Major pharma spends much more revenue on promotion for medicine that have lessen health and fitness gains for people, according to a analyze published in JAMA on Tuesday, shedding new light on the pretty much uniquely American observe amid fierce discussion in excess of irrespective of whether direct-to-customer prescription drug ads need to be banned.
Major pharma spends extra revenue on promotion for medicines that have reduce extra overall health added benefits for … [+] sufferers, study implies.
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Crucial Info
The proportion of marketing expending allocated to direct-to-consumer advertisements was an ordinary of 14.3 percentage details increased for medicine with a very low added benefit compared to all those with a substantial included advantage, according to the peer-reviewed evaluation of the 150 very best-selling branded prescription medication in 2020.
Nearly two-thirds of the country’s best-selling prescription drugs—92 of the 135 medicines details was out there for—were rated as presenting individuals lower extra reward by health companies in France and Canada, the scientists identified, relying on the foreign companies as no U.S. company compares prescription prescription drugs for success.
Promotional spending for prescription medicine different wildly, the scientists claimed, with a median shell out of $20.9 million for each drug and a median of 13.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of the advertising budget allocated to direct-to-customer ads.
Manufacturers of the best six very best-advertising medicine invested the bulk of their advertising budgets—more than 90{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}—targeting people right relatively than clinicians for a variety of treatment method selections for situations which include HIV, various sclerosis and many cancers.
Meanwhile medicines that take care of metabolic troubles and digestive tract challenges been given a substantially decrease share of immediate-to-client promotion in comparison to all round advertising budgets, the scientists mentioned.
The findings could propose pharma corporations are aiming marketing pounds immediately in direction of buyers, relatively than clinicians, as element of a “strategy to generate patient demand from customers for medications that clinicians would be significantly less most likely to prescribe,” claimed the study’s guide author Michael DiStefano, a researcher at Johns Hopkins.
Surprising Actuality
Just two nations in the globe permit drug makers to industry prescription medications immediately to buyers: the U.S. and New Zealand. Most countries ban the observe.
Key History
Most nations around the world prohibit right advertising and marketing prescription remedies to the community, a little something the WHO states influences both of those men and women and, indirectly, the health care pros treating them, creating it “harder to make choices on evidence dependent medicine.” The American Medical Affiliation opposes the apply and, alongside other health and fitness organizations, is pushing to outlaw it in the U.S. Pharmaceutical companies assert individuals gain from the commercials and that they have a ideal to know what selections are offered to them. Critics argue the ability to sideline professionals and marketplace to the community directly incentivizes organizations to exaggerate the advantage of their medications with out detailing attainable facet outcomes, a condition regulators hoped to cure by requiring adverts to dedicate time to hazards, primary to the well-recognized, speedy fire laundry record of aspect outcomes.
Major Selection
$6 billion. That’s how considerably researchers estimate pharma used on direct to client adverts in 2016. The determine grew noticeably from 1996, when purchaser ad budgets totaled $1.3 billion.
Essential Quote
“Another thought is the U.S. doesn’t at the moment level prescription medicines,” explained research writer Gerard Anderson, a professor of well being coverage at Johns Hopkins. “Imagine if the drug advertisements you noticed on Television have been needed to convey to you how well the drug executed in opposition to alternate drugs for the similar ailment. That may possibly improve how fascinated you would be in the drug.”
In 2013, Grace E. Elliott spent a night in a hospital in Florida for a kidney infection that was treated with antibiotics. Eight years later, she got a large bill from the health system that bought the hospital. This bill was for an unrelated surgical procedure she didn’t need and never received. It was a case of mistaken identity, she knew, but proving that wasn’t easy.
Shelby Knowles for KHN
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Shelby Knowles for KHN
In 2013, Grace E. Elliott spent a night in a hospital in Florida for a kidney infection that was treated with antibiotics. Eight years later, she got a large bill from the health system that bought the hospital. This bill was for an unrelated surgical procedure she didn’t need and never received. It was a case of mistaken identity, she knew, but proving that wasn’t easy.
Shelby Knowles for KHN
Earlier this year, Grace Elizabeth Elliott got a mysterious hospital bill for medical care she had never received.
She soon discovered how far a clerical error can reach — even across a continent — and how frustrating it can be to fix.
During a college break in 2013, Elliott, then 22, began to feel faint and feverish while visiting her parents in Venice, Fla., which is about an hour south of Tampa. Her mother, a nurse, drove her to a facility that locals knew simply as Venice Hospital.
In the emergency department, Elliott was diagnosed with a kidney infection and held overnight before being discharged with a prescription for antibiotics, a common treatment for the illness.
