Archive for the 'Pharmaceutical Drugs' Category

Pharma Karma: reporting in

Greetings from Philadelphia, PA. Love this city – always have. It’s the city of brotherly love, and that’s why I’m here. To share a little love — or more to the point — some perspective.

This is a conference FOR pharma marketers, but NOT put on by the pharma industry. That’s an important distinction, which you’ll understand better in a minute.

Many months ago, the conference producer, Kelly (who is delightful to collaborate with and very VERY good at her job), found my website and learned that I help patients. She asked me if I would participate in this conference, and find three “real patients” to help the attendees better understand how we patient-consumers think.

Unknown to Kelly at the time, but perhaps an even better reason to ask me to participate in this conference, is because I spent more than 20 years of my career working in marketing. I know how to talk the marketing talk and walk the marketing walk — yet stick to my number one goal: helping patients — which is why the “who puts this conference on” perspective is important. Pharma marketers would benefit because “real patients” could be objective, informative — and honest.

So here we are — Eric, from the Pacific Northwest, DeWayne, from Nashville, and Kim from Minneapolis — and me. And this afternoon we presented our points of view ….

I wasn’t sure what to expect. Would the pharmaceutical marketer attendees expect gloss? Would they expect venom? Would they be receptive? or discount our points of view? Would they try to defend their companies or dismiss us?

They did none of that. In fact, I was very pleased. The pharma attendees listened attentively to our patient stories: Eric, who is the caregiver for a loved one with dementia and another with breast cancer. DeWayne who suffers from debilitating backpain and almost fell prey to the oxycontin sham, and Kim, whose husband, an up and coming, full of life, newly appointed VP of sales for a start up company, committed suicide because he was taking zoloft to help him sleep. (Kim now advocates on behalf of patients and collaborates with the FDA. Read more: )

My hope was that the attendees would see the real faces behind the statistics — the hurting hearts and minds of patients who have suffered, the faces that represent the loss of trust in drug companies and the harmful drugs that get sped to market, or are priced so outrageously that patients can’t afford them even if they could be helpful.

They saw our faces. They asked good questions. They got it.

On behalf of all patients who have been harmed by drugs, and those who have lost loved ones to harmful drugs or drug errors, or all those future patients who may benefit from some of the words spoken at today’s gathering…

I believe we represented you well.

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Prescription Dangers = ID Theft Possibilities

Still in Sarasota, FL visiting my parents and almost dropped my teeth at a story Dad told me last night. See what you think.

Several years ago, Dad began receiving materials about heart health from the local pharmacy, part of a national chain. He tossed them; in his mid-70s, Dad’s heart was going strong (still is!) and the information was about drugs he had never taken.

A few months later, for record keeping purposes, Dad requested and received a list of all the drugs he had purchased from that same pharmacy. As he looked over the list, he found references to many drugs he knew he had never been prescribed, had never had any need to take — all heart related — including coumadin and others.

OK — so that explained why he had been receiving those health intelligence materials — presumably a nice service from the pharmacy.

But — ding ding ding!! Alarm alarm alarm! Why on earth were those heart drugs listed on Dad’s account? Who did they belong to? And who had paid for them? Going back a few years, the total cost had been almost $20,000! Because Dad has an excellent prescription plan through his pre-retirement, self-insured employer, it was that employer who had paid all that money.

Dad contacted the administrators of his prescription insurance group which, as mentioned above, were people within the company he retired from (because they were self-insured. Large corporations often are.) They sent security personnel to Florida to investigate. Afterall, it appeared that someone had fraudulently obtained prescription drugs at the expense of Dad’s company.

Dad only knows part of the rest of the story…. turns out there was a man who lived in Tampa with his same name. The man’s prescriptions had all been phoned in to another branch of the same pharmacy chain and their accounts had become mixed up within the pharmacy’s computers. The man’s wife had been picking up the prescriptions, paying the copay — Dad doesn’t know whether she knew the accounts were mixed up or not. She may have been completely unaware, or she may have realized they had a good thing going and continued to capitalize on it. Afterall, the drugs were costing her only $3 copay. $20,000 later, one can only hope that at least her husband’s heart was still going strong.

