A promise by the pharmaceutical industry to save the nation $80 billion over a decade in exchange for protection from further givebacks under health care reform pending in Congress was confirmed recently by the White House. Apparently, the pharmaceutical companies got spooked by action in the House that would give the feds negotiating authority for drug prices and bigger rebates from the industry. So the industry got an explicit affirmation of protection from deeper cuts.

The trade group PhRMA explained the quid pro quo -- drugmakers stepped up first with a cost-saving pledge, and, in return, got "a rock-solid deal" not to make further cuts in prescription drug prices beyond the $80 billion. The White House confirmed the deal.

Neither party mentioned what is apparently a side deal - drug companies will bankroll a TV ad campaign in support of health care reform. The ads would bolster the administration's plans to remake health care and expand insurance coverage to nearly 50 million people.

The drug industry, already a big spender on commercials for its medicines, is an unlikely patron for the planned ad blitz, which could cost $150 million or more, until you stop to think about all the new customers an expansion of coverage might bring to pharmacies. To put the size of the ad campaign in perspective, Sen. John McCain spent $126 million on TV ads in his bid for the presidency.

Some of the TV ads expected this fall will carry the name of the Pharmaceutical Research and Manufacturers of America, the main trade group for brand-name drugmakers, which has pushed hard for an $80 billion limit on price concessions under an overhaul.

Would it surprise anyone to learn that drug use is widespread among hospital employees? I think not. There is even a new TV show called Nurse Jackie, whose main character played by Edie Falco, is clearly addicted to prescription drugs and trades sex for drugs with the hospital pharmacist. The creators of the show have made the Nurse Jackie character the most competent person in the show's fictional hospital. That's all well and good when it comes to creating an edgy adult TV drama, but not in the real world. Real addicts are only competent in their own minds.

Meet Nurse Melony.

According to a recent Los Angeles Times article exposing the failure of the California Nursing Board Drug Diversion Program to protect us from nurses on drugs, Nurse Melony Currier is a poster child for nurses on drugs. In one episode, Nurse Melony passed out in her car the morning of her second day on a new job at Starpoint Surgery Center in Studio City, California. Once awakened, she was escorted to a drug-testing facility to provide a urine sample. In the restroom, she injected an anesthetic she had stolen from the surgery center, according to state records and a Starpoint official. Currier had failed repeatedly -- and spectacularly -- at rehabilitation. Over 4 1/2 years, she'd been discovered high in her car at a Hollywood hospital, stolen anesthetics at a San Gabriel Valley hospital, been convicted of burglary after taking more drugs from the same hospital and flunked a drug test.

Melony Currier first landed in trouble on Nov. 8, 2001, when she was arrested for stealing Demerol from Providence St. Joseph Medical Center in Burbank, CA. (She later told board investigators that she'd stolen drugs every day for months.) Nearly two weeks after her arrest, while working at Planned Parenthood in Van Nuys, she was found collapsed in the bathroom, injecting herself with the general anesthetic propofol - the stuff that killed Michael Jackson. Two days after that, she returned to Providence St. Joseph and stole more of the drug, board documents say. She was later convicted of misdemeanor theft in the Van Nuys case and petty theft and drug possession in the Burbank case.

Currier, then known by the last name Dietrich, was allowed into the California Nursing drug diversion program in February 2002, The program finally expelled her in 2006 -- after the five relapses. A month after Currier was ejected, according to board documents, she went to Providence St. Joseph, where she'd been arrested five years earlier. Posing as an employee, she said she'd come to collect drugs for outpatient surgery. When questioned, she "fled," board records say, driving 10 miles to Verdugo Hills Hospital in Glendale. Again posing as an employee, she stole two cases of propofol, according to court and board records. Two days later, on Oct. 18, 2006, Currier was arrested when she returned to Verdugo Hills for more.

