A friend sent me a press release a few days ago and I still find myself thinking about it. Here in the United States capital punishment is still legal in many states and is performed, frequently, by lethal injection. Prisoners sentenced to death have an IV placed in their arm which is then infused with the following three solutions:
- A barbiturate like Sodium Pentothal or Nembutal, used to induce anesthesia
- A paralytic like pancuronium bromide or succinylcholine chloride, used to stop respiration
- Potassium chloride used to stop electrical conduction in the heart
I remember a few years ago drug manufacturer Hospira, the producer of Sodium Pentothal, issued a statement that it disapproved of its drug being used in capital punishment. But, that was as far as their opposition went and, although Sodium Pentothal is in short supply, they have not to my knowledge formally discontinued supplying Sodium Pentothal to doctors who might use the drug in lethal injection. In 2010, the supply of Sodium Pentothal became limited and several states made the switch to Nembutal.
In response, Lundbeck, the producer of Nembutal, has issued a statement saying that they will no longer provide Nembutal to prisons in states where lethal injection is legal. In this press release Lundbeck announces its new distribution system, saying: Read more »
*This blog post was originally published at On Becoming a Domestic and Laboratory Goddess*
I used to defend pharmaceutical companies. ”What companies out there have contributed more good? Should care manufacturers make more when all they do is make transportation that breaks after a few years?”
It made sense to me that you should put a pot of gold at the end of the rainbow so that companies are motivated to invent more drugs and innovate. We throw a lot of money to athletes and movie stars who simply entertain us, shouldn’t we do better to those who heal us? I used to say that. I don’t anymore.
No, I don’t think the drug companies are “evil.” People who say that are thinking way to simplistic. These companies are doing exactly what their shareholders want them to do: make as much money as possible for as long as possible. That’s what all companies do, right? They are simply working within the system as it is and trying to accomplish the goal of making money. To say that they should “sacrifice” is foolish. They are simply playing by the rules that have been set out there. Those rules are the thing that has to change. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
Doctors are all-familiar with marketing efforts to promote new drugs, but once the new drugs displace older drugs in the medical marketplace, who serves as advocates for the continued manufacturing of older FDA-approved drugs?
In a short answer: No one.
For those of us dealing in cardiac arrhythmia management, this presents difficult challenges for patient care if people are unable to take the newer drugs due to side effects. These patients no longer have a fall-back option to turn to for medical therapy when the older drugs have become extinct on the marketplace. Read more »
*This blog post was originally published at Dr. Wes*
The essence of the moral hazard experience through a nice neighborly conversation:
Neighbor: These allergies are killing me.
Happy: That’s terrible. I hope you feel better.
Neighbor: I tried Zyrtec but it wasn’t doing anything for me, so my doctor prescribed ’x.’ (inaudible drug name )
Happy: Does it start with an ‘x?’ (The drugs name is Xyzal.)
Neighbor: Yes, it does.
Happy: Oh, that drug (Xyzal) is nothing more than Zyrtec, which the company slightly changed the formula of and now they get to sell it as a patented medication at 10 times the price for the next 10 years.
Neighbor: Oh, I didn’t know that. But you’re right. It was $110.
Happy: Did it help you with your allergies?
Happy: I guess you just wasted $100.
Neighbor. I didn’t waste anything. My insurance company paid for it.
Happy: Actually, we all paid for it with higher premiums.
Neighbor: (Walks away.)
The doctor doesn’t care — he’s not paying for it. The patient doesn’t care — she’s not paying for it. But everyone complains that their insurance rates are out of control. It’s not insurance company profits that are making healthcare too expensive, it’s patients and doctors who don’t care.
Bundled care solves this problem because the doctor won’t prescribe a $110 medication and offer therapies with no proven benefit over less-expensive options.
*This blog post was originally published at The Happy Hospitalist*