“My hospital bill was about $100, which I remember because that was a lot of money for me as an undergrad,” said Elliott, now 31.
She recovered and eventually moved to California to teach preschool. Venice Regional Medical Center was bought by Community Health Systems, based in Franklin, Tenn., in 2014 and eventually renamed ShorePoint Health Venice.
The kidney infection and overnight stay in the E.R. would have been little more than a memory for Elliott.
Then another bill came.
The Patients: Grace E. Elliott, 31, a preschool teacher living with her husband in San Francisco, and Grace A. Elliott, 81, a retiree in Venice, Fla.
Medical Services: For Grace E., an emergency department visit and overnight stay, plus antibiotics to treat a kidney infection in 2013. For Grace A., a shoulder replacement and rehabilitation services in 2021.
Service Provider: Venice Regional Medical Center, later renamed ShorePoint Health Venice.
Total Bill: $1,170, the patient’s responsibility for shoulder replacement services, after adjustments and payments of $13,210.21 by a health plan with no connection to Grace E. Elliott. The initial charges were $123,854.14.
What Gives: This is a case of mistaken identity, a billing mystery that started at a hospital registration desk and didn’t end until months after the file had been handed over to a collections agency.
Early this year, Grace E. Elliott’s mother opened a bill from ShorePoint Health Venice that was addressed to her daughter and sought more than $1,000 for recent hospital services, Elliott said. She “immediately knew something was wrong.”
Months of sleuthing eventually revealed that the bill was meant for Grace Ann Elliott, a much older woman who underwent a shoulder replacement procedure and rehabilitation services at the Venice hospital last year.
Experts said that accessing the wrong patient’s file because of a name mix-up is a common error — but one for which safeguards, like checking a patient’s photo identification, usually exist.
The hospital had treated at least two Grace Elliotts. When Grace A. Elliott showed up for her shoulder replacement, a hospital employee had pulled up Grace E. Elliott’s account by mistake.
“This is the kind of thing that can definitely happen,” said Shannon Hartsfield, a Florida attorney who specializes in health care privacy violations. (Hartsfield does not represent anyone involved in this case.) “All kinds of human errors happen. A worker can pull up the names, click the wrong button, and then not check [the current patient’s] date of birth to confirm.”
It was a seemingly obvious error: The younger Elliott was billed for a procedure she didn’t have by a hospital she had not visited in years. But it took her nearly a year of hours-long phone calls to undo the damage.
At first, worried that she had been the victim of identity theft, Grace E. Elliott contacted ShorePoint Health Venice and was bounced from one department to another. At one point, a billing employee disclosed to Elliott the birthdate the hospital had on file for the patient who had the shoulder replacement — it was not hers. Elliott then sent the hospital a copy of her ID.
It took weeks for an administrator at ShorePoint’s corporate office in Florida to admit the hospital’s error and promise to correct it.
In August, though, Grace E. Elliott received a notice that the corporate office had sold the debt to a collections agency called Medical Data Systems. Even though the hospital had acknowledged its error, the agency was coming after Grace E. Elliott for the balance due for Grace A. Elliott’s shoulder surgery.
“I thought, ‘Well, I’ll just work with them directly,’” Grace E. Elliott said.
Her appeal was denied. Medical Data Systems said in its denial letter that it had contacted the hospital and confirmed the name and address on file. The agency also included a copy of Grace A. Elliott’s expired driver license to Grace E. — along with several pages of the older woman’s medical information — in support of its conclusion.
“A collection agency, as a business associate of a hospital, has an obligation to ensure that the wrong patient’s information is not shared,” Hartsfield said.
In an email to KHN, Cheryl Spanier, a vice president of the collections agency wrote that “MDS follows all state and federal rules and regulations.” Spanier declined to comment on Elliott’s case, saying she needed the written consent of both the health system and the patient to do so.
Elliott’s second appeal was also denied. She was told to contact the hospital to clear up the issue. But because the health system had long since sold the debt, Elliott said, she got no traction in trying to get ShorePoint Health Venice to help her. The hospital closed in September.
Resolution: In mid-November, shortly after a reporter contacted ShorePoint Health, which operates other hospitals and facilities in Florida, Grace E. Elliott received a call from Stanley Padfield, the Venice hospital’s outgoing privacy officer and director of health information management. “He said, ‘It’s taken care of,’ ” Elliott said, adding that she was relieved but skeptical. “I’ve heard that over and over.”
Elliott said Padfield told her that she had become listed as Grace A. Elliott’s guarantor, meaning she was legally responsible for the debt of a woman she had never met.
Elliott soon received a letter from Padfield stating that ShorePoint Health had removed her information from Grace A. Elliott’s account and confirmed that she had not been reported to any credit agencies. The letter said her information had been removed from the collection agency’s database and acknowledged that the hospital’s fix initially “was not appropriately communicated” to collections.
