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  • The latest scripts data on Vivus' (VVUS) Qsymia puts TRx for the week ending 7/12 at 7K, a 26% increase from the prior week, a development Leerink's Marko Kozul calls "promising." As for the First Manhattan settlement, Kozul says it is "a positive development that should allow VVUS to move forward focused on maximizing the Qsymia launch while accelerating partnership/ takeout potential." This should be contrasted with Needham's analysis[View news story]
    have you tried the "" website? That is my first start, but I only see Walgreens locations listed, so maybe not in other pharmacies yet. My patients have been going to walgreens, some don't have it on the shelf, one pharmacist tried to get them switched to generic short actings, I now write DAW on my rxs and no substitutions to avoid attempted pharmacy meddling. Walgreens that told my patients they did not have it have ordered it and patients had it the next day. They just don't stock meds the way they used to, keeping inventory to a minimum. I have not had any problems getting Belviq other than pharmacies not initially having it on the shelf and having to order it.

    I am having some reports with the cards not working for both products. The cards have to be "activated" by calling a phone number on the card or going online..... it is a hassle and not sure why they make patients do that (other than so they can track card use maybe and get direct info on the patients?) I wish they didn't have this extra step, that has been the most common reason they haven't worked, although I had a patient tell my staff yesterday that the card processing site was down when they tried to use it, not sure what that was about. It seems it didn't work for about 6 hours, either there are bugs in the new system or they were over loaded with users (not likely given the early script reports for both meds.)

    I agree, without the savings cards both products are too costy to try for patients, they need the discounts or insurance coverage to get started on them to see if it will work for them, no one wants to pay full cash price until they see if it works or not.
    Jul 20, 2013. 11:03 AM | 1 Like Like |Link to Comment
  • Vivus's Qsymia Now Available At 8,000 Pharmacies - Is It Enough? [View article]

    Digging deeper into my methods,etc need go no deeper than me prescribing the medications along with the diet instructions I give, no different than an MD would prescribe meds and advise. Regarding weightloss therapy it's absolutely no different, except maybe I spend more time on it than some of my MD friends, who instead of addressing their obesity adequately are quick to prescribe medications for hypertension, diabetes and cholesterol. So whether I am a DO or MD, in regards to this forum, I am not giving advice (the way you are giving advice, telling people don't take this, don't take that, etc), I am simply telling about my real world experience with my real patients with the real medications, instead of some hypothetical scare tactic such as you saying "if you take Qsymia you are going to have memory issues and need Namenda", my real world experience with these meds, as well as the data from the year long clinicals trumps your "concerns" about what could happen and the vague warnings from your neurologist friend and wife. This goes for both Qsymia and Belviq. Because Belviq also has warnings about side effects, headaches, dizziness, potential serotonin syndrome, I haven't had a single side effect yet that fits those descriptions occur. Does that mean they are not possible? No, they were reported in the clinicals, but my experience has not observed for the month and a half I have been prescribing it.

    So if you want to explain how when I as a DO write a prescription for either of these meds, I do it differently than any MD, would love to hear your brilliance. Do I use a different pen, script pad? Maybe I write the letters or numbers differently because I am a DO.... so you see how ridiculous your issue with me being a DO and describing my Qsymia and Belviq experiences is. Now if you want to talk about how differently I handle sprains, muscle strains, chronic back pain, etc, where I am more likely to call upon my training as an osteopath in ways that would look much different than most MDs, you might have a point, I do indeed employ different methods in those type cases that you might not agree with... my patients are sure grateful I do however and that is what important to me.

    I will not comment further on this, even if you goad me... I have put it to rest.

    I will however continue to report the progress and experiences of my patients I have on Belviq and Qsymia (not at the same time with the same patient, just to be clear). And so far those experiences are very positive and my patients on them continue to grow. My only complain is regarding Medicare and Medicaid (in my state) patients not being able to be covered and not able to use the helpful savings programs both companies now offer. I am having to find other ways to treat these patients for now which does not directly relate to the investments in these companies, so I will not spend my time commenting on that here.

    And of course, Jakes, I always "take care" in all that I do.
    Jul 20, 2013. 10:40 AM | 3 Likes Like |Link to Comment
  • Vivus's Qsymia Now Available At 8,000 Pharmacies - Is It Enough? [View article]

    Your question about how I would treat the ovarian cancer patient? How exactly does that relate to this article and to investing in Arena or Vivus?

