Medications

March 12, 2019

For diabetics and dialysis patients, glimmers of better news on costs of care

Diabetics and those with failing kidneys may have gotten a glimmer of relief from the staggering costs of caring for their conditions, as Big Pharma relented a tad with news it will put out a less-costly insulin product and federal officials suggesting Uncle Sam soon may be upsetting the flush profits of the dialysis industry.

DaVita Inc. and Fresenius Medical Care AG run more than 5,000 U.S. dialysis clinics and control around 70 percent of the market, Reuters news service reported in a story describing how Alex Azar, the powerful head of the federal Health and Human Services department, wants “a new payment approach for treating kidney disease that favors lower cost care at home and transplants.”

Why? As Reuters explains, “The goal is to reduce the $114 billion paid by the U.S. government each year to treat chronic kidney disease and end-stage renal disease, a top area of spending.”

March 11, 2019

With FDA chief gone, doubts rise on battles on nicotine, opioids, drug costs

by Patrick A. Malone

The Trump Administration has lost yet another top health official: So, what happens now with key policies pushed by Scott Gottlieb, the departing federal Food and Drug Administration commissioner, to battle teen nicotine abuse, cut skyrocketing drug costs, and attack the opioid crisis?

Administration officials insist Gottlieb wasn’t ousted, and the physician and onetime Big Pharma insider said he resigned from his post after a year on the job because he wanted to spend more time with his family (they hadn’t moved from Connecticut to join him in the nation’s capital).

Though Gottlieb received mixed or favorable media coverage as he leaves, his effect on the nation’s health is as cloudy as many high school vaping spots.

March 5, 2019

For soaring drug costs and overdoses, officials offer blame and shame

by Patrick A. Malone

As tens of thousands of Americans die from overdoses and many millions struggle with skyrocketing prescription medication costs, lawmakers and regulators in the nation’s capital plodded along with procedural steps they claimed would help attack what voters insist are some of their top public policy priorities.

On Capitol Hill, seven of Big Pharma’s top executives danced and dodged with members of a U.S. Senate Committee about who is to blame for the relentless rise and unaffordable cost of American drugs. Media reports of the Senate Finance hearing called it “political theater,” and it offered lawmakers a chance to vent at execs from AbbVie, AstraZeneca, Bristol-Myers Squibb, Johnson & Johnson, Merck, Pfizer, and Sanofi.

Sen. Ron Wyden, the senior Democrat on the committee from Oregon (shown above), blasted Big Pharma, telling the stone-faced corporate suits arrayed before him, “You’re willing to sit by and hose the American consumer while giving price breaks to consumers overseas,” the New York Times reported. He added that Big Pharma attempts to justify its prices, when so many patients cannot afford them, are “morally repugnant.” Sen. Bill Cassidy (R-La.) decried sky-high U.S. drug prices, especially compared with lower rates for patients elsewhere, saying, “It is almost as if the taxpayer has ‘stupid’ written on their face.”

February 26, 2019

Doctors, Big Pharma and FDA ripped for bungling control of potent painkillers

by Patrick A. Malone

A steady flow of news reports shows how our nation’s opioid crisis can be fairly blamed on just about every actor in the medical field that should have known better: Big Pharma, doctors, hospitals, and regulators. It’s been a toxic mix of incompetence, indifference and out-and-out deceptive conduct that produced the epidemic that now claims tens of thousands of American lives each year.

Take, for instance, the drug fentanyl, a lab-created painkiller 100 times more powerful than morphine. How did it escape the confines of legitimate prescription pain control to become a killer street drug? The Washington Post reports, based on research from Johns Hopkins experts, on how doctors, hospitals, and the federal Food and Drug Administration bungled a plan to safeguard the administration of this highly potent drug that had obvious abuse potential from the day it came onto the market.

Meantime, two other news organizations — the Pulitzer Prize-winning investigative website Pro Publica and the online health site Stat — have pried loose disturbing, sealed court testimony, showing how a wealthy, philanthropic family approved a lethal deceit about the potency of OxyContin, a billion-dollar opioid pushed relentlessly by Purdue, the Big Pharma firm they owned.

February 17, 2019

Plain Talk for Seniors: Supplements can’t ‘cure’ Alzheimer’s or cancer, or anything else

by Patrick A. Malone

Seniors and their friends and companions should consider reality versus magical thinking about the power of pills. The blunt truth: Over-the-counter dietary supplements can’t cure diseases. Not Alzheimer’s, not cancer, not diabetes, not any known disease. They don’t extend your lifespan either.

Scott Gottlieb, commissioner of the federal Food and Drug Administration, not only has warned a dozen companies to stop making reckless health claims about supplements, he also told Congress his agency needs greater authority to regulate what the New York Times reported has become a “$40 billion industry, which sells as many as 80,000 kinds of powders and pills with little federal scrutiny. These products range from benign substances like vitamin C or fish oil to more risky mineral, herbal and botanical concoctions that can be fatal.”

