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Showing posts with label New England Journal of Medicine. Show all posts
Showing posts with label New England Journal of Medicine. Show all posts

Tuesday, October 29, 2013

Fungal Meningitis: One Year After the Outbreak

A year ago the medication induced infections were the focus of the US CDC as The New England Compounding Service drew national attention. Today's post is shared from the CDC.gov.

A year ago this month, the Centers for Disease Control and Prevention activated its Emergency Operations Center as part of the response to the tragic outbreak of fungal meningitis linked to three contaminated lots of preservative-free methylprednisolone acetate (MPA) produced by the New England Compounding Center (NECC). As of October 23, 2013, there have been 751 cases of fungal meningitis and other infections associated with this outbreak; 64 of these patients have died. Since July 2013, one new case has been diagnosed.
This week, CDC has two papers in the New England Journal of Medicine, one describing the clinical aspects of the infections associated with this outbreak and the other summarizing the epidemiologic investigation. The clinical paper, focusing on the early stages of the outbreak, describes patients who experienced a wide variety of illnesses, including meningitis, stroke, arachnoiditis (inflammation of one of the membranes around the brain and spinal cord), and epidural or paraspinal infections which ranged in severity from very mild to life-threatening. The epidemiology paper finalizes the original preliminary report published by the New England Journal of Medicine and details the efforts undertaken by public health agencies to identify and stop the outbreak.
This...
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Wednesday, September 25, 2013

Prescription-Drug Coupons — No Such Thing as a Free Lunch

The cost of pharmaceuticals prescribed in workers' compensation claims remains a seriously advancing cost to the system.  Employers blame injured workers for the cause and the demand. Is the actual demand being driven by the pharmaceutical industry? The following is shared from The New England Journal of Medicine www.nejm.org.

Visit nearly any official website for a brand-name drug available in the United States and, mixed in with links to prescribing and safety information, you'll find links to drug “coupons,” including copayment-assistance programs and monthly savings cards.

Most offers are variations on “Why pay more? With the [drug] savings card, you can get [drug] for only $18 per prescription if eligible” or “Get a free 30-capsule trial of [drug] with your doctor's prescription and ask your doctor if [drug] is right for you.” Why do manufacturers offer drug coupons? Are they good for patients in the long run? Are they even legal?

Commercial drug-insurance plans typically have tiered pharmaceutical formularies to guide prescription-drug use, requiring relatively small patient copayments (approximately $5 to $15) for inexpensive generic drugs and higher copayments (perhaps $25 to $100) for brand-name drugs. Manufacturers use coupons to reimburse patients for this difference in copayments when they buy brand-name medications, so that, for people with commercial insurance coverage, the out-of-pocket costs are the same as those for generic drugs.

Drug coupons are implemented through subsidies paid by drug manufacturers. Patients nearly always print coupons off...
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Joseph S. Ross, M.D., and Aaron S. Kesselheim, M.D., J.D., M.P.H.
N Engl J Med 2013; 369:1188-1189 September 26, 2013 DOI: 10.1056/NEJMp1301993