#How do I start pharma marketing company

[mostlysignssomeportents]

What the fuck is a PBM?

TOMORROW (Sept 24), I'll be speaking IN PERSON at the BOSTON PUBLIC LIBRARY!

Terminal-stage capitalism owes its long senescence to its many defensive mechanisms, and it's only by defeating these that we can put it out of its misery. "The Shield of Boringness" is one of the necrocapitalist's most effective defenses, so it behooves us to attack it head-on.

The Shield of Boringness is Dana Claire's extremely useful term for anything so dull that you simply can't hold any conception of it in your mind for any length of time. In the finance sector, they call this "MEGO," which stands for "My Eyes Glaze Over," a term of art for financial arrangements made so performatively complex that only the most exquisitely melted brain-geniuses can hope to unravel their spaghetti logic. The rest of us are meant to simply heft those thick, dense prospectuses in two hands, shrug, and assume, "a pile of shit this big must have a pony under it."

MEGO and its Shield of Boringness are key to all of terminal-stage capitalism's stupidest scams. Cloaking obvious swindles in a lot of complex language and Byzantine payment schemes can make them seem respectable just long enough for the scammers to relieve you of all your inconvenient cash and assets, though, eventually, you're bound to notice that something is missing.

If you spent the years leading up to the Great Financial Crisis baffled by "CDOs," "synthetic CDOs," "ARMs" and other swindler nonsense, you experienced the Shield of Boringness. If you bet your house and/or your retirement savings on these things, you experienced MEGO. If, after the bubble popped, you finally came to understand that these "exotic financial instruments" were just scams, you experienced Stein's Law ("anything that can't go forever eventually stops"). If today you no longer remember what a CDO is, you are once again experiencing the Shield of Boringness.

As bad as 2008 was, it wasn't even close to the end of terminal stage capitalism. The market has soldiered on, with complex swindles like carbon offset trading, metaverse, cryptocurrency, financialized solar installation, and (of course) AI. In addition to these new swindles, we're still playing the hits, finding new ways to make the worst scams of the 2000s even worse.

That brings me to the American health industry, and the absurdly complex, ridiculously corrupt Pharmacy Benefit Managers (PBMs), a pathology that has only metastasized since 2008.

On at least 20 separate occasions, I have taken it upon myself to figure out how the PBM swindle works, and nevertheless, every time they come up, I have to go back and figure it out again, because PBMs have the most powerful Shield of Boringness out of the whole Monster Manual of terminal-stage capitalism's trash mobs.

PBMs are back in the news because the FTC is now suing the largest of these for their role in ripping off diabetics with sky-high insulin prices. This has kicked off a fresh round of "what the fuck is a PBM, anyway?" explainers of extremely variable quality. Unsurprisingly, the best of these comes from Matt Stoller:

https://www.thebignewsletter.com/p/monopoly-round-up-lina-khan-pharma

Stoller starts by pointing out that Americans have a proud tradition of getting phucked by pharma companies. As far back as the 1950s, Tennessee Senator Estes Kefauver was holding hearings on the scams that pharma companies were using to ensure that Americans paid more for their pills than virtually anyone else in the world.

But since the 2010s, Americans have found themselves paying eye-popping, sky-high, ridiculous drug prices. Eli Lilly's Humolog insulin sold for $21 in 1999; by 2017, the price was $274 – a 1,200% increase! This isn't your grampa's price gouging!

Where do these absurd prices come from? The story starts in the 2000s, when the GW Bush administration encouraged health insurers to create "high deductible" plans, where patients were expected to pay out of pocket for receiving care, until they hit a multi-thousand-dollar threshold, and then their insurance would kick in. Along with "co-pays" and other junk fees, these deductibles were called "cost sharing," and they were sold as a way to prevent the "abuse" of the health care system.

The economists who crafted terminal-stage capitalism's intellectual rationalizations claimed the reason Americans paid so much more for health care than their socialized-medicine using cousins in the rest of the world had nothing to do with the fact that America treats health as a source of profits, while the rest of the world treats health as a human right.

No, the actual root of America's health industry's problems was the moral defects of Americans. Because insured Americans could just go see the doctor whenever they felt like it, they had no incentive to minimize their use of the system. Any time one of these unhinged hypochondriacs got a little sniffle, they could treat themselves to a doctor's visit, enjoying those waiting-room magazines and the pleasure of arranging a sick day with HR, without bearing any of the true costs:

https://pluralistic.net/2021/06/27/the-doctrine-of-moral-hazard/

"Cost sharing" was supposed to create "skin in the game" for every insured American, creating a little pain-point that stung you every time you thought about treating yourself to a luxurious doctor's visit. Now, these payments bit hardest on the poorest workers, because if you're making minimum wage, at $10 co-pay hurts a lot more than it does if you're making six figures. What's more, VPs and the C-suite were offered "gold-plated" plans with low/no deductibles or co-pays, because executives understand the value of a dollar in the way that mere working slobs can't ever hope to comprehend. They can be trusted to only use the doctor when it's truly warranted.

So now you have these high-deductible plans creeping into every workplace. Then along comes Obama and the Affordable Care Act, a compromise that maintains health care as a for-profit enterprise (still not a human right!) but seeks to create universal coverage by requiring every American to buy a plan, requiring insurers to offer plans to every American, and uses public money to subsidize the for-profit health industry to glue it together.

Predictably, the cheapest insurance offered on the Obamacare exchanges – and ultimately, by employers – had sky-high deductibles and co-pays. That way, insurers could pocket a fat public subsidy, offer an "insurance" plan that was cheap enough for even the most marginally employed people to afford, but still offer no coverage until their customers had spent thousands of dollars out-of-pocket in a given year.

That's the background: GWB created high-deductible plans, Obama supercharged them. Keep that in your mind as we go through the MEGO procedures of the PBM sector.

Your insurer has a list of drugs they'll cover, called the "formulary." The formulary also specifies how much the insurance company is willing to pay your pharmacist for these drugs. Creating the formulary and paying pharmacies for dispensing drugs is a lot of tedious work, and insurance outsources this to third parties, called – wait for it – Pharmacy Benefits Managers.

The prices in the formulary the PBM prepares for your insurance company are called the "list prices." These are meant to represent the "sticker price" of the drug, what a pharmacist would charge you if you wandered in off the street with no insurance, but somehow in possession of a valid prescription.

But, as Stoller writes, these "list prices" aren't actually ever charged to anyone. The list price is like the "full price" on the pricetags at a discount furniture place where everything is always "on sale" at 50% off – and whose semi-disposable sofas and balsa-wood dining room chairs are never actually sold at full price.

One theoretical advantage of a PBM is that it can get lower prices because it bargains for all the people in a given insurer's plan. If you're the pharma giant Sanofi and you want your Lantus insulin to be available to any of the people who must use OptumRX's formulary, you have to convince OptumRX to include you in that formulary.

OptumRX – like all PBMs – demands "rebates" from pharma companies if they want to be included in the formulary. On its face, this is similar to the practices of, say, NICE – the UK agency that bargains for medicine on behalf of the NHS, which also bargains with pharma companies for access to everyone in the UK and gets very good deals as a result.

But OptumRX doesn't bargain for a lower list price. They bargain for a bigger rebate. That means that the "price" is still very high, but OptumRX ends up paying a tiny fraction of it, thanks to that rebate. In the OptumRX formulary, Lantus insulin lists for $403. But Sanofi, who make Lantus, rebate $339 of that to OptumRX, leaving just $64 for Lantus.

Here's where the scam hits. Your insurer charges you a deductible based on the list price – $404 – not on the $64 that OptumRX actually pays for your insulin. If you're in a high-deductible plan and you haven't met your cap yet, you're going to pay $404 for your insulin, even though the actual price for it is $64.

Now, you'd think that your insurer would put a stop to this. They chose the PBM, the PBM is ripping off their customers, so it's their job to smack the PBM around and make it cut this shit out. So why would the insurers tolerate this nonsense?

Here's why: the PBMs are divisions of the big health insurance companies. Unitedhealth owns OptumRx; Aetna owns Caremark, and Cigna owns Expressscripts. So it's not the PBM that's ripping you off, it's your own insurance company. They're not just making you pay for drugs that you're supposedly covered for – they're pocketing the deductible you pay for those drugs.

Now, there's one more entity with power over the PBM that you'd hope would step in on your behalf: your boss. After all, your employer is the entity that actually chooses the insurer and negotiates with them on your behalf. Your boss is in the driver's seat; you're just along for the ride.

It would be pretty funny if the answer to this was that the health insurance company bought your employer, too, and so your boss, the PBM and the insurer were all the same guy, busily swapping hats, paying for a call center full of tormented drones who each have three phones on their desks: one labeled "insurer"; the second, "PBM" and the final one "HR."

But no, the insurers haven't bought out the company you work for (yet). Rather, they've bought off your boss – they're sharing kickbacks with your employer for all the deductibles and co-pays you're being suckered into paying. There's so much money (your money) sloshing around in the PBM scamoverse that anytime someone might get in the way of you being ripped off, they just get cut in for a share of the loot.

