A simple study from the March, 2008 issue of the Journal of the American Medical Association illustrates something important about the way we perceive the effectiveness of medication.82 adult volunteers were recruited. They were told they were taking part in a trial of a new pain medication, testing its effectiveness using a standardized, well-established protocol using low-voltage shocks as a painful stimulus.All ...
Meds
Arimidex price markup at major pharmacy chains
The commonly prescribed breast cancer drug, Arimidex, was released as a generic in June 2010. The generic name is anastrozole. I called several local pharmacies last week to find out how much this medicine would cost for a one-month supply. I found some very surprising results:Costco: $27Walgreens (with Saver Card): $325 (without Card): $380CVS: $361Walmart: $347Target: $340These are not typos. Costco is selling a one-month supply of generic Arimidex for $27, ...
Drugs used to treat Parkinson’s disease can worsen impulsivity
Parkinson's disease (PD) commonly includes a variety of behavioral disturbances related to impulsivity. Impulse control problems noted in PD includes hypersexuality, compulsive shopping, compulsive eating and pathological gambling.These behavioral problems may be related to the pathophysiology of Parkinson's disease. However, drugs commonly used in Parkinson's disease appear to increase the risk for impulsive behavioral problems.Clinicians face a dilemma in drug-induced behavioral disturbances. The drugs that may be effective for treating ...
A drug to treat hemophilia was polluted with hepatitis viruses and HIV
An excerpt from Doctor Guilt?by Everett Winslow Lovrien, MDThis is the story of a boy who had hemophilia, a bleeding disorder that resulted in pain, disability and death before adulthood. A new medicine was developed which brought an end to suffering and increased longevity in persons with hemophilia. The effect of the new medicine was like magic. It was a remarkable revolutionary advancement ...
Controversy about NSAIDs and heart health
by Marianna Rakovitsky, RPhRecently there has been a lot of controversy about the use of NSAIDs and heart health.NSAIDs are medications for pain and inflammation. Many of them are sold over the counter and they are used by millions of people for various aches and pains as well as for more serious chronic conditions such as arthritis. Aspirin is technically an NSAID, but its effects ...
How drug reps increase drug sales by influencing physicians
An excerpt from Unhinged: The trouble with psychiatry- a doctor’s revelations about a profession in crisis. Copyright © 2010 Daniel Carlat. Excerpted with permission by Free Press, a Division of Simon & Schuster, Inc.It may be hard for people to imagine that drug reps can get us to prescribe a particular drug by simply giving us a meal or being nice to us. The process is subtle, but ...
Finasteride, fruit, and the matter of prostate health
by Arnon Krongrad, MDThe noose was loose on its neck. At first I worried, but then I relaxed. This was a bottle of pomegranate juice, the antioxidant superpower. As the billboard implied, it could cheat death. Perhaps if I consumed pomegranate juice, I could cheat death.Last week, the Federal Trade Commission charged POM Wonderful, LLC, makers of pomegranate products, with deceptive advertising. What ...
HIV sufferers benefit from the FDA’s unapproved drugs initiative
by Gary Puckrein, PhDUnapproved drugs have never been tested by the Food and Drugs Administration for safety and efficacy. Prescribed by the million every year in the United States, these products pose a potential danger to all patients, but HIV/AIDS patients who suffer weakened immune systems are at an even higher risk as they are more vulnerable to injury due to their disease.That's why we ...
Narcotic use is rampant in workers compensation
Just in case you thought the problems with abuse of powerful prescription drugs have been overstated, here's a wake-up call.
The CDC's Director is taking this very seriously, saying: "Overdose with prescription drugs is one of the most serious and fastest-growing problems in this country."The problem is showing up in a doubling of emergency room admissions due to prescription drug abuse, driven primarily by oxycodone, methadone, and hydrocodone.Narcotic use ...