The story is interesting from a number of angles — but it set off some alarms to me that had less to do with the possible fraud, and more to do with Dad’s safety and medical identity theft.

Safety: so suppose Dad had been in Tampa for some reason, and had taken sick. Suppose the had been rushed to a Tampa hospital. Is it possible the records from the pharmacy about his drugs could have gotten mixed up with his real records? What if he wasn’t conscious… would they have given him some of those heart drugs? I don’t know the answers. I’m just throwing out the questions.

ID Theft: so suppose Dad hadn’t been so interested in his history of purchases from the pharmacy. Would that same person have continued to purchase drugs through Dad’s insurance? Would there be a history somewhere that Dad had heart disease because those drugs were on his records? Suppose he had then been turned down for a co-insurance program somewhere else, or that his company would have been defrauded further? Could that person have also been able to obtain Dad’s insurance account numbers, and from there, social security numbers or other identification that could have then turned into identity theft?

The questions remain, but they are a good reminder to all of us….

Every step along the way of our health transactions, we need to double check that the care and drugs and other treatments we need or receive are ours, and ours alone. When you visit the doctor’s office, ask to review your records to be sure they all belong to you. When you pick up a prescription at the pharmacy, ask to review the list of drugs they have on file for you to be sure they are all drugs you’ve been prescribed. And make sure they match up at least your birthdate in addition to your name. If you have a common name, be even more diligent.

Fraud, or mistakes? Intentional or accidental? When it comes to our health, and the overall ramifications of identity errors, we can’t ever be too careful.

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Drs Abr Can Mk U Sckr

An article in US News and World Report quantifies the number of deaths and injuries that result from doctors’ handwriting and the abbreviations they use on prescriptions.

Reassuringly, those errors cause only a small percentage of the 7,000 American deaths attributed to medication errors each year. It turns out that there are thousands of those kinds of errors, but most get caught by a nurse, pharmacist or someone else. (Maybe even a patient!)

I also found it interesting to learn that the Joint Commission has a list of prescription abbreviations they think doctors should avoid. Here’s a link.

Two thoughts come to mind. First, that this is exactly what I was talking about when I wrote this column, published a few weeks ago:

Your Prescriptions: Cracking the Code

And second, that these kinds of errors are 100% preventable — and WE, the patients, can prevent them by double checking everything on the prescription handed to us. Ask the prescribing doctor to provide you with verbal instructions to double check the written prescription. AND, ask the pharmacist to provide you with verbal instructions, double check them against what the doctor told you and wrote for you, AND double check them against the written instructions provided to you when you pick up the prescription.

It’s one error that can be easily checked and stopped by patients. So, let’s do it!

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Quick Drugstore Clinics Revisited

Do you have a quick health clinic in a drug or big box store near you?  They are called Quick Clinics, Redi-Clinics, Minute Clinics or other names, and you can drop in at any time for basic needs such as a bad cough, a sprained ankle, or whatever other “simple” ailments you or your children might have.

They are reviewed in today’s NY Times.  Are they a good idea?

I blogged about them a few months ago…. and yes…. for the most part I think they ARE a good idea — but with a few cautions.

But my cautions aren’t those of the NY Times, nor are they the cautions of the American Academy of Family Physicians, or the various State Regulators or the pediatrican groups. 

What are the differences?

My cautions are about the patient’s health, and theirs are about money.

I know, I know — if you read this article, or any of a dozen others written on the subject (cited in my previous blog post), the spokespeople for these various organizations will tell you just how concerned they are about the health of the person who gets treated there. 

But if you read between the lines?  Yeah.  They’re worried about money.  These clinics cut into their income, pure and simple.  A patient has a choice between walking-in (no appointment necessary), waiting 15-20 minutes (instead of who-knows-how-long), being handed his/her prescription on the spot (instead of having to travel to the pharmacy), and paying an average of $18 less than a visit to a traditional doctor’s office.  And $18 is $18.

The AMA calls it “sacrificing quality.”  Pediatricians cite the need to understand a child’s history.  And state authorities are concerned about licensing.  But they are really worried about money.  Because in the case of these quick clinics, patients are bypassing those died-in-the-wool establishments that justify charging way too much money for way too little service.