That is how the PBM scam works: they're fronts for health insurers who exploit the existence of high-deductible plans in order to get huge kickbacks from pharma makers, and massive fees from you. They split the loot with your boss, whose payout goes up when you get screwed harder.

But wait, there's more! After all, Big Pharma isn't some kind of easily pushed-around weakling. They're big. Why don't they push back against these massive rebates? Because they can afford to pay bribes and smaller companies making cheaper drugs can't. Whether it's a little biotech upstart with a cheaper molecule, or a generics maker who's producing drugs at a fraction of the list price, they just don't have the giant cash reserves it takes to buy their way into the PBMs' formularies. Doubtless, the Big Pharma companies would prefer to pay smaller kickbacks, but from Big Pharma's perspective, the optimum amount of bribes extracted by a PBM isn't zero – far from it. For Big Pharma, the optimal number is one cent higher than "the maximum amount of bribes that a smaller company can afford."

The purpose of a system is what it does. The PBM system makes sure that Americans only have access to the most expensive drugs, and that they pay the highest possible prices for them, and this enriches both insurance companies and employers, while protecting the Big Pharma cartel from upstarts.

Which is why the FTC is suing the PBMs for price-fixing. As Stoller points out, they're using their powers under Section 5 of the FTC Act here, which allows them to shut down "unfair methods of competition":

https://pluralistic.net/2023/01/10/the-courage-to-govern/#whos-in-charge

The case will be adjudicated by an administrative law judge, in a process that's much faster than a federal court case. Once the FTC proves that the PBM scam is illegal when applied to insulin, they'll have a much easier time attacking the scam when it comes to every other drug (the insulin scam has just about run its course, with federally mandated $35 insulin coming online, just as a generation of post-insulin diabetes treatments hit the market).

Obviously the PBMs aren't taking this lying down. Cigna/Expressscripts has actually sued the FTC for libel over the market study it conducted, in which the agency described in pitiless, factual detail how Cigna was ripping us all off. The case is being fought by a low-level Reagan-era monster named Rick Rule, whom Stoller characterizes as a guy who "hangs around in bars and picks up lonely multi-national corporations" (!!).

The libel claim is a nonstarter, but it's still wild. It's like one of those movies where they want to show you how bad the cockroaches are, so there's a bit where the exterminator shows up and the roaches form a chorus line and do a kind of Busby Berkeley number:

https://www.46brooklyn.com/news/2024-09-20-the-carlton-report

So here we are: the FTC has set out to euthanize some rentiers, ridding the world of a layer of useless economic middlemen whose sole reason for existing is to make pharmaceuticals as expensive as possible, by colluding with the pharma cartel, the insurance cartel and your boss. This conspiracy exists in plain sight, hidden by the Shield of Boringness. If I've done my job, you now understand how this MEGO scam works – and if you forget all that ten minutes later (as is likely, given the nature of MEGO), that's OK: just remember that this thing is a giant fucking scam, and if you ever need to refresh yourself on the details, you can always re-read this post.

The paperback edition of The Lost Cause, my nationally bestselling, hopeful solarpunk novel is out this month!

If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2024/09/23/shield-of-boringness/#some-men-rob-you-with-a-fountain-pen

Image: Flying Logos (modified) https://commons.wikimedia.org/wiki/File:Over_$1,000,000_dollars_in_USD_$100_bill_stacks.png

CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0/deed.en

[lazyscience]

So for my followers who come with a factory-installed uterus I know you're concerned about your health and autonomy. And you well should be

But here's something all of you should be thinking about and planning for no matter what your plumbing - if Trump goes through with putting RFK Jr. in a position of power as far as the Department of Health and Human Services, he could do a LOT of damage as far as vaccines. Vaccines are not super profitable for pharma companies, despite what cranks think; they take a LOT of development for only a few uses. Vaccines are driven by public health requirements and a lot of places would shrug and say "ok, bet" if there isn't a guaranteed market for them.

The professional medical community will still have recommendations about when and how to vaccinate, but they won't have the force of law, and insurance will probably smell blood in the water and start kicking up a fuss about covering vaccines when they're not required. So then when doctors recommend them there'll be suspicion and pushback that they're just doing it for "kickbacks" even though the only doctor who would have gotten paid for vaccine is ironically Andrew Wakefield, the lying fuckshit, because his whole "vaccines cause autism" lie was to push his OWN, SPECIAL proprietary vaccines that wouldn't cause his made-up syndrome, because NO vaccines were causing it. May he roast somewhere warm when the devil comes for him.

This will not happen immediately, but. Because there will no doubt be anticipatory compliance on the part of drug companies and healthcare systems. I HIGHLY advise you get the fuck out there and get your Tdap updated (tetanus, diptheria and pertussis). Whooping cough is out there, and it is horrible for babies. If you are eligible for shingles vaccine and haven't done it, get that. Get your COVID vax if you haven't, there might not BE another one, at least not that's available in the US.

If you have kids, especially make sure THEY'RE up to date because their classmates might very well not be mandated to get them any more - state regulations will undoubtedly vary, but with the current composition of the Court, it will rule in favor of every possible exemption for antivaxxers as possible because the conservatives are all "fuck the weakest of us, I got mine fuck you." And expect idiocy like "pox parties" to spread (not like the average suburban parent can tell measles from rubella from chicken pox from hand foot and mouth by fuckin' looking at it, who knows what the christ they're going to be passing around). Measles is NOT just a "bit of a rash." Rubella is the world's leading preventable cause of birth defects. Chickenpox can result in scarring, encephalitis causing blindness or even death, and the risk of shingles later in life. I have a cousin who would be 57 this year who died as a toddler from hemophilus influenzae strain B meningitis, one of those "too many" childhood vaccines that were invented in the 1990s. Tell my aunt that's too many vaccines -oh, wait, you can't, she fucking killed herself out of grief her baby died.

tweens? get them the HPV vaccine if they haven't gotten it (given its associations with sex it'll probably be one of the first to go, but it prevents CANCER. who wants their child to get cervical cancer, or penile cancer, or throat cancer, or rectal cancer? IT PREVENTS CANCER. JUST DO IT.)

Similarly, if you have a child with any kind of immune issue that precludes vaccination, I would very much look into homeschooling, because bye-bye herd immunity.

If you have teenage kids, encourage them to update their Tdap and get the meningiococcal meningitis vaccine if they haven't been mandated to already by campus policy. Tetanus and meningitis aren't common, but they are frequently permanently life-altering when they're not fatal. We're talking months in the hospital. I'm old enough that I remember people fucking dying in college, and the panic that went around campus every time one of those breakouts happened in the state wondering if it would make its way to our campus.

Stay safe out there. I have no idea what this will do to our already teetering healthcare system but I don't think it'll be pretty. Everybody pray Trump pulls his usual scam and hangs RFK Jr. out to dry, because while the plutocrats consider regulations an unnecessary burden, they don't have a stake in creating a public health state of emergency when we already have a workforce not keeping up with demand, unlike Captain Convenient Brain Worm.

[transmutationisms]

Do you have a perspective on why stimulants aren’t currently widely prescribed as weight loss drugs? Im guessing it’s related to it being a ‘controlled substance’ and ‘scary drug’ but drug marketing in pursuit of pharmaceutical profits is pretty powerful… I wonder why I haven’t seen (effective?) efforts to try to ‘overhaul’ the image of stimulants as only associated with “addiction”, “hyperactive children”, finance bros, and “lazy adults”.

I know vyvanse is also prescribed for binge eating but I get the sense most people are unaware of that. I tried many stimulants and I had the most rapid and “easy” (found food repulsive) weight loss on vyvanse. Granted all of the many prescribed stimulants I’ve tried all greatly suppress my appetite.And I’ve seen it described as a benefit by some people who have it prescribed for adhd (I understand why people do and I sometimes see it as a very depressing benefits because lack of food security despite). Binge eating disorder and prescribing for general weight loss aren’t too far from each other in the fatphobic society we live in but I guess I’m curious how it hasn’t had the ozempic treatment already/ when will it happen. People already look down of folks who can’t function by society’s standards in certain contexts and I see that similarity in how people talk about people who take ozempic for weight loss (admonishing and a moral failure).

stimulants absolutely still are prescribed for weight loss lol, in addition to Vyvanse for 'binge eating' (v unreliable diagnosis that many people receive when they are in fact dealing with subjective loss of control around food as a direct result of restrictive behaviours...) there's also Desoxyn (methamphetamine) and Phentermine (a substituted amphetamine), which are both still FDA-approved for short-term weight management. and yes that's Phentermine as in half of fen-phen. you also have to keep in mind that off-label prescribing is hard to track but is probably still occurring at not-insignificant rates (i know it happens with Ephedra and Clenbuterol, for example). and then there are also patients who use stimulants for weight loss without a doctor's knowledge, either by obtaining them on the black market or by simply getting a doctor to prescribe them for something else.

