Do you know what it’s like to sit in a meeting and learn that something you hold close as a fundamental principle is probably not as fundamentally true as you thought? That’s the way I felt earlier this week while attending a meeting on the quality of pharmaceuticals, sponsored by the Food and Drug Administration and Duke University’s Margolis Center for Health Policy. The meeting—a 
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"There are roughly 221 million people — including 48 million kids — in states where marijuana has been named a medicine. These include patients who suffer from depression and could see their symptoms worsen. Mothers who could give birth to babies with low birth weights. Children who could face an increased risk of addiction, depression, and suicide. We must allow our citizens ...

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President Trump recently signed two executive orders directly related to prescription drug prices in the U.S. One order would allow the "reimportation" of prescription drugs from Canada. This longstanding idea would allow U.S. pharmacies and drug wholesalers the ability to pay generally much lower prices for their prescription drugs by getting them from Canadian suppliers who benefit from government management of the system. Many consumers have been buying direct from Canadian ...

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Click through North Dakota's Division of Medical Marijuana website, past the addresses of every cannabis dispensary in the state, into the presentations and annual reports, and you'll eventually come to a 32-slide presentation about the state's medical marijuana program. You'll see the 26 diseases that can be treated with marijuana, a colorful flowchart showing the types of available marijuana, and a ...

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When I was in Sweden, I heard this phrase several times: “There is no such thing as bad weather, just bad preparation.” They said this when we asked them what they did with their children in dead of winter. The proud parents made it very clear that no matter what the weather, when it is time to go outside for recess at school, or to get out of the house ...

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Much controversy surrounds whether or not hydroxychloroquine is effective in preventing or treating infection with COVID-19. While much of the data so far suggests that hydroxychloroquine is not effective at treating COVID-19, and perhaps that it might even be harmful, multiple clinical trials focusing both on prevention and treatment are ongoing. The controversy around ...

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On April 29th Anthony Fauci announced the National Institute of Allergy and Infectious Diseases, an institute he runs, had completed a study of the antiviral remdesivir for COVID-19. The drug reduced time to recovery from 15 to 11 days, he said, a breakthrough proving "a drug can block this virus." Now people are clamoring for $1,000-a-pill remdesivir. While the results were preliminary, unpublished, and unconfirmed by ...

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An excerpt from Nurses are Nuts. The pharmacy department plays a vital role in hospitals. They prepare and dispense medications. Sometimes the pharmacist will receive an order from the doctor on a med whose written dosage he is not sure of. In some cases, the pharmacist will ...

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In 2002 pro baseball manager Billy Beane accomplished the impossible. He took the Oakland Athletics, a low-budget team comprised of unknown baseball players to the playoffs. The story’s magic is that he was able to compete with the Goliaths of the baseball world – the New York Yankees - with only a fraction of the budget. The idea is simple - draft players who are statistically successful in their respective ...

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The Affordable Care Act, aka “Obamacare,” has improved patient’s access to health care since its passing in 2010. The increase in coverage, however, does not address the restriction of prior authorization (PA), where a physician is required by a patient’s insurance company to obtain special approval from the insurance company for a medication or treatment. PA is not only needed for medication, but also for scans, potential ...

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My husband is a type 2 diabetic with mild chronic kidney disease, which has been well controlled on 500 mg metformin BID plus saxagliptin (AstraZeneca's Onglyza). At the end of last year, he got a letter from his Medicare Advantage PPO, UnitedHealthcare (UHC), advising him that the Onglyza (UHC only uses brand names) would no longer be covered and recommending he have his doctor switch him to another DPP-4 inhibitor, either ...

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"Boxed warnings" or "black boxes" are the strictest FDA label warnings. They appear on cigarettes, fluoroquinolones (for tendon rupture), Lamictal (for SJS and TEN), Accutane (birth defects), and other products with well-known risks. The industry obviously dislikes black boxes since they reduce sales (though their lobbyists charge the boxes "confuse" and "unnecessarily alarm" patients). So it was no surprise that when the
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In the wake of the opioid epidemic, benzodiazepines have been called “our other prescription drug problem” and “the next U.S. drug crisis.” Prescriptions are on the rise, with over 30 million Americans reporting benzodiazepine use in the previous year. This is alarming, as benzodiazepines are implicated in at least 30% ...

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There was outrage over the sudden rise in the price of the EpiPen. But the rise in many other pharmaceutical prices gets less attention but is just as concerning. It can be easy to forget issues like this until they affect us personally. My two encounters with irrational drug price increases for dermatologic conditions are a reminder of how pervasive this problem is today. I have rosacea, a ...

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Before direct-to-consumer ads, physicians tried to reassure patients they were probably fine. Today, drug ads and online symptom checkers do just the opposite. The most insidious are "unbranded" ads that scare people about a disease without mentioning the drug they are trying to sell. Notable unbranded disease campaigns sell the obscure exocrine pancreatic insufficiency, shift work sleep disorder, and non-24-hour, sleep-wake disorder. Unbranded advertising is designed to appear like a ...

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Along with a steeper financial burden and an increasingly competitive academic environment, this year’s incoming freshman university class will likely be confronted with the pressure to take a little pill that some popular culture references say will make you "awesome at everything." Or they may eschew the temptation and rely on the standard practice of study, sleep, repeat. Welcome to #GenerationAdderall, the ...

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There was a time when drug reps fed us lunch and gave us an endless supply of pens, pads, and even umbrellas all emblazoned with their newest drugs. They explained why their drug was better than their competitors’ and what it would offer to our patients. I still have my Zantac umbrella in the trunk of my car for rain emergencies. Although it was somewhat annoying, it did keep us somewhat ...

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She had been buying face cream through a friend of a friend for 12 years. This time, it was Pond’s “Rejuveness,” a version of the company’s anti-wrinkle cream that is made and sold in Mexico. But someone in the Mexican state of Jalisco laced the cream with a toxic skin-lightening compound, and it had a devastating effect on the 47-year-old Sacramento resident. She showed up at the emergency room Read more...

From time to time, I am asked by someone about participating in a medical research study.  These situations are usually when an individual, or someone close to them, has unmet medical needs.  Understandably, a patient with a condition who is not improving on standard treatment, would be amenable to participating in a clinical trial to receive experimental treatment. I find that most folks misunderstand and exaggerate the benefits they may receive ...

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Lori Pinkley, a 50-year-old from Kansas City, Mo., has struggled with puzzling chronic pain since she was 15. She has had countless disappointing visits with doctors. Some said they couldn’t help her. Others diagnosed her with everything from fibromyalgia to lipedema to the rare Ehlers-Danlos syndrome. Pinkley has taken opioids a few times after surgeries, but they never helped her underlying pain, she said. “I hate ...

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