As a treating physician who also serves as the Chairman of the Alliance for Safe Biologic Medicines (ASBM), I have been watching with great interest as the Food and Drug Administration (FDA) begins to unveil the approach it will take to bring “biosimilar” medications to the US.  Biosimilars are attempts to replicate brand name biologic medicines. But as the name indicates, they are similar to them but not identical.   ...

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Welcome to my day from hell.  It is 2 p.m. and I’ve just logged my fifth prior authorization denial of the day.  In simpler terms, five patients will either change their medications or pay for them out of pocket.  Personally, I’m sick of this crap. When it comes to prescribing medication, I am very judicious in my prescribing habits.  According to one of the largest insurers, my percent of generic prescriptions ...

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The latest supplement toxic alert thankfully involves only two young soldiers who died suddenly, both reported to have the unregulated amphetamine-like dimethylamylamine, DMAA, aka "Jack3d" and "OxyelitePro," as the suspected death-dealing toxicant. Who knows how many other unexplained deaths and near-deaths can be attributed to the vast experiment foisted upon an unwary American populace by such drugs -- I mean, "supplements"? Thanks to 1994's Hatch Act, the Dietary Supplement Health ...

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Confession: I have been watching the reality show The Real Housewives of Beverly Hills. Quite frankly, I don’t take shows like that seriously and often wonder if it is bordering on obscene to have such lavish lifestyles displayed on the televisions of homes across America (and around the world) during these hard economic times. But I was particularly disappointed in some of the footage that was shown on a recent episode. ...

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Recently, the world’s largest research-based drug company, Pfizer, announced that an automated packaging error led to a recall of the birth control medication, Lo/Ovral-28 and the generic counterpart, Norgestrel/Ethinyl Estradiol. The packaging issue had to do with the placebo pill being placed in the wrong order in the 28-day cycle and an inexact number of placebo (should be 7) or active forms (should be 21) of the medication. The placebo pill ...

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I first realized something was amiss when I picked up my prescriptions and the pharmacist explained that she could not fill the anti-malarial medications as prescribed: "Your medication plan only pays for 30 days of pills, and your prescription was for five pills." The pharmacist continued: "Your PBM [that's an acronym for pharmacy benefits management company, the type of company that coordinates many peoples' medication coverage] only fills this medication ...

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Here are some of the most common questions I encounter regarding vaccines and my answers.  I’m writing this post, from a parent to a parent, because I want to equip you with accurate information to protect your child. We give so many vaccines now and it seems like we are constantly adding more.  Isn’t this too much for my child’s immune system?  Isn’t it antigen overload?  The immune system is very complex, ...

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Julie Gralow, an oncologist at the Fred Hutchinson Cancer Center in Seattle, recently prescribed an exciting new therapy for a 60-year-old woman with metastatic breast cancer. Three-and-a-half years into her battle against the disease, the patient had already exhausted three different anti-estrogen therapies, each of which only put a temporary check on the spreading tumors. The newly prescribed drug, Novartis’ Afinitor, is one of the recently approved targeted therapies that have ...

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Since I dedicated an entire issue of JAMA on Nov. 11, 1998 to the theme of Complementary and Alternative Medicine in an effort to move CAM into the mainstream, I keep hoping that some of the numerous CAM offerings will make it out of the realm of anecdotal and placebo-healer-effect, and successfully through randomized controlled clinical trials. So I got excited when I saw the BMJ Evidence Centre via ...

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Beginning work at Launceston General Hospital in Tasmania, orientation really, I noticed a lot of things missing: places to sign my name. For any given patient I’d sign: the completed chart note, perhaps a lab (sorry, pathology) and imaging slip, a prescription form (in triplicate – ok, so that was weird), and a GP letter. I didn’t have to sign (physically or electronically) multiple different "attestations," I didn’t have to generate multiple ...

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