    I am through playing your game, you seem driven to misdirect and get personal, which I am not interested in. Simple put I have lost interest in you and really want to see comments that are directed to the articles written by the authors. When I do have time to come on here, I really don't want to spend that time schooling a person who does seems more intent on insulting others and speaking in generalities instead of contemplative thought.

    As far as your cancer question, ask your wife, unless she also has no interest in speaking to you.....
    Jul 20, 2013. 01:27 AM | 3 Likes Like |Link to Comment
  • First Manhattan Co. Goes All In On Vivus Bet [View article]
    Jakes, What methods would that be the DOs choose that don't work for a majority of "us"? Would prescribing medications when appropriate, performing surgery when necessary? Because that is what or methods involve most of the time, the same methods used by MDs.

    The treatment most patients receive from DOs is indistinguishable from that of an MD, with the exception of the training we receive in manipulation, massage and many other non-invasive techniques..... when do we employ those techniques? Not to treat heart disease, asthma, cancer, bladder infections, or even dementia, but use them to address musculoskeletal issues that benefit from a hands on approach instead of simply throwing a bunch of pills at it, although many times we use the pill approach at the same time we are working on the patient's issue by physically working the injured area, for example back pain, so the patient benefits from more than one treatment method.

    This is a very simplistic explanation, but since you seem to not have a clear understanding that DOs receive the same type of rigorous training in Internal Medicine as an MD, but have additional training to provide other therapies that make sense to treat hands on. If you have a back strain that is clearly related to damaged muscles or soft tissue, does it not make sense to treat that damaged tissue directly as well as providing some pills for mediation of the pain? In this situation an MD might prescribe physical therapy for the patient, sending them off to a therapist because they lack the training to effectively perform that treatment, but since as a DO I have that training, I can care for my patient directly, and not send them off to someone else. This being said, some DOs also refer patients to physical therapists, and do very little osteopathic modalities in the normal course of their day, and their practices look indistinguishable from that of any IM or FP.

    Like any profession, you have people who go about their business in different ways, just as MDs can be very different from each other, some spending a long time with each patient to do their best to treat, while others go through the motions and get as many patients in and out as possible. People are people and some are just better at their professions than others. The important thing in choosing any healthcare provider is finding one that will take the appropriate amount of time to diagnose your issue, initiate the proper treatment and care for you to the best of their abilities, especially important in primary care where insurance reimbursement can get in between patients and proper care.
    You keep commenting on the methods we DOs use, if you really are not knowledgeable about what those methods are and you are just commenting based on your perceptions or misperceptions as that may be, please quit maligning my profession.

    This is Seeking Alpha, really I have spent too much effort defending myself, when the discussion on these articles should be on the companies, products and investments that relate to the posted story. Making this about you are me or anything not related to articles is a waste of time and a misdirection away from the topic. Retirement must have you bored to tears, is this your sole method of entertainment?

    You seem to like a good argument and are having fun with that, maybe Yahoo or MSN would be the place for you, lets keep this talk about our investments.
    Jul 20, 2013. 01:14 AM | 2 Likes Like |Link to Comment
  • First Manhattan Co. Goes All In On Vivus Bet [View article]
    An academic, long on studying, short on practicing, and clearly with a bias against DOs and generalist physicians based on your comments on this article
    So your experience with Topamax then is mostly secondhand comments where as mine is what I observe when using appropriately with my own patients.
    And since the topiramate in Qsymia is controlled release, I expected to see less intense side effects than with the immediate release form used for head aches (and many other indications) and that has been the case. Memory issues have not been an issue for my patients, not a single report among the 20 plus patients I now have on Qsymia. Also has not been a common issue when I have used it for certain types of headaches, maybe because I don't use as high of a dose as your neurologist friend? Or maybe because your neurologist friend is a speaker or consultant for Forest, seems they are the biggest cheerleaders for that products use in headaches, which I repeat is off-label, unproven (very weak data) and is not considered a normal approach by most physicians.

