Ever heard of MedCo Health Solutions? It's not a household name like the big pharmaceutical companies Novo, Glaxo etc. However, MedCo, which happens to be in the prescription benefit management business, is a large and powerful company. Now it's about to become even larger: the company is poised to pay $1.5 billion for PolyMedica Corporation, the nation's biggest supplier of diabetes-related products.

According to a Forbes report on the deal, PolyMedica has nearly one million patients using its products. Its product line includes Liberty Healthcare brand, blood glucose test kits and meters, lancet kits, insulin and the like. The Forbes article says the move is basically a smart one on the part of MedCo: it can cash in on the growing demand(14.5 % growth, annually!) for diabetes supplies. MedCo's chief exec, David Snow, told Forbes he anticipates the purchase could make his company (indirectly) the supplier of diabetes treatment products to half of all insured Americans with diabetes.

Factoid: ads for PolyMedica star "Cocoon" and "Seinfeld" actor Wilford Brimley.

Pharmaceutical giant GlaxoSmithKline has announced an initiative designed to improve the health of employees with diabetes. Yes, the company's head honchos decided they would take the bull by the horns: if employees have difficulty taking care of their health, they determined to find out why and correct the problem. Result: an internal analysis of healthcare spending within GSK.

Turns out diabetes was one of the biggest problems for Glaxo employees. Glaxo's number-crunchers found the company spends more on diabetes medications, but less on medical care, than the national average. GSK's report states the company spent a total of $26.2 million on diabetes treatment for employees in 2005. Glaxo has now launched what it describes as a multilateral plan to address the needs of employees with diabetes. Leading the charge: a patient education campaign ("Know Your Numbers") and a physician intervention program.

Says Glaxo's US benefits chief, Michael Killian, "As a nation, we are seeing our healthcare costs soar and patients' health decline due to chronic diseases such as diabetes. GSK faces these same challenges and is prepared to meet them." Translation: prevention, prevention, prevention.

Glaxo figures there is nothing to lose, but lots to gain. Healthcare plans for employees already cost a bundle. By targeting the health issues that are hurting employees the most, the company can give those employees a better life and save a lotta money. In addition to making the results of its internal analysis available to the general public, Glaxo has invited other employers to utilize this same approach.

Chicago has a long way to go when it comes to diabetes awareness amongst the general public, says pharmaceutical company Abbott. And if the picture in Chicago is representative of the nation as a whole, we should all be very concerned. Or should we? Yes, diabetes awareness - or lack thereof - is a problem. But is Abbott painting an overly pessimistic picture of the situation?

Abbott's comments about Chicago came as it announced the results of a poll sponsored to evaluate public understanding of diabetes in the city. The initiative was in preparation for the American Diabetes Association's Scientific Sessions, which begin June 22 in Chicago. (Abbott's North American home base is in Abbott Park, Illinois, near Chicago.)

Abbott's conclusion? Most people surveyed flunked out big-time when it came to basic facts like how diabetes affects the body and how the condition can be managed. The findings are as follows: twenty-eight percent of Chicagoans know little or nothing about diabetes, while thirty-five percent of non-diabetics say they are not prepared to manage diabetes should they themselves be diagnosed in the future. My view: the former is a problem, but at least it means a majority do know something about it. And what of the the latter (preparedness)? So what if many Average Joes say they're unprepared to deal with diabetes themselves. I'd bet very few people indeed would be prepared to manage a chronic condition with which they have not yet been diagnosed! Other findings portrayed by Abbott as problematic: twenty-three percent believe glucose monitoring involves pain, while eighteen percent believe diabetics cannot eat carbohydrates at all. Again, is the glass half empty or is it half full? Quite honestly, I'm pleasantly surprised that most of those polled know better. On the up-side, Abbott does acknowledge the good news that eighty-eight percent believe having diabetes does not necessarily preclude living a long and healthy life. Another factor to keep in mind: only five hundred people participated in the poll.

Bottom line: Abbott's press release paints an extremely, and I would say overly, dire picture of the situation. Yes, many people are still pretty darn ignorant about diabetes. They may not be able to write you an essay describing its exact cause or all the treatment options. However, most now grasp that it is a serious chronic condition. Is it hopelessly optimistic to believe that things can only get better from here?

Drug giant Novo Nordisk's big white bus will soon roll into the USA. Officially known as the Novo Nordisk Changing Diabetes Bus, the vehicle is scheduled to visit a selection of towns in the USA between June and November. First, though, it's the turn of those lucky Canadians. The tour kicked off in Denmark back in September 2006 and goes under the banner "Changing Diabetes." Since Denmark, the bus and its crew have visited the following countries: Germany, the Netherlands, Belgium, France, South Africa, Australia, China, Japan, and Canada. (Cool job, huh?) The Canada sojourn will last a few more days - 'till June 12, to be exact - then it's time to cross the border into the US. Last stop is New York City, where the tour will end on November 14, which is World Diabetes Day. Oddly, the Novo "bus" is actually a big truck, at least according to the pics I'm viewing on Novo's snazzy website. I guess calling it a bus tour makes it sound a tad folksier...more Partridge Family, less soulless pharmaceutical empire? But I digress...

