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Pfizer’s patent on Lipitor, its top-selling cholesterol drug, expired in 2011. “Like any other company, our business practices must adapt to the changing nature of our product portfolio, based in part on products going off patent and new products being introduced into the market,” company spokesman Dean Mastrojohn said in an email. Novartis’ patent for its breast cancer drug Femara expired in 2011, its hypertension drug Diovan in 2012 and its cancer drug Zometa in 2013. In a statement, Novartis said speaking payments dropped in 2012 in part because of a shift from big blockbuster drugs that many doctors prescribe toward specialty products prescribed by fewer physicians. Resources were also shifted “to support potential future product launches,” a spokeswoman said in an email. One of the first drugmakers to disclose its payments to doctors has pulled the data offline. Cephalon, now a subsidiary of Teva Pharmaceutical Industries, had reported its ties to doctors since 2009 under the terms of a Corporate Integrity Agreement with the inspector general of the Department of Health and Human Services. The pact was put in place after the company agreed to pay a $425 million settlement in 2008 for marketing Actiq, Gabitril and Provigil for uses not approved by the Food and Drug Administration. But that requirement expired last September, and Teva pulled the data offline earlier this year when it updated its website. Cephalon’s payments from 2009 to 2012 continue to be available on ProPublica’s Dollars for Docs website, which aggregates payments made by 15 pharmaceutical companies since 2009. During that time, the company reported nearly $90 million in payments to doctors. The gap in the company’s disclosures will be short. Teva will have to resume publicly reporting its payments to doctors later this year under the Physician Payment Sunshine Act, which requires that all pharmaceutical and medical device companies disclose payments over $10 to doctors. The first report, covering the period of August to December 2013, is expected to be released in September of this year. The industry’s increased emphasis on expensive specialty medications for such conditions as multiple sclerosis or hepatitis C has been striking, said Aaron Kesselheim, an assistant professor of medicine at Harvard Medical School.
The Los Angeles baby is still getting AIDS medicines, so the status of her infection is not as clear. A host of sophisticated tests at multiple times suggest the LA baby has completely cleared the virus, said Dr. Deborah Persaud, a Johns Hopkins University physician who led the testing. The babys signs are different from what doctors see in patients whose infections are merely suppressed by successful treatment, she said. We dont know if the baby is in remission … but it looks like that, said Dr. Yvonne Bryson, an infectious disease specialist at Mattel Childrens Hospital UCLA who consulted on the girls care. Doctors are cautious about suggesting she has been cured, but thats obviously our hope, Bryson said. Most HIV-infected moms in the U.S. get AIDS medicines during pregnancy, which greatly cuts the chances they will pass the virus to their babies. The Mississippi babys mom received no prenatal care and her HIV was discovered during labor. So doctors knew that infant was at high risk and started her on treatment 30 hours after birth, even before tests could determine whether she was infected. The LA baby was born at Miller Childrens Hospital Long Beach, and we knew this mother from a previous pregnancy and that she was not taking her HIV medicines, said Dr. Audra Deveikis, a pediatric infectious disease specialist at the hospital. The mom was given AIDS drugs during labor to try to prevent transmission of the virus, and Deveikis started the baby on them a few hours after birth.