anyway in regards to pharma marketing strategies i think there are a few things going on here:

weight loss has never actually been the sole market for these drugs, nor was it the first. amphetamine was first synthesised in 1929; it was put into asthma inhalers almost immediately and by the late 30s was being sold as a kind of generalised wellness-producing drug, used by, for instance, college students as a 'pep pill'. the Allies used quite a bit of amphetamine in WWII to keep soldiers alert (the US military was still doing this in Iraq and Afghanistan in the 2000s; afaik they have not stopped this practice). by the late 50s stimulants were also marketed as pick-me-ups for unhappy housewives and for a dizzying array of depression 'subtypes' (postpartum, old age-related, disability-related) and 'modern miseries' (atomic anxiety, economic and political unrest). it wasn't until the 50s and 60s that stimulants really started to be marketed as diet pills, with 'overeating' configured as a symptom of depression. even those formulations also had other use markets: professional athletes, for example. i'm sure pharma companies would love to have the stimulant dominance they once did in weight loss, but it's not really necessary in order to move product: these days the ADHD diagnosis will generally do the job just fine. nicolas rasmussen's book On Speed has more on this history.

speaking of the ADHD diagnosis, i have observed that in the last two or so decades, it has increasingly been invoked in bioessentialist narratives of either 'chemical imbalances' (usually dopamine, norepinephrine) or distinct 'neurotypes' that are said to cause, worsen, or be susceptible to 'overeating', which can therefore be treated by the use of stimulant drugs. i strongly suspect an effect here is that 'overeating', weight gain, or 'obesity' are de facto being used as diagnostic criteria for ADHD, or for other psychiatric diagnoses considered to have high overlap in behavioural presentation. this is not dissimilar to the formulation in the 60s of 'overeating' as a result of depression; in both cases the narrative elides the appetite-suppressant effects of stimulants and presents them as aiding with weight loss by treating an underlying bio/psychiatric pathology. an interesting historical note here is that Adderall is simply a rebrand of the second-gen formulation of the weight-loss drug Obetrol.

presently, weight loss is largely marketed using the language of health rather than aesthetics. although pharma companies are certainly not morally above lying, i do think it would be a tough pill to swallow (pun intended) if they tried to convince anyone that a stimulant prescription is part of this sort of 'wellness' scene. that could change in the future, ofc; these perceptions and associations are socially and historically contingent. in the US even as recently as the 90s, people were definitely still presenting fen-phen as health-promoting (tautologically, because it caused weight loss!), at least until the valve disease scandal.

glp-1 agonists like ozempic are, i think, getting a lot of extremely credulous coverage, from both the medical establishment and health journalists, that is obfuscating the fact that they basically also work by suppressing the appetite. whether it is 'healthier' to do this with a substance that alters endocrine function than to do it with a substance that acts on adrenergic receptors is unclear to me. certainly there are many 'side effects' of the glp-1 agonists that are simply the results of rapid / significant weight loss (fatigue, weakness, osteoporosis, hair loss, gallstones, 'ozempic face', &c). that a process that causes these things can be marketed as health-promoting is a whole other topic lol. but i think the perception of the glp-1 agonists as healthful weight-loss agents has to do with certain misunderstandings of diabetes, metabolism, and body weight, as well as a degree of... not quite blackboxing, but something adjacent, on the part of pharma companies in their promotional materials. which is to say, it wouldn't surprise me if, in the future, people looked back at glp-1 agonists as also being risky drugs to use for weight loss, and only being worth using in specific, limited circumstances.

[mariacallous]

In his spare time, Tony Eastin likes to dabble in the stock market. One day last year, he Googled a pharmaceutical company that seemed like a promising investment. One of the first search results Google served up on its news tab was listed as coming from the Clayton County Register, a newspaper in northeastern Iowa. He clicked, and read. The story was garbled and devoid of useful information—and so were all the other finance-themed posts filling the site, which had absolutely nothing to do with northeastern Iowa. “I knew right away there was something off,” he says. There’s plenty of junk on the internet, but this struck Eastin as strange: Why would a small Midwestern paper churn out crappy blog posts about retail investing?

Eastin was primed to find online mysteries irresistible. After years in the US Air Force working on psychological warfare campaigns he had joined Meta, where he investigated nastiness ranging from child abuse to political influence operations. Now he was between jobs, and welcomed a new mission. So Eastin reached out to Sandeep Abraham, a friend and former Meta colleague who previously worked in Army intelligence and for the National Security Agency, and suggested they start digging.

What the pair uncovered provides a snapshot of how generative AI is enabling deceptive new online business models. Networks of websites crammed with AI-generated clickbait are being built by preying on the reputations of established media outlets and brands. These outlets prosper by confusing and misleading audiences and advertisers alike, “domain squatting” on URLs that once belonged to more reputable organizations. The scuzzy site Eastin was referred to no longer belonged to the newspaper whose name it still traded in the name of.

Although Eastin and Abraham suspect that the network which the Register’s old site is now part of was created with straightforward moneymaking goals, they fear that more malicious actors could use the same sort of tactics to push misinformation and propaganda into search results. “This is massively threatening,” Abraham says. “We want to raise some alarm bells.” To that end, the pair have released a report on their findings and plan to release more as they dig deeper into the world of AI clickbait, hoping their spare-time efforts can help draw awareness to the issue from the public or from lawmakers.

Faked News

The Clayton County Register was founded in 1926 and covered the small town of Ekader, Iowa, and wider Clayton County, which nestle against the Mississippi River in the state’s northeast corner. “It was a popular paper,” says former coeditor Bryce Durbin, who describes himself as “disgusted” by what’s now published at its former web address, claytoncountyregister.com. (The real Clayton County Register merged in 2020 with The North Iowa Times to become the Times-Register, which publishes at a different website. It’s not clear how the paper lost control of its web domain; the Times-Register did not return requests for comment.)

As Eastin discovered when trying to research his pharma stock, the site still brands itself as the Clayton County Register but no longer offers local news and is instead a financial news content mill. It publishes what appear to be AI-generated articles about the stock prices of public utility companies and Web3 startups, illustrated by images that are also apparently AI-generated.

“Not only are the articles we looked at generated by AI, but the images included in each article were all created using diffusion models,” says Ben Colman, CEO of deepfake detection startup Reality Defender, which ran an analysis on several articles at WIRED’s request. In addition to that confirmation, Abraham and Eastin noticed that some of the articles included text admitting their artificial origins. “It’s important to note that this information was auto-generated by Automated Insights,” some of the articles stated, name-dropping a company that offers language-generation technology.

When Eastin and Abraham examined the bylines on the Register’s former site they found evidence that they were not actual journalists—and probably not even real people. The duo’s report notes that many writers listed on the site shared names with well-known people from other fields and had unrealistically high output.

One Emmanuel Ellerbee, credited on recent posts about bitcoin and banking stocks, shares a name with a former professional football player. When Eastin and Abraham started their investigation in November 2023, the journalist database Muck Rack showed that he had bylined an eye-popping 14,882 separate news articles in his “career,” including 50 published the day they checked. By last week, the Muck Rack profile for Ellerbee showed that output has continued apace—he’s credited with publishing 30,845 articles. Muck Rack’s CEO Gregory Galant says the company “is developing more ways to help our users discern between human-written and AI-generated content." He points out that Ellerbee’s profile is not included in Muck Rack’s human-curated database of verified profiles.

The Register’s domain appears to have changed hands in August 2023, data from analytics service Similar Web shows, around the time it began to host its current financial news churn. Eastin and Abraham used the same tool to confirm that the site was attracting most of its readership through SEO, targeting search keywords about stock purchasing to lure clicks. Its most notable referrals from social media came from crypto news forums on Reddit where people swap investment tips.

The whole scheme appears aimed at winning ad revenue from the page views of people who unwittingly land on the site’s garbled content. The algorithmic posts are garnished with ads served by Google’s ad platform. Sometimes those ads appear to be themed on financial trading, in line with the content, but others are unrelated—WIRED saw an ad for the AARP. Using Google's ad network on AI-generated posts with fake bylines could fall foul of the company's publisher policies, which forbid content that “misrepresents, misstates, or conceals” information about the creator of content. Occasionally, sites received direct traffic from the CCR domain, suggesting its operators may have struck up other types of advertising deals, including a financial brokerage service and an online ad network.

Unknown Operator

Eastin and Abraham’s attempts to discover who now owns the Clayton County Register’s former domain were inconclusive—as were WIRED’s—but they have their suspicions. The pair found that records of its old security certificates linked the domain to a Linux server in Germany. Using the internet device search engine Shodan.io, they found that a Polish website that formerly advertised IT services appeared associated with the Clayton County Register and several other domains. All were hosted on the same German server and published strikingly similar, apparently AI-generated content. An email previously listed on the Polish site was no longer functional and WIRED’s LinkedIn messages to a man claiming to be its CEO got no reply.

One of the other sites within this wider network was Aboutxinjiang.com. When Eastin and Abraham began their investigation at the end of 2023 it was filled with generic, seemingly-AI-generated financial news posts, including several about the use of AI in investing. The Internet Archive showed that it had previously served a very different purpose. Originally, the site had been operated by a Chinese outfit called “the Propaganda Department of the Party Committee of the Xinjiang Uyghur Autonomous Region,” and hosted information about universities in the country’s northwest. In 2014, though, it shuttered, and sat dormant until 2022, when its archives were replaced with Polish-language content, which was later replaced with apparently-automated clickbait in English. Since Eastin and Abraham first identified the site it has gone through another transformation. Early this month it began redirects to a page with information about Polish real estate.

