torch Run CultureDecember 23, 2015Written by: Sharon Earle RelatedChristmas Rebellion To Be Celebrated December 27 FacebookTwitterWhatsAppEmail Story HighlightsMore than 250 young people from churches and youth organisations in St. James are set to participate in the 100-kilometre Flames of Freedom Torch Run on December 27.The annual event is part of activities to commemorate the anniversary of the 1831 Christmas Rebellion led by National Hero, the Right Excellent Samuel Sharpe.Addressing a recent Think Tank at the JIS’ Montego Bay Regional Office, Chairman of the South St. James Social and Economic Development Trust, Calvin G. Brown, said that all is in place for the torch run, which is in its 15th year. RelatedUSAID Mission Director hails Jamaicans RelatedPositive Results from World Heritage Education Workshop More than 250 young people from churches and youth organisations in St. James are set to participate in the 100-kilometre Flames of Freedom Torch Run on December 27.The annual event is part of activities to commemorate the anniversary of the 1831 Christmas Rebellion led by National Hero, the Right Excellent Samuel Sharpe.Addressing a recent Think Tank at the JIS’ Montego Bay Regional Office, Chairman of the South St. James Social and Economic Development Trust, Calvin G. Brown, said that all is in place for the torch run, which is in its 15th year.He informed that the 10-hour run will start at 10:00 a.m. at the Croydon Estate in Catadupa, which is the birthplace of Sam Sharpe.The torch will arrive at the historic Sam Sharpe Square at about 3:00 p.m., where it will be received by the Mayor of Montego Bay, Councillor Glendon Harris, then on to Tulloch Castle in Kensington, where a civic ceremony and concert will be held.“The torch run takes us through a number of free villages, which were set up subsequent to the abolition of slavery in 1834,” Mr. Brown informed.The ceremony, set to begin at 8:00 p.m., will feature talent unearthed from the Jamaica Cultural Development Commission’s (JCDC) Big Stage earlier this year, and performances of traditional folk forms including Gerreh. The evening will also feature the Fab 5 band in concert.The function will be highlighted by the symbolic lighting of the trash house at midnight.It is documented that the burning of a trash house of the Tulloch Castle Estate and the subsequent burning of Kensington Great House signalled the start of the rebellion.The flames and smoke were visible for miles, and sparked responses from slaves across 40 plantations in St. James, Trelawny, Hanover, Westmoreland and St. Elizabeth.The rebellion involved some 50,000 slaves throughout the island, and the inquisition that followed resulted in the execution of approximately 500 slaves, including Sam Sharpe.The 1831 rebellion helped to influence the abolition of slavery and the push for full emancipation, which came on August 1, 1838.Mr. Brown said the annual staging of Flames of Freedom aims to increase public awareness about the role of Sam Sharpe in orchestrating the events that led to the end of slavery.The torch run involves collaboration with the Office of the Prime Minister, the Social Development Commission (SDC) and the JCDC, with sponsorship from the Culture, Health, Arts, Sports and Education Fund (CHASE). Advertisements
“We are converting switching operations, balancing the network, streamlining resources and getting more out of our assets,” he said.“Although there still remains a lot to be done, we are confident that these initiatives will drive improved customer service, greater resource efficiency and superior shareholder value.”Rival rail operator Union Pacific also saw revenue-growth, of 3% year-on-year, despite just a 1% upturn in volumes.But in the mid-west things weren’t so rosy. Kansas City Southern reported declines across the board as revenue and volumes dropped by 1% – although this was an improvement on 2016’s 5% decline.And while Norfolk Southern has yet to issue its six-month figures, results from the three months to March indicated a positive start to the year, with revenues up 9% against volume growth of 4%.In Canada, both Canadian Pacific (CP) and Canadian National (CN) maintained the overall optimistic tone of the year so far.CP saw revenues climb 6%, against a 4% volume increase, but CN stood out, with revenues and volumes spiking 12% year-on-year – although revenues per carload dipped marginally.The carrier’s president and chief executive, Keith Creel, praised the results, also saying they demonstrated the “power of precision railroading”.“Strong volumes across many of our key business segments, combined with disciplined cost control, produced record operating income and earnings for the quarter,” said Mr Creel.“We are off to a strong start in 2017 and remain confident that our team of committed railroaders will continue to safely and efficiently deliver results in the second half of the year, and beyond.” © Nico Maglieri By Alexander Whiteman 26/07/2017 Results from North American rail freight operators for the first half of the year make healthy reading after intermodal rail traffic lost out to cheaper trucking alternatives in 2016.And it seems Hunter Harrison has had an immediate effect at US operator CSX, where he was appointed chief executive in March following his resignation from Canadian Pacific.CSX recorded 2% growth in volumes, with revenues per unit up 4%, while total intermodal revenues increased 7% year-on-year, taking the carrier back to its previous growth rate, which, prior to 2016, had seen a decade of average annual growth of about 7%.Mr Harrison said CSX was implementing “Precision Scheduled Railroading” on an expedited timetable as part of a major overhaul of operations.