Padfield said the error started with a “registration clerk,” who he said had “received additional privacy education as a result of this incident.”
Devyn Brazelton, marketing coordinator for ShorePoint Health, told KHN the hospital believes the error was “an isolated incident.”
Using the date of birth provided by a hospital worker, Elliott was able to contact Grace A. Elliott and explain the mix-up.
“I’m a little upset right now,” Grace A. Elliott told KHN on the day she learned about the billing error and disclosure of her medical information.
The Takeaway: Grace E. Elliott said that when she asked Padfield, the Venice hospital’s outgoing privacy officer, whether she could have done something to fight such an obvious case of mistaken identity, he replied, “Probably not.”
This, experts said, is the dark secret of identity issues: Once a mistake has been entered into a database, it can be remarkably difficult to fix. And such incorrect information can live for generations.
For patients, that means it’s crucial to periodically review the information on your patient portal — the online medical profile many providers use to manage things like scheduling appointments, organizing medical records, and answering patient questions.
One downside of electronic medical records is that errors spread easily and repeat frequently. It is important to challenge and correct errors in medical records early and forcefully, with every bit of documentation available. That is true whether the problem is an incorrect name, a medication no longer (or never) taken, or an inaccurate diagnosis.
The process of amending a record can be “very involved,” Hartsfield said. “But with patients able now to see more and more of their medical records, they are going to want those amendments, and health systems and their related entities need to get prepared for that.”
Grace A. Elliott told KHN that she had received a call from ShorePoint Health in the previous few months indicating that she owed money for her shoulder replacement.
She asked for a copy of the bill, she told KHN. Months after she asked, it still hadn’t arrived.
KHN (Kaiser Health News) is a national, editorially independent program of KFF (Kaiser Family Foundation).
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Crystal Pauley, a former physician assistant, didn’t believe in so-called chronic Lyme disease — until she became sick.
Many health care providers reject chronic Lyme disease as a diagnosis. One 2010 survey found that just six out of 285 primary care doctors surveyed in Connecticut — an epicenter for the tick-borne infection — believed that symptoms of Lyme disease persist after treatment or in the absence of a positive Lyme test.
When Pauley worked for the La Crosse, Wisconsin-based Gundersen Health System, she remembered hearing about a friend from high school battling chronic Lyme in Australia. But she had her doubts. “I’m working in the medical field,” she said. “We’ve never learned about that.”
Years later, Pauley has changed her mind. Pauley tested positive for Lyme in 2020. She suffers from unrelenting fatigue, joint pain and brain fog. She walks up stairs sideways because of the unbearable knee pain. Pauley said she has become “pseudo-Lyme literate” because of her own personal journey.
Pauley belongs to a cohort of patients with Lyme-like symptoms but negative test results or patients with positive test results who suffer from lingering symptoms long after treatment. They call it chronic Lyme disease, while the Centers for Disease Control and Prevention labels it as Post-Treatment Lyme Disease Syndrome (PTLDS). The CDC says there is no known treatment for the condition.
“Their symptoms are always real. They’re experiencing them,” said Dr. Joyce Sanchez, an infectious-disease associate professor at the Medical College of Wisconsin who treats Lyme patients with persistent symptoms.
“If someone is having physical symptoms and isn’t feeling listened to, then they’ll have mental health repercussions and then that will impact their physical well-being,” she said. “And then it’s a spiral that if you don’t address both components of health, you’re not going to make much progress on either side. And they will continue to feel sick.”
Wisconsin Watch talked with five Wisconsin patients, all women, who have been searching for validation and experimenting with personalized treatments as part of a long and sometimes grueling battle with the illness. The infection comes from tiny ticks primarily found in the northeastern United States, including in Wisconsin — which is a hot spot for Lyme, ranking No. 5 among states for Lyme cases in 2019.
One of the five tested positive for Lyme using a two-step testing recommended by the U.S. Centers for Disease Control and Prevention. Three others tested positive using a test not recommended by the CDC. The fifth woman was diagnosed as possibly suffering from the disease by a “Lyme-literate” practitioner.
Pauley, 37, who as a student cranked through medical textbooks, began having trouble remembering a simple medication direction. She put up sticky notes around her office to jar her memory.
Alicia Cashman, 57, runs the Madison Area Lyme Support Group. She recalled unbearable pelvic pain beginning in 2010. “This causes pain of a magnitude that makes you want to die,” she said.
The pain metastasized quickly. She felt joint pain, headaches, insomnia and extreme fatigue. “It was so bad that I just wanted to be in a dark room with no smell, no sound, no light. Your body has succumbed to this,” she said.
