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Archive for March, 2008

Counterfeit Drugs — They May Be In Your Medicine Cabinet

You may think, like I did, that counterfeit drugs are somebody else’s problem. If they are dumb enough to order drugs from some third-world country that probably supports drug manufacturers that use only fake ingredients? Well. Caveat Emptor — that person gets what he deserves. Not my problem.

I was so wrong!

Turns out counterfeit drugs are being manufactured, stolen, diluted, adulterated — right here in the United States of America. AND — they are infused into our American drug supply.

Lipitor, Epogen, Procrit and dozens of others have been taken by unsuspecting American patients. If you had bogus Lipitor, and took it for months, how would you know? If you took blood pressure medicine for months, and it turned out it was fake, how would you know?

I’ve written a series of articles about counterfeit drugs, and what patients can do to protect themselves at my About.com site. If you think the FDA is doing much about it, you’re wrong. They’ve been hamstrung by those who are making the most money.

Included in the articles is a review of the book Dangerous Doses, A True Story of Cops, Counterfeiters, and the Contamination of the American Drug Supply, plus an interview with its author, Katherine Eban.

Check it out. Protect yourself. Talk to your pharmacist. This is scary stuff.

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Taking Your Pills — When You’re Supposed To

packages.gifLast week I had the opportunity to speak before a group of pharmaceutical package designers. These are the folks who have to worry about making sure our pills, capsules, liquid medicines and others stay protected from heat, humidity, children and a host of regulations that require them to make packages that let the right people into them, while keeping the wrong people and elements out.

It was both informative for them — and informative for me, too.

I tackled a handful of issues, mostly wanting the attendees to understand their role in improving the quality of life for those of us who take medicine. When they make a tight, difficult to access blister or vial, then they are improving the quality of life for a child whose life is saved by not getting into something that might be poisonous.

When they create an easier to open package, they are improving the life of an elderly patient who doesn’t have the eyesight or the strength to open it.

Among the most important points is the designer’s role in compliance (also called adherence) — making sure that patients can comply with their medicine taking instructions. If a patient needs to take a pill three times a day, then she needs to be able to get into the packaging three times a day. If she takes one spoonful of liquid twice a day…. well… you get the picture.

And I addressed creative ideas for helping those things. For example — why don’t we make drug safes to keep in a linen closet to keep kids (and yes, teenagers looking for a high) out of the family drug supply? We lock up our guns, right? Why not lock up drugs that are potentially poisonous?

Or why don’t we develop gizmos that time the doses, with a beeper that goes off when it’s time to take the next pill?

Along comes an article in USA Today, describing just that kind of packaging — even connected to the internet to remind patients when it’s time to take their medicine, exactly what they should take, etc. A great idea whose time has come.

The number one complaint doctors make about patients is that we patients don’t comply with our treatment. Creative packaging is one way to boost those compliance rates and to make sure we have fewer excuses or barriers to get in our way.

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Another MRSA Death, More Heartbreak

In January, I told you about three heinous infection situations — three people who contracted MRSA from negligence and bad medical protocol. At the time, I took some major hits from providers — in effect, chastising ME for the plight of these people, and taking offense to the fact that I blamed the professionals who should have been preventing these infections to begin with.

Word came this morning from my friend and colleague, Ilene Corina, patient safety expert and president of PULSE of NY (www.pulseofny.org ) about the death of Tameka, the young woman who over a year ago contracted MRSA after surgery in a Long Island, NY hospital. Ilene herself had been called in to see if there was anything she could do to help. She observed those same professionals providing care, changing dressings, with no gloves, not taking additional precautions.

Ilene has blogged about the experience of attending the young woman’s wake, and the follow up letter she received from the NY Dept of Health in which Tameka’s name was not even spelled correctly.

My heart breaks for Tameka’s family. This sort of horror only makes me dig in my heels even further to make sure YOU, my readers, understand how to protect yourself from the same demise.

Learn about how these deadly infections spread. Understand that they can too easily be contracted — by you or by your loved ones. And please, please, please take the simple steps required to prevent them!