Altogether, Eastin and Abraham pinpointed nine different websites linked to the Polish IT company that appeared to comprise an AI clickbait network. All the sites appeared to have been chosen because they had preestablished reputations with Google that could help win prominence in search rankings to draw clicks.

Google claims to have systems in place to address attempts to game search rankings by buying expired domains, and says that it considers using AI to create articles with the express purpose of ranking well to be spam. “The tactics described as used with these sites are largely in violation of Search’s spam policies,” says spokesperson Jennifer Kutz. Sites determined to have breached those policies can have their search ranking penalized, or be delisted by Google altogether.

Still, this type of network has become more prominent since the advent of generative AI tools. McKenzie Sadeghi, a researcher at online misinformation tracking company NewsGuard, says her team has seen an over 1,000 percent increase in AI-generated content farms within the past year.

WIRED recently reported on a separate network of AI-generated clickbait farms, run by Serbian DJ Nebojša Vujinović Vujo. While he was forthcoming about his motivations, Vujo did not provide granular details about how his network—which also includes former US-based local news outlets—operates. Eastin and Abraham’s work fills in some of the blanks about what this type of operation looks like, and how difficult it can be to identify who runs these moneymaking gambits. “For the most part, these are anonymously run,” Sadeghi says. “They use special services when they register domains to hide their identity.”

That’s something Abraham and Eastin want to change. They have hopes that their work might help regular people think critically about how the news they see is sourced, and that it may be instructive for lawmakers thinking about what kinds of guardrails might improve our information ecosystem. In addition to looking into the origins of the Clayton County Register’s strange transformation, the pair have been investigating additional instances of AI-generated content mills, and are already working on their next report. “I think it’s very important that we have a reality we all agree on, that we know who is behind what we’re reading,” Abraham says. “And we want to bring attention to the amount of work we’ve done just to get this much information.”

Other researchers agree. “This sort of work is of great interest to me, because it’s demystifying actual use cases of generative AI,” says Emerson Brooking, a resident fellow at the Atlantic Council’s Digital Forensic Research Lab. While there’s valid concern about how AI might be used as a tool to spread political misinformation, this network demonstrates how content mills are likely to focus on uncontroversial topics when their primary aim is generating traffic-based income. “This report feels like it is an accurate snapshot of how AI is actually changing our society so far—making everything a little bit more annoying.”

[a-method-in-it]

One really interesting thing about the current discourse around pain management is that it obviously is inextricable from the opioid epidemic, which was essentially created by one company, and specifically one family: Purdue Pharma, owned by the Sackler family.

And so I every time this topic comes up, I feel like we as a society need to get a primer on this company and what they did starting in the late 90s. (Most of this info is coming from the excellent book Empire of Pain by Patrick Radden Keefe. Highly recommend.)

A short summary of relevant points:

In the late 1990s, Purdue Pharma created a new drug called Oxycodone and marketed it primarily under the brand name OxyContin.

They did a HUGE marketing blitz around it, including ad campaigns aimed at doctors about how important pain management is and how medical professionals should prioritize eliminating pain for patients.

They also straight up lied to doctors about the drug in very important ways, including lying about the duration of the effects and also saying it was 100% non-addictive and could not be abused because of its time release capabilities.

Turns out that

a) the "12 hour" pills did not last 12 hours and most patients started having breakthrough pain in as little as 8 hours, causing them to take their next pill before 12 hours, run out of pills by the end of the month, and turn to the black market to get more drugs; Purdue dismissed these people as addicts who were using the drug incorrectly when they tried to sue

b) it is addictive because obviously; it's an opioid, those are definitely addictive. And

c) you can very easily defeat the time release by crushing the pills.

Anyway, this created the opioid epidemic.

I am not exaggerating, this one company run by this one family essentially created the opioid epidemic almost single-handedly. No, they are not in prison, but that's another rant.

The point is that so much of our discussion around pain and pain medication has been warped by the opioid epidemic and doctors over-correcting after years of not taking the risk of addiction seriously enough.

The idea that patients should not be in pain is absolutely true, and also has been unfairly tainted by Purdue's marketing that used this same argument to harm patients for profit.

The idea that doctors should not be interrogating people about their use of painkillers and assuming they are "misusing" the drug (whatever that is supposed to mean), is running up against doctors' guilt that they bought Purdue's lies and were not properly monitoring patients for signs of addiction and getting them help.

The idea that keeping pills from addicts is not going to solve the problem and should not be our main priority is emotionally hard to accept when everyone wishes so desperately that medical providers had not been so willing to hand out pills before.

This is a hard and tricky area to begin with. How do you balance the need for pain relief against the risk of addiction (which is itself also a serious conditions that can cause physical and mental damage)? There's no easy line to draw.

And then you throw the decades of malfeasance by Purdue into the mix and everything becomes a mess.

Because ultimately, OP is right. People who don't want to be in pain should, in a society where we have invented very effective pain killers, not have to live in pain. They should be informed of the risks, including the risks of addiction and how to mitigate it as much as possible, and then they should get to make that decision for themselves.

But in order to convince anyone of that, you have to figure out how to talk people through the layers and layers of nightmares that Purdue Pharma wrought upon all of us.

It is actually way better for 100 addicts to get their fix on pain pills than a single person in pain go without. I call this the "Torture is bad" principle. You should be able to get the good stuff forever after a single doctor's visit. If you're worried about addicts fund rehab centers and needle exchanges instead of torturing people.

[taggartmcgurrin]

Threading the Needle: Taggart McGurrin on Navigating Profit and Ethics in Pharma and Biotech Startups

There are few sectors more complicated than pharmaceuticals—especially for new companies. To succeed, startups must master a complicated arithmetic that balances business decisions against the ethics of providing life-saving drugs.

Taggart (Tagg) McGurrin, a CFO/COO in the pharmaceutical space, compares leading a startup to managing air travel. Modern flight relies not only on skilled pilots, but on fully coordinated efforts of highly skilled people across various disciplines, who do everything from monitoring the weather to building reliable aircraft.

Like airlines, pharmaceutical startups often contend with last-minute changes that affect the journey, although not the destination. 

No matter what new government regulation, stakeholder concern, or market disruption occurs, new businesses must “understand the headwinds that you face and pivot seamlessly to continue flawlessly executing on the corporation’s goals and objectives,” McGurrin said.

Patients as a Priority

Typical startups worry about two concerns: connecting with clients and becoming profitable. Pharmaceutical businesses are different. Their success and failure predominantly depend on how well their medicine works.

And while a tech company can regularly update its product, pharmaceutical companies are bound by strict regulatory timelines and massive cash burn. As a result, high-growth start-ups can be a bit like building a plane while trying to fly it.

“The bottom line starts and ends with the human impact the pharmaceutical industry has on people—current and future patients,” he said. “Think about us when we were kids: My mother brought me in for vaccines and gave me medicine when I was sick. We entrusted other people to develop medications properly, the FDA to apply their regulatory authority to grant companies the approval to commercialize medications properly, and doctors to prescribe them. So, when you look at the human impact, you have to say, ‘Look, patients depend on and entrust pharmaceutical leaders with their health and well-being, just the same way they entrust doctors and nurses with their medical care and treatment.’”

Patient trust is sacred, McGurrin said, but it comes at a steep cost. Investors can grow impatient because of the tremendous cost of new drug development—from research to iteration to a long and complex approval process. It’s not unusual for pharmaceutical startups to feel constantly strapped for cash as they navigate a costly and lengthy journey toward drug approval.

McGurrin believes the key to keeping investors engaged throughout the process is to transparently identify and communicate developmental challenges, associated risk mitigation strategies, and long-term and impactful solutions to the hurdles.

“The industry allows me to do well by doing good. I like money because money is a great motivator. That's what gets many people out of bed in the morning,” he said. “But at the end of the day, is it clean money? Would you be proud to say that you earned it and did it by doing good and benefitting others?”

Yet, while patients are the ultimate priority, pharmaceutical CEOs can only make some decisions solely based on patient needs. The system forces them to consider investors' financial needs, and this balancing act is an ongoing challenge.

Balancing the Needs of All Stakeholders

The market doesn’t necessarily reward companies for making good medications. 

McGurrin emphasized that pharmaceutical companies operate within a for-profit model, which comes with its own pressures. 

“Pharmaceuticals are a for-profit business with two prongs,” McGurrin said. “One is that people expect to get a return from sizeable investment because developing a drug costs a ton of money. On the other hand, there are people who are investing in certain areas of the pharmaceutical industry or certain drugs because they have a connection to an unmet need. Perhaps it's something they or a family member have had to deal with from a health perspective, and they want to see certain drugs come forth to help in that area. And that might be a mission-driven investment for them. But nonetheless, their investment isn't a charitable contribution. People expect a return from investing in drug development, especially investors who make their livelihoods from deploying capital into highly risky development programs. They expect returns commensurate with the risk profile of their investments..”

This pressure becomes especially intense when development processes take longer or cost more than expected. Investors may push for speedier development and market access, but management often faces unexpected challenges. 