    If you truly are a Genontologist, you know how to do research, take a few minutes and look at the clinical data available and tell again how I am out if touch. Any physician reading this knows although medications can be used for many off label purposes, it is the strength of the data and the credibility of the clinicals, researchers and publications that compels a conscientious physician into using a medication. Exactly the reason I am prescribing Qsymia, the strength of the clinicals and data and now add to that my own clinical experience which has been great. The data on Namenda is weak and there is not much of it. If you presented that data at a Journal Club, your attending would tear it to pieces.... But it sounds impressive when their paid speakers throw out bullet points from those studies at dinner meetings.....

    My limited experience with Belviq limits how much I can assess it at this point, but early response appears to be good, two of my patients started last month returned this week and have lost the expected amount of weight with no troublesome side effects.

    You made a comment on one of your posts about Medicaid patients and alluded that I don't care for them, and that they should go on phen since it is so well covered by Medicaid (actually fewer than 10 states cover phen) I do accept Medicaid patients, it makes up a pretty good size portion of my practice.

    Guess what my state, Wisconsin, is now going to cover for Medicaid patients? Qsymia! Just found out yesterday, so in addition to phen, that has only been available in my state with a prior authorization, I can now prescribe Qsymia. Not sure on Belviq, I will be looking into that today, as well the details as to prescribing, ie any Prior Auth, etc. It will have to wait until I am caught up today and may not be able to post the details tonight as I will be in meetings at the hospital.
    Jul 17, 2013. 10:38 AM | 1 Like Like |Link to Comment
  • Vivus's Qsymia Now Available At 8,000 Pharmacies - Is It Enough? [View article]
    I haven't had a large number of patients complain about topiramate side effects such as memory loss when using it for headaches and have seen rather impressive results my friend. Just as I have not had any, I repeat any, of the 15 patients I now have on Qsymia report any side effects of that type during the almost 9 months I have been prescribing it. So you trying to force side effects on my patients that they are not experiencing is ridiculous. As far as not being an expert in treating headaches, generalists are not experts in anything, I am not an expert in treating infections, maybe I should send all my patients with infections to an infectious disease specialist, because I clearly don't know what I am doing. I am not an expert in asthma or COPD, so I should send all my patients with breathing problems to Pulmonologists and Allergists, since I am not an expert in that area. I am not an expert in treating the elderly, so maybe all my patients over the age of 65 I should just send on to a Gerontologist because clearly I am incapable with my medical training to care for the elderly. I should probably just stop practicing and give up my license, because I am not a specialist.... yes I am being sarcastic, but just wanted to point out what how ridiculous your statements are. I am competent to treat most ailments, I have been as rigorously trained as any MD, for you to compare my training to that of a chiropractor shows your ignorance of what a DO is and the training and residency that we go through. Snobbery among the MDs who don't understand that we have the same medical training but in addition are trained in osteopathic techniques. It is additional training, not alternative training.

    You preface this as "I am going to say this in a respectful way" but clearly there is no respect there. Not just for DOs but it appears for any generalist, since you seem to promote generalists not caring for patients as we have been trained but to delegate everything to some specialist, who only cares for a focused ailment of the patent and rarely sees the whole picture the way a generalist does.

    Regarding how I treat headaches, I did not give you a full detail of every method I use to work with my patients. My discussion was focused on my use of topiramate, which is one of the tools I have available and use for some of my patients when I feel it is the right choice based on my assessment of the patient. It is not the only tool I use and not even the most common, so don't misrepresent what I do in my practice based on your limited knowledge.

    Using your analogy about holistic medicine, why use Namenda at all, there are relaxation techniques and non pharmacologic pain methodologies to deal with headache pain, including massage and manipulation, methods you don't seem to believe in yet I have seen change patients lives who suffer from headaches. Although you paint me as someone who is quick to prescribe a medicine for someone, I am not, I am very methodical and carefully consider all factors before putting pen to paper.

    Regarding my prescribing medications for my patients for companies I am invested in and any conflicts of interest, that is also insulting, something you seem to be rather good at doing. I have a handful of patients in my practice on both Qsymia and Belviq. Not really making an impact on either companies balance sheet. In fact, compared to many of my colleagues, I am rather judicious in my prescribing of medication and work to limit medications whenever possible. All my patients who take medications are likely on something from a company that I have some investment in, either through stock or more likely through mutual funds I own. Yes, I even own stock in generic companies. So maybe I should not prescribe anything? No, I just don't make a decision about my patients healthcare based on my investments. Regarding Belviq and Qsymia, I feel strongly about their limited role in helping the curb the obesity epidemic in this country, when used with supported life style modification (or optimization as I call it) through diet and exercise, I have seen patients succeed in losing weight who had struggled to stay on reduced calorie diets in the past, even with extensive support. I am seeing patients I started on Qsymia last Sept and October still losing weight, so much so I am able to take them off some of the other dozen or so medications to treat the co-morbidities of obesity. These same patients had tried dieting and exercising in the past, only to end up heavier and even more ill a year later. For many of these patients, this is the first sustained weightloss they have had in their adult life, and they are empowered by that.

