Archive for Health /Medical Consumerism

Why Rob a Bank When You Can Make More Money by Counterfeiting Drugs?

Want to make millions of dollars quickly while risking only a few months in prison if (and that’s a big IF) you’re caught?  It’s not difficult at all. Just set yourself up as a distributor of counterfeit drugs in the United States.

This week’s announcement by the FDA that a counterfeit version of Avastin, a chemotherapy drug that is used for several kinds of cancers and tumors (lung cancer, kidney cancer, colon and rectum cancers – but no longer for breast cancer since approval was removed last year) has been found across the country, infused into the national drug supply, raises plenty of questions about how that could possibly happen.

It was followed by an interesting article in USA Today which partially answers the question.  Counterfeiting is a multi-billion dollar business that is on the rise because it’s so lucrative, and because the penalties are so… well… inconsequential.  I mean – would you be willing to spend no more than six months in jail if you could make millions of dollars for use when you got out?  (Even if you would answer no! I don’t want to go to jail!…  I’ll ask you this…. what if your child had treatable cancer and you had no insurance?  Just sayin’ …)

Avastin isn’t the only drug that may be counterfeited.  Any high cost drug that can be watered down, or manufactured to “look” right even if it is manufactured without its expensive ingredients, is a target for counterfeiters.  Lipitor and Viagra are probably the most apt to be counterfeit, but others like drugs used to treat HIV and AIDs, or diabetic drugs, or weight loss drugs, are likely targets for counterfeiters, too.

So what happens if you are somehow treated using a counterfeit instead of the real drug?  Maybe nothing. Or maybe you die. Or anything in between. The problem is, for the most part, we patients have very few ways we can detect whether a drug is real or fake.

Katherine Eban, in her book, Dangerous Doses, tells the stories of people who died from receiving infusions of counterfeit Procrit.  The conventional wisdom on this most recent discovery of fake Avastin is that there was nothing in the counterfeit version that was dangerous, and it’s difficult to tell within a regimen of 18-20 doses a cancer patient might receive over six months whether one “missed” infusion of the active ingredients has a long-term effect.

The bigger picture problem is that our drug supply is not being well enough protected by the FDA, which is tasked with protecting us. The FDA has no backbone when it comes to protecting us from bogus, counterfeit drug distributors who appear to be selling “real” drugs, but target greedy doctors, pharmacies and hospitals that are so willing to buy “discounted” drugs for their patients, knowing that there will be more profit in their reimbursements.  Experts estimate that about 1% of our drug supply is counterfeit.  That means that 1 out of every 100 administered drugs may be counterfeit, too.

One answer to this is an electronic pedigree system, meaning, from the time the drug is manufactured, until it is given to the patient, it is followed and logged using a bar code type system. If such a system was in place, then even us patients would have a way to double check that the drugs being given to us are the real drugs they are supposed to be.

So why doesn’t the FDA insist on the development of such a system?  Well, actually, they have. But again, they have no teeth, and so far, no backbone.  Every time they raise the issue, the drug companies and drug distributors begin to wail about the added cost to the system.  (Surprise!  Follow the money!)  And so, nothing gets done.

Like other issues in healthcare, it looks like little will happen to improve this system until something horrible befalls someone famous; someone who can actually override the special interests in Washington and insist on development of this electronic pedigree system.

Until then, here is information to help us patients do what we can to protect ourselves from counterfeit drugs.

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Posted in: Follow the Money, Health /Medical Consumerism, Healthcare Quality, Hospitals, Media, Patient Empowerment, Patient Safety, Patient Tools

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Your Most Important Health Resolution for 2012

This column first appeared
in the Syracuse Post Standard
January 3, 2012

When considering health-related resolutions, you probably expect me to wax poetic on the virtue of losing weight or quitting smoking.  But no, this resolution actually trumps them both.

Perhaps the most important health resolution you can make for 2012 is to establish a strong relationship with a primary care provider (PCP). Even if you think you already have the best PCP in the world, you’ll want to read on – because that relationship could change.

There are three reasons you must establish or reinforce a primary care relationship in 2012.

1.    Fewer Doctors
The number of primary care doctors is dwindling and practices are changing.  Doctors are aging into retirement, or leaving their practices due to frustrations with the healthcare system. Because fewer medical students are choosing primary care, those vacancies aren’t being filled.  In addition, some doctors will stop accepting certain types of insurance, including Medicare and Medicaid. Others are joining forces to establish larger, less personal practices.

