Why do drugs cost so much? Drug prices are a difficult issue to write about because real data about the workings of pharmaceutical companies is very difficult to uncover. Still, I came face to face with something that seemed extremely not right and so I feel I should at least make some comment. It started when I prescribed a patient sumatriptan for her recently more frequent migraines. ...

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I am currently a pharmacy student, and although I have not yet dispensed a medication, I had my first experience concerning the cost of care a few months ago. My ear hurt very badly when I woke up in the morning, and being that I had to go to work later that evening, I decided to go to the local clinic in order to get my ear treated. The physician was ...

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We always want to get it right the first time when treating patients, but the truth is this is difficult. When there is uncertainty of disease course and prognosis, multiple treatment options, and variable responses to therapy this becomes even more challenging.  Our typical strategy to making it “just right” isn’t too different from Goldilocks. We have mild treatments (too cold), and aggressive treatments (too hot), and even in the ...

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We’ve come a long way, baby. Eighty five years ago (October 18, 1929) women were declared "persons" in Canada. On that day women in Canada became eligible to be appointed to the Canadian Senate, which up to that time, had been the sole dominion of men because women were not deemed "persons" under the law.  Five Alberta women, Emily Murphy, Irene Parlby, Louise McKinney, Henrietta Muir Edwards and Nellie Mcclung declared a ...

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Physician key opinion leaders (KOLs) have been viewed as a valuable resource in the pharmaceutical (heretofore referred to as pharma but included are medical device companies) industry. In one study in which 100 KOLs were surveyed, the most important characteristics of a KOL were, “regularly sought out by their colleagues for opinions or advice, speak often at regional or national conferences have published articles in a major journal during the past ...

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The best way to avoid the flu is spending the months from fall until spring in a solitary bunker, communicating with other people only electronically. The second best way is getting the flu vaccine. The Centers for Disease Control and Prevention (CDC) recommends the flu vaccine for everyone over 6 months who doesn’t have a specific contraindication to it. Because of the increasing number of different flu vaccines that are now ...

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One catch phrase in health care reform is cost-effectiveness.  To paraphrase, this label means that a medical treatment is worth the price.  For example, influenza vaccine, or flu shot, is effective in reducing the risk of influenza infection.  If the price of each vaccine were $1,000, it would still be medically effective, but it would no longer be cost-effective considering that over 100 million Americans need the vaccine. Society could not ...

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A friend of mine, a diabetic who has been pretty passive about his medical care, suddenly learned the importance of patient engagement a few weeks ago when a matter affecting his pocketbook grabbed his attention. A bill arrived from Express Scripts, the pharmacy benefit manager (PBM) for Emblem Health, a Medigap plan offered to former New York City employees. For years my friend had been taking the drug gemfibrozil that diabetics ...

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Giving prescription refills is not quite as fun as it used to be. Years ago, we doctors would whip out our prescription pads -- often sooner than we should have -- and we’d scribble some coded language that pharmacists were trained to decipher. I’m surprised there were not more errors owing to doctors’ horrendous penmanship. On occasion, the Food and Drug Administration (FDA) would require a pharmaceutical company to change ...

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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 ...

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