Medicine and Pharmaceuticals

If the issue of drug pricing weren't a big enough issue before the election, it sure is now. Hardly a day goes by without a statement or two from the new administration regarding drug prices. Sometimes the message is even the same on two consecutive days. Or not.

This is a very good time to be asking hard questions about both the price and the value of drugs, something that Dr. Robert Popovian, the vice president of Pfizer US Government Relations has frequently discussed in that past, and continues to do so quite thoroughly. In his most recent piece, "How to Achieve Value-Based Reimbursement" Popovian specifically focuses on specialty drugs because they are quite pricey, but are increasingly important in patient care. He asks a critical question: How can you value a drug that is...

Let’s be honest. It is the rare few of us who don’t start empathetic itching when we even read stories about skin mite infestations or head lice, for example, let alone experience them first hand.  

According to the Dayton Daily News, things got all too real for 86 hospital employees at Kettering Hospital when spokesperson, Elizabeth Long, confirmed an outbreak of scabies among the staff. The hospital representative maintains the spread can be traced to a patient and the proper precautions are in place to prevent further issues—maintaining no other patients have been affected.

What better time to clarify some misperceptions about scabies and a few...

Alternative medicine is like an "alternative fact." If it was real, then the word "alternative" wouldn't be necessary. 

Yet, occasionally, alternative medicine gets something right. Though uncommon, investigations sometimes demonstrate that an herbal remedy used in traditional Chinese medicine (TCM) has a legitimate biological or chemical basis. A fungus harvested from termite nests, for instance, has been traditionally used to treat depression and insomnia. Now, Taiwanese scientists think they have discovered a plausible scientific rationale for this practice.

The team cultured the fungus Xylaria nigripes (also called Wu Ling Shen) in the laboratory and then performed a chemical extraction to obtain biologically active compounds. (This...

There is no shortage of blame for the microbial mess we now find ourselves in. Antibiotics that used to easily cure infections no longer work, leaving us dangerously close to the pre-penicillin days. In the absence of new antibiotics (especially new classes), this trend can only continue. But, thanks to an observational study conducted by multiple groups in the UK, it may be possible to buy us some more time by using antibiotics more judiciously. They even tell us how.

Some of the "culprits" that have put us in this situation include:

  • Evolution (selective pressure): It is inevitable that resistant bacteria or viruses will emerge when they are exposed to a drug that kills them, or inhibits their growth.
  • Drug companies: Companies have been blamed for...

Let's call progress against cancer a mixed bag. Until 20 years ago, chemotherapy drugs — poisons that kill or stop the division of cells— have been the mainstay of cancer treatment. These cytotoxic drugs, many of which are more than 50 years old, work on the principal that cancer cells divide more rapidly (1). So that anything that poisoned all cells would disproportionately affect cancer cells. It works-- sort of. 

Some commonly used cytotoxic chemotherapy drugs and the year they were discovered or approved. Progress?

Two of the many flaws in the use of cytotoxic drugs are...

Video of Minnesota’s Governor—Mark Dayton— collapsing while giving last night’s State of the State address entered the media and digital echo chamber. Fortunately, it has been reported that he swiftly recovered, was assessed by EMTs at the site, went home and will be back today for another scheduled public appearance.  

Moments ago, the Associated Press and multiple news outlets announced the Governor revealed he was diagnosed recently with prostate cancer. As a result, the picture is now clearer when put into context of yesterday's events.     

In general, fainting is called “syncope” involving an abrupt, usually fleeting, loss of consciousness (LOC). Near fainting is near syncope characterized by no LOC. It is typically transient resulting from lack of blood and oxygen...

How would you like to spend the day taking water samples from a sewer pipe off the coast of Sardinia? It’s probably not as much fun as it sounds, but it’s a good thing that Giuseppe Brotzu found himself doing just that in 1945.

Brotzu made what turned out to be a very important discovery—a new class of antibiotics called cephalosporins, which includes drugs such as Keflex and Suprax.  About 80 different cephalosporins have approved in the US.

Since we are in a (losing) race against bacterial resistance, a new class of antibiotics is just what the doctor ordered. Thanks to a group from Quebec, we may have another avenue to explore.

Finding new classes of antibiotics—something that is sorely needed—is very difficult. When American Council advisor Dr. David Shlaes and...

For several hours on July 12, 2016, a group of 33 people in New York City were in a "zombie-like" state: staring blankly, moving and responding to medics slowly, and occasionally groaning. This bizarre spectacle was the result of a very bad trip on a synthetic cannabinoid that Reddit users have called "out-of-this-world potent."

Synthetic cannabinoids are used by researchers to study the nervous system, but they are now produced illegally and sold on the street. Though smoked like cannabis, synthetic cannabinoids share little in common with it or its active ingredient, THC. Indeed, the synthetic drugs are much more dangerous because some have killed people. 

To determine the cause of the NYC case, researchers chemically analyzed the contents of the packaging (shown in the...

Make room, Genocea and Rational Vaccines. There may be a new Herpes kid on the block.

A new study describes a trivalent vaccine—containing different strains — called HSV-2 gC2/gD2/gE2. HSV-2 refers to the herpes strain that causes genital herpes (1), and gC2, gD2, and gE2 are glycoproteins—proteins that are bound to sugars—that have different functions. The gD2 protein helps block the entry of the virus into the cell, while gC2 and gE2 help the virus evade the immune system.

This means that the vaccine produces antibodies that target two different mechanisms that help HSV-2 cause infection. 

The degree of protection of the new vaccine, as well as...

I am usually supportive of the pharmaceutical industry (1). People who reflexively criticize it have no idea how difficult and expensive it is to get something from the lab to the pharmacy. Also, many people think that drug companies don't provide innovation, and do little more than manufacture something that the NIH or a university came up with. This could not be more wrong. Pharmaceutical companies have discovered and developed drugs that have had an enormous impact on human health. They do all the heavy lifting.

But, there are exceptions. For example, AstraZeneca marketed a drug that should have never been approved in the first place: Nexium. They did it solely for money—without any benefit to society— and it has sure worked out well for them. It made ...