Medications

October 10, 2018

Not so noble: Big Pharma profiteering off the work of Nobel laureates

The 2018 Nobel Prizes represent a pinnacle of global recognition for path-breaking research, but the awards also surface some less than noble aspects of modern science and medicine.

This year’s prizes cast a spotlight on breakthrough findings on how to take off the immune system’s natural brakes to allow it to attack cancer, and on speeding evolutionary processes so enzymes and bacteria-fighting viruses can be harnessed to create compounds helpful to mankind. Advances in these areas promise to improve and lengthen lives around the planet.

And it was terrific at a time of so much gender-based discrimination and abuses of women in science, technology, engineering, mathematics, and medicine, to see prestigious prizes, finally, awarded to two women in chemistry (the fifth such Laureate) and physics (the third).

October 9, 2018

Congress approves 650-page bill to attack opioid crisis, as doubts abound

by Patrick A. Malone

Congress has approved a major new push to deal with the opioid crisis that kills tens of thousands of Americans annually. Voters can expect President Trump to sign the big bill, passed easily and with rare bipartisan support in the House and Senate, just in time for politicians in the mid-term elections to campaign on their drug-fighting initiatives. But critics say it won’t be enough.

The opioids legislation covers 650 pages, and, in brief, the Washington Post reported, would:

Require the U.S. Postal Service to screen packages for fentanyl shipped from overseas, mainly China. Synthetic opioids that are difficult to detect are increasingly being found in pills and heroin and are responsible for an increase in overdose deaths.

September 25, 2018

Doctors too readily provide dubious treatments to vulnerable seniors

by Patrick A. Malone

Doctors subject older patients to risky, costly, invasive, and painful tests and treatments, perhaps with good intention but also because they fail to see that the seniors in their care are individuals with specific situations with real needs that must be considered.

If physicians too readily accept conventional wisdom in their field, for example, they may push patients 65 and older to take low-aspirin, with the popular but mistaken belief that this practice will help prevent heart attacks, strokes, and dementia. This doesn’t work, and, it increases the risk in seniors of “significant bleeding in the digestive tract, brain or other sites that required transfusions or admission to the hospital,” the New York Times reported.

The newspaper cited a trio of studies, published in the New England Journal of Medicine and based on “more than 19,000 people, including whites 70 and older, and blacks and Hispanics 65 and older. They took low-dose aspirin — 100 milligrams — or a placebo every day for a median of 4.7 years.”

September 14, 2018

Common sense on kids and concussions, adult heart disease, frats and booze

by Patrick A. Malone

Common sense and moderation can matter a ton in maintaining good health, as recent news reports show, particularly with kids and concussions, middle-aged adults and heart disease, and collegiate alcohol abuse.

With youngsters returning to school and so many of them participating in sports and recreation programs, it’s good that the federal Centers for Disease Control and Prevention has issued evidence-based guidance on protecting kids who suffer mild traumatic brain injury or what most of us would call concussions.

These injuries have become a growing concern for parents and young athletes. Sports leagues and sporting groups are coming to a time of reckoning with just how harmful head trauma can be.

September 13, 2018

Maryland researchers set a new stage for clearer explanation of medical risks

by Patrick A. Malone

What’s an internist to do when an 81-year-old patient, already in failing health with advanced emphysema, seeks a second opinion because he’s been told his prostate specific antigen (PSA) levels are unacceptably high? This senior also has been advised to schedule a prostate biopsy urgently to determine if he has cancer. Can this discussion with both a scared patient — and his bright, concerned personal doctor — be any tougher?

For Andrew Lazris, who is also a geriatric specialist practicing in Maryland, this was a hard, complicated case because it involved his dying dad.

It also exemplified for him the work that he has undertaken with Eric Rifkin, an environmental scientist and adjunct researcher at Johns Hopkins University, in ensuring that patients retain their fundamental and critical right to have a say in their care. And, in doing so, they have developed what they argue is a clear, comprehensible way to help patients grasp and deal with the inevitable uncertainties, risks, and complexities of the array of medical treatments they can get overwhelmed with by doctors, hospitals, Big Pharma, medical device makers, and others in health care.

