captioned by the national captioning institute --www.ncicap.org-- >> welcome to "european journal ," here in the berlin. >> thank you for joining us. >> coming up this hour, police and protesters clashed in athens as trade unions staged a strike. angela merkel clashes with the opposition and head of the summit on thursday. an empty chair as europe honors a cuban dissident in his absence. police in greece and fired tear gas at protesters in athens as

protests erupted in demonstrations over the government's austerity measures. workers are holding a nationwide strike against reforms approved by parliament this morning. these were condition for greece to receive a massive bailout from the eu. >> protest in athens escalated into violence soon after they began. demonstrators set fire to a crash can and a car outside of a luxury hotel. -- to a trash can and a car. they were shouting dc -- the ives. most people protested peacefully. starting on the first of january, employers will no longer be bound by wage

agreements negotiated earlier with unions. severance pay will be cut by half. >> we have to stop this law from coming into force because this will destroy our children's future. this is a disgrace. the workers have a responsibility and duty to react to this and organize resistance to these policies and fight back against the politicians. >> the general strike began early wednesday. ferry's remained at anchor in the port. inthens, the trash has not en collectinays. action bro til nwork to a stan. or d bus transportaon

on>> if a counteditorwill have.

hat ulemnal outoruron.

he,: uced tonndioanth t stlht blo fmo

ecd. t and

rang lower this the spanish construction firm a cm has sweetened its takeover bid ftsrival. the the biggest the drug -- the biggest builder in germany said e offer should be rejected. theti bid of 2.7 billion euros was too low. the top ecuve from qatar

holdings and -- have been meeting to discuss the battle. qatar holding could be playing a mediator role in the takeover more business coming up in just a bit. >> we turn our attention to meds that 39 people have been killed and dozens more woundedsuicide . diaz agency said that the attack took place outside of a mosque where many people gathered at head of an important day in the shi'a calendar. there has been numerous seat train attacks in recent years. the russian court has suddenly postponed a verdict in the money-laundering trialf thno reason was given forthe de.

th ce as a surprise. critics of the kremlin said that the trial is politically motivated and coming just x nt bor the presidential election. police say they have detained at least 1000 people in moscow in a bid to prevent ethniclaes scuffles erupted outside as a train station after slavic russians gathedndhoed slogans med nic minorities from the southern caucasus. there was speculation that some people were planning a rally to counter rating by racist to begins. -- rioting b racist hooligans. there are accusations that a pre minister depart in -- took

rtn assassinations and organ trafficking in coast of love. he was declared the wne o the first election since independence. -- there are accusations that the prime minister of took part in the assassinations and organ trafficking in kosovo. the council of eup's ys th he led a mafia-style crime ring inside of the kosovo liberation army. it is believed that they sold the kidneys of serbn soldiers. >> it is impossible to do something like that but there is a political desire to damage to the democratic process after an election. >> the ports followed a two-

year investigation. it alleges thathewe are of the activities. >> they are studying theept and we would like -- we would not want to comment beforee read it. >> people are skeptical about the accusations. >> anything is sslehai can hardly imagine it. i cannot judge of this is true. >> some people are exploiting this. 'm not convinced of this. >> thaci might have some difficult questns to answ. international my tears have pointed to irregularities in the election. >> how would you like to wor more and get paid less? -- international monitors have pointed to irregularities in the

election. >> saries have risen over the past decade but here in germany, that is not the case. many german worke are earning considerably less. according to a survey, germany came in last place. >> german workers are productive and their products are in demand around the world but economic strength comes at least partly at the expense of workers' pay. salaries in germany have shrunk while they grow elsewhere. wages and salaries fell in germany by 4.5% in the last decade. by comparison, pay increased by 25% on a worldwide average. the international labor organization says that while wages are falling in germany, productivity is actually increasing. that might make german producers more competitive on global markets but ultimately ts threatens consumption that tom,

according to the ilo. >> turbulence in the global aviation sector will continue into next year according to the international air transport association. the estimate that air carriers will post a 40% dip in profits in 2011 because of slower growth and more expensive jet fuel. economic growth in asia will have a positive impact. on next year will be marked by a two step recovery in aviation industry. european airlines will underperform because of the debt crisis and austerity measures while markets in the asia- pacific region will grow strongly requiring more air travel. siemens seems to have found a solution for their struggling subsidiary. they will be sold to french software company. in return, they will purchase a 15% share in the company. -- recently announced a loss of

