Drugs and prescribing

1,242 articles · Since 2007

Articles, page 35

Curb the soaring costs of vaccines

September 30, 2014Sep 30, 20142

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…

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

September 29, 2014Sep 29, 201425

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,…

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

September 28, 2014Sep 28, 20146

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…

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 …

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The long road to a blockbuster drug

Vern L. Schramm, PhD

September 24, 2014Sep 24, 20144

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.…

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

September 16, 2014Sep 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…

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

September 11, 2014Sep 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…

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

September 6, 2014Sep 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…

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

September 2, 2014Sep 2, 201410

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…

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

August 29, 2014Aug 29, 20145

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…

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

August 17, 2014Aug 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

August 15, 2014Aug 15, 20142

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

August 11, 2014Aug 11, 201423

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

August 9, 2014Aug 9, 20149

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…

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

August 6, 2014Aug 6, 20146

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.…

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 …

Requiring a prescription for pseudoephedrine: How effective is that?

David P. Smith, MD

August 2, 2014Aug 2, 20143

The State of Mississippi passed a law in 2010 which banned sales of pseudoephedrine without a prescription. The law has resulted in a dramatic improvement in which 698 total methamphetamine (meth) incidents with 314 operational labs were identified in 2010 while there were 119 incidents with only 8 labs in 2013. Other states such as Tennessee are considering similar laws and Oregon already has a law in place as restrictive …

The execution in Arizona: There’s no mystery why it took so long

Karen S. Sibert, MD

August 2, 2014Aug 2, 201410

There’s no mystery about why the July 23 execution of Joseph Wood in Arizona took so long. From the anesthesiologist’s point of view, it doesn’t seem surprising that the combination of drugs used -- midazolam and hydromorphone -- might take…

Here’s why.

The convicted murderer didn’t receive one component of the usual mixture of drugs used in lethal injection: a muscle relaxant. The traditional cocktail includes …

The unintended consequences of well-meaning FDA regulations

Brian C. Joondeph, MD

July 29, 2014Jul 29, 2014

We rely on the FDA to protect public health “by assuring the safety, efficacy, and security” of medical drugs and devices. The FDA takes its marching orders from Congress via the legislative process. One such law is the Compounding Quality Act of 2013, passed in response to a series of fatal infections due to improper compounding pharmacy processes. While such oversight is important and well meaning, the unintended consequences may be …

Contrave: A promising new approach in the fight against obesity?

David Macklin, MD

July 27, 2014Jul 27, 201427

As a family physician whose practice deals exclusively in the treatment of obesity, it strikes me as remarkable how little we understand about the disease, which is Canada’s second-leading cause of preventable death. In every region of the developed world,…

In every region of the developed world, obesity doubled in the twenty years between 1988 and 2008, according to World Health Organization, which now count more than a half-billion of Earth’s population as obese. The Public Health Agency …

Streamlining the process to approve new drugs can save lives

Nathan Fountain, MD

July 14, 2014Jul 14, 2014

My heart sinks each time I see the subject line in this too common email I receive in my medical practice: “Sad news: Matthew was fine when he went to bed last night but his mother found him dead in bed this morning.” Matthew (not his real name) had epilepsy with seizures that persisted despite use of currently available antiseizure medications.

We started Matthew’s evaluation when the latest antiseizure medication had been …

Treating hepatitis C: Is sofosbuvir worth it?

Ashish Advani, PharmD

July 14, 2014Jul 14, 20147

In 2011, Food and Drug Administration Commissioner Margaret Hamburg remarked upon a “new direction in the treatment of hepatitis C,” as a success rate of approximately 70% marked a significant improvement over the previous rate of approximately 50%, and suggested…

Today, that cure has been realized as Sovaldi (sofosbuvir), a novel agent, has shown a success rate of 95% in clinical trials. Sofosbuvir comes without the …

Drugs and prescribing

Articles, page 35

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