August 30, 2018

Can ‘sunshine’ of evidence-based facts dispel fog of diet and nutrition hokum?

by Patrick A. Malone

Media coverage of diet and nutrition topics, for their abundance of hype and sheer bunk, may take the cake. Some recent, solid reports not only offer examples of the scope and scale of this public tomfoolery and its costs but also the reasons why it persists.

Let’s start with reporter Liz Szabo’s deep, detailed take-down of Michael Holick, a Boston University endocrinologist and unabashed pusher of a widespread medical myth that many of us may be deficient of Vitamin D, the so-called sunshine supplement.

Szabo, investigating for the independent, nonpartisan Kaiser Health News Service and the New York Times, reported that Holick has advocated for Vitamin D sufficiency guidelines that created in 2017 alone a $936 million market for its supplementation, with Americans spending another $365 million for more than 10 million vitamin deficiency tests paid for by Medicare.

August 27, 2018

As Pharma beefs about testing, tougher comparative studies may be key

by Patrick A. Malone

Big Pharma howls often about the federal Food and Drug Administration path to get prescription drugs approved for markets, complaining current regulatory processes take too long and, with their requirement for rigorous clinical trials, are too tough.

Even as drug makers seem to be finding sympathetic officials to make these regimens faster and laxer, some voices want the FDA to consider costlier and what they say is more realistic and useful scrutiny of drugs that goes beyond current attempts to find if they are safe and effective.

Shouldn’t regulators — at the FDA or elsewhere in the federal bureaucracy — help consumers much more to know the answers to “two crucial questions: How do … new therapies compare with already known ones? What are the relative benefits and harms in a particular situation, for a person like you?”

August 20, 2018

Drug overdose toll hits another record as abusers fall prey to synthetic opioids

by Patrick A. Malone

In 2017, drug overdoses killed 72,000 Americans, a 10 percent increase over 2016 and yet another record, according to the latest provisional federal estimates.

That single year toll would be more than double the American deaths attributed to the Korean War, and almost 1.25 times those caused by the Vietnam War. The New York Times reported that 2017’s overdose deaths were “higher than the peak yearly death totals from HIV, car crashes or gun deaths.”

The newspaper said experts, analyzing the numbers, blamed them on a few reasons (see NYT chart above): “A growing number of Americans are using opioids, and drugs are becoming more deadly. It is the second factor that most likely explains the bulk of the increased number of overdoses last year.”

August 13, 2018

After feds bust U.S. rep for insider trading in Pharma stock, will Congress drain ethics swamp?

by Patrick A. Malone

At a time when prescription drug prices keep skyrocketing and Americans pay hundreds of billions of dollars for medications that account for as much as 15 percent of all U.S. health care spending, federal law enforcers provided a rare and jarring sight with the public arrest of a congressman on charges he engaged in insider trading involving an Australian drug maker.

Chris Collins, a Republican who represents a western New York district and was among President Trump’s earliest and most vocal supporters in Congress, insists he committed no wrong. He says he will be exonerated, but he has pulled the plug on his plans to seek reelection in November.

The sordid details of his financial dealings, as laid out in news stories and a damning indictment, however, may keep front and center not only the charges against him but also troubling questions about members of Congress and their private investing, corporate board roles, and especially their tenacity as Big Pharma lapdogs, instead of being watchdogs on behalf of besieged, too often bankrupted American patient-consumers.

August 6, 2018

As Big Pharma rivals battled to hype opioids, watchdogs dozed. They slumber still.

by Patrick A. Malone

When Big Pharma pursues rapacious profits and regulators snooze, patients suffer terrible consequences, as new revelations about the opioid crisis show.

Kaiser Health News Service , via the Washington Post, and The New York Times both have done excellent investigative digging into drug makers’ role in fueling the prescription painkiller mess that authorities estimate claims 116 lives a day due to overdoses.

Fred Schulte, writing for the independent, nonpartisan Kaiser service, reported that rival makers — seeing how much money Purdue Pharma was making with its powerful and addictive OxyContin drug and that it was encountering law enforcement and regulatory challenges — stepped in with “similarly dangerous painkillers, such as fentanyl, morphine and methadone.”