how many of u are you stuck with? 80-90% of RX's coming from speakers or attendees? How bogus are they right! Seems like they continue to blur the lines. Are you keeping track for the DOJ? If you aren't you're an idiot PS- sacubitril reduces volume right? How about a trial with same diovan dosage + HCT Vs Diovan/Sacubitril ? Wonder how that would turn out Hmmmmmmmmmmm
Untrusto featuring it's own "speaker direct netowrk" http://entrestospeakerdirect.com/newuser/welcome makes it easy for the govt to obtain records : - )
lol what a joke, you'll get the same results with diovan HCT prove me wrong Even with the (lowest dose) mono Enalapril the results were 20% vs 24% (untrusto) the highest dose of valsartan & the unproven unstudied SuckUbitril (where are trials on SuckUbitril mono??????) Expain how a trial is = with a combination Vs Mono ???? Hmmmm Most parents & their kids will be happy to spend $300 a year Vs $4000-5000 Anyone with a brain knows that laughable trial conducted by high paid pharma whore Milton Packer had as many holes as most swiss things like their cheese for instance Besides don't take my word for it , take the prescribing community that is shunning this latest novartis snake oil (like Tekturna , Amturdnide , Valtuna before them) Tell you one thing , at some point with the recently announce $200 million "boost" in desperation marketing Novartis just annouced be prepared to be sitting in front of the DOJ sooner than you think & we'll see how many docs will be stupid enough to attend the same "speaker programs" 10x a year this go round Notable Quotes PARADIGM-HF study compared a high dose of valsartan, 160 mg twice a day, (plus sacubitril) to a medium dose of enalapril, 10 mg twice a day. Apparently, no trial comparing just valsartan 160 mg to enalapril 10 mg twice a day has been done. So it is quite possible that a high dose of valsartan is better than a medium dose of enalapril. Thus, PARADIGM-HF could not prove that sacubitril has any benefit independent of high dose valsartan. PARADIGM-HF design prevented any assessment of the adverse effects of sacubitril independent of those of valsartan. Furthermore, the trial had an active run-in period which resulted in the exclusion of patients who failed to tolerate valsartan-sacubitril in a pre-trial run-in period. This effectively biased downward the prevalence of adverse effects due to the combination reported during the trial. In a recent Medscape post, Dr John Mandrola noted additional problems with the study that raise doubts about its validity. These included its early termination, the very large number (1000) of study sites raising doubts about quality control of implementation and data collection, and the finding, not emphasized by the authors, that valsartan-sacubril caused an apparent increase in hypotension, a significant issue for CHF patients. There have been no other big trials of sacubitril, with or without valsartan, so there are no other source of clinical research data to address these questions. As we notedhere, one of the most prominent PARADIGM-HF investigators tried to rebut Dr Prasad, but did so mainly by employing logical fallacies. So in my humble opinion, there is only weak, ambiguous data to show valsartan-sacubitril produces benefits that outweigh its harms for congestive heart failure patients seen in usual clinical practice. Note that the article disclosed Dr Cleland does research funded by Novartis, maker of Entresto, and Dr Packer is a consultant to Novartis. Is is possible these commercial relationships tempered any concerns that might have had about the study design. Again, it is not clear that Entresto would be better than generic enalapril dosed at 20 mg/day, which is a lot cheaper than $4,500 a year. But could it be that visions of billions of dollars have clouded some peoples' thinking, at least people paid by or owning stock in Novartis? Unfortunately, Entresto (valsartan-sacubitril) is now one of a long line of new drugs that are breathlessly hyped, often by people who should know better, despite weak evidence in their favor. It is one of a long list of examples of drugs approved based on poorly designed studies whose design flaws seem likely to make their commercial sponsors' products look better.
