Drugs that flow from humans into the environment may include the lingering analgesic diclofenac, the long-lasting antiepileptic carbamazepine, the omnipresent antibiotic ciprofloxacin, and even seemingly mundane painkillers like ibuprofen, gemfibrozil, and naproxen, not to mention synthetic estrogens. The problem has led to government hearings at the state and federal levels and to scientific m...

If you are an editor, author, reviewer, or reader of medical journals, or if you depend on your doctor or health care provider getting unbiased information from medical journals, then the 1,500 documents now hosted on the PLoS Medicine Web site [1] should make you very concerned and angry. Because, quite simply, the story told in these documents amounts to one of the most compelling expositions...

BACKGROUND Rare diseases are of increasing concern to private and public healthcare insurance plans. Largely neglected by manufacturers before the 1983 passing of the Orphan Drug Act (ODA), orphan drugs have become a commercialization target of steadily increasing importance to the healthcare industry. The ODA mandates the coverage of rare diseases, which are defined in research communities as ...

August 2005 | Volume 2 | Issue 8 | e256 Armed with the power to prescribe, doctors are in a position to fl ood their patients’ bodies with potent medicines at a stroke of their pen—and they have been consistently wooed by the pharmaceutical industry. Doctors in Nepal have started to become targets for the pharmaceutical industry’s promotional activities. The mountainous, landlocked, developing ...

Collusion between insurers and drug companies Insurance companies and drug manufacturers can give consumers a headache when they join together. They may also be violating the law. The recently-proposed federal health care plans spark fear and apprehension in most areas of the health care industry. Many physicians, hospitals, and corporations are scrambling to predict the path of legislation and...

When an experimental medicine helping her son was dropped because it didn’t seem profitable, Connecticut homemaker Abbey Meyers turned into a lobbyist. Her crusade: Change the law to create incentives to develop drugs for rare diseases. Congress responded with the Orphan Drug Act of 1983, giving companies a seven-year monopoly for bringing a new treatment for a rare disease to market. Within tw...

It is axiomatic that prescription drug prices are higher in the United States than Canada. While many politicians and consumer advocates consider this prima facie evidence of drug company greed, economists are less quick to judge. The monopoly offered by patents generates the profits that are necessary to motivate innovation. Still, the evidence is rather overwhelming that drug prices vastly ex...

In a clarion call to consumers, colleagues, and policymakers, Dr. Nortin Hadler, in The Citizen Patient, warns that aspects of America’s health-care system are so corrupt and ethically compromised that we’re all at risk of succumbing to its harmful effects. Yet, he also offers a vision for how to restore the once-safe harbor citizens have relied on from cradle to grave. Hadler, a long-standing ...

In this issue of the journal we highlight important and controversial issues which affect patient management. There is currently an ongoing debate about the use of Dabigatran and the lack of need for monitoring the level of anticoagulation, which has previously been claimed to be one of the most important advantages of the drug. Furthermore, the RELY study has come under scrutiny, as has the dr...

Faced with surging drug development costs and fierce generic competition, pharmaceutical companies are under increasing pressure to find ways to increase and prolong the profitability of both existing and new products. In addition, many of the advanced molecules being developed by biotechnology companies require more efficient delivery than that offered by conventional delivery routes and syste...