Monday, September 18, 2006

Yearly drug

Happy birthday, now take your medicine. Can you ever imagine saying this to someone? Well, it may actually happen. Swiss drugmaker Novartis announced over the weekend that it is in final development of a yearly medication to treat osteoporosis, according to this article from the Sydney Morning Herald. As you know, osteoporosis is a condition in which the bones become brittle and in some cases break or fracture.

I really try to keep up on this stuff. Because even though this drug is still in clinical trials and not able to be prescribed yet, I guarantee I will get questions about this in my office. Even though it sounds promising, here's the rub...
The most common side-effects associated with intravenous injection of Aclasta included fever, muscle pain, flu-like symptoms and bone pain. Most occurred within three days of administration of the drug and were resolved within three days of onset, Novartis said.
Potential side effects is one of the major stumbling blocks for drugs succeeding. There's already a drug out now for osteoporosis which you only take once a month. "Does this mean that if I have side effects, they will last a month?" patients ask me. I then quote them the info from the company, but the perception is there. Yes, it's good that you only have to take it once a month. But, it's bad if you have a problem.

The other major stumbling block is cost. No one knows how much this whiz-bang new drug is going to cost. I'm definitely sensitive to the cost of meds for my patients. In my practice, the typical patient who would get this drug will already be on between 5-8 other prescription medications, in addition to over the counter and herbal meds. The cost adds up quickly.

I understand that companies want to generate buzz and attention for new drugs in their pipeline. But, it does cut both ways. And, sometimes, the negative press can overwhelm anything positive. We'll have to see what happens with this medication.

9 comments:

rdl said...

Wow once a yr. (tho that would be good for me - the pill phob.) but i still can't believe the once a month. what about the jaw thing??

R2K said...

YEARLY!? I dont understand how than can work, how long could it last?

Dr. A said...

I admit I don't fully understand all the pharmacokinetics (like that word?), but it's a fascinating idea, isn't it?

Amka said...

5-8 medications? That is a lot. What kinds of drugs? Is it inevitable when one gets older?

Dr. A said...

In my anedotal experience and non-scientific data, people I usually prescribe osteoporosis meds usually have medical problems such as arthritis, high blood pressure, maybe diabetes. Some of these medical problems require more than one medication. That's where I got my number from.

The Curmudgeon said...

There was a story on the radio here in Chicago in the last few days about a new medicine for people at risk for developing Type II Diabetes. Funded in part by the maker of the medication, the study found that the medication was very effective at preventing the onset of the condition.

Just a small problem: Taking the medication puts you at risk of congestive heart failure. (There were other problems cited, too, but this was the worst.)

Whereas controlling your weight prevents the onset of Type II Diabetes almost as effectively -- without the risks.

Here's my question: Aren't we being overmedicated? My late mother used to feel cheated if she didn't get a prescription every time she went to the doctor -- to the point where the doctor's nurse/receptionist (also the doctor's wife) used to give my mother samples she'd saved up, just in case her husband failed to prescribe something.

In fact, isn't that part of the spinach scare, now ongoing? Did I understand correctly that the e-coli strain that is at issue in these cases is resistant to typical antibiotics?

Dr. A said...

Are we being overmedicated? That's a blog discussion itself. I guess this is in the eye of the beholder. We are living longer and a case can be made that it's because of medications and awareness of chronic medical conditions. I feel like I'm dancing around land mines here, so I won't say much more than that. I'm curious to see what others think.

As far as the spinach thing, I've heard those reports also. And, a case could be made (since you're a lawyer) that antibiotics could be a cause of the e-coli strain. As you know, all the potential factors are trying to be sorted out as we speak.

Amka said...

I would say over medicating occurs when medication is used in place of lifestyle. Of course, not everything can be helped by physical exercise, diet, counseling, or little fixes the patient can do at home. This is when the appropriate drug becomes useful.

Drugs are so expensive, why can't we get insurance to pay similar prices or even lower prices for things such as personal coaches to help someone achieve a healthier lifestyle?

Dr. A said...

Oh, I'm with you there. If insurance companies would pay for preventative things, then it would be cheaper for them in the long run, and better patient care. I'll stop myself before I really go on a rant.