I’ve covered the approval of Merck’s HPV vaccine extensively in the last month or so. It’s great news for women everywhere, both here in the United States, and especially in the third world. The question now is “should it be mandatory?” Of course ACIP recommended the vaccine, as I predicted they would, so it’s certainly something to consider.

An editorial by someone published in the NYT this past week questions whether the vaccine should be mandatory. Of course, there are some vaccines that are required for anyone entering a public school, for instance. Gardasil could be among these required vaccines (MMR, etc.) for girls aged 9-26. (So that means college students as well.)

I don’t see the problem with making the vaccine mandatory. While there are some reasons that this might not be necessary — cancer-causing HPV can only be contracted through sexual contact — there aren’t any reasons listed that are compelling safety issues.

So we have a sexually-transmitted disease, and a vaccine to prevent it. Should the vaccine be mandatory?

Continue reading Should the HPV vaccine be mandatory? →

It’s a funny thing, you know, medication errors. But probably not how you’re thinking it. In a retail setting, a pharmacist makes an error, and depending on what part of the country s/he lives in, and who he works for, it can be all over the news. Basically, it’s a publicity circus.

On the other hand, you’ve got hospitals where errors occur almost daily. In fact, these errors occur more often than you’d think:

Mistakes in giving drugs are so prevalent in hospitals that, on average, a patient will be subjected to a medication error each day he or she occupies a hospital bed, the report by a panel of experts said.

Continue reading Medication errors harming millions? →

Over the last year that I’ve been writing about science and medicine, I have argued for protections for those who object to performing procedures or dispensing medications that they find morally reprehensible. The more I read and see about the issue, my feelings lie towards the “find another line of work” slant. I found this editorial in the WaPo the other day, and I’ve only just now gotten around to reading it.

Pharmacists refusing to dispense Plan B. Doctors refusing to prescribe Viagra to unmarried men. Fertility specialists refusing to artificially inseminate a gay woman.

Continue reading Moral and ethical boundaries in healthcare →

Hey now this is pretty cool. Atripla is a once-a-day AIDS, 2-in-1 cocktail of Sustiva and Truvada. The hope is that this formulation will help increase patient compliance, which any medical provider will tell you is one of the biggest problems when it comes to achieving positive therapeutic outcomes.

“We know that an HIV-AIDS patient needs to take 95 percent of his or her pills or they won’t work,” said John C. Martin, chief executive of Gilead Sciences Inc., one of the companies in the Atripla project. “So the fewer pills a patient needs to take, the better the outcome.”

Even I’m terrible at compliance, and I understand this better than most. I’d love to see some graphs that show the correlation between the number of times per day that a drug is taken vs compliance over time. I bet you see much higher compliance rates for a once-a-day drug than you do with twice-a-day regimens, and an even steeper drop-off when you’ve got someone who needs to take something 3 and 4 times a day. I bet it’s particularly bad with 4 times a day dosing, because then you’re not necessarily tying a dose to a specific daily activity (eating).

Hrm.

[tags]Medicine, pharmacy, Atripla, HIV, AIDS, Sustiva, truvada, patient compliance[/tags]

I found this today, and I’m thinking that I should print out about 100 copies and keep them handy for people who are skeptical about the efficacy of generic drugs.

• What are generic drugs?
• Are generic drugs as safe as brand-name drugs?
• Are generic drugs as strong as brand-name drugs?
• Do generic drugs take longer to work in the body?
• Why are generic drugs less expensive?
• Are brand-name drugs made in more modern facilities than generic drugs?
• If brand-name drugs and generic drugs have the same active ingredients, why do they look different?
• Does every brand-name drug have a generic counterpart?
• What is the best source of information about generic drugs?

Straight from the horse’s mouth.

Apologies for my lack of writing lately — I have been extremely busy with work and offline life. After tonight, things should go back to normal.

Anyway, looks like I was right about Gardasil not having an uphill fight:

A government advisory committee is recommending that all 11- and 12-year-old girls get a new vaccine to prevent the sexually transmitted virus that leads to most cases of cervical cancer. Moreover, the vaccine will get federal funding under the Vaccines for Children program.

Additionally, the vaccine can be given to girls as young as 9.