 “I think a time where the rubber meets the road with those two competing interests—returns for investors versus what you're doing to move things forward for the patients—what it really comes down to is how you're managing the overall timeline to approval,” he said.

For McGurrin, leadership must remain committed to the long-term efficacy and safety of the drug. In some cases, that means extending timelines or requesting additional funding rounds. 

“I think that people often want to take the path of least resistance, but that could result in lower returns for investors, a limited label for patients, or both. It’s critical to be transparent with investors and say, ‘Look, we spoke to the FDA and they requested additional data, or there is additional regulatory work required. As long as you approach investors with a revised plan and timeline, the relevant risks, and the capital required to execute, you can effectively address investors' concerns while preserving the integrity of the drug you are trying to deliver to patients,” McGurrin said.

Striking the Right Balance

Encountering turbulence is simply part of the journey for pharmaceutical startups. The industry offers attractive rewards for investors and amazing results for patients—but only so long as the dynamic path from research to market is managed with finesse. “If startups want to bring the most effective medication to market on a timeline that suits investors, the best tool for the job is constant, comprehensive, and transparent communication to all stakeholders,” McGurrin said. 

“You need to set realistic expectations and be very upfront and honest with your investors. As long as investors are fully informed, I truly believe management will be given the requisite support to deliver for both investors and patients.”

[flivv-developers]

One of the biggest questions you have, if you have money, is “where can I invest?” You have tons of investment options on your face while scrolling through social media, while traveling or when, shopping. Considering the marketing persuasiveness all around, you become reluctant to put your money at risk. That’s when plot investments come into the picture, and here’s how:-

The Real Estate, Stock, and Crypto market currently, are the hot options out there for everyone to invest in. From a teenager to mid-ages people, everyone is looking for feasible options to get their investment journey started. However, we (obviously) as realtors would suggest you invest in Real Estate.

Considering the present market situation of the crypto market, we can easily figure out the position it’s in that is affecting the investors more volatility. Coming to the stock market, you cannot guarantee profits when you purchase stock, which makes it one of the riskiest investments. Hence, we are left with a comparatively easy and safer investment, that is plot investments, or open land investments.

Are Plot Investment in Hyderabad Worth it?

Real Estate investments do not have an oh-so-wow factor all the time. The market also is subjected to various fluctuations considering the economies and markets of the particular areas. However, there’s no sundown for real estate plot investments option either. The massive globalization, infrastructural plans, and settlements require real estate to be present. Without which, there’s no development in any sector whatsoever.

Investments in Real Estate have numerous and detailed branches. Land and improvements include buildings, fixtures, roads, structures, and utility systems. These aspects create opportunities for all the stakeholders to grow and earn well and achieve the target in the specific period. If you’re an investor, you reap profits post-development. If you’re a builder and a developer, you get a cut-off price and earn a good name in the market for a future project. Any stakeholder involved in the process of the Real Estate market does not get anything in return. This whole cycle starting, from initiation to execution, is beneficial to all the parties involved.

Hyderabad has been one of the finest destinations for both big and small investment options. The global foreign investments in the past couple of years have proven that the city’s expansion shall be massive compared to other cities. Considering the recent project launches like Safran Aircraft Engines, and T-Hub, it is safe to assume that the investors of Hyderabad will only see a bright future from now on.

Plot Investment in Hyderabad Pharma City

Similarly, the project launch of Hyderabad Pharma City is yet to launch with 20,000 acres of acquisition, making it the world’s biggest eco-friendly pharmaceutical hub. Since it is in its initial stages, the plot investments in that area are super affordable and readily available for the investors to move forward. The availability of Amazon Data Center, a beautiful 200 ft main road, makes the area more investment-friendly. Big shot pharmaceutical companies like Austrak, Dr. Reddy’s & Novartis have already acquired land in the project to set up their state-of-the-art facilities.

Hence, purchasing property near the world’s biggest Pharma city would be beneficial for the investors in the long run as the people who own a piece of land there will reap returns every year. This growth is only possible because of the Plot investments in Hyderabad south around the key areas of Kandukur, Yacharam, Kadthal, and Maheshwaram.

Your wise decision will help you understand the benefits of the plot investments in pharma city and aid in securing your future. If you’re looking to start your Real Estate journey, make sure to contact us. With 10+ years of being in business and a 99% client retention rate, we know what’s best for you.

[jcmarchi]

Heico Sandee, Founder and CEO of Smart Robotics – Interview Series

New Post has been published on https://thedigitalinsider.com/heico-sandee-founder-and-ceo-of-smart-robotics-interview-series/

Heico Sandee, Founder and CEO of Smart Robotics – Interview Series

Heico Sandee, is the Co-Founder and CEO of Smart Robotics.

Smart Robotics offers technology and services designed to automate pick-and-place stations in fulfillment centers. The company provides user-friendly, reliable, and adaptable pick-and-place systems capable of handling a wide variety of items.

What inspired you to co-found Smart Robotics back in 2015? What challenges in the robotics industry were you aiming to solve?

Together with Mark Menting, I founded Smart Robotics in May 2015. We opposed the status quo within the robotics industry and noticed there was a need for renewal. Traditional robot applications are created for a specific project and need custom programming, resulting in high costs per installation, low flexibility and limited functionality. However, in today’s society there is an ever increasing and varying consumer demand, which is why logistics- and production companies are in need of more flexible and innovative pick & place automation.

How has Smart Robotics evolved over the past nine years, and what are the key milestones that have shaped its growth?

In 2015, Smart Robotics started in a small office at the High Tech Campus Eindhoven. Now, we are situated in our head office in Best, in the middle of the high tech region Brainport. After our start, Smart Robotics was quickly noticed within the industry. Nowadays, you can find our pick and place robots all over the world and we have developed a strong partner network within Europe and beyond.

Smart Robotics has seen impressive global expansion. Could you share some insights into the key markets you’ve entered and the specific industries where your solutions are most impactful?

Europe as a region is specifically focusing on industrial automation and smart infrastructure development, creating opportunities for robotics companies. Benelux and Dach are our strongest markets and our solutions are most impactful in the food, retail, pharma and parcel logistics industries.

Smart Robotics designs robots to work alongside people rather than replace them. Could you elaborate on how this human-centered approach differentiates you from competitors?

Human-centrism is fundamental for Smart Robotics.Our mission is to create a workplace where people do what they are valued for, through collaboration with smarter robots. For example, the use of Smart Robotics cobot palletizers significantly improves the speed and accuracy of palletizing tasks. Our cobot palletizer cooperates safely with your employees, as there is no need for safety fences because it can continue its operation when an operator is near. This approach results in high flexibility and user-friendly cooperation with the cobot.

How is Smart Robotics specifically addressing the increasing demand for automation within the pharmaceutical sector?

Smart Robotics is addressing the increasing demand for automation in the pharmaceutical sector by offering tailored robotic solutions designed for precise, repetitive tasks like order picking, and packing.

Our hardware-agnostic software allows for seamless integration with various robotic systems, optimizing operations in sterile environments. The robots’ advanced vision and task planning capabilities ensure accurate handling of sensitive pharmaceutical items, enhancing efficiency, minimizing human error, and improving overall operational safety. This approach supports the sector’s need for reliable, scalable automation solutions in line with stringent regulatory requirements.

Can you walk us through how the Smart Palletizer has improved operational efficiency for your pharma clients, like Bayer? What specific benefits have they seen?

Bayer was in search of a cobot integrated palletizing system. For them, the relevant certificates and safety were of great importance. Even though they did not yet have any experience with cobot systems, they were already convinced of the quality of Smart Robotics’ Smart Palletizer. At the beginning, Bayer’s line operators were not entirely convinced of a cobot system, because it is a new technology that was quite unfamiliar to them. However, because the Smart Palletizer is very user-friendly, the employees on the floor at Bayer were able to work with the system quickly and it has now become one of the more popular ‘colleagues’.

What role does AI play in the operation of your robotics systems? How do features like continuous learning and adaptability enhance their performance?

AI plays a fundamental role in Smart Robotics’ robotic  systems by enabling robots to autonomously navigate complex logistics tasks. Through AI-driven vision, task planning, and motion control, the robots can interpret their environment, optimize their movements, and execute tasks efficiently. Continuous learning allows the robots to improve with each task, adapting to new items, environments, and challenges without needing manual intervention. This adaptability enhances their performance by reducing errors, increasing accuracy, and ensuring smoother, faster operations, especially in dynamic and changing environments.

The Technology Trinity (motion, vision, and decision making ) is a core innovation. How does this improve the accuracy and reliability of your robots?

Vision is powered by 3D camera sensors and deep learning, enabling precise detection of items in their surroundings. Motion planning ensures smooth and efficient movements, while decision-making algorithms guarantee tasks are executed at the right moment. These systems work together to allow the robot to pick and place a wide variety of items with precision across different environments, significantly improving reliability.

Could you share more about your software’s hardware-agnostic nature? How does this feature offer flexibility to your clients across different industries?

Our software integrates seamlessly with a wide range of robotic systems, independent of the hardware in use. This flexibility enables businesses across various industries to tailor the software to their specific operational needs while benefiting from advanced technology, without being restricted to a single type of hardware platform.