Russia continues to press ahead with its nuclear weapons modernization program; however, domestic production difficulties and the coronavirus pandemic hindered the development of its latest strategic systems during the course of the last year.In 2020, the Strategic Missile Forces (Raketnye Voyska Strategicheskogo Naznacheniya—RVSN) were ordered to deploy for combat duty 20 launchers armed with Yars intercontinental ballistic missiles (ICBM) as well as 2 UR-100N UTTH launchers with the Avangard hypersonic glide vehicle (RIA Novosti, December 24, 2019 and October 13, 2020). These tasks were completed. Two regiments of the RVSN’s Barnaul Missile Division were re-equipped with mobile-based Yars ICBMs, while a missile regiment of the Kozelsk division was filled out by equipping it with a separate variant of this ICBM complex (Izvestia, December 21, 2020). The Dombarovsky Division, meanwhile, received two missiles with the Avangard hypersonic glide vehicle (Izvestia, December 22, 2020). Yet besides these modest accomplishments, Russia’s nuclear arms modernization efforts during the past 12 months saw wide-ranging delays affecting its flagship projects.Last year was supposed to see the first flight design tests of Russia’s newest intercontinental ballistic missile, the RS-28 Sarmat. But those never occurred. The initial stage of testing is to involve two launches of a missile with a mass-dimensional dummy warhead, from the silo at the Plesetsk cosmodrome to the Kura test range in Kamchatka. Ultimately, Russia plans to conduct at least five test launches in total before starting operational production. The phase one tests launches were originally scheduled for the beginning of 2019 (RIA Novosti, December 17, 2018). However, in July 2019, those flight tests were postponed to the end of 2020 (Interfax, July 6, 2019).In May 2020, Deputy Prime Minister Yuri Borisov said that preparations for the Sarmat’s flight tests had not been interrupted by the COVID-19 pandemic (RIA Novosti, May 21, 2020). And in August, the head of Roscosmos, Dmitry Rogozin, reiterated those claims (Interfax, August 24, 2020). At least two tests of the missile were to be carried out before the end of the year (Vedomosti, October 29, 2019). But in the end, there was not even one such test, having again been deferred until the following year. Moreover, in December, authorities noted that the Sarmat missiles would not begin entering service in 2020, as had heretofore been the plan; instead, the ICBM would only start to appear in 2022 (Radio Sputnik, December 16, 2020).Intercontinental ballistic missile test launches, by their nature, are quite difficult and expensive to organize. On December 30, Deputy Defense Minister Alexey Krivoruchko said that flight tests of the Sarmat will begin in the near future (Rossiyskaya Gazeta, December 30, 2020). However, to complete the trials, Russia will first need to upgrade the testing site. Indeed, Minister of Defense Sergei Shoigu recently admitted that a test range for flight trials of the Sarmat missile system has yet to be built; but plans call for completion of such a launch site, near the village of Severo-Yeniseysky, in Krasnoyarsk region, sometime during 2011 (TVZvezda, December 21, 2020).Drastic delays and planning setbacks affected other strategic platforms as well. In 2020, Russia’s Long-Range Aviation (Aviatsiya Dalnego Deystviya—ADD) was to receive six upgraded Tu-95MS strategic missile carrier planes. However, at the end of the year, the Ministry of Defense received only five aircraft (Mil.ru, December 2020). In this case, the problem was related to unsatisfactory management and mounting debts of the production plant (Bloknot-taganrog.ru, November 12, 2020).Similarly, at the end of 2020, the Tupolev Company was supposed to transfer two new Tu-160M strategic bombers to the Ministry of Defense for state testing (Interfax, August 26, 2019). This did not happen because of the pandemic. First, the Tu-160M test pilots and support crews could not make it to the Kazan Aviation Plant for a long time, thus forcing delays to flight test schedules. Second, representatives of the suppliers of the new aircraft systems were also barred from accessing the production facilities for an extended period. Third, coronavirus-related shutdowns prevented specialists on the implementation of new technological equipment from entering the Kazan plant, creating even more delays to development of the latest Tu-160M model (Business Gazeta, May 8, 2020). Throughout all of 2020, the Ministry of Defense received only two upgraded, but still Soviet-built, Tu-160s (TASS, April 23, 2020). The aircraft received more advanced inertial navigation and engine-control systems as well as weapons devices driven by modern digital technologies.Finally, COVID-19 derailed development plans for naval nuclear weapons (see EDM, December 2, 2020). In April 2020, sea and state trials of the K-329 Belgorod submarine were to begin; and the vessel was supposed to be transferred to the Military-Maritime Fleet (Voyenno-Мorskoi Flot—VMF) by the end of the year (TASS, June 26, 2019). The Belgorod is to carry the Poseidon (a.k.a. Status-6) autonomous nuclear-tipped super-torpedo. Yet as a result of the pandemic-related delays, the defense ministry only announced on July 27 that tests were being conducted (Sudostroenie.info, July 27, 2020). And an unnamed source within the Russian military-industrial complex said last May that the tests of the Belgorod would continue for another year and a half (RIA Novosti, May 26, 2020). At the same time, the first test-launch of the Poseidon was supposed