Shelbie Bertolasi, 47, is a stay-at-home mother in Waukesha with four children ages 5 to 24. Until about seven years ago, she was healthy and stuck to a workout routine.
Shelbie Bertolasi was diagnosed with Lyme disease in July 2020 after suffering for many years with a variety of medical issues, including sweats, joint pain, rashes, intestinal issues and a miscarriage of twins. A naturopath finally recommended a Lyme test after she visited numerous doctors who she says failed to take her symptoms seriously. “I just want people to understand that Lyme is real. It’s not in our head. I want doctors to understand. I told doctors about my brain fog. My regular doctor wouldn’t even believe me.” She is seen at her home in Waukesha, Wis., on Dec. 1, 2021. (Coburn Dukehart / Wisconsin Watch)
Bertolasi’s health steadily deteriorated starting in early 2015 when she miscarried twins. Then, she developed a high fever, with stomach and intestinal pain. She lost 30 pounds in a month due to constant diarrhea. Doctors flagged and treated excessive bacteria in her small intestine. She felt better but gradually was beset by continual pain in her joints, back, knees and hip.
Sometimes, she loses feeling in her feet. “It’s a nuisance when you’re in the middle of (driving), and you can’t feel the pedals that well,” she said.
Judy Stevens, 52, a former school counselor and psychotherapist from Wauwatosa, says shortly after the loss of her father, she was hit by joint pain, brain fog, insomnia, hair loss and night sweats. She was an athletic person, a cross-country coach at school and a triathlete.
None of these women recalled seeing a tick, except Jessica Croteau, who lives in Rice Lake. The 34-year-old noticed a tick on her neck in the summer of 2019 at home and started to have flu-like symptoms, but she tested negative for Lyme. Croteau suffered bouts of low-grade fever, a stiff neck and gastrointestinal problems. She ended up visiting the emergency room when her blood pressure spiked.
Going down ‘rabbit holes’
Often, chronic Lyme patients present multiple symptoms that make their diagnosis challenging. They bounce from one specialist to another to tackle each problem, but each diagnosis cannot explain all of the symptoms they are experiencing.
Cashman underwent an MRI because of her severe pelvic pain, and the results found two deflating ovarian cysts which can cause severe pain in the lower abdomen. But that diagnosis did not explain the unbearable pain that gravitated to her knees and to her head. She recalled that the swollen knee “got red hot to touch,” and she developed a fever.Cashman began to look for causes. “Not everything is Lyme, but everything can be (Lyme),” she said. “It’s a weird thing, but you got to go down these rabbit holes.”
Croteau saw specialists, including emergency physicians, a cardiologist, a kidney specialist and an immunologist. All the tests she took were negative for Lyme disease. She was told the problems may be related to psychological issues.
“So basically, it’s been a timeline of two years of not being taken seriously, just pushed away — either told I can’t do anything for you (or) there’s nothing really wrong with you,” Croteau said.
Judy Stevens, 51, was diagnosed with Lyme disease in July 2017, but thinks she may have had it since childhood. Her symptoms included brain fog, depression, insomnia, and she said she was often treated as a psychiatric patient by the more than 30 different doctors she saw. Prior to remission in 2020, she says she was taking more than 40 herbs and supplements a day. She estimated it cost her $25,000 to $50,000 a year to treat her Lyme disease. “It was a huge strain on us. I can’t even imagine not having the resources,” she said. “This is people’s reality. It’s really costly to get better and stay better.” She is pictured at her home in Wauwatosa, Wis., on Dec. 1, 2021. (Coburn Dukehart / Wisconsin Watch)
A medical provider suggested that she seek counseling and increase her dose of anti-anxiety medicine. But the pain in her joints and wrists were real, and her knuckles often got swollen. The brain fog made it hard for her to punch in a phone number correctly.
Bertolasi saw a pain specialist, a psychiatrist, a spinal therapist and a neurologist. They diagnosed her with SI joint dysfunction. Back surgery, therapy and exercise relieved some of her pain, but her knees continue to hurt. She was told, “You’re getting older, (so) things don’t work as well as they used to.”
Unsatisfied, in 2019, Bertolasi saw a rheumatologist who ordered several tests, including for rheumatoid arthritis and lupus, and the results were all negative. And the forgetfulness has persisted; she has left her phone in the refrigerator.
“You’re just surrounded by this dark (mental) fog, and you just don’t know how to navigate your way through,” she said.
After seeing around 30 specialists, Stevens had a bag of medications, including many prescribed psychotropic drugs. She went on those drugs, and her psychiatric symptoms got worse. However, she doesn’t blame doctors, who generally specialize in one area of the body or a family of diseases.
