Medications

The cost of ignoring pharmacist clinical judgment in health care

Conditions
January 21, 2026

A patient walks into the pharmacy with a prescription. The pharmacist reviews it, recognizes a serious problem, and contacts the prescriber. The prescriber dismisses the concern. The pharmacist has two choices: dispense a medication they know is wrong, or refuse and risk professional consequences. This happens daily. And health care pretends it doesn’t.

The power imbalance nobody discusses

Pharmacists are trained to be medication experts. They study pharmacokinetics, drug interactions, disease-specific dosing, …

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Regulatory red tape threatens survival of rare disease patients [PODCAST]

Podcast
January 10, 2026
YouTube video

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Medical oncologist, geriatrician, and physician scientist GJ van Londen and Chief of Genetic and Genomic Medicine at the University of Pittsburgh School of Medicine Gerald Vockley discuss the article “FDA delays could …

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Methodological errors in Cochrane reviews of anticoagulation therapy

Conditions
January 4, 2026

My previous KevinMD article discussed a Cochrane Collaboration review that was completed in 2002 but was not published until 2006. This review examined three randomized controlled trials (RCTs) comparing anticoagulants with placebos or anti-inflammatory drugs for venous thromboembolism (VTE).

Along with my two co-authors, I found that across these three trials, anticoagulant-treated patients had six deaths out of 66 patients, compared to only one death out of 60 in the placebo …

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Corporate greed and medical complicity fueled a $250,000 drug [PODCAST]

Podcast
January 2, 2026
YouTube video

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Internal medicine and pulmonary physician Bharat Desai discusses his article “How Acthar Gel became a $250,000 drug.” Bharat shares the shocking moment he realized an obsolete pituitary extract from 1952 was being …

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Is tramadol really ineffective and risky?

Meds
December 29, 2025

For nearly half a century, tramadol has been used as a pain reliever. It is not perfect, no analgesic is, but it has helped millions upon millions of patients with chronic pain. That is why recent headlines declaring tramadol “less effective” and “more risky” caught my attention. These stories were based on a single meta-analysis, which concluded that this medication offers “limited analgesic benefits” and that its harms, …

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The dangers of oral steroids for seasonal illness

Meds
December 25, 2025

“I’m here (cough) to pick up (cough) the steroid,” says the visibly sick patient at the pharmacy. The pharmacist tries not to breathe in too deeply to catch the contagion as she hands over the box of pills. The patient has no idea that others have nicknamed it “poison” or “the Devil’s drug,” because it’s not worth it. The risks of casually prescribing prednisone or Medrol Dosepaks for seasonal illnesses …

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The AI innovation-access gap in medicine

Meds
December 22, 2025

Artificial intelligence has transformed pharmaceutical science more rapidly than any other part of health care. AI can now:

  • Identify molecular targets faster than human researchers
  • Compress early discovery timelines from years to months
  • Simulate how millions of compounds might behave in the body
  • Predict toxicity or poor efficacy before a drug is ever synthesized
  • Help design personalized therapies built on real-world clinical data

Recent analyses in Drug Discovery Today and …

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The loss of community pharmacy expertise

Conditions
December 15, 2025

Walk into most community pharmacies today and you’ll notice something off. The pharmacist who used to remember your name and medication history is gone. The one who caught that dangerous drug interaction last year? Also gone. In their place, a rotating cast of temporary faces, each one just trying to survive the shift.

This isn’t about a labor shortage. We have pharmacists. What we’re losing is something else entirely. Expertise, continuity, …

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How should kratom be regulated? [PODCAST]

Podcast
December 14, 2025
YouTube video

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Retired nurse practitioner Heidi Sykora discusses her article, “The case for regulating, not banning, kratom.” She provides an evidence-based perspective on why kratom (Mitragyna speciosa) should not be treated as a dangerous …

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Why the cannabis ethics debate is really about human suffering

Meds
December 10, 2025

Most discussions about cannabis stay on the surface: legality, crime, or medical claims. But the core question is this: What suffering does a society allow? After watching a recent documentary with police, lawyers, physicians, and families, I found cannabis is the stage. The real drama is the system behind it. When ethics is pushed far, inconsistencies become impossible to ignore.

1. Legal ethics: When the law punishes pain instead of harm

Some …

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Why medical malpractice data is hidden

Physician
November 19, 2025

I learned the forbidden truth by searching “how many medical malpractice lawsuits are filed per year and how many are frivolous?” The answer is “17,000-20,000 and all are legitimate.” This answer is incongruous with seven facts.