    So maybe I should stop prescribing Qsymia and Belviq for them, because clearly as a generalist I don't know what I am doing, I am not a weight loss expert after all. I should stop prescribing it for them because even though they have no side effects involving memory, a person on SA told me they should have those side effects and I am a bad Dr for prescribing these approved medications for my patients as they as indicated. Stop prescribing it for a side effect that is not even listed as a common side effect in the PI, not seen by most patients in either 12 month study or the 12 month followup study. If I have a patient report memory problems, (which according to reports from Topamax data is transient and resolved when patients stop taking the medication, so it does not appear to be a permanent memory loss as you seem to imply by connecting it with using Namenda ), I will discontinue it, but I refuse to kowtow to a phantom side effect my patients have not experienced.

    And thanks for quoting Ghandi, truly priceless in reminding me what it means to be a DO from someone who clearly is clueless....
    Jul 17, 2013. 09:02 AM | 1 Like Like |Link to Comment
  • First Manhattan Co. Goes All In On Vivus Bet [View article]
    Jakes, did you not read my lengthy response to your rambling and nonsensical comparison of Namenda and Qsymia? If not please do so as I am not about to take my time to retype it.

    Regarding Phen and Medicaid, so you are an expert on Medicaid coverage as well as a Namenda expert (not knowing that headache is a controversial usage of Namenda and certainly not a common use). In most states, here is what Medicaid coverage for all weight loss treatments, including Phen looks like: "Medications for the treatment of obesity are excluded from coverage...." Only 10 states cover any kind of obesity medications, and less than that cover phen.

    So it seems the Medicaid patient just has a raw deal in most states with any weight loss therapies, not just medication either. That is the sad truth. So I work with those patients, giving hours of weight loss counseling for which I am not reimbursed (yes I accept them, despite your desperate attempt to belittle me), they participate in my weight loss support groups I offer weekly after hours and I give them assistance to help plan reduced calorie meal planning, which is difficult given the food that is often available to them (you have an unusually great understanding of the poor demonstrated by your dollar tree comment, gleaned I would be from guess from your higher education and extensive experience working with those with lower income, way to go!)

    Since you continue to talk out of an orifice other than your mouth, making unfounded accusations about my practice that you know nothing about, from your place of hiding where no one knows who you are or what you do for a living, I will not waste my time or effort attempting to respond to your nasty drivel.

    I have shared my background, so what makes you an expert on all things, since you obviously think you are so clever. If you want to put your education and training or compassion for patients against my own, come out of the shadows and tell everyone a bit about your esteemed back ground.

    Seems to me, someone as bitter and berating as you does so because they have nothing to offer and it makes them feel better about themselves to try to tear others down.
    Jul 17, 2013. 12:27 AM | 1 Like Like |Link to Comment
  • First Manhattan Co. Goes All In On Vivus Bet [View article]
    I have been practicing for 25 years and have seem the value in controlled release medications. There is not a generic controlled released topiramate available, so you can not write the generic form of Q, your statement is incorrect.

    You can prescribe short acting topiramate with a separate prescription for phen, but that combo behaves differently in regards to side effect intensity due to plasma level spikes of immediate release preparation, I have seen that in my own patients who had tried the generic short acting form and did not tolerate it as well, something that is very important for a medication some patients may be taking for years.
    If you have been practicing for 40 years, surely you have seen benefit for your patients when other immediate release medications were released in a controlled release form (to be fair, the benefit varies depending on the drug, some meds it doesn't make much of a difference, with a medication like topiramate, where side effects are directly related to peak blood levels, it does make a difference.)
    You are right, you cannot fool practicing doctors.......
    Jul 16, 2013. 12:25 PM | 4 Likes Like |Link to Comment
  • Vivus's Qsymia Now Available At 8,000 Pharmacies - Is It Enough? [View article]

