Part 3 of a series.  Please read part 1, DTC advertising, and its history with the FDA, and part 2, Economic and commercial impact of DTC advertising. In the first two parts of this article, we explored the historical and legal contexts of direct-to-consumer (DTC) advertising, the effects of these ads on prescribing behavior, and the economic incentives to advertise. In this final installment, we will examine what ...

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New medicines are like new fashions in clothing. They are introduced with great fanfare. Most turn out to seem fairly ordinary after a few years. Some are quickly forgotten or discarded and make us say: “What was I thinking?” Evaluating a new drug is difficult, for the pharmaceutical and scientific communities as well as for us clinicians. It often takes years of general use before a drug can really prove its ...

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As a primary care doctor, I have figured out many tricks for helping patients save money on prescriptions. Some of them I am sure you have never heard of, and others , well -- you might have, but they bear repeating. All of the prices quoted here are from Costco, unless otherwise specified. 1. Price compare between pharmacies. Can't stress enough the potential differences in medicine prices between pharmacies. Generic medicine prices vary more than ...

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What’s happened to psychiatry over the last 15 to 20 years? That’s a big subject, discussed in many recent and excellent books. One of those books is by Daniel Carlat, author of Unhinged: The Trouble with Psychiatry – A Doctor’s Revelations about a Profession in Crisis. One of the problems Carlat readily acknowledges is that psychiatry is excessively focused on psychopharmaceuticals at the ...

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With the darker days upon us, it may be tempting to try to fight fatigue with energy drinks. Ever wonder what’s really in them and what they might be doing to you? I just came across an article in the November issue of the Mayo Clinic Proceedings that broke it down nicely. Here’s the summary. Caffeine.  No brainer. Interestingly, it is on the list of substances banned by the International Olympic Committee (which is ...

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Antibiotics for viral infections are a big pet peeve of mine. No. Make that a huge pet peeve. Some doctors prescribe antibiotics for coughs and stuffy noses because the patients want them. If you’re one of those patients who think that antibiotics make your coughs go away, or clear up your stuffy noses, or somehow make your sinus headaches vanish, or if you’re a doctor who prescribes antibiotics for these symptoms, ...

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Physicians hate acid. But,  hey, who doesn’t hate acid? It burns things. It corrodes. It’s that after-pizza punishment. We prescribe antacid medications by the ton in this country, not because people’s stomachs have developed increased acidity, but because people in our modern society are generally overweight, like to eat large meals, and prefer fatty foods and things like alcohol, chocolate, and tobacco, all of which tend to worsen acid reflux. Physicians like ...

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Published earlier this year in the journal Neurology – not typically on my radar screen — is this remarkable study comparing pregabalin to placebo for HIV-related distal sensory peripheral neuropathy. Here are the results:

At endpoint, pregabalin and placebo showed substantial reductions in mean Numeric Pain Rating Scale (NPRS) score from baseline: -2.88 vs -2.63, p = 0.3941 ... ... Individuals with HIV-associated neuropathy achieved NPRS treatment effect size similar to those in ...

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by Nancy Walsh The recent report of the deliberate infection of Guatemalans with syphilis in the 1940s to see if penicillin could cure and prevent transmission of the disease was a reminder of just how short the time has been since most infectious diseases were untreatable. Penicillin -- discovered by Scottish biologist Alexander Fleming in 1928 but not available for clinical use until the 1940s -- ...

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An excerpt from White Coat, Black Hat. by Carl Elliott [Michael] Oldani worked as a rep in the late 1980s and the 1990s, a period when the drug industry was undergoing key transformations. Its ethos was changing from that of the country-club establishment to the aggressive, new-money entrepreneur. Impressed by the success of AIDS activists in pushing for faster drug approvals, the drug industry increased pressure ...

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