The other day, the mother of a nine-week-old baby girl called my office in a panic.  Her daughter was having terrible breathing trouble, with coughing and wheezing.  She asked to been seen that day, and of course I said yes. I asked mom how the baby had been doing overall, and she said that she’d had some noisy breathing as a newborn, but all was well until the past few ...

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The letter from the insurance company was addressed to my patient. The two pages of information boiled down to one simple sentence: “After a thorough review, our decision to not cover the medication Provigil (modafinil) is unchanged.” The letter went on to explain that there was no further recourse, and that the medication would not be approved because it was not Food and Drug Administration–approved for the condition my patient had: ...

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Last year, there was a rash of ill-researched articles in the press claiming a connection between the HPV vaccine and POTS (postural orthostatic hypotension syndrome) and CRPS (chronic regional pain syndrome).  Toronto Star, The Independent, Daily Mail I’m looking at you. These articles read like propaganda for anti-HPV vaccine groups. They all followed such a similar format that I wondered if they had ...

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According to a study published in the New England Journal of Medicine, the use of dietary supplements sends an estimated 23,000 Americans to the emergency department each year. Approximately 25 percent of the ER visits that were supplement related were by adults who were using herbal weight loss products. Another 10 percent were caused by adults consuming “energy products” (although people using energy drinks were excluded from the ...

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An August, 2015 study in Multidisciplinary Respiratory Medicine is being touted as evidence that homeopathy is as effective as antibiotics for respiratory infections in children. It doesn’t show that at all -- in fact, it doesn’t show anything, except that crappy studies in crappy journals can nonetheless be used to manipulate opinion. Beware. First, the study itself. Researchers in Italy looked at about 90 children with ordinary ...

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A new study in JAMA Internal Medicine finds that two-thirds of cancer drugs considered by the U.S. Food and Drug Administration (FDA) over the past five years were approved without evidence that they improve health outcomes or length of life. (This study closely corroborates and acknowledges the findings published last year by John Fauber of the Milwaukee Journal Sentinel and Elbert Chu of MedPage Today.) Follow-up studies showed ...

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Most of my patients think about pain medicines in terms of the symptoms they treat. “This is my headache medicine, and this is my arthritis medicine,” they often say. Health care providers are more likely to categorize pain medicines by the way they work: some are anti-inflammatory, some affect nerve endings, and others influence how the brain perceives pain. But the truth is that no matter how you classify pain ...

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Recently, the clinically positive results from the CLEOPATRA oncology trial were released, showing that pertuzumab, when added to docetaxel and trastuzumab as first-line chemotherapy, produces an average survival benefit of 15.7 months in HER2 positive breast cancer patients. That good news notwithstanding, the authors calculated that Genentech’s price for adding pertuzumab to gain one quality adjusted life year is a breathtaking $713,219. In dry academic language, the ...

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The shaming campaign that followed the news of two generic drug prices somersaulting into the stratosphere after being acquired by private companies is not too surprising.  The idea that a drug that cost $13.50 one day can cost $750 the next, seemingly on the whim of greedy Wall Street investors and pharma start-ups, is fodder for the outrage machine. But what the outrage machine does not realize is the ...

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Cancer drugs have become increasingly expensive in recent years. No one blinks anymore when a new lung cancer or colon cancer treatment comes to market priced at more than $100,000 per patient. In part, we don’t blink because we have simply gotten used to such prices -- the shock has worn off. Moreover, many of these new treatments are targeted therapies that only work for patients whose cancers express specific mutations, ...

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