    I am a DO (an Osteopathic physician) and practice primary care and have been for more than a few years. I use common medical techniques to diagnose and treat patients for many ailments, prescribe drugs, perform surgeries, in addition to using osteopathic manipulative techniques to diagnose and treat patients. I focus on a more holistic approach to care, concentrating on wellness and preventative medicine and I trained for many years to be able to care for my patients in the manner I do today. In addition to my initial medical training, I complete many hours of medical education every year to stay current and skilled. For more information about DOs,

    Your personal attack is both upsetting and unacceptable. Even calling into question if I am even a real doctor... where the h*** does that come from and what gives you the right to make such an inflammatory comment? If it is because of my comments about what you said about Namenda, my comments were made because what you said above, that "Qsymia=Namenda" was very confusing. I was not sure what point you were trying to make and I was clarifying the indication for Namenda, which is for moderate to severe dementia of the Alzheimer's type. There is some data on using it to treat headaches (off-label use) but the data is not very convincing to me, at least not as convincing as the data on the use of Topamax to treat headaches. In fact, one of the most common side effects with Namenda is Headache (which is also a common side effect with Belviq, not Qsymia). So wasn't sure where you were going with your linking of Qsymia and Namenda, that was my point. I am well aware of Namenda's use (and off-label touted uses)
    I take great care in how I chose to treat my patients, that includes what medications I chose to prescribe. Each patient I have started on Qsymia I have carefully considered and felt it was the right option and the benefits outweighed any potential risks for that patient, just as I had to do for the patients I have started on Belviq.
    I have to make a comment here, that it is interesting that with all the positive comments I have made about Arena and Belviq (yes I am Arena and Vivus long, I am betting on both companies and believe in the future of both medications), I have never been attacked or bashed by a Vivus or Qsymia supporter... never. Dozens of positive Arena and Belviq posts, not a single lashing out. Yet any time I make a positive comment about Qsymia, I get bashed over and over by Arena nuts and frankly I am tired of it. As an Arena investor I understand the frustration with the lack of traction of the stock lately, with many times what I considered positive news I thought would have lifted the stock. And then I look at my Vivus investment and see it starting to climb. It makes many Arena investors think the whole world is against them, and maybe that is why they are lashing out at anything they perceive as pro-vivus and or anti-arena. I see the lack of stock traction differently and therefore am not so bitter..... I think, like it or not, most investors (other than the attacking nutcases) are waiting for clear signs of a sustained positive sales trend, and I believe we will see it over the next few months and will see the stock start to take off again. I am in it for the long run, and by long I do not just mean a few months.
    So bash me if you want, but you are right, I am far too busy as a doctor to take the time to respond to inflammatory nonsense such as what you posted about me. Your personal attack was unnecessary and unacceptable.
    I try to be fair and unbiased in my posts here, I have tried to provide counter balance when I read something that appears to either be written in error or present only one side of the equation. I also thought by posting my own experiences with both Qsymia and Belviq (both of which have been positive so far), it would help others gain some insight into the real world side of their investment.
    I am not happy about having to take so much time to respond to this and debated whether I wanted to invest that much time, however I did not want to leave this personal assault without a response. I will not, however, be goaded into defending my professional qualifications again. Just don't have the time...

    Just for fair balance, Jakes, maybe you can share your professional qualifications for making any of the comments that you post here, let other judge how they stand up to mine.
    Jul 13, 2013. 03:09 AM | 1 Like Like |Link to Comment
  • Vivus's Qsymia Now Available At 8,000 Pharmacies - Is It Enough? [View article]
    Gian, I understand your interest in this, and I am sure some weight loss centers may try having patient take both, and some patients on their own may doctor shop like they do with opioids, getting one med from one doctor, the other from the another, because people get stupid sometimes when it comes to losing weight and would do anything, thinking if one is good, both would be better.

    I would not even consider it, I am far too conservative to think about pushing things that far. Besides, for most patients, paying for both meds (out of pocket cost) alone would be a deterrent. I have no idea how patients would react to lorcaserin and topiramate together, without any clinical evidence on potential risks I would not be willing to try. I am interested in seeing lorcaserin with phen data when it becomes available (in people, not mice, lol) that does intrigue me but again, I would likely wait for an approval, or at least for published data from large trial.
    Jul 3, 2013. 10:27 AM | 1 Like Like |Link to Comment
  • Vivus's Qsymia Now Available At 8,000 Pharmacies - Is It Enough? [View article]

    I am a physician, have been using Topamax for years, mostly for migraine, and in some patients, not most, have seen some memory issues, usually at higher doses.

