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Top Stories for the Week of May 5, 2008
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FDA Approvals |
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Industry Highlights |
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Treximet Approved for Migraines |
Costs Can Vary By $100 or More for Same Drugs Low-Income Moms Rarely Speak to Infants During TV/Video Time |
Costs Can Vary By $100 or More for Same DrugsIt pays to shop around for the best prescription prices, survey finds |
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MONDAY, May 5 —Prices of prescription drugs can vary by $100 or more for the same drug from store to store -- and even within the same chain. So it pays to shop around, a new survey found. But the survey also found that consumers are less likely to consult with pharmacists about the drugs they're using than they were in the past, which can lead to serious consequences in terms of drug interactions. "More people are paying a higher percentage of out-of-pocket expenses for their prescriptions than they did in 2002," said Tod Marks, senior editor at Consumer Reports magazine, which conducted the survey. "In our survey, we found that there was a significant price difference, not only for the same drug at different stores, but there were price differences within the same chain and the online price," Marks said. "Sometimes those prices can be significantly different." The findings were published in the June issue of Consumer Reports. For the survey, the magazine called 163 pharmacies nationwide to determine price differences for four prescription drugs -- three name brand medicines and one generic. The price for a three-month supply of the urinary incontinence drug Detrol ranged from $365 to $551. The price for Plavix, a drug that prevents blood clots, ranged from $382 to $541. Prices for Levoxyl, a treatment for hypothyroidism, varied from $29 to $85. And the costs for the generic osteoporosis drug alendronate ranged from $124 to $306, the survey found. Costco was the cheapest source for the four drugs, while Walgreens and Rite-Aid were among the most expensive, according to the survey. The survey also found that consumers shouldn't rule out independent drug stores -- while they may not be the cheapest, their prices are competitive, and they offer top service. "A lot of people have the assumption that independent drug stores are expensive," Marks said. "In many cases, they were not the cheapest overall, but we did find a significant number of mom-and-pops that were highly competitive." Consumers should also ask their employers about pharmacy benefit managers (PBMs), which can offer substantially lower prices and co-payments, Marks said. Marks also recommended buying generic drugs because they can cost up to 50 percent less than their brand-name equivalents. And consumers should look for store discount programs that can lower the cost of prescription medications for those without drug insurance, he said. In another part of the survey, Consumer Reports questioned 40,133 readers about their drugstore experiences. Among the findings: People asked pharmacists for advice on prescription drugs just 38 percent of the time. That's down from 50 percent since the last survey in 2002, Marks said, adding, "That's a pretty significant shift in the consumer-pharmacist relationship." That's a worrisome trend, Marks said, because one-third of U.S. adults take five or more prescription medicines or supplements. And some 18 million people end up in hospital emergency room's each year because of medication errors, he said. "Consumers should consult with their pharmacists, whether they're taking prescription drugs or even over-the-counter stuff, because people think they're innocent, but the fact of the matter is they can have serious ramifications," he said. Marks noted that independent and chain drug stores both ranked high in consumer approval. Independent local pharmacies often ranked higher in personal service, compared with chain pharmacies, where consumers often experience longer waits, he said. Pharmacies within supermarkets were rated high for convenience, Marks said. "One of the nice things about supermarket pharmacies is that they tend not to be as crowded as the big chains," he said. Among mass-market retailers, Kmart and Shopko came out on top in terms of drug prices, Marks said. Wal-Mart and Target got high ratings for offering cheap generic drugs, he said. A representative of the pharmacy industry said the reasons for the price variance between stores are likely to be complex. "In any market, there is a price variation," said Chrissy Kopple, vice president of media relations at the National Association of Chain Drug Stores, based in Alexandria, Va. "As a trade association, we cannot comment in great detail on prescription drug pricing due to anti-trust issues. However as is the case with any business, many factors play roles in pricing decisions, including costs, business strategy and local competition," she said. More information For more on comparing drug prices, visit Consumer Reports.
