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November 2016 Newsletter

Recent Project News

  • On October 7, Dr. Fugh-Berman and Dr. Batt published another article in the Hasting Center's Bioethics Forum on the overuse of EpiPens in food-allergic people. The authors point out that "only a tiny minority of those with food allergies die from anaphylaxis . . . far less than anyone's risk of dying from accidents" and that "encouraging people to inject an expensive, potent prescription drug if they so much as suspect that they ate a peanut is both irrational and unethical."

  • Our paper, "Treatment of Men with 'Low Testosterone': A Systematic Review" was covered by Bloomberg, DrugWatch, and the Daily Hornet.

  • The launch of our new DCRx modules on opioids was covered in the GW Hatchet, a student newspaper. Dr. Susan Wood, the director of DCRx, said, "This is not an easy problem to solve. We hope that this will add to what is already out there and contribute to a better understanding [of opioid epidemic]." Make sure to claim your three credits of CME or CPE at doh.dc.gov/dcrx.

  • On October 16, Dr. Fugh-Berman was quoted in "The drug industry’s answer to opioid addiction: More pills" in the Washington Post. "The best way to treat opioid-induced constipation," she said, "is to prevent it in the first place by not overusing opioids."

  • Dr. Fugh-Berman was interviewed on KCRW's Second Opinion on Salespeople in the Surgical Suite: Relationships between Surgeons and Medical Device Representatives.

  • PharmedOut intern Sara Bellakbira's photos of drug rep promotional items, including PharmedOut artworks by Barbara Leckie (Medically Enhanced Chest) and former intern Terra Blissett ("Pen Hospital"), were featured in "The provider gift ban: The day the tchotchkes died." Dr. Fugh-Berman commented on the gift ban, saying "[m]any physicians thought the ban was silly, but that's because they were — and are — unaware of the effect of small gifts on creating a sense of obligation. There was also a certain amount of consternation among some docs, who couldn't figure out how to procure a pen that had not been provided by a pharmaceutical company."


The "Medically Enhanced Chest"

PharmedOut Conference: Call for Abstracts

Save the date: June 15-16, 2017! Registration will open soon. For our 2017 conference, we will be featuring abstracts of students, residents, and fellows. Selected abstracts will win free conference registration. Submission requirements and more information are available on our website. Submissions are due December 9, 2016.

RxFiles

Andrea Sikora Newsome, PharmD

"Uh! Uh! Uh! Uh!" The nurse shouts sternly, as she runs over to stop the patient from pulling his IV out of his hand. The patient is a cantankerous man at baseline, had suffered a complicated hospital course and appeared to be floridly positive for ICU delirium. (An evidence-based screening tool for delirium is available at icudelirium.org. Of note, questions like "what is your name?" or "where are you right now?" are not validated as tests for delirium). We had started olanzapine, an atypical antipsychotic. It had shown little effect, but what else could we do?

Sitting at my rounding table, I watched as the physical therapist came into the room. She was a stocky, middle-aged woman with her dark hair pulled back in a tight bun, white streaks showing in some parts. It strikes me that she was the only African American staff in the unit and the patient was the only African American patient in the unit. More importantly, she seemed an equal match for his personality. The patient must have tried some funny business on her, because she immediately says to him in that strict-but-affectionate schoolteacher tone, "Oh honey, I know you didn’t just try that funny business on me." Duly reprimanded, he quiets down, and they get to work. She spends the next hour with him, berating him, albeit in an affectionate tone. "Oh, you’re a strong man, I know it, I can feel it, why are you stopping now? Don’t you slack off now." She does mobility exercises, strength exercises, occupational exercises. She asks him questions about his family. She leaves him with "Bye sugar."

Looking up from my computer, I see him sitting up high in bed, his cheeks flushed, a slight sheen of sweat on his forehead. We make eye contact and we nod at each other in mutual acknowledgment. His nurse comes by, and he politely requests some water. The nurse then tells me she plans to hold the olanzapine because he is so alert and calm, even oriented and pleasant. I agree and recommend this to the resident. The resident is amazed, but why?

We have taken this man from his home, opened his chest, isolated him from his family, and stuck him with at least a half dozen lines and tubes. He finally got an hour of what most every human being crave. We gave him one-on-one attention, a sense of purpose, conversation, and physical touch. We gave him physical activity. We stimulated his mind and his body, and he responded. Who wouldn’t feel better if they had enjoyed a stimulating conversation, an invigorating workout, and a relaxing massage? Sadly, PT positions are limited, while olanzapine is plentiful. Compared to the costs of a full-time staff position, olanzapine is a steal. The only problem is that it doesn’t really work. In comparison to the documented costs of delirium, maybe PT is the real steal here.

Andrea Sikora Newsome, PharmD, is a Critical Care Pharmacy Specialist at Georgia Regents University, North Augusta, South Carolina.

Check this out!


PharmedOut conference speaker, Dr. Joel Lexchin's new book, Private Profits versus Public Policy is out now! Dr. Nuria Homedes from the School of Public Health University of Texas said "Private Profits versus Public Policy is a very interesting and well-referenced work. It offers a wealth of information in a field of work where hard information is difficult to gather." The book is available for order at University of Toronto Press.

News Round-Up

(For more, follow @Pharmed_Out on Twitter!)


Oct 19

‘Watching the ship sink’: Why primary care doctors have stayed out of the fight against opioids by Bob Tedeschi (STAT)

Oct 17

The CDC is being being influenced by corporate and political interests by Carey Gilam (The Hill)

Drug firms helped create $3 billion overactive bladder market by Kristina Fiore (JS Online)

Oct 16

The drug industry’s answer to opioid addiction: More pills by Ariana Eunjung Cha (The Washington Post)

Oct 13

Doctors Without Borders chastises Pfizer for refusing to lower vaccine price by Ed Silverman (STAT)

Oct 12

How Tiny Are Benefits From Many Tests And Pills? Researchers Paint A Picture by Jay Hancock (Kaiser Health News)

Reviews Of Medical Studies May Be Tainted By Funders' Influence by Richard Harris (NPR)

Drug Coupons: Helping a Few at the Expense of Everyone by Margot Sanger-Katz (The Upshot, New York Times)

Oct 11

Shire wants consumers and their eyes to be 'Friends' by Lisa LaMotta (Bio Pharma Dive)

Oct 10

Big Soda sponsored 96 health groups — a big conflict of interest, study says by Kerry Lauerman (The Washington Post)

Rethinking Automatic Insurance Coverage For Preventive Health Care by Alison Kodjak (NPR)

Oct 7

Anthem declines to cover Sarepta drug for Duchenne, citing doubts over data by Ed Silverman (Stat News)

Including Pharmacists in Primary Care Saves $$$, Helps Patients by Shannon Firth (Medpage Today)

Trade associations' joint statement on transparency in the commercial publications trade by Alastair Matheson (BMJ)

Oct 5

Novartis to pay $35 million to settle charges of illegally promoting a drug for infants by Ed Silverman (Stat News)

Ads disguised as news: A drug company's stealth marketing campaign exposed by Kelly Crowe (CBC News)

New anti-PD1 drugs overpriced, ICER says by Suzanne Elvidge (Bio Pharma Dive)

Oct 3

Drugmakers Point Finger at Middlemen for Rising Drug Prices - WSJ by Joseph Walker (Wall Street Journal)

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