The Changing Diabetes Bus tour is touted by Novo as an attitude-altering event with its high-tech educational displays that are housed on board the bus/truck. (See the website for a fun virtual tour of the bus.) A vehicle for change, if you will (yukkity yuk) designed to reach out to everyone: diabetics, their families, healthcare providers, as well as curious Average Joes. The specific purpose, says Novo, is to support the passing of a United Nations resolution on diabetes. Listen, I hate to be catty, but it's been an awareness-raising event in more ways than one, don't you agree? It's been a great promotional venture. An all around image-polishing exercise for Novo too. Hey, that's not to say this tour has not done good things to educate the public. I mean, it's good that mega-companies like that put aside money in the budget for feel-good, reach-out-to-the-community stuff. But let's be honest. Would they have put up the cash if their name wasn't plastered all over? Probably not.

So the price of drugs just seems to keep on climbing. And sometimes I wonder if the sky really is the limit in terms of the prices we are expected to pay. I, for example, just filled a prescription and received a tiny bottle the size of a purse-pack-sized bottle of eye drops. And how much did I pay? $25. Yes, and that's with insurance. It's insane. But it's not happening everywhere. In western Europe, where publicly-owned, government-run health care systems are the norm, people are putting the squeeze on the big pharmaceutical companies.

Let's look at insulin. A while ago there was a kerfuffle in the UK when government advisers overseeing the National Health Service basically said "no, thanks" to Pfizer's inhalable insulin, Exubera. Too expensive, they said. Now, Germany. This week, the biggies - Eli Lilly, Novo Nordisk and Sanofi-Aventis - decided to slash the cost of their insulin products in Germany. Why? Officials from Germany's health ministry say the new fast-acting versions of insulin just aren't worth the money. That left Big Pharma with little option but to play ball anyway, by cutting prices by up to thirty percent. For Novo Nordisk, this means a projected loss of $14.5 million in sales this year, reports Bloomberg.com. According to this article, the German government is, in this regard, following in the footsteps of the UK and the US. In effect, this means trying to cut spending by carefully weighing the costs of specific drugs against their benefits, rather than just picking up the tab willy-nilly.

Bottom line? Market expert Mark Belsey says the big drug producers will have to adapt as the tide turns, spending a lot more time and money justifying the worth of their products. This new strategy, he says, will come at the expense of what used to be their main focus: creating and marketing fancy new mega-drugs.

It's very seldom that organizations geared toward aiding the human struggle are called out. If you'll remember, this surprisingly happened to the American Red Cross after 9/11 when people cited misappropriation of donated funds. More recently, a New York Times article raised questions about the relationship between the ADA and food and drug companies.

In addition to a previous product tie-in with SnackWell's Sugar-Free Lemon Creme cookies (which included the affixing of the ADA label as a proud supporter on the side of boxes), the ADA has reportedly partnered with a number of other food companies whose foods are still as high-calorie as their sugar-rich alternatives. This list of products included Frosted Shredded Wheat and Sugar-Freedom Eskimo Pies up until last year, when the A.D.A. began cutting ties with some food companies that offered foods that were high in calories (sugar-free or not). But, critics complain that not all ties have been severed, as evidenced by the ongoing relationship that the A.D.A. still maintains with the Cadbury-Schweppes company. Specifically, the three-year, $1.5 million sponsorship deal allows Cadbury to promote the A.D.A. as a "proud sponsor," has permission to use the A.D.A. logo on its Diet-Rite sodas, Mott's Apple Sauce, Snapple unsweetened tea and other products. While these products themselves may not be unhealthy choices, critics feel that the A.D.A. affiliation has allowed Cadbury to pose as a "concerned corporate citizen," clouding the fact that this company still sells fattening foods like Dr. Pepper and Cadbury Cream Eggs in grocery stores.

The other major concern of critics is the A.D.A.'s relationship with big pharma. Evidently, the A.D.A.'s annual convention is largely paid for by drug companies, and corporate execs of these companies have also sat on the A.D.A.'s policy setting volunteer committees. According to these critics, this relationship has led to more of a focus shift to the treatment of diabetics through the use of pharmaceutical drugs, rather than offering healthy ways that people can change their lives (i.e. exercise programs, dietary suggestions, etc.).

Quite frankly, I'm not sure if I agree with these critics or not. The A.D.A. is a great organization, one that is tasked with attempting to curb the single-most pervasive health problem in the U.S. And, despite the fact that the number of people who have type 2 diabetes has increased by 80% in the last decade, it for some reason or another still does not get the public attention (and funding) that many other health organizations receive. So, if the A.D.A. is able to get millions of dollars by putting their logo on the side of a damn bottle of Snapple UNSWEETENED Ice Tea, is there really anything wrong with that? If so, maybe we should get those Girl Scouts off the streets right away, because if you eat ten boxes of their cookies, you may gain weight, too. But, and here's my big but (that sounded weird), perhaps it is somewhat misleading when you see the A.D.A. logo on the box of a sugar-free cookies, suggesting that because the A.D.A. is a health conscious organization, those cookies must also be a healthy choice. The high calorie count and saturated fat content tell a different tale, however. So, like I said, I'm not sure if I agree or not. I think that I could probably be swayed one way or the other fairly easily. Oh yeah, and insofar as the A.D.A.'s relationship with pharmaceutical companies is concerned, I'm not exactly sure that I can find a justification -- other than again stating that the A.D.A. is underfunded in its battle against one of the most expensive diseases in the world. The money has to come from somewhere.