[…]

The Advisory Committee on Immunization Practices, ACIP, convened by Centers for Disease Control, also recommended routine use of the vaccine for women between the ages of 13 and 26 regardless of the status of pap-smear tests that measure precursors to cervical cancer.

This is good news for Merck, and for all women. Glad to see the religious retardsright was not able to derail Gardasil recommendation. This part stood out to me, because it notes that the decision was really a non-event:

In a note this morning that preceded the meeting, Timothy Anderson, pharmaceuticals analyst at Prudential Equity Group, had called the decision “a formality.”

Hooray common sense!

[tags]Medicine, pharmacy, Gardasil, Merck, politics, religion[/tags]

Here’s another story that you can file under the “I’ll take this more seriously when more research is done” category. Apparently fish oil works as well as Ritalin in calming hyperactive, ADHD children.

Before I started writing here, I was a science journalist — I covered developments in the world of science that interested me. I did it for myself and for an established publication. Anyway, I quickly learned to develop a skeptical attitude, particularly when somewhat extreme claims were made. I consider this to be one of those. Things like this set off my BS radar:

Psychiatrist Dr Sami Timimi (CORR) said: ‘It stands to reason that using a natural supplement that has few dangers or side-effects must be preferable to using drugs which have considerable dangers associated with them.

‘This is a non-toxic way of doing something that might make a difference.’

First off, natural supplements can be just as toxic and dangerous as synthetic ones. Second, “natural” substances aren’t usually studied because there simply isn’t a lot of money in them because they can’t be patented. Third, OTC supplements (like herbals and fish oil) aren’t regulated by the FDA, so what you’re actually getting can vary from manufacturer to manufacturer — and from bottle to bottle from the same manufacturer. And yes, I realize this study was conducted Down Under, where the laws might be different.

None of the above are smoking guns when it comes to invalidating this story, they’re just things to keep in mind.

The Australian researchers looked at the effect of eye q (CORR) fish oil capsules on a group seven to 12-year-olds with ADHD.

Some were given the capsules, while others took a placebo or dummy capsule.

Within three months, the behaviour of those on the fish oils had dramatically improved and, by seven months, many of the children were less restless and doing better at school.

If true, this is fantastic news. Until other studies corroborate these findings, I’ll treat this with a healthy dose of skepticism rather than gospel. But it certainly is interesting.

[tags]Medicine, pharmacy, fish oil, omega-3, ADD, ADHD, Ritalin, Concerta[/tags]

I was reading on Kevin, MD the other day a post about pharmacists “wanting” to prescribe. The article was about Canada, but we’re rapidly moving in that direction here in the United States as well, with the PharmD degree being the only one that’s offered.

This article is pretty long, so you may wish to get a cup of coffee or something before you read it, but I do think it’s very relevant to healthcare today. The sections:

• The retail misconception
• Healthcare as a collaboration
• A problem of medical records?
• Making a diagnosis vs determining treatment options
• Pharmacists are already prescribing today
• Who’s more qualified?
• Random talking points
• Conclusions

Continue reading Pharmacists as prescribers of medication →

About a year or so ago I got annoyed with all of the little red squiggly underlines that appeared in documents that dealt with medicine. I also got tired of hitting “Add to dictionary” every 3 seconds. So I decided to create my own custom dictionary and make it available as freeware to everyone. The first version had some 40,000 or so words. Not a bad start, but it still wasn’t good enough, so I’ve been working at it slowly and now my dictionary has some 66,239 words.

Since most of my readers work in the medical profession, I thought I would post it here. Anyway, feel free to pass it around to friends, relatives, medical students, pharmacy students, people you hate, you know, whatever.

I hope to include a form for submitting new words in the future.

MeDic for Word (and any other program that uses plain text dictionaries).

Cheers!

[tags]Medicine, pharmacy, biology, chemistry, spelling, transcription, stenography, dictionary, grammar, word, microsoft word, hacks, freeware[/tags]

Reading articles like this irritates me more than just a little bit. I have written extensively about the coming Part D doughnut hole already.

Furfaro, a disabled heart-transplant patient, hit the doughnut hole last month when he tried to fill a prescription for two medications. Instead of two $25 co-pays, the pharmacist charged him $661 and $329 for the prescriptions.

“I threw a fit,” he said. “What am I supposed to do? I don’t have $661 in my pocket.”

Continue reading Hitting the Medicare doughnut hole early →