“When you have a whole slew of symptoms, it’s hard for the physicians to dig deeper,” she said.
Sometimes, patients with waning and waxing symptoms are labeled as malingerers who are faking symptoms to get attention. “This is very common with people with Lyme,” Stevens said.
Sanchez, the infectious disease doctor, worries that patients who do not get answers from mainstream medicine may gravitate toward unproven — and expensive — alternatives. But she sees no harm in some strategies that may offer relief, including meditation, tai chi, acupuncture or massage therapy.
No quick fix
Two of the five women interviewed by Wisconsin Watch have been diagnosed through the CDC’s two-step testing regimen: the ELISA test followed by the Western Blot, two different ways of looking for Lyme antibodies in the patient’s blood. Pauley tested positive for Lyme using the CDC’s recommended criteria, and Stevens tested positive on just one of the two tests.
Two others used a laboratory that administers the same tests but uses less-stringent criteria to determine whether a person has Lyme. Cashman and Bertolasi both tested positive through that testing. A 2014 Columbia University study found that some labs using their own criteria reported more false positive results — 57{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} — among people with no history of Lyme than the 25{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} false-positive rate using CDC criteria. Croteau used three different laboratories but tested negative each time.
With a Lyme disease diagnosis, Pauley took the standard treatment, doxycycline, for three weeks.
Judy Stevens is seen in the September 2015 photo when she says she was suffering from undiagnosed chronic Lyme disease. “I had lost 30 pounds and was almost put on a feeding tube. I clearly look very distressed and weak. At this time, I was diagnosed with an eating disorder, even though I was eating,” she said. Ten days later she had symptoms of Bell’s palsy in her face, and her husband took her to the emergency room because he thought she was having a stroke. She was told it was likely stress and was sent home. (Courtesy of Judy Stevens)
But when she completed the antibiotic therapy, she felt even worse. While her memory has improved, she has developed muscle pain, and her knees hurt even more. She felt tired, saying she could sleep 10 to 16 hours a day. But her doctor, following standard protocol, has told her she is done with treatment.
The same thing happened to Stevens. The doctor prescribed her 30 days of doxycycline and suggested that she seek a “Lyme-literate” doctor as she could not prescribe any longer course of antibiotics.
Stevens’ doctor followed CDC guidance, which recommends against prolonged antibiotic treatment, saying the harm outweighs the benefit. Sanchez echoed the argument, saying that doctors must weigh the risks and benefits of antibiotics, just like other prescribed medications.
“If we don’t see any plus side benefit to it, then we’re only exposing people to unnecessary risks,” she said. “Nothing comes with a free lunch. It’s important to be thoughtful about the right antibiotic at the right dose for the right amount of time.”
She also said some antibiotics could bring down inflammation as a side effect, making some patients feel better. This is also the point at which some patients begin experimenting with treatments that mainstream medicine does not recognize.
Sufferers try unconventional treatments
Cashman, living in Cataract, Wisconsin was also diagnosed with Bartonella, or Cat scratch disease, and went through five years of “systemic, holistic” treatments, which included a host of herbs, antibiotics, a high dose of vitamin C and supplements. She also received ozone therapy and laser therapy for pain relief. She is now nearly symptom-free, but still deals with spine stiffness.
Alicia Cashman shows a variety of treatments she uses for her chronic Lyme disease. Seen on her counter is a jar of homemade Japanese knotweed tincture, as well as a bottle of Dimethyl Sulfoxide (DMSO) and MSM power, which she puts into a homemade pain ointment — seen in the jar on the right. “We call it a ‘do it yourself disease’ because you have to be an active participant in your own healing,” she says. “I attribute my health today to doctors who were willing to work outside the box.” Photo taken Jan. 31, 2020. (Coburn Dukehart / Wisconsin Watch)
A bottle of A-Bart, an herbal supplement, is seen at the home of Shelbie Bertolasi in Waukesha, Wis., on Dec. 1, 2021. The bottle costs $90 and is just one of the many supplements Bertolasi takes to treat her chronic Lyme disease. “We spend tons and tons of money on treatments. There are things my family can’t do because of all the money we have to spend to treat the Lyme,” she says. (Coburn Dukehart / Wisconsin Watch)
Stevens found two Lyme-literate doctors in Wisconsin who are versed in both Western and alternative medicine. She said she was co-infected with Relapsing Fever, Babesiosis and Bartonella. She said her treatments are highly individualized, and her doctors tweak her therapies from time to time. At one point, Stevens was on more than 40 types of herbs and supplements.
“I’m living proof that I got better as a result of all those herbal treatments,” she said. “I was not on antibiotics for four or five months.”