The California nursing board filed a public accusation against Currier in March 2007-- nearly 5 1/2 years after the agency first learned of her drug problems. When the board settled the case in 2008, Currier's license was suspended for one year and she was put on probation. As part of the settlement, she admitted the allegations. Currier is now free to practice nursing with restrictions.

She may stay off drugs, but it seems unlikely. How many more patients will have to suffer because of Nurse Melony and others like her?

An external insulin infusion pump is an FDA approved mechanical device used to deliver insulin to manage diabetes mellitus. The pump is about the size of a deck of cards, weighs about 3 ounces, and can be worn on a belt or in a pocket. It contains a cartridge reservoir filled with fast acting insulin. The pump connects to narrow flexible plastic tubing that ends with a needle inserted just under the skin near the abdomen. Users set the pump to give a steady trickle or "basal" amount of insulin continuously throughout the day. Pumps also release additional ("bolus") doses of insulin at meals and at times when blood sugar is too high based on user input. Frequent blood glucose monitoring is essential to determine insulin dosages and to ensure that insulin is delivered appropriately.

Private insurance companies as well as Medicare will pay for infusion pumps as medically necessary for patients with documented diabetes mellitus meeting all the following criteria:

1. Has been seen by their medical provider four times within the last year; and


2. Completed a comprehensive diabetes education program within the past two years; and


3. Follows a program of multiple daily injections of insulin; and


4. Has frequent self-adjustments of insulin doses for the past 6 months; and


5. Has documented frequency of glucose self-testing an average of at least 4 times per day during the past month; and


6. Has documentation of any of the following while on a multiple daily injection regimen:




a. lycosylated hemoglobin level (HbAlc) 7.0 percent; or
b. "Brittle" diabetes mellitus with recurrent episodes of diabetic ketoacidosis, hypoglycemia or both, resulting in recurrent and/or prolonged hospitalization; or
c. History of recurring hypoglycemia or severe glycemic excursions; or
d. Wide fluctuations in blood glucose before mealtime; or
e. "Dawn phenomenon" with fasting blood sugars frequently exceeding 200 mg/dl.
f. Pre- conception or pregnancy to reduce the incidence of fetal mortality or anomaly; or
g. The patient with diabetes mellitus successfully using a continuous insulin infusion pump prior to enrollment in a new health insurance plan has documented frequency of glucose self-testing on average of at least 4 times per day during the month prior to enrollment

Here's the insurance company's rationale:

"External subcutaneous insulin infusion pumps are considered medically necessary only for people who have demonstrated the ability and commitment to engage in a regimen of pump care, frequent self-monitoring of blood glucose and careful attention to diet and exercise.

The pump must be ordered by and follow-up care of the member must be managed by a physician with experience managing persons with insulin infusion pumps and who works closely with a team including nurses, diabetic educators and dieticians who are knowledgeable in the use of insulin infusion pumps.

Documentation of continued medical necessity of the external insulin infusion pump requires that the member be seen and evaluated by the treating physician at least every 6 months.

Some external insulin infusion pumps are able to take results of the blood glucose reading, calculate the appropriate insulin infusion rate, wirelessly transmit the results from the blood blucose monitor to the pump, and automatically adjust the insulin infusion rate, saving the member some extra steps. These insulin pump features, when present, are considered integral to the external insulin infusion pump and blood glucose monitor."

Hey people, wake up. When faced with the choice of buying groceries or your prescription medications, it's time to get smart. There are plenty of ways to save money on your prescription drugs if you're willing to educate yourself and put in a little effort. You'll also have to learn about pharmaceuticals, know your health plan, become a savvy healthcare shopper. So, before you skip a dose, read on to learn 7 ways to score cheaper prescription drugs.