The facts are: First, a complication causes a medical malpractice lawsuit. Some are medical errors; some are random errors-of-nature. Since an error-of-nature is not caused by negligence, a resulting lawsuit is frivolous. Second, …

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Are you neurodivergent or just bored?

Meds
November 18, 2025

Do you get bored when reading a boring book? Do you struggle to concentrate when you haven’t had enough sleep? Do you have difficulty following instructions, make careless mistakes and forget to return calls? Are you sometimes the last one to “get” a joke?

You may be “suffering from” with Autism Spectrum Disorder (ASD) and are “neurodivergent” and “on the spectrum.”

Today’s ASD “neurodivergence” craze has spawned at least two lucrative and …

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Pharmacy benefit manager reform vs. direct drug plans

Meds
November 6, 2025

Much has been made of the move by President Donald Trump and the pharmaceutical industry to offer direct-purchase drug programs at heavily discounted rates. Following the announcement of these new programs and TrumpRx, we’ve heard news and opinion pieces from every major outlet, but missing in the conversation is one of the most important voices: the patient. Key questions remained unanswered:

“What does this mean for my care?”

“Does this work with …

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Why pharmacist burnout is a patient safety issue

Conditions
October 5, 2025

Behind every prescription safely dispensed stands a pharmacist making dozens of clinical decisions under mounting pressure. What happens when that pressure becomes unbearable? When the professionals who are the last line of defense against medication harm are pushed to their breaking point, patient safety breaks with them. This crisis is real and it is often invisible.

The invisible epidemic

Surveys and workplace reports repeatedly show that large numbers of pharmacists experience burnout …

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How India-Pakistan tensions could break America’s generic drug pipeline

Meds
September 25, 2025

With over 270 active drug shortages and growing global instability, the United States must protect itself from a worsening crisis in cancer care. The fragile supply of generic chemotherapy drugs like cisplatin, which is important for treating bladder, lung, and testicular cancer, could collapse if geopolitical tensions between India and Pakistan escalate further. To preserve this diminishing supply, the U.S. must reduce its overreliance on Indian pharmaceutical manufacturing and …

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Drug giants face suit over hidden cancer risks

Meds
September 20, 2025

Bridgett Brown, a resident of California, developed breast cancer from using brand-name and generic versions of the antipsychotics Risperdal (risperidone) and Zyprexa (olanzapine) says a new lawsuit from the Wisner Baum law firm.

Neither Brown or her two prescribing physicians knew or “had reason to know” that the drugs could cause breast cancer since the drug manufacturers “obfuscated and disclaimed such risks while promoting these dangerous, expensive drugs over safer, …

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The diseconomics of scale: How Indian pharma’s race to scale backfires on U.S. patients

Meds
September 16, 2025

Why Indian pharmaceutical companies run the risk of driving up U.S. consumer drug prices when scaling too quickly: the diseconomics of scale.

Why the U.S. looks to India as a global supply chain hub for medications

India’s pharmaceutical industry saves U.S. consumers billions, but scaling too fast is a mistake. Premature scaling through mergers and acquisitions (M&A) is not just unsustainable, it is reckless and a recipe for inefficiency, error, and rising …

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How drug companies profit by inventing diseases

Meds
September 4, 2025

Funding from direct-to-consumer (DTC) “ask your doctor” drug ads has captured news media outlets and all but blocked important health stories like these. Read on.

1. “Hormone replacement therapy” (HRT) is back.

It is said that those who forget the past are doomed to repeat it, and nowhere is this more evident than the re-marketing of HRT to menopausal women who do not remember the first debacle (which increased the risk …

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Every medication error is a system failure, not a personal flaw

Meds
August 29, 2025

Every 24 hours, at least one person dies from a preventable medication error. Every hour, countless others suffer complications that could have been avoided with better systems. Yet despite billions invested in health care technology and training, these numbers are not improving.

Here’s the uncomfortable truth: We have been solving the wrong problem.

For decades, health care has treated medication errors like individual failures — a tired nurse, a distracted doctor, a …

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mRNA post vaccination syndrome: Is it real?

Conditions
August 15, 2025

This past week, an unhinged man in Atlanta committed an atrocity. He went to the Centers for Disease Control (CDC) with five guns and killed a policeman. He blamed the COVID-19 vaccine for making him depressed and suicidal, and it is reported that he had been reaching out for mental health assistance for weeks.

Since January 2022, I have been interacting with national experts on a clinical problem that has hit …

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