2.    Healthcare Reform
In 2014, when the biggest portion of the Affordable Care Act kicks in, there will be 32 million new Americans with insurance, and newfound access to healthcare. For some, it will be the first time in their adult lives they’ve been able to afford care.

3.    More Older Patients
As baby boomers age, they will need more care, more often than when they were younger. Further, they are living longer than previous generations, so they’ll need medical services longer, too.

Bottom line – a year or more from now, the competition will be fierce.  All those aging baby boomers, plus those 32 million new patients will need to be absorbed by a dwindling number of primary care doctors. After 2012, it may be impossible for you to find a PCP who is accepting new patients.

Thus – an important resolution!  As best you can, think beyond 2012 and what your medical needs may be. If you don’t have a primary care doctor, find one.  If you have one, but you haven’t seen her in more than a year, then visit her before she decides to drop you from her patient roster. If you have a PCP, but you aren’t happy with the relationship, then make a change in 2012, before it’s too late. If you like your doctor, then ask questions about insurance coverage or practice changes, and then make adjustments if necessary.

That’s a New Year Resolution worth keeping.

Here is more information about finding a primary care doctor:

The Shortage of Primary Care Doctors

Finding Dr. Right

How to Decide Whether to Change Doctors

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Posted in: Health /Medical Consumerism, Patient Empowerment, Patient Tools

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The Ultimate Gift – Organ Donation

This column first appeared
in the Syracuse Post Standard
December 20, 2011

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I live in Central New York State, where we are grieving the loss of 17-year-old Taylor Fleming who died in a car accident last week.

In the face of their unimaginable heartbreak and pain, Taylor’s parents decided to donate her organs and tissues, knowing that at least something good could come of her death. They realized their loss, and Taylor’s donation, will help others by extending their lives, or improving the quality of their lives.

Taylor’s eyes will provide sight to someone who has been blind. Her skin will help a burn victim heal. Her lungs may help someone with cystic fibrosis or COPD.  Her heart, kidneys and liver will restore lives. Sixty transplants from Taylor’s body are already benefitting others.

Like Taylor’s parents did on her behalf, we can make the choice to donate our own organs and tissues when the time comes, too – whether we die through tragedy, or from natural causes.

Sadly, despite knowing that tens of thousands across the country are waiting for transplants, too few people consider themselves eligible to donate. You may believe you can’t be a donor, but you are probably wrong.

For example, some people think their religions preclude organ donation.  But no major American religions restrict donation, including Christians, Jews and Muslims.

Some people believe that if they are chronically or terminally ill, they can’t or shouldn’t donate.  But that is also a myth. Your donation may not take place directly to an individual, but your contribution to medical research may ultimately improve thousands or millions of lives.

There are three important steps for you to take if you decide to donate your organs or tissues.  First, sign the organ donor statement on the back of your driver’s license while someone else watches you.  Second, check to see if your state has an organ donation registry (we have such a registry in New York) and sign up to ensure your wishes will be carried out.

Finally, and perhaps most important – discuss your wishes with your family.  Whether or not you can actually donate when the time comes can be decided by the professionals when it happens.  Understanding your wishes will allow your family to have the conversation.

We never know when tragedy will strike.  But we can honor those who have been lost by making the commitment to donate our own organs and tissues upon death.

Learn more about donating your organs, tissues or body so you, too, can give the gift of life.

Note: a reader has reminded me of another excellent gift:  Registering for the Bet the Match bone marrow registry, too.  Learn more.

Here are some additional resources for
end of life choices:

End of Life Decision-Making : The Ultimate in Patient Empowerment

Start an End of Life Wishes Conversation

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Posted in: Health /Medical Consumerism, Patient Empowerment, Patient Tools

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Check Out Those Health Charities Before You Donate

This column first appeared
in the Syracuse Post Standard
December 6, 2011

It’s that time of year again.  The holidays, of course. But also the end of the tax year, when charities, including groups like cancer societies or hospital foundations, are pleading for donations.

Each year in December my husband and I make contributions to the charities we think are important, many of which are health-related.  Last year money was tight, and we knew we would either have to cut back on how much we donated, or leave some organizations off our list.

To help us make those difficult decisions, I did some background research on each of the charities we ordinarily support. I was surprised at what I found!  And learned some tips to share with you, too.