1. Insist on Generic Prescription Drugs

A generic drug is a pharmaceutical no longer under patent protection. An example of a generic drug, one used for diabetes, is metformin. A brand name for metformin is Glucophage. (Brand names are usually capitalized while generic names are not.) A generic drug, one used for hypertension, is metoprolol whereas a brand name for the same drug is Lopressor. Generics are sold over the counter or at low cost as a generic prescription. Generic drugs are copies of brand-name drugs that have exactly the same dosage, intended use, effects, side effects, route of administration, risks, safety, and strength as the original drug. In other words, their pharmacological effects are exactly the same as those of their brand-name counterparts. They are every bit as safe and affective. Some people become concerned because generic drugs are often substantially cheaper than the brand-name versions - generally at least 70% cheaper. They wonder if the quality and effectiveness have been compromised to make the less expensive products. The FDA requires that generic drugs be as safe and effective as brand-name drugs. So there's no truth in the myths that generic drugs are manufactured in poorer-quality facilities or are inferior in quality to brand-name drugs. The FDA applies the same standards for all drug manufacturing facilities, and many companies manufacture both brand-name and generic drugs. In fact, the FDA estimates that 50% of generic drug production is by brand-name companies. Another common myth is that generic drugs take longer to work. The FDA requires that generic drugs work as fast and as effectively as the original brand-name products.

Sometimes, generic versions of a drug have different colors, flavors, or combinations of inactive ingredients than the original medications. Trademark laws in the United States do not allow the generic drugs to look exactly like the brand-name preparation, but the active ingredients must be the same in both preparations, ensuring that both have the same medicinal effect.

Over the next three years, drugs with $100 billion of annual sales will become generics as their patents run out, including the cholesterol-lowering statin - Lipitor, asthma medication - Advair and antipsychotic - Seroquel. That means big savings for you.

Some big retailers like Walmart and Target take drug savings to the limit. Walmart's $4 Prescriptions Generic Program has been a groundbreaking success. Target followed with their own version. They offer hundreds of prescription drugs and more than 1,000 over-the-counter medications at only $4 per 30-day supply, or $10 for a 90-day supply. The list of eligible drugs in the $4 prescriptions represents up to 95 percent of the prescriptions written in the majority of therapeutic categories.

2. Shop Online for Brand Name Prescription Drugs

If you must fill a prescription for a brand name drug, always ask your doctor for a written prescription for a 90 day supply so that you can fill your Rx by mail order. With that prescription, you'll be able to shop for the lowest rates possible. I strongly suggest you begin by shopping online even if you eventually buy from a local pharmacy. Start your shopping at PharmacyChecker.com. where you can compare prices from a long list of mail order suppliers. You'll be amazed at the wide range of prices for the same product. For instance, recently posted prices for Lipitor 20 mg tablet ranged from a low of $1.24 per pill to a high of $4.78 per pill. All of the suppliers with the lower prices are foreign suppliers, most are based in Canada, the United Kingdom, New Zealand, and Singapore. The lowest price from a U.S. supplier was $3.80 per pill, so you can see there is a strong financial incentive to buy from a foreign supplier. Do I recommend that? I can't because I don't have enough proof that it's 100% safe to buy your brand name drugs outside of the U.S.. Personally, I feel comfortable doing it. I guess because I view these countries - Canada in particular - as trustworthy. I have ordered prescription drugs from foreign suppliers for years without incident. Even if you are uncomfortable doing so and end up buying your prescription from an online supplier in the U.S., you will be getting the best U.S. price available.

3. Split Pills to Double Your Savings

The pharmaceutical companies price their pills pretty much the same regardless of dosage. For example, a 20 mg dose costs the same as a 40 mg dose. So if you buy the 40 mg pill and cut it in half you'll cut your drug bill in half. What could be simpler? Critics say the practice can lead to uneven dosing, but that can be minimized with a simple pill splitter that you can purchase at the drug store for a couple of bucks. Don't try cutting pills with a knife or razor blade. You'll never get it exactly right. Round pills are the easiest to split. Oval or elongated pills, like Lipitor, require a somewhat more elaborate splitter.