over 4000 dogs -- 4000 jobs. the restructuring means that -- will move up to become the second-biggest i.t. consulting firm. now, back to megyn. >> an empty chair instead of the prize winner was present at a ceremony in france honoring human rights. the cuban dissident guillermo farinas was not allowed to travel to strasbourg to collect his award. he used a recorded message instead to call for the release of all political prisoners in cuba. >> a symbolic vacant chair and the european parliament. the president of the assembly appealed to the cuban authorities to allow guillermo farinas to travel to strasbourg it to collect the prize. >> this empty chair, this they could place beside me is

assembled and it shows how important this price is and how necessary it remains. we must raise our voices to protect all of those who risk their lives in the battle for freedom. >> guillermo farinas is a psychologist and journalist to continues to write articles critical of the cuban regime. he recently went on a hunger strike for 133 days. in a message to the european parliament, he pleaded for solidarity. >> anyone who is afraid of allowing people like this to travel has good reason to be afraid. like other dictatorships, this regime will not survive. >> the european parliament hopes that by awarding the prize to guillermo farinas, it would alter his cause for the release of political prisoners in cuba. -- it would bolster his cost for the release of political

prisoners in cuba. >> we will look at how obesity is a growing problem.

>> obesity is becoming a growing problem around the world. a recent report by the organization for economic cooperation and develop -- development revealed some disturbing figures. after a survey of 33 best allies country, on average one in two people is overweight and 50% are obese. -- after a survey of the 33 industrialized countries. this takes into account weight and height. some feel that this method is too limited. however, the statistics are a cause for concern. >> too much fatty food, too much sugar. around the world, people are piling on the pounds.

the consequences weigh heavily. in the united states, 68% of people are overweight. one in three is classed as morbidly obese. in europe, britain is the fattest nations. they're, 61% of people are overweight and one in four is obese. germany is roughly on a par with the oecd average. the japanese, widely perceived as being among the more slender people, are also getting fatter. obesity is not just a problem for those affected, this is putting a strain on health services around the world. being overweight or obese increases the risk of heart disease and diabetes and the the physical strain of carrying the extra pounds leads to bone and joint problems. obesity can reduce a person's life expectancy by 8-10 years.

research suggests that fat people are more likely to be unemployed and on an average of 18% bonds and earning an average of 18% less than people that are not -- and earning on average 18% less than people who are not fat. the better educated people are, the more likely they are to stay slim. >> the problem with being overweight is not just confined to industrialized countries. this is also on the rise in some american economies. in the past, they have been forced to grapple with malnutrition. now, many have seen an increase in the number of overweight people. in brazil, a 50% of the overweight and 14% as obese. >> always at the beach, always looking good, that is the stereotypical view of

resilience. the other side of the story is very different. a new study by the brazilian health ministry has found that every second brazilian is over weight and the trend is increasing. a number of factors are to blame. people have more money but they are also more stressed out of work. they are getting less physical exercise and they are eating more fast food. >> people have gotten used to eating in fact all the time. people here use any excuse to eat. that is why we are getting fatter. >> there are many opportunities in brazil to git delicious food. people eat for enjoyment, not because they are hungry. >> this is a pediatrician who specializes in dealing with children with weight problems.

this 8-year-old was overweight at the age of 5 and his cholesterol lowers work way too high. -- his cholesterol levels were way too high. >> these days, the number of overweight children, especially the boys, has reached 30%. this is a national problem that is causing problems for our health service. >> he must make major changes to his diet and lifestyle. before, he used to spend most of his time watching television and playing video games. he played little sport and ate a lot of snacks. that is now over, exercises on the menu. >> the doctor said that we had serious problems. we had to change his lifestyle which has changed our lives as

well. >> he is now playing more sports. he goes swimming four times a week. he is much more active generally, says his mother. obesity is a problem affecting all levels of brazilian society. there are a number of problems aimed at combating the problem. the university of sao paulo has designed a course for overweight girls. >> i was lonely at school and always being picked on. here, i feel welcome. >> brazil seems to have acknowledge that obesity is a problem but even so, losing the extra weight is still a challenge. >> as we heard from that young brazilian girl, people who are overweight often feel excluded

or discriminated against. societies and doctors are constantly telling you to diet and become thinner. many people are happy with the way that they look. they are encouraging fat people to resist pressure to conform. >> they have endured enough teasing and snide remarks about their body size. they confess that they are fat but they are campaigning to be exempted as they are. -- expected -- accepted back as they are. >> genetically that people are fat because they are. there's no one to blame. there is usually little instigation to change it.