First, I learned that when children need specialized cancer treatment, they will get the same treatment  whether they live in Paris, Tokyo, Sydney – or Syracuse. Pediatric oncologists worldwide share their research and successes to the benefit of children everywhere.

I had to ask myself – why would we send a contribution to a children’s hospital out of state?  Since children receive the same specialized treatments, doesn’t it make more sense to donate in our own backyards?  I’m sure those famous children’s hospitals provide excellent care.  But if my child was sick, and I had to stay with her in a city far away, how would I get to work?  Where would I stay?  Bottom line – we decided to donate to our local children’s hospital, knowing local kids would get the great care they need.

Next up – family interests. Within my husband’s family or mine, we have loved ones who have dealt with Alzheimer’s, diabetes, lymphoma and breast cancer.  We have always donated to those very large, national charitable foundations, thinking our money was going toward education, research, and of course, a cure.

Not so fast! It turns out that not all charitable foundations are equal – including those we’ve sent money to each year.  I discovered that some charities are actually quite questionable. For example, too much of their money goes toward “undetermined” administrative costs. Or worse, only a small percentage of their budget goes toward their stated goals of education, patient support or research.  One very well known charity is spending the bulk of its donations on legal fees, suing smaller charities!

Based on that information, we decided against supporting two of the organizations we’ve sent money to for years.

As a result of this process, I realized that if more of us were choosier about our donations, health-related or not, the most effective and efficient organizations would have more funds to really make progress with their missions – a benefit for everyone.

You may want to review your charity choices, too, to be sure your donations have the best chance of accomplishing the goals you think are important.

Here are some additional resources for
choosing the best charities for your donor dollars:

How to Donate Money to Health and Disease Charities

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Posted in: Follow the Money, Health /Medical Consumerism, Healthcare Quality, Medical and Research Studies, Politics and Medicine, Self Help

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Healthy Travel Tips for the Holidays

This column first appeared
in the Syracuse Post Standard
November 22, 2011

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You may be among the millions of Americans who will travel during the upcoming holidays. Travel takes you out of your normal environment and disturbs your routine. If you have health issues, like a chronic disease, an injury, or even a short-term illness, it’s smart to prepare ahead of time for those changes and accommodate for them where possible.  You’ll want to be sure your travel doesn’t upset your health, and your health doesn’t upset your travel.

Drugs, supplements and supplies:  Pack enough to cover the days you’ll be away, plus extra, in case flights are delayed or a blizzard closes the roads. If you fly, remember that airlines can lose checked bags, so keep all medical supplies with you in your carry-on bag. Any time difference at your destination may require an adjustment of your drug routine. Make yourself a chart ahead of time to keep your regimen on schedule.

Airport security:  The TSA has strict rules about what can, or cannot go through security.  Medications, oxygen, inhalers and other medical items must be packed in certain ways, and will be screened through x-ray machines. Go online before you fly to learn to learn how to get your medical equipment or materials through security.  http://1.usa.gov/TSAMedical

Foods:  Alert your host ahead of time if you have special dietary requirements, or if certain foods upset your digestion. Mention any food allergies you have or conflicts with drugs you take. Plans can be made to accommodate your needs when they are discussed ahead of time.

Contagious diseases:  Of course, holiday time is often cold and flu time, too.  Get your flu shot prior to travel. Wash or sanitize your hands as often as possible, and keep them away from your mouth, nose or eyes. If you are highly susceptible or your immune system is compromised, consider wearing a face mask to protect yourself from others who might be contagious. If you have a cold, then cough or sneeze into your elbow, not your hands, to prevent infecting others.

Long Distance Travel:  If you’ll be sitting for great lengths of time in a car or plane, you risk potentially deadly blood clots in your legs called DVT (deep vein thrombosis.). Keep your blood circulating by taking hourly breaks to walk around and stretch.

These travel preparations will keep you healthier and will make your visit more enjoyable, too.

Here are some additional resources for
making sure you stay healthy while traveling:

•  Tips for Healthy Travel
Before You Go, As You Travel, and At Your Destination

•  Tips for Healthy International Travel

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Posted in: Health /Medical Consumerism, Health Insurance, Healthcare Quality, Medical Errors / Mistakes / Misdiagnosis, Patient Empowerment, Patient Safety, Patient Tools, Self Help

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