Many Lipitor users and many physicians do not realize that the cost to the individual is around $1,300 per year regardless of whether they need the 80 mg tablet, the 40 mg tablet, the 20 mg tablet or the 10 mg tablet. (The 10 mg tablet is slightly cheaper.)

• Splitting the 80 mg Lipitor tablet into quarters will save $1,001 per year.
• Splitting the 80 mg Lipitor tablet in half will save $668 per year.
• Splitting the 40 mg Lipitor tablet in half will save $655 per year.

Not all drugs can be split, including time-released medications, capsules and gels. United HealthCare has a website that lists the drugs and their strengths that it considers safe to split.

4. Ask Your Doc for Free Samples

Big pharmaceutical makers ply doctors with samples as part of their marketing efforts to get them to prescribe their drugs. You might as well enjoy some of their largess. But you should know that using free samples of prescription drugs is a potentially risky practice for several reasons. For one, drug manufacturers typically use free samples to promote the newest and most expensive drugs. When the freebies stop, you'll probably be reluctant to switch to something cheaper. Once you start on a drug you tend to stay on it, even if there is a good generic. That's one reason the drug companies spend billions of dollars on sampling. Secondly, free samples don't show the side effects or precautions on the label, and you might not receive accompanying literature. Also, the medication won't be entered into your pharmacy's computer system, which screens for harmful interaction or duplication with other drugs and supplements you take, allergies you might have, and unacceptable doses. Having said that, let's say you are already taking a maintenance medication for a chronic condition and you can no longer afford to pay for it. Get over your pride and ask your doctor for a month or two supply to get you over the hump. Just one month of samples will reduce your annual expense for a drug by almost 10%.

5. Know Your Health Insurance Plan

If you have health insurance, the first step in saving is to learn how your plan works.
Health plans give members an incentive to choose cheaper medicines through a tiered system of co-payments. The least expensive drugs - usually generics - might have a co-payment of $10 or $15 for a 30-day supply. The next tier is usually for brand name drugs that are on your insurance company's drug formulary list. Each insurance company has its own drug formulary list. Non-formulary drugs are either not covered at all or require that you pay much more out of pocket. Specialty drugs such as injected, infused, oral, or inhaled medications that require close supervision by a doctor tend to be higher in cost as well. Many lower cost health plans have adopted deductibles of $500 or more applied specifically to the prescription drug benefit. Typically the deductible does not apply to generics. You will usually have lower costs if you fill prescriptions through the mail or at particular pharmacies.

6. Look for Discount Programs

Recognizing that costs for name-brand prescriptions can be steep, many pharmaceutical manufacturers may offer discounts or rebates to keep your business. For example, drug maker, AstraZeneca, has a program that limits your co-payment for the statin, Crestor, to $25 for a 30-day supply. A host of programs offer uninsured patients help getting prescription medicines for free or at a discount from pharmaceutical companies including , Merck and GlaxoSmithKline. Some offer discount cards good for their own medicines only. AstraZeneca has one discount card just for Medicare Part D recipients.

Another option is the PS Card, which offers discounts on prescriptions filled at over 56,000 drugstore and supermarket pharmacies nationwide, including CVS, Rite Aid, Walgreens, Wal-Mart and Target. Founder Jim Robbins, a former United HealthCare executive, has negotiated discounts at these retailers, which he passes along to cardholders. Robbins earns his cut by collecting a small referral fee on each prescription. The card is free and anyone can sign up at the PS Card Website. There are many other free prescription card offers. To find them simply Google "prescription drug discount card".

7. Lower Income Patients Should Seek Assistance

There are hundreds of programs nationwide that help low-income patients (usually less than $30,000/yr annual income for a single person or $40,000/yr for a couple, and family) obtain medications at little or no cost. Many are listed with the Partnership for Prescription Assistance, a drug industry-managed clearinghouse. About half the programs are run by large pharmaceutical companies. The rest are sponsored by makers of generic drugs, private foundations and government agencies. The partnership has helped about 5.5 million people nationally. People who apply can get free drugs or low cost prescriptions for just $3 to $5.