All that said — there are some real cautions for patients that have to do with their health — so if you are tempted to use one of these quick clinics, please take note:

  • Remember that these clinics (and therefore the doctor or nurse practitioner who sees you) do not have your records or your history.  If you are someone who has had challenges, allergies, or reactions to treatments or symptoms in the past, you’ll want to continue seeing your primary care physician.  The clinic provider can’t know what your past history is and could recommend something that makes you even sicker.
  • Remember that these clinics are just as interested in selling you the drugs they have on their shelves as they are making sure you get the right medicine.  Your physician will prescribe based on what s/he knows is right.  The clinics will prescribe based on the deals they’ve made with pharmaceutical distributors.  That may not matter — it might still be the right drug — but it might not.
  • Drug interactions and contra-indications are a real concern.  With a pharmacist right there, you should be OK, but make sure you take a master list of everything — EVERYTHING — you take on a regular basis, long or short term, and share it with the practitioner you see.  Prescription drugs, yes, but also any pain relievers, vitamins, herbals, etc. 
  • Some quick clinics do not accept Medicare or Medicaid, and not all insurance companies will work with them, so ask that question before you see the quick clinic doctor.
  • If, in fact, you are really sicker or hurt beyond what you realize, you don’t want one of these quick clinics recommending the next steps — you want that to come from your primary care doctor — or — your specialist.  If you question your situation at all, don’t fool with these quick clinics.  You could end up sicker.

A cautionary tale?  Yes, but no less enthusiasm for a good idea whose time has come.

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Chasing Symptoms vs Finding a Cure

I’ve got a really lousy cold.  You know, the kind that fills your head like a water balloon, makes your throat feel like someone has raked long finger nails down your esophagus and each time you cough, your entire body hurts.  Yeah, the “common” cold.

It started Saturday with the general malaise, intermittent cough, slight headache…. and I knew.  Don’t we always?  Quick — run for the zinc, echinacea, airborne — whatever you can find!  Trying to stave it off seems like the only way to handle it. Pass me another box of tissues, please.

Problem was — I was still in Tennessee attending the conference I wrote about last week.  No medicine chest 😦  The 13-hour drive home on Sunday was no picnic either!  But since then, I’ve spent most of my time resting, drinking orange juice, blowing my nose and popping sudafed.  Many years ago I had a cold and didn’t take care of it, and it developed into pneumonia.  That will NOT happen again.

With so much quiet time — the road trip Sunday, plus bed rest since then — I’ve had time to ponder the common cold….

I remember reading years ago that a true cure had been invented, but had been squelched because pharmaceutical companies make so much money with drugs that treat the symptoms that they would all go broke if there really was a cure!  Hmmm…. maybe….. but that doesn’t help me today.

I know there have been tests on zinc and ecinacea — maybe they could cure the cold, or at least make it less of a drain (so to speak) on our systems… but still a cold seems to last at least 7 days.  That doesn’t strike me as much of a cure!

Then my mind wanders to the general “symptoms vs cure” conundrum that patients get pulled into every day, usually unaware that treating symptoms may, in fact, prevent the cure…. hear me out….

Suppose I am running a fever.  It means that I have some form of infection, and my body is trying to heal it.  So I take a tylenol or an aspirin and my fever goes down.  BUT, the aspirin only treated the fever, it didn’t cure me.  So I still have the infection — which could spread and make me sicker.

Suppose Fred’s arm is aching.  Fred works in a physical job, and he can’t afford a day off from work.  Fred takes an ibuprophen or something else to make the ache go away so he can keep working.  The pain subsides a little — but Fred suffers a heart attack on the job that day because the aching arm was really a symptom of that impending heart attack.

When we have symptoms, no matter what they are, and we see the doctor, often the doctor gives us something to treat the symptoms — but — that doesn’t mean we are on the road to a cure!  It’s a relief not to deal with the symptoms anymore, but does that really help us in the long run? 

In many cases, people go undiagnosed for years, but they are taking drugs left and right to depress their symptoms, some of which may be masking the very symptoms that might help them get a diagnosis. 