>> two year is ago, -- started an organization. she would like to bring the issue out into the open. this contains practical information such as stores that have larger clothing sizes. people love spent years fighting but now they would like to have -- dieting -- people have spent years fighting but now they would like to change. >> sometimes, when the problem has nothing to do with weight, like letter complaints. they say the problems would stop if you lose weight. i change my doctor when that happens but this is still unpleasant. >> the organization also functions as a self-help group

where women can build their confidence >> fat people the belief -- >> fat people -- >> they are often viewed stereotypically as lacy, slow, and lacking disciplined. their real performances eclipsed by their body size. >> how much am i perceived as a proper gentleman with something to say or as a fat cow? >> the organization would like to show that overweight people can also be happy. her husband loves her just the way she is. >> the growing problem of obesity has been the focus of ours "in-depth."

thank you for joining us.

new and improved? the pharmaceutical industry in america is constantly researching and innovating. this makes it possible for the industry to market new medicine, all the time. but new is not necessarily improved. so says a brand new study funded by the british government. the study found that older, cheaper, generic drugs were treating mental illness were better across-the-board than newly marketed medications. when it comes to prescription drugs, how can you tell when new really means improved? we'll ask dr. sharon levine.

if. for such a small if i live to a hundred. if social security isn't enough. if my heart gets broken. if she says yes. we believe if should never hold you back. if should be managed with a plan that builds on what you already have. together we can create a personal safety net, a launching pad, for all those brilliant ifs in the middle of life. you can call on our expertise and get guarantees for the if in life. after all, we're metlife.

new study i referred doctor sharon levine, from san francisco, associated executive director of kaiser permanenty. that new study refers to schizophrenia and the new drug it was found is better than the existing drug, right? >> yes, that's right this. is a very important studdy and it demonstrated in a large population that the older antipsychotic drug, heldol, was more affective than the newer category called a typical antipsychotics. and it really speaks to the fact that we have a buys, all of us, consumers, physicians, we assume that new means improved. and in fact, what is really true is that needs to be established by solid

evidence and not just assumption. this is a very important study for the federal government. very important study for state government. because this category of drugs is a substantial expense for the medicaid program. >> what's the cost between haldol and the new drug that came out? >> it's a difference between haldol and a entire category, the a typical antisigh cotics. it's a many expense. that doesn't mean haldol is the right drug for every patient but what this study demonstrate said when you look at a large population, for a substantial number of patients, the older now available as a generic drug, is in fact more effective at controlling symptoms than the newer category of drugs. so it just speaks to the issue of first of all, the treatment needs to be at a lord to the individual and

that if -- tailored -- we need to enter into the prescribing process with an open mind whether in fact this new drug offers any advantage whatsoever to our patients. >> the cost of the treatment will drop by as much as 80%. >> correct. >> and you get the same effect right? >> correct. >> that's really quite dramatic. in fact, it led an editorial writer for the british study, his name is jeffrey lieberman, a researcher in the trial, and he said the claims of superiority were greatly exaggerated, of the new drug. the aggressive marketing of these drugs may have contributed to this enhance perception of effectiveness in the absence of information. so apparently they haven't done their test to show this new drug was an improvement over what existed. there is very little research in this country of

com parityive effectiveness. and that is looking at a new drug, comparing it in what we call a head-to-head trial to see whether the drug offers an improvement. when the fda aproves a drug for marketing, a new drug, what the manufacturer has to establish is that the new drug is better than nothing. >> are we talking about wikperdol? >> that's one of the drugs. this is a whole category but that's the one in the study. if you found this is true, the newer drug will claim it's an improvement or suggested an improvement, plus the impact of the advertising programs and the solicitation of doctors from brands? i don't want to -- we're not here to fault brand drugs and we'll explain that in a minute.