Avandia aftermath: winners and losers
Responses to the Avandia panel have been all over the map, as cleverly noted on the Wall Street Journal's Health Blog. Avandia is “dead” (Forbes), or, perhaps worse, “now a Zombie” (BNET). By contrast, others thought the panel granted Avandia a “reprieve” (Wall Street Journal and that Avandia would now probably be allowed to stay on the market (Los Angeles Times, Pharmalot).All these ...
How academic physicians turn into drug company shills
An excerpt from White Coat, Black Hat.by Carl ElliottThese days many thought leaders find themselves on shaky ground. The past few years have not been good for business. Some of the most prominent thought leaders have been exposed and censured by Grassley. Others have seen public opinion turning against them and gone underground. As more states institute Sunshine laws, anyone considering an industry ...
Why drug companies lavish doctors and how they price their drugs
An excerpt from Unhinged: The trouble with psychiatry- a doctor’s revelations about a profession in crisis. Copyright © 2010 Daniel Carlat. Excerpted with permission by Free Press, a Division of Simon & Schuster, Inc.My own education in pharmaceutical marketing began during my second year of residency at Massachusetts General Hospital.Suddenly, I noticed that Paxil bagels began appearing everywhere. I first saw them in the break room of the ...
The benefit of a drug cannot be measured by the law of averages
One of the topics that I have often thought about (especially in light of our seeming inability to develop zero-risk obesity drugs) is the problem of averages. Our entire medical philosophy of “evidence-based” medicine seems built on the “Gaussian” assumption that averages can reflect the true benefit (or risk) of a drug, when in real life (or medical practice) there is no such thing as the truly average patient.Clearly, a ...
Can a pharmacy profit from gouging patients without insurance?
It just shouldn’t be hard to get a refill on the medicines I’m taking:
- phone the pharmacy to refill prescriptions
- show up the next day to pick up refills
- pay
DTC advertising is annoying but should it be banned?
Should the public be shielded from medical information that can mislead it?Many argue against direct-to-consumer (DTC) advertising, which is omnipresent in print and on the airwaves. Opponents of this practice argue that it promotes the use of expensive medications when patients ask their doctors if the "drug is right for them," the tag line that appears at the end of every ad. This phrase is the drug company’s limp disclaimer ...
Switching diabetes patients from Avandia to Actos
I have a lot of diabetes patients and have been an avid user of the thiazolidinediones (TZD) class. There are many reasons to like the TZD's:
- The older, generic medicines like metformin and sulfonylureas are known to fail over time. After 3 years, most patients on one of these drugs lose control of their blood sugar. In contrast, patients on TZD's maintain glycemic control (at least up to 4-5 years which ...
DTC advertising, and its history with the FDA
Advertising is everywhere.That should come as no surprise to anyone who has lived in modern America. It is impossible to turn on the television, ride the subway, or even sort through the daily mail without coming across an ad for a new car, a soft drink, or the latest digital toy. These advertisements have only one goal: to entice you to buy their products. This is harmless enough when these ...
Are opioids any less safe or effective in non cancer patients?
by Drew Rosielle, MDRecently, the New York Times reported of the movement in Washington State to officially do something about prescription opioid abuse, coming on the heels of course of the FDA rejecting the current risk evaluation and mitigation strategy plan as, essentially, not going far enough.The article basically discusses the discussion in Washington about what to do; no formal new plans have been ...
Why a marketing study for Niaspan was published in a medical journal
The authors call it “an in-office linguistic study” and write that it “was conducted to assess physician–patient discussions of mixed dyslipidemia.” But it’s really an Abbott marketing study for Niaspan, the company’s long-acting niacin product, and the question is: why is it published in the American Journal of Cardiology?The study involves the recorded conversations of 12 cardiologists and 12 PCPs with 45 patients with low levels of HDL. The authors ...
Mail order pharmacies have cheap prices, but also problems
After seeing Mrs. WhiteCoat argue on the phone with Medco representatives for 20 minutes about why one of her 80+ year old patients hadn’t received her medicine despite three lost faxes to Medco, I had to write this post to let the public know what is going on with some mail order pharmacies.If you’re like most Americans, you want to try to save some money. One of the ways that ...