To access the drug assistance programs, call the clearinghouse at (888) 477-2669 weekdays from 8 a.m. to 8 p.m. Eastern time or go to the PPARx website. You'll have to answer some screening questions to determine your financial eligibility and medical condition.

For example, here is the information provided by one company - AstraZeneca.

Patient applications are evaluated on a case-by-case basis by the Program. Eligibility is based on income levels and absence of private prescription insurance, third-party coverage, or participation in a public program including the Medicare Limited-Income Subsidy. Income eligibility is based on levels at or below $30,000 for an individual; $40,000 for a couple; $50,000 for family of three; $60,000 for a family of four. The Program requires proof of income and US residency (Social Security #, work visa # or green card #). Patients approved into the Program will receive an acceptance letter and should receive their shipment of product within 1-2 weeks. Patients denied to the program will receive a denial letter if the individual does not meet the eligibility guidelines of the Program. Enrollment is for 12 months with reapplication at month 10.

Product(s) covered by program:

Accolate®
Arimidex®
Atacand®
Atacand® HCT
Casodex®
Crestor®
Faslodex®
Merrem I.V.®
Nexium®
Nexium® I.V. Injection
Nexium® Oral Suspension
Pulmicort Flexhaler®
Pulmicort Respules®
Rhinocort Aqua®
Seroquel XR®
Seroquel®
Symbicort®
Toprol® XL
Zoladex®
Zomig ZMT® Oral Disintegrating Tablets
Zomig® Nasal Spray
Zomig® Tablets

Watch out for scams. If you call a number and they say it will cost you $100 to join, or they ask for your checking account number, you should hang up quickly.

I really liked smoking. I started when I was 15 and smoked for over 13 years. Let me tell you, I'm one of those addictive personalities. Part of it is genetic, I'm sure. My father is a recovering alcoholic, sober over 20 years now. Most of women in my family are compulsive overeaters. If it feels good, I'll get hooked on it. A lot of my friends started smoking when I did, but some were just chippers - only smoked a few times a day, or could go days without smoking. My best girlfriend is still a chipper after smoking for 13 years. For me it was love a first puff. I was up to like a pack a day in no time.

I would still be smoking if it weren't for my husband and my son. They just wouldn't let up - nagging and making me feel guilty, I finally gave up and quit about six months ago. That may have sounded easy - I quit smoking six months ago - but I had tried to stop many times. I tried nicotine gum and the patch, but I still felt really tense. I felt like I was walking a tightrope and at the first stressful test, I fell off the wire.

I'm a nurse, so we like talk about drugs all the time at work. The doctor I work for suggested I try Zyban. - said it had worked really well for a lot of people. So I did and I kid you not, within a few days, I didn't care that much about smoking anymore. When I did smoke, I didn't seem to get the same satisfaction out of it. Awesome, right? Sure, but now I don't want to give up the Zyban. I can honestly say that I can see myself taking this drug for the rest on my life.

Come to find out smoking was like a medicine for me. I can see now, looking back, that I was borderline depressed most of my life. Like, duh, what teenager isn't depressed, right? The link between nicotine and depression has been known since the late eighties, not long in scientific terms. Nicotine stimulates the production of two brain chemicals - dopamine and norepinephrine. The short story is these chemicals make you feel good and combat the depression. So smoking is like a way of self medicating, a way of treating undiagnosed depression. This also explains why people get hooked on nicotine gum.

Antidepressants like Prozac and Zoloft are not successful as nicotine replacements because these drugs help the brain create serotonin, another feel-good brain chemical, but not the same ones that nicotine produces.

