prescription drugs

Seniors On Drugs: Report Finds Many Taking ‘Risky’ Meds

Are we unnecessarily drugging our seniors?

That’s the subtext of an analysis by public health researchers at Brown University which found that more than 1 in five seniors with Medicare Advantage plans got a prescription for a “potentially harmful high risk medication,” a.k.a. “Drugs To Avoid In The Elderly,” during 2009.

Researchers report that 21.4 percent of the patients — more than 1.3 million people — “received at least one high-risk medication, for which there is often a safer substitute.”

Getting a prescription for a “risky” medication (among a list of 110 drugs agreed upon by a group of clinicians and other experts) was more common in the Southeast, among women and people living in relatively poor areas, the study found. In terms of geography, it was least prevalent in New England; indeed, Worcester, Mass. had “the best rate of single and multiple high-risk prescription use, respectively,” researchers report.

Amal N. Trivedi, an associate professor of Health Services Policy and Practice at Brown said one of the key take-home messages is that patients should regularly “review their medication lists with pharmacists and their health care providers.”

(According to the report, high-risk medicines in the elderly are broadly defined as “medications that should be avoided among patients 65 years of age or older because the associated adverse effects outweigh potential benefits or because safer alternatives are available.) Continue reading →

FILED UNDER: Insurance, Medicine/Science, Personal Health, medications, prescription drugs, seniors

September 12, 2012 | 9:11 AM | Carey Goldberg

Prescription Nation: 4 Billion A Year, Antipsychotics Lead Psych Meds

To share these mind-boggling (and I use the term advisedly, because so many of these drugs act on the mind) statistics, I’m passing along a press release just in from the American Chemical Society in full:

People in the United States took more prescription drugs than ever last year, with the number of prescriptions increasing from 3.99 billion (with a cost of $308.6 billion) in 2010 to 4.02 billion (with a cost of $319.9 billion) in 2011. Those numbers and others appear in an annual profile of top prescription medicines published in the journal ACS Chemical Neuroscience.

Journal Editor-in-Chief Craig W. Lindsley analyzed data on 2011 drugs with a focus on medications for central nervous system (CNS) disorders. So-called antipsychotic medicines — including those used to treat schizophrenia, bipolar disorder, obsessive-compulsive disorder, Tourette syndrome and some forms of depression — ranked as the fifth most-prescribed class of drugs by sales. Antidepressants, for conditions that include depression and anxiety, ranked No. 7.

XanaxTM, CelexaTM and ZoloftTM were the most-prescribed psychiatric medicines, with other depression and anxiety medications rounding out the top 10. Two antipsychotics were among the 10 drugs that Americans spent the most on, with AbilifyTM in fourth place. Lindsley explains that while antidepressants continued to be the most-prescribed class of CNS drugs in 2011, prescriptions for ADHD medicines increased by 17 percent and multiple sclerosis medications by 22.5 percent in sales from 2010. While expiring patents on major antipsychotics in the next few years will put pressure on drug makers to innovate, the industry should be heartened by the growth of the number of prescriptions and spending.

The full paper is here, including this chart of the top 10 drugs:

Top 10 drugs in 2011 (Source: IMS Health via ACS Chemical Neuroscience)

FILED UNDER: Medicine/Science, Money, antidepressants, antipsychotics, prescription drugs

July 16, 2012 | 9:40 AM | Carey Goldberg

Mass., 50th State, Now Allows Drug Coupons: What You Need To Know

An example of a drug coupon on internetdrugcoupons.com

By Karen Weintraub
Guest Contributor

For years, the small print at the bottom of prescription drug coupons offered by magazines and Websites has included the words “not valid in Massachusetts.”

But the next batch that’s printed won’t need that language, because when Gov. Deval Patrick signed his 2013 budget into law last week, it included a provision legalizing the use of drug coupons here – at least on medications for which no generics are available.

Massachusetts is the last state in the nation to make coupons legit.

This change may actually add to patients’ confusion, at least in the short-run. Many of the coupons in your favorite magazine are for products that have generic equivalents. That Prilosec coupon still needs to go in the recycling, along with those for Lipitor, Zantac and Seroquel.

The wrangling over whether to legalize these coupons led to some weird political bedfellows.

A quick check of the website InternetDrugCoupons.com reveals a large number of drugs that would be covered, though, including the depression and anxiety medication Cymbalta, the rheumatoid arthritis drug Humira, the sleep aid Lunesta, the mental health drug Abilify, and the heartburn medication Nexium. (See a fuller list at the bottom of this post.)

Coupons for over-the-counter medications have always been allowed in Massachusetts.

The wrangling over whether to legalize these coupons led to some weird political bedfellows. Healthcare For All, the advocacy group concerned with health access for the poor, allied with insurance companies to lobby against the provision. Allowing coupons, the group said, would drive up the cost of healthcare by encouraging people to use name-brand drugs, instead of lower-cost alternatives. As insurance companies’ expenses rise, they will push their added costs onto customers, said Alyssa Vangeli, a policy analyst with the group. Continue reading →

FILED UNDER: Money, Personal Health, prescription drugs

February 14, 2012 | 10:07 AM | Rachel Zimmerman

Public Health Committee Hears Of Dire Drug Shortages, Crisis In Care Delivery

Drugs, particularly generic injectables, are running dangerously short, health officials say.