What are your long-term goals for Smart Robotics? How do you envision the company’s role in shaping the future of warehouse automation and robotics?

The ultimate goal for Smart Robotics is to create smoothly functioning warehouses where a team of robots, guided by advanced software and AI, can efficiently handle products and packages. This doesn’t mean robots will take over human jobs. Instead, they’ll work alongside people, making their tasks easier and more effective and safer.

We can expect to see a 50% or greater increase in the use of robotics in warehouses worldwide over the next five years in which Smart Robotics will play an important role. As more distribution centers evolve into ‘smart warehouses,’ it’s crucial to focus on key areas for improvement. The best approach involves maintaining flexibility, focusing on productivity and efficiency, creating valuable career growth opportunities for employees and implementing smart technologies. By following these practices, warehouses can optimize their operations while still valuing and developing their human workforce.

Thank you for the great interview, readers who wish to learn more should visit Smart Robotics.

[mportal]

More because I can’t stop myself.

You woke up in a garbage truck. You hadn’t been sure you would wake up. First, you noticed the blood soaking your clothes, even though you felt fine. Then, you noticed the smell, the darkness, the weight of the leaking trash bags partially concealing you. Then, you noticed the garbage man. He was looking in at you.

You stiffened.

“It’s ok,” he said, bouncing along with the truck as it drove down a shadowed street in the early morning. “I’m not going to tell anyone. You’re that gal from the news that killed a cancer patient, right? By trying to heal her? Must be pretty desperate to hide in a dumpster.”

“What do you want?”

“Nothing. Just didn’t like how they were talking about you on the news. They think you should be locked up in a lab forever, you know. Like a rat. Like you’re not human. You are human, aren’t you?”

You nodded.

“Yeah, I thought so. I didn’t like how they talked about you at all. Stay down there. I’ll let you know when to come out.”

He helped you climb out 30 minutes later. You didn’t know why, but you felt like you needed to explain.

“I didn’t mean to kill her. I thought I could help. I don’t know what’s happening. After the accident everything changed and I-I—,” you stopped as the tears started again. It felt like your throat was closing around itself.

He shook his head. “It’s ok, baby. You got away. Do you have somewhere to go?”

You took a deep breath. “Yeah, I got somewhere.”

“Okay. Go there. Don’t talk to anybody.”

You went. Your mom’s old storage unit had a tv and antenna, some old clothes, a bike, and thankfully a bike pump. You took them all and pedaled down to the warehouse district, wearing a band shirt and too-tight capris from the early 2010s instead of your blood-soaked hospital gown. You knew the way, even in the dim dawn light. Your dad used to take you there, back when the factories were still active and he thought he had a long career ahead of him. They were mostly abandoned now, full of dust and forgotten real estate pamphlets about refurbished factory living. Some of the buildings even had working electricity.

You camped out, binging the news and scared beyond reason. You were being called a murderer, and “your therapy” a miracle. The drug had been fast-tracked through the FDA for its first indication and was in new trials for an additional ten more. It could be acquired for a staggering 2 mil, but insurance brought the cost down to a supposedly modest 100k. Meanwhile, you were eating scavenged pizza slices and drinking from gas station faucets. They ran your face daily with the number for a tips hotline.

The slow slide from fear to bitterness to rage was the only distinction in your days. And soon enough, the rage gave way to hopelessness.

You tried drowning first. It seemed quick and easy, but all that happened was wet clothes and a lot of very uncomfortable coughing. You tried stabbing. The warehouse had broken panes of glass, old tools, rusted rebar. None worked. When you found a sledge hammer, you considered blunt force trauma but couldn’t figure out the angle when you realized your jump from the hospital window had already answered that question for you. Then you tried dehydration and starvation. Three weeks later you gave up on that as well.

The hopelessness grew as you realized escape might be forever outside of your reach.

You went back to watching the news. Coverage of your story slowly dwindled, and you became little more than an offhand remark during other reports. Pundits instead spent their time rehashing old debates on whether drug pricing had gone out of control. Financial programs criticized the board’s actions and their effects on shareholders. Investigative segments switched focus to theories about what else the pharma company might be hiding and whether the mismanagement of treatment production and access was a cash grab. Patient boards were filled with complaints and pleas, and the black market was rife with counterfeits. It was all reported on with minimal feeling, interspersed with footage of company executives being rushed out of court, lawyers shielding them from view with black briefcases.

One day an ad came on. It was for the treatment, your treatment. They were now approved for late stage cancer, and several other indications. It was a new age of man, and you could be part of it, for the right price.

You watched the ad play out, blank faced. They hadn’t even used your photographer’s shots of the array. Maybe the shots no longer fit brand strategy. Maybe the camera had been confiscated during the investigation.

You turned off the TV and looked around at the empty warehouse. There was nothing of value. Nothing important to you. No one important to you. What was it all for?

You thought of your friend.

It’s ok. Maybe…I’ll have helped.

You stood up, slowly, and started to walk. What was it all for? You grabbed an old screwdriver and walked out of the warehouse. You walked past projects, gated communities, discount shopping centers, elementary schools. You wondered how people found contentment and meaning. If they got lucky and stumbled on it, or if it was something you had to make out of whatever was at hand.

Midnight, and you found yourself in front of the hospital. Even emaciated as you were, the staff recognized you when you walked in. You asked them to call the pharmaceutical executive board. They called security instead.

“Jerry, come at me and I’ll stab you,” you told your favorite security guard as he approached you with arms out. His favorite breakfast was a blueberry muffin; you used to bring him one when you came in for your weekly blood draw. You held the screwdriver tight in your fist. He hovered a hand over his firearm. “Shoot me and I’ll walk it off. I swear to God.”

They made you prove it, and a few hours later found you in the hospital CEO’s office while you pried a bullet out of your leg. The hospital CEO had come in and spoke with you briefly, and was now arguing with someone about overstepping professional relationships just outside the office door.

There was a soft knock, and that someone came in. You recognized him immediately. A member of the board.

“You’re back,” he said, eyeing you up and down. You were aware of what you looked like (matted hair, bloody, screwdriver in hand), but it didn’t matter.

You gave him a flat look and sat back in the chair with a casual manner. “I want to renegotiate my contract.”

You are a supervillain with healing powers. The only reason you are labelled a supervillain because the American healthcare system is intimidated by you.

[timbrehealthcare]

Best PCD Pharma Franchise in India

In the growing franchise business in India. PCD Franchise Company is also increasing rapidly. The franchise model plays an important role and acts as a bridge between healthcare providers and the local communities. We Timbre Health Care is the most trusted PCD Pharma Franchise in India. We will solve all your queries and help you to start and grow your pharma business.

In this blog, we explore why we have the best PCD franchise and how it works, how we generate profit from it and many more. So read this blog till the end!!

What is the actual meaning of the PCD Franchise?

The franchise model is not easy, as you can see from the outside. Some scholars of this industry have said that “ The PCD Franchise business is the backbone of the healthcare system” because if you want to earn more money and profit, then you should know how the PCD Franchise business model works.

The meaning of PCD is Propaganda Cum Distribution. PCD is when a pharma company contracts a franchise agreement with a person or group. This franchise business deals with marketing and distributing rights for the products by the parent pharma company.

We have made ourselves the best PCD franchise Pharma Company in India. Our aim is to give a healthy life to all the individuals. When starting a business in the industry through the franchise route, choosing the right partner plays a very important role in the pharma industry.

As a result, a pharma company can sell and distribute rights for a particular product range to another business. The local dealer or the enterprise holder will market the franchise-branded medicines to his targeted audience.

Future scope of PCD companies in India:

The Indian economy is in great shape. But in medicine, there is huge competition. We have a Pharmaceutical Business in India. We generate a lot of employment, and most people get employment with us. 

Because the franchise business only requires dedication and hard work. The best thing about this business is that you do not have to invest so much, and the ROI (Return on investment) is so high that everyone can easily learn about this business.

Benefits of Franchise business: 

Marketing and distribution: The Franchise business is a designated area in which to promote and sell a range of medicinal products from the franchisor. This covers tasks like patient meetings with health facilities and pharma products.

Less investment, high return:- As I mentioned earlier, in this business, the ROI is so huge that it gives opportunities for new entrepreneurs; the franchise model requires less investment and gives you a high return. Brand value:- Partnering with us gives you instant brand recognition and credibility, and it cuts off the competition.

Local support: This model has an intimate understanding of local market dynamics and will help you with five products according to the demand. The Indian pharmaceutical market has seen considerable growth. 

After the US, India nine out of 10 prescription drugs are produced in India.

How you will generate profits:

In the pharma business, profit is generated through the distribution and sale of pharmaceutical products. Franchise distributors purchase products from a pharmaceutical company at wholesale prices and sell them to retailers, hospitals, clinics, and other clients to earn profit.

Franchisors often charge franchisees ongoing royalties and fees. These can include franchise fees, marketing fees, and ongoing royalties based on a percentage of sales. These fees contribute to the franchisor's profits.

A successful pharma franchise benefits from the reputation and brand recognition of the actual owner or a parent company. This can lead to increased sales and customer loyalty, which in turn generates more revenue and profits for both the franchisor and the franchise.