To convince us that we live in the best of all possible worlds, however, the media is full of proclamations that we are in a new era of marvelous medical and health care "innovations" that will bring us all untold benefits. The notion that physician-industry collaboration is necessary to continue to produce these wondrous "innovations" is a talking point used to counter those who criticize conflicts of interest affecting academic medicine. Yet the evidence supporting many game-changers and blockbusters is often weak and ambiguous. This rarely seems to deter the drug, device and biotechnology industry from charging more and more for them. The sober, evidence-based medicine approach is being lost in all the hoopla and hucksterism. We are adopting treatments of unproven value, whose benefits may be much less, and harms may be much worse than we imagine, and paying unconscionsable prices for them. The results for patients and society include our ever rising health care costs, ever challenged access, and no evidence that outcomes are better for patients. True health care reform would encourage sober discussion of the evidence, of benefits and harms, and of fair pricing, and would challenge the hype, hucksterism, and conflicts of interest that all swirl around modern health care.
You have point. However, I don't think it's hype because the market has spoken, 1 year into launch entresto has 20k patients on it. So doctors have decided to use it after ace s and if its covered. Nvs is guilty of beating the drum for wall street that this is a $ 7 billion drug. It's not. It's place in the market is small. I wont say don't use it because it has helped some.
All which begs the question, just how unbiased & truly educational in nature are these "entresto speaker programs?"
So much typing, yet so easy to refute: 1) a massive claims review of the largest US payers shows that in HF the average dose of Enalapril is 10 mg 2) patients in PARADIGM were on HCT in both arms 3) pretty easy to see why all the guidelines for HF now include Ent 4) PARADIGM was halted early because it would have been unethical to doom Enalapril patients to a quicker fate 4) Original poster is confusing Hypertension and HF or has no clue what dose of ACE Cardios use You should get informed before you spend so much of your time typing inane drivel.
snake oil noun NORTH AMERICAN Entresto with no real HF advantage over existing therapies value sold as an improvement for HF a product, policy, etc. of little real worth or value that is promoted as the solution to a problem. By extension, a snake oil salesman is someone who knowingly sells fraudulent goods or who is themselves a fraud, quack, charlatan or paid novartis speaker.
Untrusto = diovan with mystery meat added no one on earth knows what TF suckUbitril does or perhaps they do locked in some basel vault hence the reluctance to perform public trials with it as mono therapy This is vanlev redux
Thank you. It's amazing that the original post has no understanding of the drug or HF in general. Original poster. There is NO Mortality benefit with diuretic therapy, it's used for symptom control, so, NO, YOU WOULDN'T GET THE SAME BENEFIT WITH DIOVAN HCT , YOU FOOL! If you don't understand this, just quit. Go work on a Denny's making grand slam breakfasts…
Thank you. It's amazing that the original post has no understanding of the drug or HF in general. Original poster. There is NO Mortality benefit with diuretic therapy, it's used for symptom control, so, NO, YOU WOULDN'T GET THE SAME BENEFIT WITH DIOVAN HCT , YOU FOOL! If you don't understand this, just quit. Go work on a Denny's making grand slam breakfasts…
LOL what are the speaker programs for ? Is it to ejumacate on nearly 20 year old diovan? That had 80,000 or so speaker programs already? Is it about val-heft which was a decade ago? Since you're so smart explain to the uninformed WTF it is about the SuckUbitril that helped with the meager 4% difference in outcomes since you're apparently too stupid to understand the numerous design flaws on that trial peformed by pharma whore & novartis shill milton packer?
Yes doctors world wide need more education on ARB's because there hasn't been enough in 20 years from Cozaar Avapro Diovan Micardis Teveten Benicar Attacand..... SMH phycians attending this crap should be ashamed
Who wouldn't be horrified to know their doctor feinged ignorance of ARB's to get on the $ train for this POS drug not to mention if he/she couldn't explain the NI function with respect to how it impacted the trial then it would be near malpractice to use it in heart failure with so many co morbid conditions already present & the huge risk of hypotension. Medicine Russian Roulette style. Risk of Legal liability should be printed on the PI
Do doctors today even attend speaker programs? I mean, it's not like this is a new exciting thing. And it's not like the 80s when the doctor could bring a spouse for a nice evening out at a nice restaurant. And if a cardiologist attends an annual cardiology conference he will learn about new drugs anyway. Why do drug companies even bother with speaker programs these days? Seems like a huge waste of resources.
