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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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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Daraprim is a drug that no one ever heard of unless they are taking it. It is used to treat toxoplasmosis, a parasitic infection, has been around for decades, and is prescribed typically in patients with weakened immune systems, such as those with AIDS. Daraprim has been newsworthy because a small company, Turing Pharmaceuticals, recently purchased the drug from Impax Laboratories for $55 million, and promptly raised ...

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Recently, public outrage over Daraprim’s price hike from $13.50 to $750 was loud and clear -- so loud that its CEO Martin Shkreli had to rescind it. In the business world, he might be praised as a savvy investor. He saw a product that was drastically undervalued and priced it at a level that the market was willing to bear, reaping huge profits. This type of mentality is a trait many ...

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What is not to like about medical marijuana? It treats pain, vomiting, fatigue, anxiety, depression, insomnia, seizures, muscle spasms, Crohn’s disease and allows many cancer patients to resume remarkably normal lives. It is not addictive. It does not interact with other medicines. It acts quickly and is easy to adjust. It can be consumed in numerous ways. It is safer than essentially any other drug: 1,500 Tylenol deaths in the ...

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A brief article recently posted the name and picture of a neurosurgery resident accused of smoking marijuana on the job.  Dr. Gunjan Goel, MD is a neurosurgery resident at University of California, San Diego, and the list of her awards and publications alone is almost as long as my entire CV.  The article is brief, and rather uninformative.  The only facts that are known are this: ...

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Medication non-adherence is a hot button topic in health care. Physicians lament patient “non-compliance” with their medical advice, and policy wonks tell us that more than half of patients do not take their medications as directed. Missed opportunities to control chronic illnesses such as diabetes, heart disease, and cancer surely do cost us untold billions of dollars and millions of quality life years lost annually in the U.S. ...

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Katie had always come to clinic in an anxious and frazzled state. Hair blond hair disheveled, large handbag open, items at the verge of spilling out. Yet she came, dutifully, to meet her counselor, to attend group therapy, to get vitals checked by her nurse, then to drop off a urine sample. But not today. Nor did she return to clinic over the next three weeks. Katie was found by ...

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While studying for a certification exam, I came across a question that stayed with me well after taking the practice test. The case discussed a patient who was prescribed antibiotics by his physician for a presumed bacterial illness and then returned the following week with an antibiotic-associated diarrheal infection. The test question then asked what could be concluded from this case. The answer: informed consent (i.e., patient permission for a ...

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