but, there is no advertising for the drugs that we're talking about here. the generic drugs. >> very little promotion of generic drugs to consumers or doctors. >> because when the brand drugs goes off patent, you get a variety of generic companies. it's per missibility and for all genarks to enter the competition, correct? >> for the first 6 months, the first generic manufacturer to challenge the patent has exclusivity for 6 months. this is very important because this was created by the hatch wax man act in 1984. and it creates a 6 month exexclusivity for the first generic company because we want judge nark companies to come into the market. after 6 months, the generic drug goes from being a monopoly product to a commodity. get lots of hopefully lots of manufacturers coming in producing quality generics.

that works in consumers benefit because it's competition and the ability to say no to one manufacturer in favor of another for price concessions&that's how consumers interests are served. congress established an effective patent life for a drug. when that expires, there is a real value opportunity through generics, through the availability of quality generics for consumers to take advantage for their own economic and health purposes of a generic availability in the market. >> are generics controlled or examined or reviewed for their quality in comparison to the brand drug? >> absolutely. >> who does that? >> the fda does that and they have been very rigorous for the last 20 years of ensuring that the manufacturering process, the cleanliness where the drugs

manufacture these are generic manufacturers. they have to establish that the drug is the same. the chemical is the same and that it is bioequivalent. it does the same thing in the body. and the fda is rigorous about examining these manufacturering plants, the manufacturering processing. when the fda certified the quality generic, consumers and patients can be >> identical in administration, strength, doseage and qualitiy? >> that's correct. >> you found that to be true in your own medical practice? >> absolutely. and kaiser goes a step further. we -- our pharmacy organization does its own investigations of manufacturing plants that manufacture generics and we

ascertain for ourselves on behalf of our 8 1/2 million members that the generic manufacturer is a good manufacturing process but as is going to consistently that mean? >> it means the effect -- effect in the body of the drug will produce the same effect in the body as the brand drug. and those are the two things the fda requires. >> now, does a biopharmaceutical main generate friday so many form of life as opposed to chemicals -- >> that's correct. biopharmaceutical or biotech drugs comes from living materials. cell is generally a protein. and it's a much more complex molecule than a simple small molecule traditional pharmaceutical. >> but there are these biodrugs are also in the

generic sphere? >> no, they are not. >> they are not? >> no. and the reason we don't have generic by lodgics is that there is no framework for bringing a generic by logic to market. this is something that ooking at. this is something that i think everyone agrees needs to happen. >> what do you mean there is no framework? examination procedure? >> no regulatory framework for a generic manufacturer of a biopharmaceutical to say to the fda, we have a drug that is equal in affectiveness and is going to produce the same effect. in 1984 what the hatch-waxman act did was it said, the manufacturer of the generic can now use the research that the brand manufacturer did. they don't have to start from ground-zero.

and if one is a drug is the same and they can prove it's bioequivalent, they can base their effectiveness argument on the research done by the grand wump. >> i don't get it. i don't get it. if you can take the research of a nonbiological biogenic you're calling them. a biopharmaceutical, and -- you can not take -- you can take the research or can you - ue can take the research? you can. >> you can? >> for a traditional pharmaceutical. a generic merfer can say -- >> if it's only chemistry? >> yes. >> was that distinction made by hatch and wax man in 84? >> in 84 i don't think anyone envisioned what was coming in terms of biopharmaceuticals and so the hatch-waxman act in 84 addressed traditional

pharmaceuticals and what we need is a comparable regulatory process in legislation to do the same thing. >> is it that much of a distinction between a biopharmaceutical and a nonbiopharmaceutical? >> there really is. >> so you could exact that kind of reaction to it o or -- it's a regulation? you can only deal with tra dition additional drugs? and these are new drugs. they are also very expensive drugs. and you need support for $5,000 a month to treat colon cancer with the drug used to treat a judge nark condition that costs you a lot annually. >> rem cade -- >> rem cade used for severe rheumatoid arthritis. $5,000 monthly. >> 3,500 a year. still a lot of money. >> this is astronomical. >> yes, it is. >> and no relief for that?

