Physicians writing on KevinMD about prescribing: the prior authorization that stands between a prescription and a pharmacy, opioids and the tapers that followed the CDC guideline, GLP-1 drugs and what happens when patients stop them, compounded and direct-to-consumer drugs, shortages, and what a prescription costs the patient. Three maintained records draw on this archive: Prior authorization: what physicians say, in their own words, Opioids: what physicians and pain patients say, in their own words, and GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words.
As of September 2, CVS — the ubiquitous pharmacy/convenience store — has stopped selling tobacco products, including both cigarettes and smokeless tobacco. This is a bold move from the retailer, which is also planning to rebrand itself as “CVS Health” to emphasize its place in the health care delivery chain. I personally applaud the decision, because there are simply no benefits to tobacco use in any form.
And it’s also …
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CVS removes tobacco products: Did they go far enough?
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 …
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Price shop your prescriptions to dramatically reduce costs
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 …
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Inhaled medications: Nefarious reasons for the lack of competition
My patients lie to me every day. Some tell me that they have been taking their medications regularly when they haven’t. Some say that they have been eating a healthy diet and exercising for at least 30 minutes every day and don’t know where the extra pounds are coming from. Some lie that they are using condoms every time they have sex, that they have quit smoking, and if they …
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Lying to receive pain medications hurts patients in true pain
Today’s article highlights the lingering problem of physicians buying and selling prescription medications to patients — at a profit.
The medical profession has struggled with this controversial practice for more than 150 years.
In George Eliot’s 1874 novel “Middlemarch,” an idealistic young doctor named Tertius Lydgate questions the ethics of fellow physicians who make handsome profits prescribing and dispensing their own remedies to the townsfolk. His medical colleagues shun him for it.
Around …
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Oncologist pay and chemotherapy: Buy and bill needs to stop
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 …
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Using technology to improve medication compliance
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 …
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Reducing health care costs is a team effort
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 …
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7 ways patients can help reduce medication errors
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 …
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Are you a medical liberal or a conservative?
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 …
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Vitamins are not magic. We need good science and better sense.
The deadly outbreak of Ebola virus in West Africa is the worst on record, with over 603 deaths reported as of July, 2014 (according to the CDC Ebola outbreak update). The virus is confirmed in Guinea, Liberia and Sierra Leone — and the crisis appears to be far from over.
The geographical complexity of the current crisis highlights one of the most crucial obstacles to …
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Why is there no cure for Ebola?
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 …
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Requiring a prescription for pseudoephedrine: How effective is that?
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 nearly two hours to cause death.
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 …
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The execution in Arizona: There’s no mystery why it took so long
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, 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 …
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Contrave: A promising new approach in the fight against obesity?
Recently I was the only witness to testify against local medical marijuana legislation. The bill, already endorsed by all members of the Council of the District of Columbia, would allow use of marijuana for “any condition for which treatment with medical marijuana would be beneficial, as determined by the patient’s physician.” As I waited hours for my turn to highlight the medical evidence about marijuana’s health effects, I sat silently, taking in …
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Medicine by public opinion: Where are the doctors?
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 …
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Streamlining the process to approve new drugs can save lives
“The Eastern medicine revolution?”
These were the words emblazoned across the screen behind Dr. David L. Katz, founding director of the Yale-Griffin Prevention Research Center, as he discussed the growing popularity of holistic integrative medicine on a recent edition of the Katie Couric Show.
The conversation centered on the opening of Cleveland Clinic’s Chinese herb therapy ward in January of this year, the first of its kind at a major U.S. hospital. Dr. …
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Why we’re not ready to embrace Eastern medicine
A health research company just released a list of the 100 top drugs in America according to sales. 29th on the list, with sales of over $1.8 billion, is the cholesterol lowering drug ezetimibe, brand name Zetia.
This drug was released over 10 years ago because it worked really well in combination with statin drugs such as Zocor (simvastatin) to lower LDL cholesterol levels. It was released as a single agent and combined …
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Why are doctors still prescribing Zetia?