Well, these are some ways you can generate income. And Timbre healthcare, will help you to start your business and in gaining profits.

Conclusion:

Finally, I hope you understand how the pharmaceutical franchise business works. In this business, choosing the right pharmaceutical franchise is difficult because of a competitive market. Not anymore, because we, Timbre, are the most trusted PCD Pharma Franchise in India. We are committed to growing your business with our commitment, customer service, and many other things. So what are you waiting for? Come join us now!!!

[sapphirehealthcareindia]

How Do I Start A Nutraceutical Company?

The nutraceutical sector in India has been rising massively over the past few years in India. That’s why it’s a very common urge of all newcomers in the pharma industry to start their own nutraceutical company anywhere in India to earn a handsome profit. But it’s not a game of few minutes. You need to follow several necessary steps correctly to establish a nutraceutical company in India. If you are one of those newcomers who doesn’t know how to start a nutraceutical company, then we are here to guide you. In this blog, we will give you a step-by-step guide to start your own nutraceutical franchise in India. Stay with us to the end to get the complete guidance.

What Is A Nutraceutical Company?

We will tell you the steps to start a nutraceutical franchise, but before that, you need to gain some knowledge about a nutraceutical company.

A nutraceutical company is basically a pharmaceutical company that manufactures different varieties of health supplements which are called nutraceutical products and made of essential nutrients that people often lack in their bodies. Nutraceutical manufacturing companies produce nutraceutical supplements in various forms like tablets, softgel and hard gel capsules, syrups and so on. Nutraceutical companies come into existence to fulfilling the nutrition gap in several people in this world. This company is the most dominant and profitable business sector in the pharma industry and has a brighter future ahead. That’s why everyone who is planning to start their own pharma company, starting as a nutraceutical company is the best way to get quick success.  

Steps to Start A Nutraceutical Company

All set to start your new nutraceutical firm? That’s great, but do you know about all the steps required for launching your nutraceutical firm anywhere? If not, then quickly go through these steps mentioned below. They will guide you correctly to establish your dream company without much hassle. 

1. Do Thorough Market Research

Since the nutraceutical sector is highly competitive, to stay ahead of all your competitors, first you have to do a thorough market research before starting the company. Check what is the trend in this market now, what types of nutraceuticals are in highest demand. Keep an eye on those successful nutraceuticals manufacturers and suppliers in India and check what kinds of products they are selling. This will help you to make a unique and stronger business plan from others and help you stand out from others easily. 

2. Make Sure You Have All Legal Certifications

To make your company a trusted and legal one in the market, you must follow all legal guidelines and collect legal certifications from WHO, GMP or ISO. To get all these certificates, it is necessary to register your company first through FSSAI. Also, partner with a successful nutraceutical company to get legal monopoly rights that will allow you to start your business anywhere in India legally.

3. Find Your Target Audience

Since customers are the main essentials for any business, it is important to find your target audience. You should find out who needs your products most and always prioritise them to get quick success.

4. Stock Best-quality Products

Products are one of the most crucial elements in a business. Especially in nutraceutical business where people’s health is connected with your business, you must make sure that you are selling best-quality nutraceutical products only. To check the quality, you may clinically test those products which you have collected for selling. 

5. Contact Most Trusted Manufacturer

Don’t want to take responsibility for manufacturing nutraceutical supplements? Well, in this case, you have to search a lot and partner with the most reliable nutraceutical manufacturing company like Sapphire HealthCare. Only a fully trusted and expert manufacturing company can provide you with genuine and effective products with zero side effects.

6. Choose A Good Name for Your Brand

Many people take this step as a less important one but you shoudln’t do the mistake of overlooking it. This is as important as other steps. Your brand name is the only thing by which people will remember your company and services. So, try to choose an easy-to-spell, easy-to-remember and quite attractive name for your brand. 

7. Create Strongest Marketing Strategy

To make your small nutraceutical franchise company a popular one in the entire nutraceutical industry, selling best-quality products or giving an attractive brand name are not enough. You have to do promotion of your company using the best marketing strategy. Creating unique and attractive packaging for products, giving attractive ads on various social media platforms about your products, creating a user-friendly website for product selling are some of the best strategies you can use in marketing to increase your brand awareness. 

Final Words

All newcomers who are entering the pharma world with their own nutraceutical companies, must remember these basic steps. Those who will follow them step by step, will sure get a positive result within a few months of establishing their companies. Go ahead, start following these steps and plan accordingly so that you can earn a good profit from the first month of starting your company.

[medicinedistributors]

5 Reasons Why Pharma Companies Are Essential for Medical Breakthroughs

There are several reasons why pharmaceutical companies are essential for medical breakthroughs and the importance of best pharma company in madurai:

Research and Development:

Pharmaceutical companies invest heavily in research and development (R&D) to discover and develop new drugs and medical treatments. They have the expertise, resources, and infrastructure required to conduct clinical trials, analyze data, and obtain regulatory approvals. Their R&D efforts drive innovation and pave the way for medical breakthroughs.

2. Financial Investment:

Developing and bringing a new drug to market is an expensive and time-consuming process. Pharmaceutical companies bear significant financial risks to fund the extensive research, clinical trials, and manufacturing required for medical breakthroughs. Their financial investments are essential for the advancement of medical science.

3. Collaboration and Partnerships:

Pharmaceutical companies often collaborate with academic institutions, research organizations, and healthcare providers to accelerate medical breakthroughs. They pool together their expertise, knowledge, and resources to address complex medical challenges. These collaborations foster cross-disciplinary research and facilitate the translation of scientific discoveries into real-world applications.

4. Regulatory Expertise:

Pharmaceutical companies navigate the complex regulatory landscape to ensure that their drugs and treatments meet high safety and efficacy standards. They work closely with regulatory authorities to obtain necessary approvals and comply with regulations. This expertise is crucial in ensuring that medical breakthroughs reach patients in a safe and effective manner.

5. Global Reach and Access:

Pharmaceutical companies have extensive global networks and distribution channels, enabling them to effectively deliver medical breakthroughs to patients worldwide. Their expertise in manufacturing, supply chain management, and commercialization ensures that innovative treatments are accessible to those who need them, regardless of geographic location.

Overall, pharmaceutical companies play a vital role in driving medical breakthroughs by investing in research, bearing financial risks, fostering collaborations, navigating regulations, and ensuring global access to innovative treatments so you may reach the best pharma company in madurai.

       Contact Us: +91 97509 72060

Visit Our Website: https://pharmafabrikon.in/

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[sepulchral-pulchritude]

forgive me my ignorance (<-not sarcastic, this really is an area i know very little about), but my perspective as a consumer (for car insurance specifically), is this: my big issue is that insurance is REQUIRED to register and drive a car (at least in all the states I've lived in) and driving a car is basically required to have and hold a job.

to be fair, the second thing is more of the problem, but notwithstanding major legislation to expand public transportation which has yet to materialize, the situation is that i have to be able to drive to make enough money to live in a home, and the car insurance company can basically name their price (notably this issue is part of what is so heinous about medical insurance also)

and to be fair to insurance companies, even if they were trying to be good and give the best possible prices to their customers, they are at the whims of the larger markets -- the prices on medical bills (ballooned by medical supply companies and pharma companies basically extorting them), the prices of car parts, the price of gasoline to transport those car parts, probably lots of other market stuff I don't know because like I said i do not know much about this. so there is a bunch of risk the insurance company has to take as well. it is in their interest to act like a company, a money-making entity.

notably, as a profit-seeking entity, they then also find themselves relying on statistics as per @cobrilee's tags, and relying on those kinds of statistics ends up reinforcing institutionalized prejudice. you want redlining? this is how you get redlining.

in the process of writing this post, i looked up the official reason why car insurance is mandatory in 48 out of 50 states. the given reason? public safety.

specifically the idea that if you are hit by a car at no fault of your own, that you should not be expected to pay your medical bills. and i basically agree! that is an assumption that seems fair to buy into as part of living together in a cooperative society. (i will note that who "you" is can really determine who gets to be "at fault" buuuuut we cannot disentangle all of society's prejudices in one go so moving on)

but you know what? if it's for public safety, why is it being handled by entities that are necessarily driven by profit?

the fact is that having and driving a car is basically a requirement to be a working (usamerican) adult, but that it is regulated like it is a luxury item and it is really frustrating. if insurance is mandatory for public safety, it should be a matter of public safety handled by the government. it should be unconcerned with profit!

and if the government had to start really shouldering those costs, i think they might just see that public transportation is much cheaper, more efficient, and all around better than the 1 Car Per USAmerican (Mandatory) system we currently have. and we could have a competent public transportation system. and i would cry tears of joy.

The most frustrating part of working in insurance is knowing why people's insurance premiums are increasing so dramatically but not being able to explain it without sounding like you're defending a bunch of giant megacorporations

[cpharmaceutical]

1-CLAV-228 Dry Syrup MANUFACTURER/ MARKETER C Pharmaceuticals SALT COMPOSITION Amoxycillin (200mg) + Clavulanic Acid (28.5mg) STORAGE Store below 30°C

Your child’s medicine at a glance

1-CLAV-228 Tablet is an antibiotic medicine that helps treat bacterial infections of the ear, nose, throat, chest, lungs, teeth, skin, and urinary tract. It is capable of killing bacteria that have become resistant to other therapies and thus also helps treat tuberculosis that is resistant to other treatments.