    I now have over 6 months experience with Qsymia and have reviewed the clinical data thoroughly, I have not had a single patient have issues with this, it is part of the standard questions I have been asking when they come for monthly followup. Mostly I am hearing constipation, taste change and tingling in the fingers, but not so troublesome they want to stop taking it. I truly believe this is due to the fact that the topiramate is controlled release slowly over 24 hours and the dose is so much lower than used for seizures.

    Peak plasma concentration at cMax is where you are most likely to experience side effects with medications, by eliminating the peak plasma spikes you get with generics, it is reasonable to expect less severity in side effects and I believe that is the case with Qsymia.

    Also, by titrating slowly and starting with tiny doses the way Vivus recommends, this also lessens the likelihood of these side effects, that is specifically mentioned in their PI.

    It is important to distinguish between potential side effects, that is anything that has ever been observed with patients taking the medication and common side effects, memory issues were not commonly reported in either of the two large scale Qsymia trials that lasted a year.

    Namenda is used for Alzheimer's, not sure I have a lot of elderly dementia patients I will be starting on either Belviq or Qsymia, so not sure where you get the idea they are going to be put on Namenda. If you don't understand the appropriate use of Namenda and are just trying to make an uninformed comment based on opinion, maybe look into it first.

    And yes you are trying to bash the drug, the verbiage you use and analogies you make show that clearly.

    So why do I write Qsymia? Because it works, most of my patients are losing weight consistently at a rate of about 1-2 lbs a week, several patients who had failed at diet after diet are down over 30 lbs since October and keep losing. The big thing is they tell me the hope the now have, they believe with Qsymia they are able to stick to the life style changes we have been trying to do for years, but failed when doing it on their own because their bodies would always fight them from losing the weight.

    I expect Belviq to work equally well for my patients, after I identify if they are responders or not. I will know more in a few weeks when my first patients started on Belviq start coming back for monthly follow up and to get their next Rx. I will be asking them similar questions about mental status issues, memory, attention, etc, because they are all potential side effects. Based on the clinical trials, I don't expect to hear much here either, because while they are potential, they do not appear to be common. I have to admit I will be looking more closely at Belviq and judging it more carefully, simply because of the limited amount of use and information we have. But that is the point of good medicine, helping the patient means taking calculated risks, even taking aspirin has its risks. Taking the time as a health care provider to follow the patients closely is the tricky part in today's managed care "get'em in and out" as fast as possible world we live in. With things like treating obesity, it takes a little more time to talk to the patient, counsel them, listen to them and encourage them. Just handing them a prescription for Qsymia or Belviq and pushing them out the door could spell doom for either of these medicines, they are not placebo, they are real medicine. Care must be taken, but I believe the risks for both can be managed if the provider is mindful.
    Jul 3, 2013. 10:12 AM | 1 Like Like |Link to Comment
  • Vivus's Qsymia Now Available At 8,000 Pharmacies - Is It Enough? [View article]

    yes Wisconsin cheesehead and a DO.... Don't know if sports plugs are allowed, but BIG packers fanatic..... Think it is brain washing at birth, lol

    Thanks for positive words but not needed, just sharing my insights but gets me fired up when I see misinformation or opinion being presented as fact. That includes if I see any erroneous Belviq bashing, I will correct it, but haven't observed that as much as the Qsymia attacks. I've never seen so much direct pumping or bashing of products by investors, usually they are supporting or bashing management and management decisions, or the company's financials, not the products they make.

    Have several patients on Belviq now, rep is nice and well informed. Both Vivus and Eisai reps have been respectful about the other competitor product so far and very professional, just informing about their own med and talking about obesity treatment in general. I wish Arena and Vivus investors could get along like that! lol
    Jul 2, 2013. 10:14 PM | 1 Like Like |Link to Comment
  • Vivus's Qsymia Now Available At 8,000 Pharmacies - Is It Enough? [View article]

    As a physician, I am aware of many successes of medications that took short acting twice a day generics and put them in a once a day branded drug and had very successful products, and in those cases for usually the same or a more limited indication. Dozens of cardiovascular drugs, psych drugs, etc. (Toprol-XL was a good example, which sold over a Billion $ when cheap generic twice daily metoprolol was available the whole time. Why? Because for many medications, slow, controlled release of the med over 24 hours makes a big difference.