Bertolasi turned to a Lyme-literate doctor who also treats one of her friends with similar symptoms. Besides Lyme, she was also diagnosed with Bartonella. She has completed a 14-month course of antibiotics. Now, besides taking herbal supplements, Bertolasi follows a strict diet excluding alcohol, dairy, gluten and sugar to reduce inflammation in her body.
Shelbie Bertolasi explains the variety of supplements she takes to treat her Lyme disease. Bertolasi has spent the past few years treating her symptoms with a variety of supplements, some of which cost anywhere from $30 to $90 a bottle. She estimates she spends about $500 a month on supplements. She is seen at her home in Waukesha, Wis., on Dec. 1, 2021. (Coburn Dukehart / Wisconsin Watch)
She said she is at least 80{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} better than about a year ago. Her memory has somewhat returned. Still, brain fog waxes and wanes — as does pain in her joints and lower back.
Croteau tested negative with three Lyme disease tests, but she was diagnosed by a Lyme-literate doctor with Bartonella and “questionable” Lyme disease. The doctor prescribed her doxycycline, triggering a severe reaction that Lyme-infected patients sometimes experience during treatment.
When Croteau found herself pregnant, the doctor suggested she take amoxicillin and clindamycin in low doses during her pregnancy. She stopped taking them after giving birth to her second child in late October 2021 and has been symptom free for the following two months. Croteau said her symptoms have returned since January, including fatigue and brain fog, neck stiffness, headache and nausea. She cares for her newborn at home and hasn’t started any treatment due to financial constraints.
‘A rich person’s disease’
Since chronic Lyme is not a recognized disease, it’s difficult to get insurance coverage, so patients are usually stuck paying out of pocket for treatment.
Pauley, who lives in Woodstock, Illinois, is still searching for affordable treatments.
Her dementia-like symptoms made it impossible to continue working as a veterinary assistant, and she quit her veterinary clinic job in 2020. Previously, she had quit her physician assistant job in La Crosse and moved back to Illinois.
“It was hard,” she said. “I went from the middle-upper class to the poverty line.”
She went to see a Lyme-literate doctor in Milwaukee in August, when she was also suspected to have Bartonella. Pauley was charged $525 per hour for the initial consultation fee, not counting testing fees and supplements. She was irritated to hear the doctor refer to it as “a rich person’s disease.”
“It’s hard to understand any doctors that charge like Beverly Hills lifestyle out in the Midwest,” she said. “We’re not celebrities, and I don’t get paid 30 million per film.”
Stevens said her average costs out of pocket range from $25,000 to $50,000 a year. “It was a huge strain on us,” she said. “This is why a lot of people can’t get better, because they can’t afford it.”
Cashman knows the financial burdens chronic Lyme patients bear, too.
She estimates she has spent $150,000 out of pocket for treatments that she and her husband — who also is a chronic Lyme patient — have taken over the years. Cashman has found ways to reduce the costs by, for example, buying pounds of ground herbs and making her own capsules at home.
Although all five women interviewed by Wisconsin Watch have tried unconventional treatments, they say they are skeptical about anyone who claims their chronic illness can be cured quickly.
Alicia Cashman leads a meeting of the Madison Area Lyme Support Group at the East Madison Police Station in Madison, Wis., on Feb. 8, 2020. About 13 other people were in attendance, some of whom had driven from more than an hour away. The group shared personal experiences with chronic Lyme disease. Also pictured is Olivia Parry of Madison, Wis. (Coburn Dukehart / Wisconsin Watch)
“(If it) is just a quick fix to make money, and I’m just very leery of it,” Bertolasi said.
And they are using their experiences to help others. Pauley has become an advocate for lower health care costs. Bertolasi is writing a Lyme-friendly cookbook to chronicle recipes that have worked for her.
Although Stevens said being a chronic Lyme patient is “like a full-time job,” she wants people to know there is hope.
“You can be in terrible shape, but you can get better,” Stevens said. “It’s really easy to go down the road of ‘poor me,’ but it is possible to get better. There is hope. You can reach remission.”
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by Zhen Wang / Wisconsin Watch, WisconsinWatch.org June 9, 2022
CBD of Denver (OTCMKTS: CBDD) has been under accumulation in recent weeks and recently broke north of its trading range. The stock had fallen to lows of $0.0016 from highs near $0.04 in early 2021, and the cannabis market looks ripe for a rally as there are 8 states with Marijuana legalization measures on the ballet including Texas, Oklahoma, South Dekota, Ohio, North Dekota, Nebraska, Missouri, Maryland, Iowa, and Arkansas.
