What disease do people fear most? It’s no contest: Cancer. At one time we fantasized about having a weapon against cancer that’s better than early detection. Now we do, and I’m not just talking about better treatment. We have vaccines to actually prevent some cancers by preventing the viral infections that lead to them. So why doesn’t everyone get these vaccines when they should? The youngest generation, if they received the complete ...

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I recently received a declaration of war from one of the major healthcare insurers.  Not happy with its current record profits, this insurer has decided to reduce its reimbursement on immunizations and injectable medications by 40%.  I do not have a 40% margin on immunizations and injectable medications.  My margin is at most 10%.  This means that with a 40% reduction, I will have to pay at least 30% ...

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There was news of yet another high profile death from an uncertain cause in a star with addiction history.   Media accounts included reference to the "27 club" -- a lengthy list of famous artists who have perished by their own hand, often unintentionally, at the age of twenty seven. The reality is that too many fatal overdoses responsible for the deaths of the famous and not-so-famous are from medications ...

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I like Iceland. It is a really neat place; great people; terrific scenery; lively nightlife; surprisingly temperate climate, considering the latitude, thanks to the Gulf Stream. Of course, it is true that some of the Iceland bankers, poorly regulated and without scruples, were even more predatory than many of the American Wall Street investment bankers, taking the money and running to lead a pack of nations into international fiscal calamity, a ...

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My iPhone vibrated with an urgent message that read: "Please call … the INR on your atrial fibrillation patient scheduled for cardioversion is too low.  He is on that new blood thinner, Pradaxa.  What do you want to do?" I responded, sounding like an expert: "It’s ok.  Pradaxa thins the blood adequately, it just doesn’t change the INR." She astutely responded, "How do know the blood is thin?  What if ...

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Boniva continues to use Sally Field as a celebrity spokesperson for their product but as John Mack pointed out, should any prescription drugs be paying celebrities to endorse their products?  Well, according to an Ace Metrix study the answer to that is "probably no." The Ace Metrix study found of more than 2,600 ads that celebrity ads do not perform any better than non-celebrity ads and in some case ...

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You have insurance and, supposedly, it covers your medicines. However, you still get stuck with a portion of the bill that the insurance company calls a "copay." In some cases these copays can run more than $150/ month per medication (e.g. Enbrel). If you are on more than one of these expensive, branded medications the copays can really add up. What are your options?

 1. Generic alternative. Always ask your doc if there ...

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The scientific journal Nature ran an editorial recently with a rather ominous headline: "Psychopharmacology in Crisis." What exactly is this "crisis" they speak of?  Is it the fact that our current psychiatric drugs are only marginally effective for many patients?  Is it the fact that they can often cause side effects that some patients complain are worse than the original disease?  No, the “crisis” is that the ...

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We  certainly wish that antidepressants in particular, and all psychiatric medications in particular were free of side-effects. It would be a boon to our patients, and their families. Sadly, there is no such thing as a medication without any risk of side-effects. Even over-the-counter medications such as Tylenol, Benadryl an aspirin can have pretty serious side-effects. Some side-effects of medications are related to dose -- the higher the dose, the ...

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What else is on the horizon? There is progress to develop vaccines to control addiction to both nicotine and to opioids. Vaccination may be the best route to get control of the bacteria having a major impact on methicillin resistant Staphylococcus aureus (MRSA) and other highly pathogenic antibiotic resistant bacteria that have become endemic in hospital ICUs. A vaccine for dengue is likely within the next five years. The World Health Organization ...

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