Gottlieb told the newspaper that regulators have been reluctant to rein in the wildfire spread of supplements and their wilder claims. But the public health is at such risk now that Congress must step in.

February 12, 2019

OxyContin reformulation faulted in 222% spike in hepatitis C infections

by Patrick A. Malone

Investigators have teased out yet another damaging thread in the villainous web of harms of the opioid crisis. A spike in hepatitis C infections is a costly, long-term, and major health consequence of the hype and disastrous reformulation of OxyContin, the powerful painkiller made by Purdue Pharmaceuticals owned by the wealthy Sackler family.

Purdue, in the 1990s, promoted and sold OxyContin to doctors and hospitals in a relentless campaign that stressed how this drug was supposedly safer and longer acting, releasing its potent effects over as long as a 12-hour span instead of requiring many pills that needed to be taken more often.

Although those claims of the drug’s benefits were dubious to start, patients — especially those abusing the highly addictive prescription medication — found they could get around OxyContin’s delayed release, getting an immediate jolt or walloping high, by crushing their pills. They then snorted Oxy as a powder or mixed it with a liquid and injected it.

February 5, 2019

Harsh reminder of opioid peril: A single smuggling bust seized fentanyl enough for 144 million fatal overdoses

by Patrick A. Malone

If anyone around doubts still the threat that the opioid crisis poses to the nation, a drug bust involving a vegetable truck in Arizona should provide powerful persuasion: Federal agents, suspicious about the vehicle’s floor, loosed a drug-sniffing dog, resulting in the seizure of not just 395 pounds of methamphetamines but also 254 pounds of fentanyl.

Fentanyl is a synthetic opioid, a lab-created super drug that experts say is 50 times stronger than heroin and up to 100 times more potent than morphine. It packs a wallop for users in tiny grains or flecks.

The record-setting seizure at the Arizona border stop amounted to 144 or so kilograms of fentanyl, with drug enforcement officials estimating that just 1 kilogram of fentanyl can produce 1 million fatal doses. That means just this one bust had the potential to cause 144 million deaths.

February 3, 2019

Will Rx drug costs fall if U.S. puts squeeze on middlemen and curbs rebates?

by Patrick A. Malone

The Trump Administration has put out its latest prescription to try to slash out-of-control prescription drug prices: Officials want to call medication “rebates” what they say they’ve really become — “kickbacks” — and crack down on the crazy rise of profit-reaping middlemen in the drug business.

Alex Azar, secretary of the Health and Human Services Department, announced that Uncle Sam, via the giant Medicare and Medicaid plans, hopes to fix big flaws in the drug industry by barring prescription medication discounting to PBMs (prescription benefit managers). The discounts still would be available to patient-consumers. But eliminating them for PBMs could be a major step in cutting drug costs, not the least because this step could give parties in this medical “supply chain” more transparency on what products cost.

January 24, 2019

Savvy Rx from a resident: Docs, know why and what you’re ordering, please

by Patrick A. Malone

Well, just because.

That isn’t a great answer for cranky toddlers with too many questions. It’s also an unacceptable but real reason why too many hospitalized patients get woken up in the middle of the night and subjected 24/7 to expensive, invasive, and often unnecessary tests and procedures.

Abraar Karan (right), an internal medicine resident at the Brigham and Women’s Hospital/ Harvard Medical School, has blogged with welcome candor about doctors’ casual acceptance of medical routines that not only discomfit but also can harm patients. As he wrote online for BMJ (aka the British Medical Journal): “The reality of medicine is that there are many things we as doctors do for absolutely no reason. That is to say, there is no evidence (randomized controlled trial or otherwise) for doing them, other than ‘that’s the way we’ve always done it.’”

January 22, 2019

Diabetes is serious. So why aren’t patients getting more treatment help?

by Patrick A. Malone

Doctors, hospitals, health officials, and disease advocacy groups race to warn about diabetes’ risks, harms, and increasing prevalence. But why, then, doesn’t modern medicine also do much more to help diabetics with the skyrocketing costs of their care, whether with insulin at excessive prices or with expensive medical aids?

Ted Alcorn of the New York Times drilled down on one slice of diabetes care to capture how medical profiteering distorts what ought to be a more direct, simple, and less pricey treatment for a disease that afflicts as many as 100 million Americans in varying degree.

He reported on the “strange marketplace” for the chemical-imbued plastic strips diabetics use to test their blood sugar, inserting them into specialized meters for glucose readings. Before diabetics adjust their diet or take insulin, they may test themselves with strips and meters as many as 10 times a day. The costs add up. Diabetics can pay thousands of dollars annually to get test strips over the counter.