CBDD hit the OTC in November 2018 and Microcapdaily reported on it at the time, stating in our article from November 16 “CBDD is a publicly traded company listed on OTC Markets and traded under the stock symbol CBDD. The Company is currently developing innovative CBD products and related social networking. CBDD is the new ticker for VGMI. The Company is led by new CEO Nicholas Sprung, a serial entrepreneur who used to be CEO of a Ski Company with an ambitious vision to make CBD of Denver a leader in the booming CBD space. The Company has established its principal corporate office located at 4610 South Ulster Street, Suite 150, Denver, CO 80237, where it has rented office space.
CBD of Denver (OTCMKTS: CBDD) is a Distributor of CBD and Cannabis flower and a producer of a full line of CBD oil and unique products sold in Switzerland and throughout Europe. CBD of Denver, Inc. is focused on using equity to acquire profitable Swiss assets at attractive valuations to create value for all our shareholders and is driven by a passion to improve lives and strengthen communities by unleashing the full potential of cannabis. Through our Rockflowr brands we have built a very strong European customer base by focusing on top quality products and meaningful customer relationships.
Earlier this year CBDD reported it filed audited financial statements for fiscal year 2021 on April 15, 2022 reporting a record $23.5 million in revenue and net income of $0.33 million. Management credits a fast growing market for its success and first profitable year. According to CBD of Denver CEO Paul Gurney: “While our internal momentum continues to grow, the market itself is providing increasing tailwinds. Just this week, Swiss authorities greenlighted a recreational usage pilot in the city of Basel to begin over the summer. As this trend potentially spreads across Switzerland, and ultimately across Europe, CBD of Denver is ideally positioned to capitalize on the rapidly evolving opportunities,” added Gurney. “I want to thank our shareholders for their continued support. I firmly believe we are on a great trajectory and look forward to reporting on our ongoing successes.”
While fiscal year 2021 financial results were exceptional the Company was negatively impacted in Q1, 2022, due to the reintroduction of COVID controls across Europe and pricing pressure on CBD flower. These trends have already reversed, and the Company’s April revenue nearly surpassed the entire first quarter’s revenue as prices began to stabilize. CBD of Denver generated $908,086 revenue in the first three months of 2022, with a net loss of $314,248 mainly on an inventory write down of $102,856. CEO Paul Gurney said “On the surface, the numbers don’t tell the full story and should be viewed in context. While revenues at 3.5{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} margins don’t usually result in overall profitability, my mandate is to transform this business from a commodity trader into a higher-margin, multi-pronged, health and wellness powerhouse in Europe and Asia.”
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The Company recently acquired 100{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of Mellow, a CBD ecommerce distribution platform and technology company, with capabilities in the UK, Europe, and Asia, for an undisclosed sum. The acquisition is expected to close in the second quarter of 2022. With operations in Asia, Mellow gives CBDD an entrance into the rapidly evolving CBD markets in the fast-growing Asia Pacific region. The Mellow technology stack will accelerate the Company’s plans to become the go-to name for cannabis across all parts of the value chain in international markets. his acquisition will combine technology and retail e-commerce distribution alongside manufacturing and supply chain infrastructure to create a turnkey solution for the CBD industry across Europe. According to CBDD management “Mellow is also the leading multi-channel distribution partner of choice for globally minded CBD and Hemp brands in Asia too, with our own physical store network and ecommerce channels. This is a global play.”
The Company recently expanded into the German medical cannabis market with the hiring of Bijan Hezarkhani to lead CBD of Denver’s growth in this fast growing European market. Bijan has extensive experience in the cannabis industry, including building out a medical cannabis franchise in Germany. He was the business development manager for Khiron Life Sciences for the last three years, visiting doctors and pharmacies in Germany to build Khiron’s medical cannabis business. Previously, he spent time at Canopy Growth as a business analyst covering Europe. Bijan will be the head of the Company’s medical cannabis sales in Germany and will be based in Frankfurt.
Germany officially approved medical cannabis in 2017. Germany is the largest medical cannabis market in Europe at 15 tonnes annually and generated approximately US$300 million of revenue in 2021. According to Forbes Magazine, over a million patients in Germany will have access to medical cannabis by 2024, with the German medical market worth €7.7 billion by 2028. The German market appears to be moving closer to adult-use legalization, a market estimated at 400 tonnes annually, making it critical to have the infrastructure in place in country. With 83 million people, Germany is the most attractive market in Europe for cannabis.