Zyban (as well as WellbutrinSR which is the same formula) stimulates the production of dopamine and norepinephrine just like nicotine does, but hopefully with less dangerous side effects. Zyban should not be used by severely depressed teenagers. Suicides have been documented for this class of drugs. Also these drugs can interact with many other prescription drugs, so make sure your doctor knows what else you're taking before he prescribes Zyban or WellbutrinSR. Finally it's not cheap, $100 a month. A generic, called Bupropion, is available, and it will run $35 for a month supply. Still, it costs less than cigarettes and your loved ones won't be on your case.

CVS Drugstores, one of the largest national drugstore chains, announced it will sell 90-day supplies of more than 400 generic prescription drugs for $9.99. Wal-Mart started a similar program a few years ago. The $9.99 CVS offer is just a penny less than Wal-Mart's $10 charge for a 90-day supply. In order to get the $9.99 generic deal, customers must enroll in the program by paying an annual fee of $10.

These cut rate prices are a relief for consumers from rising health insurance premiums and other out-of-pocket medical expenses. Insurers and employers are pushing generic substitutes to save costs. However, many drugs are still available only in expensive, patented formulations, and even where generic substitutes are available, they don't work for everybody. People wonder why those drugs are so expensive.

Databases with the prescription drug histories of 200 million Americans are now being used by many health insurance companies to evaluate applications for individual health insurance. The data work like a credit report for health. The data originate with pharmacy benefit managers and contain details like the prescribing doctor, dates, drugs, dosages, etc.. The benefit companies then give their client insurance companies access for a fee. Insurance companies can better evaluate the expected risk for a particular applicant so this is a great value for them. It works a lot faster that their alternative which is to request medical records from the applicant's physicians.

Privacy and consumer advocates complain that there are more and more companies holding vast amounts of patients' health information, mostly unknown to the average consumer. The database companies say they provide information to insurers only after having been released by consumers.

Walgreens is no longer going to fill prescriptions for these four CVS Caremark plans: ArcelorMittal, Johnson Controls, Progressive Casualty Insurance, and the Wisconsin Education Association Trust managed plans. These plans are available in Ohio, Wisconsin, Illinois, Indiana, and Michigan.

Wallgreens says they can't make money on these four plans, saying "The reimbursement rates are unreasonably low and below-market". Wallgreens is trying to preserve profits while CVS Caremark is trying to lower the cost of health care for its members. In this case, it looks like CVS Caremark stonewalled too long.

Some infant (children younger than two years old) cough and cold medicines are being taken off the market because of their potential for misuse (overdose), meaning they are not dangerous if taken as directed.

Here's a list of the branded cough and cold medicines that are being voluntarily withdrawn:

Dimetapp Decongestant Plus Cough Infant

Dimetapp Decongestant Infant Drops

Little Colds Decongestant Plus Cough

Little Colds Multi-Symptom Cold Formula

PEDIACARE Infant Drops Decongestant (containing pseudoephedrine)

PEDIACARE Infant Drops Decongestant & Cough (containing pseudoephedrine)

PEDIACARE Infant Dropper Decongestant (containing phenylephrine)

PEDIACARE Infant Dropper Long-Acting Cough

PEDIACARE Infant Dropper Decongestant & Cough (containing phenylephrine)

Robitussin Infant Cough DM Drops

Triaminic Infant & Toddler Thin Strips Decongestant

Triaminic Infant & Toddler Thin Strips Decongestant Plus Cough

TYLENOL Concentrated Infants ' Drops Plus Cold

TYLENOL Concentrated Infants ' Drops Plus Cold & Cough

Wal-Mart Stores will begin selling eight additional generic drugs for $4 per 30-day prescription and several family-planning drugs for $9. The added medications include treatments for glaucoma, attention deficit disorder, attention deficit hyperactivity disorder, fungal infections and acne. In addition, Wal-Mart will offer generic versions of the birth control drugs Ortho Cyclen and Ortho Tri-Cyclen and a fertility drug for $9 per 30-day supply.