is there an insurance policy for that? >> most insurers cover biopharmaceuticals as part of the drug benefit. it's the fastest growing component of drug costs. >> suppose there is for these -- for these biopharmaceuticals you just said there is no -- >> no generic. >> no equivalent. >> right. >> so you mean you're going to pay an extra premium and an extra copay? >> yes. >> to get this drug at these rates? to save your life? >> another way of looking at it is the patent's life on these drugs is essentially infinite until we have regulation that allows what are biogenerics or biosimilars is another name for them, to come to market. >> i show 150 of these biotech drugs. >> i suspect there are actually more and there are another 500 in the pipeline.

>> are they over priced? >> that's a good question. they are very, very expensive and if you ask the manufacturers they will say, and very legitimately, thee are complex protein molecules. the manufacturing process is very complex. but as a consumer, as a physician, one of the questions i ask is, how do you defend the pricing on these drugs given that the price has a lot to do with whether consumers can actually take advantage and have access to these modern miracles? >> it started a decade ago and it was 8 billion dollars a year industry. it's gone to a 40 billion dollar a year after 10 years. it's going to be 90 billion dollars in 3 more years. does tv advertising for new drugs distort their effectiveness? leading people to think that new means improved?

we'll put that question to our guest. first here is her distinguished profile. >> born boston. 60 years of age. husband, francis j cross um. one child. harvard university ratcliffe college. bampt a. tough university md. couple laddy. georgetown and tust universities school of medicine instructor in pediatrics, 3 years. the permanent medical group. multiple leadership roles including chief of pediatrics and associate executive director. 29 years all together and currently. hobbies, hiking. sharon levine. >> sharon levine, we are joined by vicki got lick, senior policy attorney for the center of medicare advocacy. are thru? >> i am.

good morning. >> vicki, do you have thoughts on what we've been saying so far about the cost implications of by lodgics versus traditional drugs or any aspects of the conversation thus far? >> i have a lot of conthoughts about your conversation. cost is a very important factor and cost very often will cause the population not to be able to afford the drugs. even if they have drug coverage for a biopharmaceutical, very often the copayments are so high that people can't afford the copayments. people are bankrupting themselves in order to get these needed medications and it would be very useful if they could in fact have a generic version if a generic version were available. and in some instances where there are generics available, but people cannot tolerate the generic we have the opposite problem. have you somebody who needs a brand name drug but the person is on a health plan

that only covers a generic drug. again they have no insurance for the brand name drug. we have encountered many people in the work that the center does who tried the generic drugs. they for some reason don't work for them and they need to go back to the brand name. but they need to go through a lot of hoops through their insurance company to get the brand name drugs covered. >> is the inability tow take a generic -- i think you're talking biojenics? no, you're not. a generic drug. a traditional generic drug. is that owing to any deficiency in the product or is that because of a special characteristic in the patient? >> i think very often it's going to depend on the patient. there was some litigation about the medicaid program on its failure to cover brand name drugs in florida. and there was some affidavit

testimony from a neurologist who said that he had a lot of patients with epilepsy who were on brand named drugs forced to switch to generics and had seizures when they had been seizure free for years t may be the individual patient who can't tolerate perhaps the finding agent in the generics or something in the generics. and for these folks, when they can't get active to the brand name drug, they have a hard time. >> have you heard of a doctor who took a brand name drug when off pattent and he tweak today? i believe the drug was called, i show here abrexaine. and he tweak today so taxol was the generic, its active ingredient was coated and easier to take and avoid an allergic andraection potential side affects from taxol. he then took that tweaked

drug and instead of making it a generic which was his rbleginal intention. this doctor patented it and he's made himself an enormous amount of money. >> i think that's not the only example. i think that there are several examples where there have been tweaking of drugs so that they become a new brand name drug and inessinence a way defeat the hatch wax man act. and to make it more difficult to get cheaper generic drugs on to the market. >> the history o wave, are we n?