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Low-Income Moms Rarely Speak to Infants During TV/Video TimeWhat they're watching impacts frequency of verbal interactions, study finds |
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MONDAY, May 5 —When infants in low-income families are watching television or videos, their mothers seldom speak to them, a U.S. study finds. "There has been a dramatic increase in television programming directed toward young infants. This has occurred despite recommendations from the American Academy of Pediatrics that children younger than 2 years should not watch any television. Much of this programming is marketed toward parents as 'educational,' despite limited data to support this assertion," noted Dr. Alan L. Mendelsohn, of the New York University School of Medicine, and colleagues. They found that over one 24-hour period, 149 of 154 mothers (96.8 percent) reported that their 6-month-old infants had a total of 426 exposures to television or videos. These included: 139 exposures (32.6 percent) to educational programs for young children; 46 (10.8 percent) to non-educational programs for young children; 205 (48.1 percent) to programs for school-aged children, teenagers or adults; and 36 (8.5 percent) to unknown programs. The mothers reported that they talked to their infants during 101 (23.7 percent) of those 426 television and video exposures. "Consistent with our first hypothesis, interactions were most commonly reported in association with educational content, especially among programs that had been co-viewed," the researchers wrote. "However, approximately half of the exposures consisted of programs not intended for young children; these were not associated with frequent interactions even when they were co-viewed." "Our findings are important, because parent-infant interactions are associated with long-term developmental-behavioral outcomes. Verbal responsiveness is frequently seen in association with reading and playing with toys. Given the large amount of media exposure and low frequency of reported interactions, additional study is needed to determine whether media exposure can facilitate interactions of sufficient quantity and quality to be associated with benefits for young children," the researchers concluded. The study was published in the May issue of the Archives of Pediatrics & Internal Medicine. More information MedlinePlus has more about children and television. |
Malpractice Premiums, Rate of C-Sections Rise TogetherWhich one drives the other a matter of debate, experts say |
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MONDAY, May 5 —As medical malpractice premiums increase, so do the rates of Caesarean sections, new research shows. The study provides a small snapshot of the association, drawing on data from the University of Connecticut Health Center in Farmington. The findings, while not national in scope, could further fuel the debate about whether higher malpractice rates boost the C-section rates, or visa versa. "When I compared the malpractice rates to C-section rates prior to 1999, both were declining at a similar rate," says study author Dr. Jeffrey V. Spencer, a maternal-fetal medicine fellow at UConn. From 1999 to 2005, however, both were increasing. The study was scheduled to be presented Monday at the American Society of Obstetricians and Gynecologists annual meeting, in New Orleans. Spencer and his team reviewed the center's perinatal database from 1991 to 2005, noting how many vaginal deliveries and how many C-sections took place. They got the average malpractice rates from the primary carrier at their institution and adjusted them for inflation over the years. "I can't say one led to the other or vice-versa," Spencer said. But he speculates the medical malpractice rates are driving up the C-section rates. "The theory is, doctors are practicing more defensive medicine. Maybe doctors are fearful of litigation,'' he added, perhaps likely to decide on a C-section at the first sign of any potential problems. In all, 23 percent (15,021) of the 64,767 deliveries studied were C-sections. Spencer's team also looked at first and repeat C-sections and compared those with the average malpractice premiums by year and found a relationship between increased malpractice rates and both first and repeat C-sections. In a second study, Spencer and his colleagues looked at the impact of increasing malpractice rates on what is known as "operative vaginal deliveries" -- delivering a child by forceps or vacuum They found that 16 percent (10,299) of the 64,767 deliveries were this type. From 1991 to 2005, average malpractice rates increased from $50,345 to $126,806. The rates for malpractice rose, he said, even though both types of vaginal deliveries declined. Forceps deliveries declined from 11 percent to less than 1 percent, and vacuum deliveries went from 17.2 percent to 6.2 percent. Nationwide, C-section deliveries accounted for 30.2 percent of all deliveries in 2005, according to the U.S. Centers for Disease Control and Prevention, a record high for the nation. In 1996, in comparison, 20.7 percent of deliveries were by C-section. Another expert said the findings are nothing new. "These two papers do nothing more than substantiate what we already know," said Dr. Marsden Wagner, a perinatologist and former director of Women's and Children's Health for the World Health Organization. One of the reasons for what Wagner refers to as the "scandalous " rate for C-section is that "doctors are afraid of litigation." "Any physician who picks up a scalpel and does major abdominal surgery, which is what a C-section is, because that doctor is afraid of litigation, is not practicing medicine but is practicing fear and greed," he said. "The increasing C-section rate has not decreased the amount of litigation," Wagner said. "So their attempt to avoid litigation by doing C-section is not working." Spencer agreed. "The only thing to my knowledge that has changed or lowered malpractice rates are states having legislation to place caps on malpractice settlements." More information To learn more about C-sections, visit the National Institutes of Health.