The discount drug program, which started in September 2006, now will cover 361 prescriptions representing different formulations of 157 generic drugs. The new additions add about 24 prescriptions to the program.

Other retail chains, including Kmart, Publix and Target, have advertised similar programs.

More proof that prescriptions should be submitted by computer rather than handwritten appeared recently online in the Journal Health Services Research. In U.S. hospitals with computerized prescription systems there was a 66 percent drop in prescription errors.

Illegible handwriting and transcription errors are responsible for most medication errors in hospitals. A decimal point in the wrong place can lead to a patient's dosage being 10 times the recommended amount. Filling a prescription for the pain medication Celebrex instead of antidepressant Celexa is one of the nore comon errors because of the similarity of names. Most errors go undetected unless they led to an adverse reaction for the patient. Each year, more than one-half million patients sustain injuries or die in hospitals from adverse drug reactions.

Currently, only about 9 percent of hospitals have computerized prescription systems. It takes 12 to 36 months to implement computerized prescribing system.

Divigel, from Upsher-Smith Laboratories, is a odorless gel that dries quickly. It is applied daily on the thigh. Significantly, it absorbs directly into the bloodstream thus bypassing the liver. The FDA just approved Divigel and it will be abailable in July 2007.

The estrogen in Divigel (Estradiol gel) is identical to the primary estrogen produced by women before menopause. It is derived from plants and is available in the lowest dose of Estradiol available. Clinical trials of Divigel showed a decrease in frequency and severity of hot flashes among those tested. Side effects were minimal.

Divigel appears to be a convenient, low-dose therapy for coping with uncomfortable hot flashes. As with any estrogen hormone therapy, this product should be used at the lowest effective dose for the shortest amount of time.

New Hampshire has distributed 14,000 doses of Gardasil (Merck) at no charge since January. The HPV vaccination program aimed at girls 11 to 18 has proven to be 100% effective at preventing HPV which is responsible for 70% of new cervical cancer cases. (Search this blog for "HPV Vaccine" to view related articles). In 2007, New Hampshire will spend almost $5 mil (28% of it's immunization budget) on the Gardasil program. Private insurers and the federal government provide all of the funding.

New Hampshire never sought to make HPV vaccination mandatory and has avoided the controversy and parental backlash experienced with the mandatory proposals in Texas. Virginia has a mandatory HPV Vaccine law but offers parents an option to decline. South Dakota and Washington, have voluntary programs offering free vaccine.

Doctors routinely treat cancer patients for anemia with 3 FDA approved drugs - Epogen, Procrit, and Aranesp. The prarmaceutical companies market the drugs to help with fatigue and improve the cancer patients' quality of life. At a $1,000 a dose, there's potential for abuse. Indeed, aggressive marketing to doctors and TV advertising to patients has led to overuse of the drugs and may be contributing to safety problems.

Recently the FDA warned that the drugs may speed the growth of cancer and increase the liklyhood of heart attacks and strokes leading to earlier death for some. The increased risks are due to overprescribing to a wide spectrum of patients. As many as 450,000 American patients are taking the drugs, which are covered by Medicare.

Bianca Kennedy, age 41, suffered terribly from hot flashes after being treated for breast cancer. Up to 25 times a day, she turned red and sweated uncontrollably. For the last 18 months, she's been completely free of hot flashes after a series of 3 injections of local anesthetic into nerve tissue located in the neck. She calles the treatments "life changing".

Stellate ganglion blocks (SGB), have been used safely for over 60 years to treat pain says board-certified anesthesiologist and pain management expert Eugene G. Lipov, M.D., Medical Director of the Chicago area-based Advanced Pain Centers. Nineteen out of twenty patients had at least an 80 percent decrease in hot flashes for a period of two weeks to a year following SGB. The SGB treatment is undergoing clinical trials with breast cancer patients under Dr Lipov's supervision.