Yesterday, the state’s joint committee on public health held hearings on the critical shortage of prescription drugs, including cancer medications, antibiotics, anesthetics for surgery and more.

Here’s the news release:

Chairman Jeffrey Sánchez and Chairwoman Susan Fargo hear testimony from hospitals, physicians, and pharmaceutical industry leaders detailing the impact of drug shortages on patient care and the cost of pharmaceuticals.

BOSTON—The Joint Committee on Public Health held an oversight hearing today to investigate the impact of drug shortages on patient care in Massachusetts. Within the last several years, drug shortages have greatly increased in frequency and severity, directly impacting patient safety in Massachusetts. According to the American Society of Health-System Pharmacists, drug shortages quadrupled in the last five years.

“This dire situation has evolved into a public health crisis that threatens our ability to not only provide routine and timely medical care to patients in need, but also to save the lives of people from what should be treatable and curable conditions,” Representative Jeffrey Sánchez said. “Hospitals can’t get the drugs they need, doctors are being forced to alter or delay the course of treatment for their patients, and patients are left wondering if the drug they need to get well will be available for them.” Continue reading →

FILED UNDER: Medicine/Science, Personal Health, prescription drugs, public health

November 15, 2011 | 8:43 AM | Rachel Zimmerman

Dropping Co-Pays Boosts Adherence, Health After Heart Attack

Can free medications help solve the problem of poor adherence among heart attack patients?

A new study by researchers at Brigham & Women’s Hospital (and funded, in part, by the insurer Aetna) concludes that eliminating co-pays for drugs prescribed after a heart attack improves patients’ medication adherence rates and health outcomes without increasing overall costs.

The research, published online in The New England Journal of Medicine, split heart attack patients into two groups: one with full insurance coverage — including all prescription drugs routinely prescribed after a heart attack, including statins, beta-blockers, angiotensin-converting-enzyme (ACE) inhibitors, and angiotensin-receptor blockers — and another with usual insurance coverage, including co-pays.

While adherence rates were incredibly low in both groups, study authors write: “Rates of adherence ranged from 35.9 to 49.0% in the usual-coverage group and were 4 to 6 percentage points higher in the full-coverage group.” Continue reading →

FILED UNDER: Insurance, Medicine/Science, Money, Personal Health, cost, heart attacks, insurance, prescription drugs

November 3, 2011 | 12:09 PM | Rachel Zimmerman

Herald: Co-Pay Nightmare With Cost Hike From $42 To $600 For Meds

When your co-pay for a critical medication jumps from $42 to $600 a month, you know something’s gone wrong.

That’s the sad fate of retired pressmann Ken Helgeson, as told by Margery Eagan in today’s Boston Herald. Helgeson is just a regular guy trying to care for his daughter and paraplegic wife. He “could be you” Eagan writes, “simply another man who played by the rules, and now faces a nightmare.”

In what he calls “a sellout,” Helgeson says Medicare has changed its deal for covering the prescription drug that kept him working for 10 years with increasingly severe rheumatoid arthritis. Enbrel used to cost him a $42 per month co-pay. Now it costs him $600 a month. He can’t afford it. So he stopped taking Enbrel four months ago.

“Six hundred a month is an awful lot of money on a fixed income,” he said. “I just can’t pay.” Continue reading →

FILED UNDER: Insurance, Money, Personal Health, cost, medicare, prescription drugs

May 12, 2011 | 11:35 AM | Rachel Zimmerman

Study: Rogue Online Pharmacies Linked To Increased Drug Abuse

The proliferation of easily available medications from “rogue” online pharmacies may be driving the epidemic of prescription drug abuse, researchers report.

Investigators from Massachusetts General Hospital and the University of Southern California found “states with the greatest expansion in high-speed Internet access from 2000 to 2007 also had the largest increase in admissions for treatment of prescription drug abuse.”

The report, which focused on online pharmacies that dispense drugs without a doctor’s prescription, was published today online by the journal Health Affairs.

According to the news release:

In their report, [Dana] Goldman, PhD, director of the Schaeffer Center for Health Policy and Economics at USC and lead author Anupam B. Jena, MD, PhD, of the MGH Department of Medicine, note that the recent marked rise in the abuse of prescription narcotic painkillers – drugs like Percocet and Oxycontin – corresponds with an increase in the presence of online pharmacies, many of which do not adhere to regulations requiring a physician’s prescription. Drugs that are frequently abused – painkillers, stimulants, sedatives and tranquilizers – often can be purchased from rogue sites that may be located outside the U.S. The current study was designed to examine the potential link between online availability and prescription drug abuse, an association that has been suspected but not investigated in depth.