    If Qsymia had used short acting topiramate you might have a valid point, or if there was a long acting extended release generic topiramate on the market, but since neither case is true, your point simply is invalid. With Qsymia containing the only form of controlled release once daily topiramate on the market, it makes all the difference in efficacy and tolerability and there is no generic equivalent.

    If you need me to list the numerous examples of other meds I have used where both I and my patients prefer the controlled release once a day brand over the twice a day cheaper and less tolerated generics, let me know, I'll put a list together when I have time. Off the top of my head... Concerta vs cheap Adderall, Long acting insulin like Lantis vs short acting insulin, Carbatrol vs Carbamazepine, Oxycontin for pain vs cheap short acting oxycodone..... the list could go on forever and I think the point is clear.... Extended release is no gimmick but a clear benefit for the patient, simply the fact Joseph.

    Also, I agree Qsymia has serious risks, as many medications do, including Belviq. I will use both, keeping things like potential clefts and serotonin syndrome in mind so I can balance risk vs benefit. I am invested in both companies for a reason, I believe both medications will find their patients/customers or vice versa and as a duel investor I believe I am seeing upsides and downsides of both meds clearly. It seems your one sided investment in Arena is making is making you only see the good in Belviq and the bad in Qsymia and seems to give you the false belief there can be only one winner. That is simply not the case.
    Both products and companies can have a bright future without one having to fail, there are simply too many obese people in the world that need help and have not had it until now and too many reasons they are obese to think one product is the answer for all. I even welcome more products to come to market, if they look good I will probably invest in them, have a few I have been watching recently.
    Jul 2, 2013. 09:48 PM | 2 Likes Like |Link to Comment
  • Vivus's Qsymia Now Available At 8,000 Pharmacies - Is It Enough? [View article]

    Nice article,

    I do think this will have a big impact, and right away.

    I have many colleagues who have told me they were interested in prescribing it, but the whole filling out the mail order paperwork and having their staff take time to deal with gathering the information requested on the form and faxing it looked like too much of a PIA for them to bother. In addition, I have heard several reports from others who tried to order it and the mail order system failed, either they didn't get the faxes, the paperwork wasn't filled out properly, the pharmacy couldn't (or didn't) reach the patient by phone for payment information needed to process the Rx. Weeks later the physician heard patient never got the Qsymia.

    Based on my own patients poor experience with some of the mail order pharmacies Vivus used for Qsymia, we have no idea how many prescriptions were lost for Qsymia during the whole faxing in the Rx, mail order pharmacy trying to reach the patient by phone for payment information and then the 2 week wait for the prescription, then repeat with every refill.

    This will not only have positive impact on new Rxs, but on refill business..... now that patients can be handed a Qsymia Rx, drive down the street and pick it up immediately. My staff is relieved they no longer have to deal with the paperwork and faxes, my first patient actually picked up Qsymia at Walgreens yesterday, they had it on the shelf, so must have been auto shipped from the warehouse.

    The new discount plan looks good also to get patients started so they can try it out, and doesn't give the farm away forever for long term profitability since it discounts first 3 months only after 2 first 2 weeks free..... Belviqs program lasts longer, 12 fills, but first 100 days makes or breaks diets. If they are on Qsymia for 100 days and losing the kind of weight patients in the studies did, they will be likely to continue, especially as more insurance plans continue to pick it up. My patients who have been on it for months are on track with the weightloss seen in the clinicals, have not had any major side effect issues.

    Both the discount programs for both products are adequate, much better than what Vivus offered initially, looks like they have progressively learned what patients want and need as they have made adjustments to this program.
    Jul 2, 2013. 08:27 AM | 3 Likes Like |Link to Comment
  • Arena's Belviq Discounts And Impacts On Revenue [View article]
    Thanks for sharing link, Vitosoranno. Interesting to hear Dr Aronne speak.
    Jun 14, 2013. 09:28 PM | 1 Like Like |Link to Comment