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Amitiza Treats Irritable Bowel With ConstipationApproved for women 18 and older WEDNESDAY, April 30 —Amitiza (lubiprostone) has been approved by the U.S. Food and Drug Administration to treat irritable bowel syndrome accompanied by constipation (IBS-C) in women 18 and older. It's the first IBS-C treatment that's been approved by the FDA. IBS -- with symptoms including cramps, abdominal pain, bloating, constipation and diarrhea -- affects twice as many women as men, the agency said in a statement. Amitiza's safety and effectiveness were evaluated in two studies involving 1,154 people with IBS-C, more than 90 percent of whom were women. More people treated with the drug said their symptoms were moderately or significantly relieved than those who took a non-medicinal placebo. The effectiveness of the drug in men wasn't conclusively established during clinical testing, the FDA said. Common side effects included nausea, diarrhea and abdominal pain. More serious yet rarer adverse reactions could include urinary tract infections, dry mouth, fainting, swelling of the extremities, difficulty breathing and heart palpitations, the agency said. The 8-microgram dose is meant to be taken twice daily with food and water. Amitiza is produced by Maryland-based Sucampo Pharmaceuticals and Illinois-based Takeda Pharmaceuticals North America. More information The FDA has more about this drug's history. |
Device Approved to Assess Arterial PlaqueHelps doctors evaluate heart attack risk TUESDAY, April 29 —The InfraReDx LipiScan NIR Catheter Imaging System, a device that helps doctors explore blood vessels to assess the fat content of arterial plaque, has been approved by the U.S. Food and Drug Administration. Plaque -- made up of cholesterol-laden fat, calcium and other blood substances -- reduces blood flow to the heart when it accumulates on the walls of the blood vessels. This can lead to the formation of clots that can trigger a heart attack. The newly approved device works by inserting a catheter equipped with a fiber-optic laser light into the artery, measuring the light reflected back from the artery wall. This helps doctors assess the fatty makeup of the plaque that has built up in the artery. Nearly 1 million Americans have a heart attack each year, and about half die, the FDA said. LipiScan is produced by InfraReDx Inc., based in Burlington, Mass. More information To learn more about heart attack, visit the National Library of Medicine. |
Relistor Helps Ease Painkiller-Related ConstipationFor people who use ongoing opioid therapy FRIDAY, April 25 —The U.S. Food and Drug Administration has approved Relistor (methylnaltrexone bromide) to treat constipation stemming from continuous use of opioid painkillers. Opioids, including morphine, are commonly prescribed for people with late-stage cancer, heart failure, respiratory disease and other illnesses. But the painkillers can interfere with normal bowel function by relaxing the intestinal muscles that push out waste. Relistor prevents opioids from affecting these muscles, allowing the bowels to function normally. The drug is injected at intervals not to exceed once in 24 hours. It's not recommended for people with known or possible bowel obstructions. Side effects can include abdominal pain, gas, nausea, dizziness and diarrhea. Users with severe symptoms should discontinue the drug's use, the FDA said. Relistor is produced by Philadelphia-based Wyeth Pharmaceuticals and Tarrytown, N.Y.-based Progenics Pharmaceuticals. More information The FDA has more about this approval. |
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