On May 26 CBDD announced mellow has signed an agreement with UK luxury CBD consumer brand OTO to act as their distribution partner in Asia. OTO, headquartered in London, is a premium positioned consumer CBD wellness brand, specializing in offering sophisticated products at the luxury end of the industry price spectrum. Mellow aims to provide the OTO brand experience through its mellow Asia division, which is operated out of the Hong Kong market, and which already operates a network of physical retail stores under the mellow banner as well as an eCommerce site
CBDD CEO said Paul Gurney said: “We are extremely excited to welcome the OTO brand to the mellow portfolio of brands in Hong Kong. This agreement will combine retail and technology/e-commerce distribution to enable mellow to continue the great work that the OTO team have achieved in other markets, and in doing so, will position OTO as the leading luxury CBD and wellness brand in the Asian markets. There is no other company present in the industry in Hong Kong with offering close to that of OTO. We are very pleased to be able to make this announcement, and we have much more in store ahead.”
Microcapdaily reported on CBDD in November 2020 in the $0.002 level right before the stock skyrocketed to over $0.03 per share in December. We stated in our article “CBD of Denver Inc. (OTCPINK: CBDD) is making an explosive move up the charts after the Company announced record revenues of $5,963,820.00 with gross profits of $484,666.00 for the 3rd quarter ended September 30, 2020. CBDD is an emerging player in the booming global CBD oil and CBD consumer health market which is expected to reach USD $123.2 billion by 2027, expanding at a CAGR of 25.6{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} over the forecast period. It’s easy to see why penny stock speculators are so bullish on CBDD; the Company’s subsidiary Rockflowr GmbH is quickly emerging as one of the leading wholesale companies for CBD in Switzerland. Rockflowr sources its hemp flower from the United States in large quantities and its distribution has grown to more than 7 countries in Europe. Rockflowr GmbH generated the bulk of CBDD revenues.”
Currently trading at a $31 million market valuation CBD of Denver has come a long way since we first reported on it in 2018, when the Company as nothing more than an ambitious vision. CBDD had a stellar year in 2021 reporting a record $23.5 million in revenue and net income of $0.33 million. While fiscal year 2021 financial results were exceptional the Company was negatively impacted in Q1, 2022, due to the reintroduction of COVID controls across Europe and pricing pressure on CBD flower. These trends have already reversed, and the Company’s April revenue nearly surpassed the entire first quarter’s revenue as prices began to stabilize. CBDD has been under accumulation in recent weeks and recently broke north of its trading range. The stock had fallen to lows of $0.0016 from highs near $0.04 in early 2021, and the cannabis market looks ripe for a rally as there are 8 states with Marijuana legalization measures on the ballet including Texas, Oklahoma, South Dekota, Ohio, North Dekota, Nebraska, Missouri, Maryland, Iowa, and Arkansas. Microcapdaily gave the heads up on CBDD in November 2020 when the stock was $0.002 right before it ran to over $0.03 in December 2020.We will be updating on CBDD when more details emerge so make sure you are subscribed to Microcapdaily so you know what’s going on with CBDD.
Disclosure: we hold no position in CBDD either long or short and we have not been compensated for this article.
As the Boston Celtics prepare to host the Milwaukee Bucks for Game 7 on Sunday, there’s a chance they could get back big man Robert Williams III, who is officially listed as questionable. Williams, who has missed the last three games of this series against the Bucks, has been dealing with left knee soreness, but Boston has upgraded him to questionable for Sunday afternoon’s showdown.
Williams injured his knee after colliding with Bucks superstar Giannis Antetokounmpo in Game 3, and scans of his knee showed that there was no structural damage. This is the same knee Williams had surgery on back in March after tearing his meniscus, which forced him to miss a month. Celtics coach Ime Udoka, however, assured that this injury didn’t stem from the surgery.
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“He got his knee scanned and everything structurally is good.” Udoka said before Game 6 Friday. “Looks fine. The swelling went down but he still had some soreness and pain. Revealed that he has a small bone bruise from collision he took in Game 3. Structurally he’s fine from the surgery; it’s just that’s where the swelling and soreness came from.”
While that doesn’t mean that Williams could suit up, it does essentially mean there’s a 50-50 chance of it happening, which is a good sign for the Celtics. Having Williams available helps give Boston more size to contend with Giannis Antetokounmpo, who has had a dominant series against Boston. In Williams’ absence, Grant Williams has stepped in to fill his shoes, and he’s done an admirable job on defense to make things a bit tougher on Giannis.
It will be interesting to see what Udoka does with the rotation if Robert Williams is healthy, because while having him in there to protect the rim could be beneficial, Grant Williams has been a more versatile defender in this series. It may also be risky to start a player who has missed five of Boston’s 10 playoff games so far with the season on the line. But regardless of how Williams is used if he’s healthy, having him available is better than not, and the Celtics will need every healthy player to try and send Milwaukee home for good Sunday afternoon.