If you are a patient who is undiagnosed, consider asking your doctor if it’s possible a treatment or drug you are taking is getting in the way of your diagnosis, masking your real problem.  And, take some time yourself to review each drug you are taking to see what symptoms it is supposed to overcome.  (Here’s a list of websites that can help you.)  There may be a nugget in there that can move your diagnosis quest forward.

There you go.  And now I’m going to go swallow some more nyquil and take a nap.

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Lymphoma Patients’ “Secret” Option

Before you read this blog post, I’ll beg you to be patient with me. Having been diagnosed with lymphoma myself, and reading the article I’m about to cite, my disgust and anger can’t be bridled…

If you have been diagnosed with non-Hodgkin’s lymphoma, there may be a cure for you that your oncologist hasn’t even mentioned to you. Yes, I said a CURE. Not just a treatment. A cure.And the reason you don’t know about it is because your oncologist won’t make any money from it. Since he can’t profit, you won’t be cured. Seriously.

Find the rest of this post at its new location:

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What Sicko Doesn’t Tell Us

As I mentioned in yesterday’s post, Michael Moore’s movie Sicko provides background on how our American healthcare system has become so dysfuncational, and some of the horrifying ripple effects on the health of our nation.  What it fails to mention is one major group of ripples:  medical errors and misdiagnoses.

According to the US government’s Institute of Medicine, between 44,000 and 98,000 Americans DIE each year from medical error or misdiagnosis.  Other organizations, including HealthGrades, suggest those numbers are way too conservative, that, in fact, the numbers are much higher.  Beyond those who die, millions more are injured by these mistakes.

So it begs the question:  what differences in the rates of medical errors and misdiagnoses might we find between universal health care, such as those systems cited in Sicko in Canada, France and Great Britain, and privatized healthcare programs such as the system we use here in the United States?

I’ve poked around the internet and can’t find any numbers to speak of… I can find a few within certain diseases, but nothing that helps compare apples to apples…..

When I refer to medical errors, I’m referring to problems such as:

  • surgeries:  operations on the wrong body part, called “wrong site” surgeries, or mistakes made during the surgery, or even equipment left inside the patient.
  • drugs:  the wrong drug is prescribed, or the wrong drug is dispensed, or the wrong dosage is prescribed or dispensed, or the drug is given at the wrong time, or a dose is missed
  • other treatments:  therapies are mis-prescribed, for example, an orthopedist sends a patient for physical therapy which ends up exaserbating the problem, not helping it
  • infections:  usually facility acquired (such as in hospitals or nursing homes) — a patient is admitted for one problem, but acquires an infection while resident in the facility.  MRSA, C. Diff and necrotizing fasciitis (flesh eating bacteria) are examples

When I refer to misdiagnosis, I mean:

[A request — if anyone can point me to real numbers among the other countries, I would really appreciate it!]

My sense is this — purely a guess, but an educated one — that the error rate in the privatized US system,  where healthcare is more about money and less about care — is higher.  That we are dying and getting sicker because of our privatized system.

Why do I think this is true? 

If you review the kinds of errors listed above, you’ll see that most are time-related.  If the professionals who made them weren’t in such a hurry, if they weren’t worried about reimbursement rates or malpractice insurance payments, if they were more inclined to spend the time that is really needed to LISTEN and communicate with patients, then those errors could, in many cases, be prevented. 

Drill it down:  who will make fewer errors?

  • a doctor who has the time necessary to listen to a patient?  — or — the doctor who knows that in minute #7, he begins losing money because the insurance company won’t reimburse him for any time beyond that?
  • a surgeon who has the time to carefully review the charts prior to a surgery, takes the time to mark which body part needs to be cut, then operates correctly — or — the one who knows s/he has only one hour to perform the surgery and move on to the next one or it will impact the hospital’s profits?

Patients — take heed — there are many many ways you are hurt by our current dysfunctional system….  not all are raised in Sicko, but at least its the start of a conversation.

… and in the meantime?  Regardless of what system provides us with health care — or no health care — we still need to advocate for ourselves in all those good practice ways I talk about on this blog, and through my columns, every day.


Read two more posts about Sicko:

A Patient Advocate’s Reaction to Sicko
Why Sicko is only the tip of the Iceberg

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