It begins by insisting on handwashing.

And clearly, when that isn’t done, it ends in heartbreak.

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Prescription Drug Ads – Your Help Needed

What do you think of those prescription ads you see on TV, in magazines, newspapers and other places? Do you think they are helpful? Do you get frustrated because you know you can’t purchase those drugs directly anyway? Did you go to your doctor to ask about one of them? Do you think they are dangerous?

Prescription drug ads will be on TV for a long time. People may be objecting, but pharma is making a lot of money from them. I expect we’ll see many more of them, not fewer.

Truth is — if viewed in the right way, they can be useful. Unlike the dozens of anti-pharma folks who call for the demise of those ads, I say — if you can’t beat ‘em, then learn about ‘em.

And now, my friend Kim Witczak, founder of Woody Matters, has teamed with Consumer’s Union (non-profit publishers of Consumers Report) to petition the FDA to make these ads more helpful to consumers. It’s an idea borne of Kim’s wish to make drugs safer for Americans, based on the death of her husband, Woody, whose side effects from Zoloft caused him to take his own life.

The idea is that many side effects are unreported by drug companies, and the FDA can’t know about them unless those who take the drugs report them. (Don’t EVEN get me started on how that happens!) The proposal / petition asks for all pharma drug ads to include an 800 number and web address to report these problems as a part of the ad or commercial. Kinda like the warning on cigarette packaging — but even more useful because it’s a way we patients can really take action.

MedWatch is the FDA’s process for consumers to use to report their negative side effects and outcomes, but most consumers don’t know about it. The toll free number and web addresses already exist for reporting. (See below for that info.)

Consumer’s Union is hoping to garner 50,000 signatures — and you can easily sign right here online. You can take 30 seconds to say YES! to the idea of adding these two ways to report problems with drugs. Just follow this link to have your say.

……………………………………………..

Do you want to report side effects, problems or adverse events for a drug you take to the FDA?

Link here to MedWatch.

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Hospitals, Never Events and Your Bill

Last week was National Patient Safety Awareness Week. Seems like the press just caught up this week. From MSN and NBC, to Reuters, and hundreds of news outlets that are more regional or local in nature…. this week patient safety is the bulk of what I see in the headlines.

Most of us patients don’t give safety much thought. Afterall, the whole idea of seeking medical care is to improve our health and well being; not to make it worse. Sadly, for almost 100,000 Americans each year, patienting isn’t safe at all — it’s deadly.

The National Quality Forum, a combination government and not-for-profit agency, listed what it called “never events.” Included are drug errors, surgical errors, even criminal acts on the part of healthcare providers — or not prevented by healthcare providers.

Not listed, but just as deadly, are hospital acquired infections like MRSA.

What comes as a surprise to most is that even if a hospital or doctor has created an unsafe environment for you and you are harmed — you will get the bill for it! Say you acquire an infection while hospitalized. Not only do you have to stay in the hospital for several extra days or weeks, but you get the bill for it, too! Seriously — you get to pay for the additional insult, even though it was someone else’s fault.

That is now changing. Last year legislation was passed which allowed Medicare to proclaim that beginning in October of this year, Medicare will no longer pay for a list of eight medical mistakes; from MRSA acquisition to surgical errors to bedsores.

Now private insurers are saying they want to do the same, and their voices are getting louder.

The problem is, of course, that someone will have to pay the bill. A portion of the Medicare policy means that hospitals can’t bill the patients who suffer the errors — the hope being that instead, they will clean up their acts and stop commiting them.

But as I just said — someone will have to pay the bill. Will those of us not Medicare-insured end up paying the bill? Will those charges get hidden somewhere else? Will that 50 cent box of tissues we get billed for begin to cost us $5?

No specific answers for you today — just a caveat to stand back and watch out and be vigilant. There will be much more about this in the next several months. When coupled with the presidential elections only a month after the new policy goes into effect — well — it’s going to make for an interesting Fall.

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