to take place in the fall of 2020 (Flotprom.ru, May 26, 2020). That trial has still not been completed. Another vessel designed to carry and launch the Poseidon nuclear super-torpedo—the first submarine of the new Khabarovsk-class, which was supposed to be launched in the spring of 2020 (Rossiyskaya Gazeta, May 14, 2019)—also failed to materialize.The Borei-A-class submarine Knyaz Oleg was ultimately not transferred in 2020 either, despite the defense ministry’s previous expectations that this could be accomplished (Kremlin.ru, December 24, 2019). In addition to mooring as well as factory and state trials of all of the submarine’s structures and mechanisms, it will still be necessary to conduct a test launch of the Bulava missile from this vessel. This means that it is far from certain that the SevMash company will be able to transfer the Knyaz Oleg to the navy even before the end of 2021.Management and technical issues, compounded by last year’s coronavirus restrictions and accompanying delays, had relatively little impact on the overall growth of advanced weapons in the nuclear triad. According to previous planning, the share of advanced weapons in the nuclear triad was supposed to increase from 82 to 87 percent by the end of 2020 (RIA Novosti, March 25, 2020), and according to official data, that share reached 86 percent by last December. On the other hand, the coronavirus had a much greater negative effect on the testing of weapons under development. Because of this, the impact of the pandemic will be quite long lasting. Already, the Ministry of Defense’s planning has become more modest: by the end of 2021, it projects a further increase in the share of the latest nuclear weapons by only 2 percent (Kremlin, December 21, 2020).
SAN FRANCISCO | Chaos broke out during a performance of the musical “Hamilton” at San Francisco’s Orpheum theater Friday night after audience members mistook a medical emergency for a shooting.FILE – This Aug. 16, 2017 file photo shows The Pantages Theatre on the opening night of the Los Angeles run of “Hamilton: An American Musical” in Los Angeles. Chaos broke out during a performance of the musical “Hamilton” at San Francisco’s Orpheum theater after audience members mistook a medical emergency for a shooting on Friday, Feb. 15, 2019. (Photo by Chris Pizzello/Invision/AP, File)A woman had a heart attack and someone broke open an emergency defibrillator, activating an alarm at the same time that gunfire went off on stage as part of the show’s duel scene, city fire department spokesman Jonathan Baxter said.The scene depicts the deadly duel between Alexander Hamilton and Aaron Burr.“We all ducked and ran out of the theater, one person was yelling ‘gun,’” tweeted Shirin Rajaee, a reporter for CBS Sacramento who was in the audience.Another theater-goer named Marianne Favro tweeted: “Dozens of us hid behind seats til police cleared us. Very scary.”Three people were injured as panicked audience members rushed out of the theater. One person broke a leg and two others had moderate injuries, Baxter said.The woman who had a heart attack was revived and remained hospitalized Saturday in critical condition, he said.The performance did not continue but people were allowed back into the theater to grab their belongings.The owner of the Orpheum said audience members were invited to see another performance of the popular Tony Award-winning show.
04/04/2016 In their last two games against Villarreal and Real Madrid, Lionel Messi, Neymar and Luis Suarez have managed just one goal – a penalty from the Brazilian at El Madrigal. ”We both know each other really well, so I don’t think there will be much room for surprise,” Simeone said ahead of the first leg. It is a match up between two well-acquainted teams. Simeone masterminded a win over the Catalans at this stage of the competition two years ago, but he’s yet to beat them since Luis Enrique took charge in six attempts. “But hopefully they will face the best of us as well. It is important that my players understand that one minute on the pitch will be a lifetime.” “Barça play a specific type of football and they play spectacularly well under Luis Enrique. “They will definitely be up for it, playing at home. They are strong, tough opponents.” Simeone, though, doesn’t think that’ll hamper them on Tuesday: “We are used to seeing the MSN, with all their individual qualities which make Barcelona even better. “I don’t think their loss against Real Madrid will affect how we play. We always expect the best from Barcelona. Upd. on 05/04/2016 at 00:01 CEST Barça go into the match having lost their 39 match unbeaten record against Real Madrid at the weekend, although they still maintain a six point lead over Atletico at the top of the league table. Sport EN Diego Simeone expects Barcelona to be back to their best when Atletico Madrid meet them in the quarter-final of the Champions League at Camp Nou on Tuesday.
By ANEEKA SIMONIS THE Pakenham Branch of the Red Cross handed down a long service award to a valued member…[To read the rest of this story Subscribe or Login to the Gazette Access Pass] Thanks for reading the Pakenham Berwick Gazette. Subscribe or Login to read the rest of this content with the Gazette Digital Access Pass subscription.
A much loved English Staffy pup is missing after he was stolen from a Pakenham veterinary clinic by a man…[To read the rest of this story Subscribe or Login to the Gazette Access Pass] Thanks for reading the Pakenham Berwick Gazette. Subscribe or Login to read the rest of this content with the Gazette Digital Access Pass subscription. By Mitchell Clarke