>> absolutely. and one of the things that is produced this year is this is the first year of medicare part d. and one of the things that medicare part d has done is its raised consciousness and awareness among medicare members about the potential benefits of generic drugs and so you see, while 56% over all of americans or prescriptions are now generics. if we look at the medicare population, it's more than 10% higher. >> if i use medicare to pay for my drugs, i'm going to get a generic drug? it depends. it costs less to get a generic drug. for some plans, if you really want the brand name drug you're going to to pay more. some of the problems we encountered with some of the medicare drug plans is that you have to give prior authorization in order to get the brand name drugs. so if you go to the drugstore, you're out of your prescription, you need the brand name drug for some

reason because you can't tolerate the generic. you're going to have to wait several days to go through the process and you may be out of medication. >> but the ratio of nonacceptance to being able to accept is very small, is it not? most patients can take a generic drug without any problems? i want to ask you this, dr. levine. would you regard yourself as pro generic without being antibrand? is that a fair description? >> i think that's a very fair description. i am pro consumer and pro patient and to me, the ability to access generics at a much lower cost is really important for my patients. >> vicki, do you have to be pro generic? >> i think that i like what dr. levine said initially. that you need to take the individual assessment of the patient. so over all, of course i'm pro generic because it's

going to cost people less. but if a person can't take the generic drug i want them to be able to get their brand name drug. >> do you think that we run the risk today of making brand manufacturers look like groweddy mortals of who will do anything to -- greedy -- make a buck and stretch out their patents whereas thaddle that's totally unjustified because they do such marvelous work in creating, finding, discovering, new drugs. and there is no system in the world that can match ours for the discovery of new pharmaceuticals. and then the generics come along and they take all of that research and use it. and it's legitimate.

but they don't spend a billion dollars in bringing a drug to market. they don't go through the agony of protocols put out by the fda. so wei not really knocking brand drugs here, are we? >> not at all. what congress said is there is a period of time where the brand manufacturer has the right to monopoly price the product and get return on that investment and there is a point at which though, consumers have the right to have access to those drugs when the patent expires. and i agree with you, this is not about knocking brand manufacturers. it's about a balance. it's finding a balance between ensuring. we have enough investment in brand pharmaceutical companies to insure a continuing stream of invasion but also that we have a point at which those patents expire and the price comes down and then consumers who by the way,

through their taxes, are supporting a lot of the basic research that goes into this drug development, they have a right to get access to those drugs at a price they can afford. >> i know. but the brand -- if i were the ceo of a brand company i would think a lot of these generic companies are paracytic. now that's a tough word to use in regards to generics but they poach on what we have produced. right? and we run the risk. we get the down on this before we let you go vicki? >> let's take a look at this in comparison to other markets. let's look at all technologies and how price comes down. think about the price of a personal computer compared with the price of a computer today or the price of a dvd player. or even mp-3 player.

somebody develops the technology. other people come along, use it and it's time to buy, they can make the product cheaper and that's real what he we are doing here. in many ways the brand name drug manufacturers are luckier. because they have a legislatively protected lot of contho isn't it correct and fair to say that we need both generics and we need brands? not necessarily in that order? no brands no generics but they are both needed and needed urgently? >> absolutely&they are both required for effective and efficient market for prescription drugs. >> is that really your opinion, vicky? >> yes it is. >> i got another question for you. the fda has been without a fullrs worely on the fda to permanent . >> i see i've >> absolutely.120,000 workers. it's it's an extremely important agency. do you think it's

unconchenable our legislature has not solved that problem? >> we have to understand that there is some really good career civil servants who probably are making sure that agencyre are drug manufacturers raising the price in the very clutch at the end? >> we do see some raising the price in the 6-9 months before the patent expires. >> does that defeat the alleged massive savings to the consumer from ger nark drugs? >> not at all. the opportunity is enormous. we know that if the country used anti-inflammatoriy drugs the way doctors and kaiser did rather than celebrex and vioxx, the country would have saved 5 billion dollars. >> i'm sorry we are out of time dr. sharon levine. if. for such a small word it packs a wallop. if i live to a hundred.

if social security isn't enough. if my heart gets broken. if she says yes. we believe if should never hold you back. if should be managed with a plan that builds on what you already have. together we can create a personal safety net, a launching pad, for all those brilliant ifs in the middle of life. you can call on our expertise and get guarantees for the if in life. after all, we're metlife.