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down 60 percent from 2001 levels because of competition from generics and from AstraZeneca s shift in marketing and advertising to its Prilosec replacement, Nexium. The U.S. patent on Nexium, esomeprazole magne sium, expires in 2014. Patent law is often at odds with medical cost containment. For exam ple the effect of the hotly debated C-91 Bill passed by the Canadian Gov ernment in 1992 was to nearly triple the protection afforded branded pharmaceuticals from competition by cheaper generics. The protection that the branded pharmaceuticals are afforded increased from 7 to 20 years. This concession to the branded pharmaceutical industry was a con dition for Canada s participation in the North American Free Trade Agreement (NAFTA) and General Agreement on Tariffs and Trade (GATT). Prior to the passage of C-91, many patients in the northern United States crossed the border into Canada to purchase lower-priced generics that weren t available in the United States. However, with C-91 in effect, not only is the generic industry in Canada nearly in synch with that of the industry in the United States, but NAFTA effectively prevents the adoption of a national Pharmacare program in Canada because such a program would interfere with the rights of foreign companies to sell drug insurance in Canada. The evolving linkage of intellectual property with trade agreements isn t limited to North America, but is an issue through out Europe as well.

(C.34) (C.35)

There may come a time when you or one of the users of your QuickBooks application may need to change a password. In fact, it is probably a good policy to require users to change their password on a regular basis, perhaps every one to three months. To change a password: 1. Be sure QuickBooks is in multi-user mode. Next, choose Company Menu, choose Users, and then Set up Users. 2. The Change Password dialog box appears. Enter the existing password in the Enter Old Password box, and then enter and reenter the new password. 3. Click OK.

where :F == 10 + En inln and f is the three-dimensional vector formed with the imaginary components of the quaternion:F. Right regularity means that :FO = 0, which in terms of components reads

8 I o =\7.f, 8xo 8f \710 = --8

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Designer drugs, at-home tests, and more accessible, more complete online biological databases have the potential to disrupt and rede ne the value chain associated with traditional, one-size- ts-all pharmaceuticals. In par ticular, the future role of the physician as gatekeeper of health-care dollars, especially in the areas of prescription medications and testing, is undergo ing constant erosion. As the effectiveness of direct-to-consumer pharma ceutical advertising demonstrates, consumers are increasingly taking charge of their health care and their health-care dollars. Advances in genomics, proteomics, glycomics, and the related molec ular level technologies are rede ning the patient-doctor relationship and the role of caregivers. For example, consider how the onslaught of ge nomic information will be incorporated into the training and practice of physicians. One possibility is that information on gene testing and related tests will be incorporated into the existing medical specialties as it be comes clinically relevant. This scenario is most likely as new laboratory tests such as gene-chip based diagnostic tools become available. These tests are novel today but are likely to be seamlessly incorporated into the daily activities of most physicians.

Summary

(C.36)

(8.127)

27There was an experiment in 1994 [16] which ultimately aimed at approaching this goal, but it was not possible to reach the strong-coupling regime at the time. 28This idea was first considered by the author and collaborators in [174].

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