You can give 1-CLAV-228 Tablet to your child with or without food. It is better to give it with food as that helps increase absorption and decrease the risk of stomach upset. The doctor may prescribe giving it two to three times a day. Medicine dose depends on the severity of the infection, its type, and your child’s body weight and age. So, stick to the dose, time, and way prescribed. If your child vomits the medicine within 30 minutes of intake, let the child calm down and repeat the dose. Do not double dose if it's the time for the next dose.

1-CLAV-228 Tablet may cause vomiting, diarrhea, nausea, abdominal pain, and allergy. These side effects should diminish on their own. But, in case they persist or start bothering your child, you must not delay speaking to your child’s doctor.

Share your child’s entire medical history with the doctor, including any previous episode of allergy, heart problem, a blood disorder, birth defects, airway obstruction, lung anomaly, gastrointestinal problem, skin disorder, liver impairment, and kidney malfunction. This information will assist the doctor in making dose alterations and in planning your child’s overall treatment.

Uses of 1-CLAV-228 Tablet in children

In Treatment of Resistance Tuberculosis (TB)

In multidrug-resistant (MDR) tuberculosis, the causative bacteria produce an enzyme called beta-lactamase. This enzyme breaks down the antibiotics and makes them ineffective. As a result, the bacteria become resistant to the antibiotic being used for treatment. Moxclav 228.5mg Tablet comprises two active ingredients, amoxycillin and clavulanic acid. While clavulanic acid stops the enzyme from rendering amoxycillin ineffective, amoxycillin works towards killing the tuberculosis-causing bacteria. This makes the combination of amoxycillin and clavulanic acid an effective treatment for resistant tuberculosis.

Side effects of Moxclav 228.5mg Tablet in children

Moxclav 228.5mg Tablet does not pose serious side effects and is well-tolerated by children. In case the side effects do occur, they’re likely to subside once the body adapts to the medicine. Consult your child’s doctor if these side effects persist or bother your child. The most common side effects include-

Common side effects of Moxclav

Nausea

Vomiting

Abdominal pain

Diarrhea

Allergy

Skin rash

How can I give Moxclav 228.5mg Tablet to my child?

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Moxclav 228.5mg Tablet is to be taken with food.

How Moxclav Tablet works

Moxclav 228.5mg Tablet is an antibiotic. It has two active agents, amoxycillin and clavulanic acid. Amoxycillin works by preventing the formation of the bacterial protective covering (cell wall) essential for the survival of the bacteria. Whereas, clavulanic acid serves a special purpose of inhibiting an enzyme (beta-lactamase) that is produced by resistant bacteria. This makes the combination of amoxycillin and clavulanic acid an effective line of treatment for many types of infections.

[drcarlosferrari]

Which Is Right For Me: Weight Loss Surgery or Weight Loss Drugs?

Obesity and bariatric science are in a really interesting phase right now. Surgical Weight Loss vs. Weight Loss Drugs?

Powerful new medications that can cause significant weight reduction have recently entered the market in addition to extremely effective, secure, and affordable weight loss operations.

A new class of type 2 diabetes drugs, semaglutide (marketed under the brand names Wegovy and Ozempic) and liraglutide (marketed under the brand names Saxenda and Victoza), is making headlines for its potent weight loss properties. Some research on these medications demonstrate an amazing 15% body weight loss over six months, however trials on a more recent medication called irzepatide (marketed under the brand name Manjaro) demonstrate an astounding 22% weight loss over six months. Surprisingly, even more potent drugs are being developed and will probably be made available in the upcoming years.

Those figures for weight loss are noteworthy. For perspective, we are aware that people with high Dr. Ferrari can significantly improve their metabolic health by decreasing merely 5% of their body weight. The health of that person would be significantly improved if they were to receive these new meds and achieve treble or quadruple those results.

How Do Drugs for Weight Loss Operate?

What features do these novel medications share? Along with other weight reduction advantages, they all promote the synthesis of the hormone Glucagon-like peptide-1, or GLP-1, which is produced in the gut to assist in signaling when you are full (fewer excess calories stored, slower movement of food through the GI tract).

Bariatric surgery has shown us that this hormone rises after the procedure. By duplicating the hormonal effects of bariatric surgery, these new medications enable patients to first absorb this hormone exogenously (through injections).

GLP-1 medications versus bariatric surgery

Bariatric surgeons, weight loss specialists, and prospective patients are asking: should I attempt weight loss medication instead of weight loss surgery? because of these treatments' success.

It's important to note that bariatric operations like gastric sleeve and gastric bypass are now much more successful at starting and maintaining weight loss. This is due in part to the fact that exogenous injections have a logarithmically lower effect on GLP-1 than surgery does. Additionally, weight loss surgery can be a long-term solution if the patient maintains the required lifestyle modifications, which is considerably different from having to take intravenous injections every week permanently.

However, there is yet another, more serious drawback to these drugs: according to many of our patients, they are only offered at exorbitant prices. These medications can sometimes cost a patient more than $1,000 per month, which is just out of reach for many people who require weight loss interventions.

It is unlikely that the price of these medications will decrease anytime soon because demand far outweighs supply and Big Pharma cannot get them on shelves fast enough even at their current prices.

The patient or their insurance company has paid for the equivalent of a gastric sleeve procedure after ten months of exogenous treatment with these weight-loss medications, with the outcomes from the surgery being noticeably better and more long-lasting.

Combo therapy is the best option for weight loss.

At Dr. Ferrari, we don't think that weight loss surgery and weight reduction medications are mutually exclusive. Instead, we think that, whenever possible, combining weight loss surgery with GLP-1 medication is the optimal course of treatment.

A patient may increase total weight reduction results by 20-30% if they undergo weight loss surgery first and start using a GLP-1 medicine six months later. This is a substantial benefit in the fight against obesity.

It's important to note that research on people who had weight loss surgery was used to produce these new medications. In other words, it has been demonstrated that they function well together.

Every Successful Solution Matters

GLP-1 medications like Wegovy, Ozempic, Saxenda, and Victoza are a tremendously promising development in the field of bariatric medicine. It is unquestionably beneficial to have more safe, effective weight loss treatments to tackle obesity, regardless of the expense, with well over two thirds of the country suffering from overweight or obesity – many of whom are ineligible for bariatric surgery.

Because of this, we think it's usually a mistake to choose between weight loss surgery and GLP-1 therapy; instead, they should be used in tandem whenever it's possible to achieve the best results.

[martynnikkpharma]

Top PCD Pharma Franchise Company in India—A Proper Guide

PCD Pharma Franchise is one of the best business opportunities in India. With the development of the healthcare industry and the increasing demand for pharmaceutical products, pharmaceutical companies in India are expanding their businesses by providing PCD Pharma franchise opportunities. This enables them to distribute their products to various parts of the country and increase their market share. Aspiring entrepreneurs can also benefit from this business opportunity by partnering with a reliable and experienced PCD Pharma franchise company. Here you can get information about "Top PCD Pharma Franchise Company in India.

What are the most successful PCD pharma franchises?

Among the top PCD Pharma franchise companies in India, Martyn Nikk stands out for delivering quality services and products. In addition to having a wide range of products, the company offers a team of highly qualified professionals and delivery systems that are reliable and efficient. They have an experienced team of salespeople and managers who are dedicated to helping customers find the best solutions for their needs.

Through their innovative product portfolio, they are continuously creating new and improved solutions to meet the evolving needs of their customers. Their top-tier services and customer support make them a reliable and trusted partner for pharma companies looking for a reliable business partner.

How do I get a PCD Pharma franchise?

To be a part of this business, you must meet certain eligibility requirements in order to obtain a pharmacy franchise. We have given the required criteria below that you can check out.

A minimum of 3–4 years of experience in the sales and marketing of pharmaceutical products is required. Additionally, the company should be well recognised.

PCD companies do not ask for a high level of qualification. They must, however, have at least a 10th or 12th grade certificate from a recognised board or be a graduate. In many cases, these documents are extremely rare.

Investment Requirements

Depending on the company, the required investment for attaining a pharma PCD franchise may differ greatly.

For those looking to own a PCD (Pharma Company Distributorship) franchise, the investment needed varies depending on the company. Many companies only require an initial investment of Rs 10,000, while some may require up to Rs 3–4 lakhs. The amount of investment reflects the amount of services and support that the company will provide and the promoter’s responsibility in offering these services. In addition to the initial investment, it is also important to consider the recurring expenses that may arise, such as marketing costs, commissions, and other operational costs.

Conclusion

Starting a PCD (Pharma Company Division) franchise business is a great way to make a living. There are several criteria that need to be met in order to qualify for this type of franchise business. Each organization has a different set of requirements to be met in order to obtain a PCD franchise. To learn more about becoming a part of the "Top PCD Pharma Franchise Company in India," visit Martyn Nikk's official website and download the entire information about starting a "PCD Pharma Franchise."