Medications

Physicians writing on KevinMD about the drugs they prescribe and the ones they cannot get: prior authorization and step therapy, opioid prescribing and the tapers that followed the CDC guideline, the GLP-1 drugs from Ozempic to oral Wegovy and what happens when patients stop them, shortages, compounded versions, and what a prescription costs the patient. Three maintained records draw on this archive: Opioids: what physicians and pain patients say, in their own words, Prior authorization: what physicians say, in their own words, and GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words.

Two-tiered generic drugs will lower quality of care

Trudy Lieberman

Medications

October 9, 2014

As we head into health insurance enrollment season, which opens in November, consumers/patients will face yet another challenge in selecting the best health plan. Sorting through policies was tough already, but now insurers are making it even harder by changing the way they will cover generic drugs.

It used to be that opting for generics was a snap. Health plans usually offered three or four tiers of drugs — one for …

Prevent the overdose of OTC pain medications

Byron Cryer, MD

Medications

October 6, 2014

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Recently in the emergency room, I saw a 35-year-old patient — we’ll call her Jane — who was vomiting blood. The source of the vomiting turned out to be a bleeding ulcer caused by unintentionally overdosing on ibuprofen. Jane was in pain — she was taking prescription ibuprofen for her chronic knee pain — but she was also taking over-the-counter (OTC) …

Marijuana and motor vehicle safety: An impending public health dilemma

Abraar Karan, MD

Medications

October 4, 2014

Since 1996, 21 states have approved the legalization of marijuana for medical use. More recently, Washington and Colorado have legalized the use of recreational marijuana, with California and Oregon not far behind. The health risks associated with marijuana have been well documented in a number of studies, but these are secondary to the much greater mortality risk associated with an increased prevalence of the drug: driving under the influence.

As is …

Medical reversals: When wonder drugs become harmful

John Schumann, MD

Medications

October 3, 2014

Twenty-five years ago, the New England Journal of Medicine issued a report on a stunning new medical discovery: Aspirin helps prevent heart attacks.

Yes, good ol’ aspirin. Known since the time of Hippocrates for its magical abilities to quell fever and pain, it took only 2,000 years for us to understand the science of it well enough to design a ‘sufficiently powered’ double-blind, placebo-controlled randomized trial on aspirin’s efficacy in preventing heart attacks. The Physicians’ …

7 common reasons for refusing vaccines

Claire McCarthy, MD

Medications

October 3, 2014

The Centers for Disease Control and Prevention (CDC) reported that between January 1 and May 23 of this year, there were 288 cases of measles reported in the US. That’s more than the total number of cases in any year since 2000, when measles was eliminated in the U.S.

We have got to get more people immunized.

Essentially all of the cases were linked to “importations,” cases brought in from other …

Read more…

7 common reasons for refusing vaccines

A new drug to treat RSV bronchiolitis

Christopher Johnson, MD

Medications

October 1, 2014

Respiratory syncytial virus infection, aka RSV, is a common infection in children. A key aspect of RSV is how poor a job our immune systems do in fighting it off. Virtually all children are infected with RSV during the first few years of life. Not only that, all of us are reinfected multiple times during our lives. Attempts at devising a vaccine for RSV have all been unsuccessful. In fact, …

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A new drug to treat RSV bronchiolitis

Curb the soaring costs of vaccines

Ruth Macklin, PhD

Medications

September 30, 2014

Few medical interventions have been as successful as vaccines in improving public health.

Whether they are childhood vaccinations, vaccines to prevent healthy adults from contracting influenza or the more recent HPV vaccine for adolescents, these preventive methods have resulted in dramatic benefits for individuals and the public. We have only to think of the eradication of smallpox and the virtual eradication of poliomyelitis to see the enormous benefits vaccines can bring. …

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Curb the soaring costs of vaccines

What is going on with generic drug prices?

Hans Duvefelt, MD

Medications

September 29, 2014

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Fran Barker called today. She was in a panic because the cost of her monthly prescription of 150 mg amitriptyline tablets had gone up to $130 from $13 the month before.

Amitriptyline has been available in this country since 1961, and the 100 mg strength was on Walmart’s list of $4/month drugs the last time I looked at it a few months …

Estrogen therapy and breast cancer: The pharmacist said no

Anne Katz, RN, PhD

Medications

September 28, 2014

It’s not often that I find myself speechless. I have heard all sorts of stories in my office — as a sexuality counselor, I am often humbled by the trust that people place in me and how much they disclose about their private lives. But one conversation I had with a patient literally made my jaw drop.

The patient is a …

The long road to a blockbuster drug

Vern L. Schramm, PhD

Medications

September 24, 2014

One thousand dollars per pill?

A single treatment course for hepatitis C virus to cost $83,000?

How can those prices be justified?