Using data available from the Federal Communications Commission, the researchers first compiled statistics on access to high-speed Internet service in each state during the years studied. Since actual rates of prescription drug abuse would be difficult if not impossible to calculate, they used information on admissions to substance abuse treatment facilities from a database maintained by the U.S. Substance Abuse and Mental Health Administration. Changes in both measures over the seven years were analyzed on a per-state basis, and treatment admissions were categorized by the particular types of abused substances involved.

The analysis indicated that each 10 percent increase in the availability of high-speed Internet service in a state was accompanied by an approximately 1 percent increase in admissions for prescription drug abuse. The increases were strongest for narcotic painkillers, followed by anti-anxiety drugs, stimulants and sedatives. During the same period admissions to treat abuse of alcohol, heroin or cocaine, substances not available online, showed minimal growth or actually decreased.

For more on the prescription drug abuse epidemic — accidental overdose deaths from these medications now exceed crack deaths in the 1980s — listen to this segment of On Point. The program examines the “pill mills” in Florida that funnel the drugs into poor communities of West Virginia, Kentucky and Tennessee, and includes interviews with former addicts on how oxycontin and other prescription narcotics decimated their lives.

FILED UNDER: Medicine/Science, Personal Health, drug abuse, online pharmacies, prescription drugs

October 1, 2010 | 11:22 AM | Rachel Zimmerman

Psychology Versus Psychiatry: Do The New Depression Guidelines Take Sides?

New guidelines on how to treat depression stress medication over talk

In our post-Freudian, post-Prozac-crazed era, you’d think the fierce debate over what works better — psychiatry (drugs) or psychology (talk, lots of it) might have quieted. Most professionals I interact with these days take a more pragmatic, mash-up approach to mental health, trying to figure out what combination of therapeutic talking, behavioral retraining, and (conservative) medicating, offers relief to each individual patient.

But on the front lines of mental health, the debate still rages, according to Time Healthland, which has a niece piece today on the new American Psychiatric Association guidelines for treating depression, and why all these various mental health providers can’t just get along. The bottom line? In this latest battle, at least, the psychiatrists (or is it the drug industry?) won.

According to the new guidelines — which will govern treatment for the 200,000 in-patient psychiatric patients in the U.S., as well as the 20 million or so who get out-patient treatment — the No.-1 preferred approach is drugs. Just drugs. The guidelines don’t mention psychological approaches like cognitive-behavioral therapy until No. 3, just after electroshock therapy. Ouch.

The new guidelines underplay an enormous body of data from the past decade showing that even the best psychiatric drugs work better than sugar pills only when the drugs are used in conjunction with psychological therapies that help patients change how they behave and how they form their thoughts. Neither a strictly psychiatric approach (just drugs) nor a strictly psychological approach (just talk therapy) works much better than a placebo pill on its own. But when used in combination, the psychiatric and psychological treatments help a majority of people get better.

Medscape offers a less pointed analysis of the new guidelines.

Clearly, the questions raised here aren’t going away soon. An accompanying story reports that 1 in 10 Americans, or 9 percent, suffer from depression and 3 percent suffer from major depression.

FILED UNDER: Medicine/Science, Money, Personal Health, cognitive behavioral therapy, depression, mental health, prescription drugs

August 30, 2010 | 2:55 PM | Rachel Zimmerman

Coakley Recovers $2.65 Million From CVS For Overpricing

Attorney General Martha Coakley announced an $2.65 million agreement with CVS over alleged overpricing by the national pharmacy chain, Bloomberg Businessweek reports.

An investigation found that the drug chain was overcharging public entities for prescription medications under the workers compensation program. According to a news release from Coakley’s office:

“The city of Boston will receive $60,000 in restitution, and the cities of Brockton, Lowell, Fall River, and Springfield will each receive refunds in excess of $10,000. Other cities and towns will receive lesser amounts, based on the volume of overcharges applicable to those towns. On average, the municipalities will receive approximately $4,500 each.”

FILED UNDER: Money, CVS, Martha Coakley, prescription drugs

August 27, 2010 | 9:55 AM | Rachel Zimmerman

Genzyme Ups Shipments of Rationed Drugs As Patients Wait

medication

Plagued by production problems and nervous about competitors creeping in, Cambridge-based biotech Genzyme told U.S. patients and doctors that it will double shipments of two drugs it has been rationing for a year, reports The Boston Globe.

“The ramp-up of enzyme replacement treatments for Gaucher and Fabry diseases, a pair of rare genetic disorders, comes as the Cambridge biotechnology company continues to haggle with French drug maker Sanofi-Aventis SA over Sanofi’s proposal to acquire Genzyme.”

Patients on one of the drugs, Cerezyme, who had been taking half the normal dose since February, will get the normal dose in September, The Globe says, but patients taking Fabrazyme — which has been rationed to about 20-30 percent of the normal dose — will get only 50 percent of the normal dose in September and October. Genzyme didn’t say when patients could once again get the regular dose of their drugs.