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However, it has the benefit of being a lot cheaper in comparison. Such programs can increase overall medication costs, particularly if they nudge patients to stay on brand-name drugs over cheaper generic versions. Read, the immediate past board chairman of industry trade group Pharmaceutical Research and Manufacturers of America, cited insurance plans now shifting more costs onto patients, plus some Affordable Care Act exchange plans and insurance formularies that exclude pricier prescription drugs. Dr Ronan Boland, chairman of the Irish Medical Organisation GP committee, said the Irish Medicines Board had adopted a cautious approach to the over-the-counter provision of certain prescription drugs, and he shared their concerns. Like many other drugmakers, Pfizer is suffering as cheaper generic versions erode sales of older drugs, no longer protected by patents, that once brought in billions annually. He said he urged top management to approve the program, presenting a recent Associated Press article about how newly uninsured diabetics are suffering serious complications because they can no longer afford the medicines and testing supplies. Hypertrophy increases by two to three times an adult’s risk of suffering cardiovascular disease, including heart failure and sudden cardiac death. Improvements with BH4 therapy were almost as dramatic in at least three other measurements of organ health, including heart wall thickness, muscle cell size and fibrosis, and lowered chemical production of dangerous free radicals. Three of Pfizer's six business segments —primary care and specialty care drugs and off-patent medicines—had lower sales. Pfizer's program comes at a time when many drugmakers, including Pfizer, have been raising prices on their drugs, partly to offset declines in revenue as the global recession reduces the number of prescriptions people can afford to fill. 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