The drug-discovery process is a long one, fraught with disappointments and massive investment, no matter what the outcome. Some pharmaceutical companies argue that the high prices charged for their rare “blockbuster” drugs help them recover research and development costs.

While drug pricing and drug access are contentious and controversial issues — ones …

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The long road to a blockbuster drug

Alternative medicine: There should only be one standard

Hans Duvefelt, MD

Medications

September 16, 2014

“Doctor, what do you think of alternative medicine?” a patient with chronic fatigue syndrome asked me the other day. She was interested in doing something more for her severe fatigue. “Would acupuncture help me?”

I paused and, as I have done many times before, answered that my training and most of my clinical experience has been in Western, allopathic medicine. (Ironically, the word “allopathic” was first used as a derogatory term …

Don’t become your kids’ drug dealers

Roy Benaroch, MD

Medications

September 11, 2014

Doing drugs no longer requires a dealer on the street corner.

Between the late 1990′s and 2010 sales of narcotic pain medicines quadrupled in the United States. Hydrocodone use increased by 280%, methadone by 1300%, and oxycodone by 900%. As the consumption of these medicines increased, so did ER visits and deaths from overdose — up by about 500%.

A whole lot of these medicines are not going to medical use. And …

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Don’t become your kids’ drug dealers

The vaccination decision isn’t a purely personal one

Claire McCarthy, MD

Medications

September 6, 2014

These days, we hear a lot about the risks of vaccines. As a pediatrician, I talk to many parents who are very frightened about those risks — and some choose not to vaccinate because of their fear.

Some of the risks we hear about are real, but some of them aren’t.

I absolutely support the right of every parent to make what they feel is the best decision for their child. The …

Price shop your prescriptions to dramatically reduce costs

Ali Khoshnevis, MD

Medications

September 2, 2014

My brother and I, both optometrists, had a heart-to-heart discussion about the loss of one of our patients. We discovered he was not taking his medications as prescribed, which was leading to vision loss. When pressed, the patient said he had a choice of eating, supporting his family, or purchasing his medication.

He was under the impression that the $150 price for his generic Lipitor was “about the same” at any …

Inhaled medications: Nefarious reasons for the lack of competition

John F. Hunt, MD

Medications

August 29, 2014

Check out the prices for nebulizer solutions of albuterol and budesonide (generic Pulmicort). They are totally affordable. $4 for a month for albuterol. $14 for a month for budesonide respules. Pulmicort respules used to be very expensive. Now even the branded budesonide is less than 10% of a monthly cable bill.

Then check out the prices of inhaled steroids delivered through meter dose inhaler (MDI) or dry powder inhaler (DPI). These …

Using technology to improve medication compliance

Kevin R. Campbell, MD

Medications

August 17, 2014

It is clear that patient compliance with prescribed medications is critical to success in the treatment of any chronic disease process. In addition, patient engagement and co-management of their disease has been proven to improve outcomes. A new study from the Annals of Internal Medicine suggests that any changes in the appearance of a medication may result in a decrease in compliance; when a pill looks differently patients often simply …

Reducing health care costs is a team effort

Megan Sanders-Sneller

Medications

August 15, 2014

There are several different scenarios that I can think of in the past four years of pharmacy school that exhibit the high cost of prescription health care. Prescription medications are constantly becoming more expensive. Patients are unaware of their prescription benefits and how prescription insurance works. It leads to a lot of frustration for pharmacies and patients on a daily basis. However, every now and then there is something that …

7 ways patients can help reduce medication errors

Margaret Polaneczky, MD

Medications

August 11, 2014

I just got off the phone with a very upset patient who had just discovered that her pharmacy had been giving her the wrong medication for the past 5 months, substituting a similarly spelled antibiotic for her rheumatoid arthritis med. She was tipped off when she realized how bad she had been feeling of late and decided to check the expiration …

Are you a medical liberal or a conservative?

Michael Kirsch, MD

Medications

August 9, 2014

Our nation is highly polarized today, and often bitterly so. Democrats rail against the GOP. Pro-lifers face down pro-choicers. Fox News disses MSNBC. Isolationists push back against expansionists. Traditionalists disdain the politically correct. Free marketers duel against government advocates. Carnivores deride the gluten-free crowd. Martin Bashir trashes Sarah Palin, two proxies in a culture war.

There’s a philosophical divide among physicians also. Would you prefer a liberal physician or a conservative …

Vitamins are not magic. We need good science and better sense.

Afshine Ash Emrani, MD

Medications

August 6, 2014

The scientific literature is replete with the failure of vitamins to support diseases. Yet, the industry is booming and people’s cabinets are filled with potentially harmful, poorly studied colorful bottles that make unsubstantiated magical claims.

This year, we witnessed Dr. Mehmet Oz, a celebrity doctor who frequently extols weight loss products, supplements and vitamins on his syndicated television show come under fire from regulatory committees for false claims and poor outcomes.

The …

Medications

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