Medicine and Pharmaceuticals

One of the many responses to the opioid crisis has been the development of Prescription Drug Monitoring Programs (PDMP) - databases containing the drug utilization of patients based upon physician prescriptions. As a result, we have a lot of information on who is prescribing and who is taking opiates. In a paper from the National Bureau of Economic Research [1], a recent working paper by Thomas Buchmueller and Colleen Carey looked at The Effect of Prescription Drug Monitoring Programs (PDMP) on Opioid Utilization in Medicine.

 

PDMPs, permit physicians to view a patient’s prescribing history.  PDMP use are part of the controversial CDC guidelines,

 

Clinicians should review the patient’s history of...

The newest wrinkle in the assault of opioid drugs on Americans is just about the last thing we need: Killer pills.

Opioid pills, such as Vicodin and Percocet have (wrongfully) been blamed for the soaring death toll in the US (See: No, Vicodin Is Not The Real Killer In The Opioid Crisis). But, in a perverse twist, pills are, in fact now making a greater contribution to the number of overdoses. But it is not the real pills that are doing the damage. Rather, it is counterfeit versions of those real pills, which can be indistinguishable from the real thing. And extremely dangerous. 

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Though pneumonia and infection are among the litany of known complications following a water birth, the Centers for Disease Control and Prevention (CDC) just reported two cases of Legionnaires’ Disease in newborns in Arizona born this way at home. Upon this discovery, further investigation identified a Legionellosis death of an infant after a water birth in 2014 in Texas. 

I will interpret these cases momentarily.

Yes, babies have been born healthy via water birth. However, when problems arise they are serious to catastrophic and amidst so unpredictable a journey as childbirth they occur rapidly and can be irreversible. Delay in clinical intervention is common given these births traditionally take place in a home or outside of a hospital. When oxygen deprivation is the...

Columbia University Professor Jeffrey Sachs is one of the world's most influential public intellectuals. His war against global poverty is commendable, if not always congenial. His expertise is rightly sought by national and international media outlets.

It's strange, then, for someone of his knowledge, accomplishment, and reputation to repeat verifiably untrue claims. A recent exchange on Twitter reveals that, at times, Dr. Sachs has merely a casual relationship with the truth.

Jeffrey Sachs's War on the Pharmaceutical Industry

Dr. Sachs really does not like the pharmaceutical company Gilead, which has developed a cure...

The story of Easton Elrod, a 4-year old boy “born broken, everywhere” having sustained over 100 bone breaks in his lifetime was recently trending in the news. Birth, alone, broke “both legs, one arm, the back of his head, all of his ribs,” according to his mother Brianna Elrod.

None of us remember—or, maybe I should speak for myself— but birth can be quite traumatic even in the most routine of circumstances. The infant sustained for months in a fluid-filled environment contained within the greatest suspension system known— aka the pregnant womb— must squeeze through the birth canal to make his way into the world for his first breath of air. 

Sounds daunting enough, but...

A few recent studies with weak design sought a link between pediatric obesity and method of delivery: vaginal birth versus cesarean section.

Confirmation bias typically arises from seeking information that confirms your predetermined hypothesis. To simplify: what you seek, you shall find.

So gave birth to the notion that there could be causality or at a minimum a link between Cesarean Delivery (CD) and the development of childhood obesity. The reality is rates for both have been on the rise in recent decades which is why pursuing a magic bullet relationship holds appeal. 

However, a new longitudinal study just published in the journal Pediatrics undermines this...

Let's give a (non) round of applause to the CDC. I have written many times about how the agency's bungling of the opioid overdose epidemic by "solving" the wrong problem has only succeeded in making things worse. (See: How the feds are fueling America’s opioid disaster.)

Data from all over the US makes it patently obvious that opioid pills are not the driver of overdose deaths, which have skyrocketed in the past 2-3 years. Rather, the real killers are the drugs that replaced the pills. (See: No, Vicodin Is Not The Real Killer In The Opioid Crisis ). Yet that hasn't stopped the agency...

The most common form of dementia, Alzheimer’s Disease (AD), currently afflicts 5.5 million adults in the United States and is estimated by 2050 to impact 13.8 million (age 65 or older). 

Why is this happening? 

Given that age is the most significant risk factor for disease development, fewer are dying from other illnesses due to treatment advances, hence, more and more people are surviving into later adulthood. As a consequence, death rates for AD have risen 55% between 1999 and 2014 according to the Centers for Disease Control and Prevention’s (CDC) latest Morbidity and Mortality Weekly Report (MMWR). 

The analysis is “the first to provide county-level rates for deaths caused by AD” obtained through review of state- and county-level death certificate data provided...

Welcome back. In Part 1 we considered the spread – the difference between the cost of a product or service and the price charged for that product or service – for the three major suppliers in the pharmaceutical supply chain, manufacturers, wholesalers, and retailers. And we mentioned, in passing, the role of payers who fund the supply chain, insurance, the government and the only group paying for any of this, us.

Intermediaries – facilitators of transactions

Using cost and price to improve your spread requires having the information necessary to discover the little differences, the points of arbitrage you can exploit – ‘knowing the market.’ Information like any asset is distributed unevenly. Differences in our knowledge, information asymmetry, like any...

The difference between the cost of a product or service and the price charged for that product or service is the spread. The pharmaceutical industry, more of a pharmaceutical industrial complex (PIC), has been responsible for many miraculous things. Harvoni, a medicine that has a greater than 95% efficacy in eliminating Hepatitis C, for example. But there is no more extraordinary feat by the PIC than for a manufacturer to price a medication at $10 a pill, receive $5 a pill as payment and along the way they and five or six intermediaries profit – and profit hugely. This ‘miracle’ of market forces, regulation and brokers are the ‘secret sauce’ behind the increasingly frequent distress over the high cost of drugs. The spread drives and often best describes these forces. Rather than...