With worldwide concerns about the influenza virus on the rise, interest in point-of-care tests is... more With worldwide concerns about the influenza virus on the rise, interest in point-of-care tests is peaking. While complex tests necessitate specialized personnel with specific laboratory skills, simpler, safe tests becoming available are yielding fast results.
P & T : a peer-reviewed journal for formulary management, 2016
Dr. White, known worldwide as an expert in the use of 24-hour ambulatory blood pressure monitorin... more Dr. White, known worldwide as an expert in the use of 24-hour ambulatory blood pressure monitoring (ABPM), discusses hypertension, the importance of accurate measurement, and the utility of ABPM for effective diagnoses and treatment.
Some are using the word "cure" for chimeric antigen receptor T cells. The modular natur... more Some are using the word "cure" for chimeric antigen receptor T cells. The modular nature of CAR T cells could provide novel strategies to combat resistance and convert more initial complete responses into lasting complete responses. Problems include: cytokine release syndrome, resistance, and finding ways to produce them more efficiently.
P & T : a peer-reviewed journal for formulary management, 2015
Women with hormone receptor-positive, human epidermal growth factor receptor 2- negative breast c... more Women with hormone receptor-positive, human epidermal growth factor receptor 2- negative breast cancer-the most common subtype-have new options as palbociclib and similar drugs debut. This article outlines the rationale and evidence for their use.
By some measures, the financial and health toll from inflammatory bowel disease, rheumatoid arthr... more By some measures, the financial and health toll from inflammatory bowel disease, rheumatoid arthritis, and psoriasis is comparable to stroke and lower back pain. Collectively, they affect about 10 million patients in the United States. They are chronic conditions characterized by immune-mediated inflammation of unknown etiology and for which there is no cure.
Next year marks the 30th anniversary of the discovery by Milstein and Köhler of a technique for p... more Next year marks the 30th anniversary of the discovery by Milstein and Köhler of a technique for producing monoclonal antibodies (mAbs). This achievement, for which they won the 1984 Nobel Prize, also helped launch the biotech industry. With the recent approval of ImClone’s Erbitux and Genentech’s Avastin, 17 mAbs have been approved by the U.S. Food and Drug Administration for therapeutic use. What’s the rationale behind mAb treatment?
P & T : a peer-reviewed journal for formulary management, 2015
Dr. Tanabe, Chief of the Division of Surgical Oncology at Massachusetts General Hospital, studies... more Dr. Tanabe, Chief of the Division of Surgical Oncology at Massachusetts General Hospital, studies preventing and treating hepatocellular carcinoma, the most rapidly rising cause of cancer-related mortality. Promising developments are on the horizon.
P & T : a peer-reviewed journal for formulary management, 2014
The prognosis for patients with pancreatic cancer remains poor, but a widely recognized expert on... more The prognosis for patients with pancreatic cancer remains poor, but a widely recognized expert on pancreatic and biliary surgery at Massachusetts General Hospital and Harvard Medical School expresses optimism about improvements in the next decade.
For doctors at Memorial Sloan-Kettering Cancer Center in late 2012, it was an easy call. The drug... more For doctors at Memorial Sloan-Kettering Cancer Center in late 2012, it was an easy call. The drug Zaltrap, new on the market (Bach 2012) for treatment of patients with metastatic colorectal cancer, promised to provide an overall survival benefit of 1.4 months compared with a standard chemotherapy regimen. But so did Avastin (bevacizumab) — and the two drugs had similar mechanisms of action, preventing the interaction of VEGF with its receptors. The chief difference was that Zaltrap, initially priced at $11,000 for one month of treatment, cost more than twice as much as Avastin. So the oncologists decided not to use this costly drug. And from the perspective of the cancer center, the story has a happy ending: The marketers of Zaltrap began offering the drug to hospitals at a 50% discount. But other comparisons of oncology products are not so straightforward. A new drug may offer a modest improvement in overall survival quality of life in the absence of a survival benefit. What then? Outside the United States, policymakers turn to a measurement unit called the “quality-adjusted lifeyear,” (see “What’s a QALY?” on page 33), though with less enthusiasm than in years past to inform decisions on allocating resources to new drugs. And some experts think it may be time for QALY’s American debut. Could QALYs Help in Assessing High-Priced Cancer Treatments?
P & T : a peer-reviewed journal for formulary management, 2013
The arrival of ipilimumab and vemurafenib has provided oncologists with new choices in a field in... more The arrival of ipilimumab and vemurafenib has provided oncologists with new choices in a field in which options were slim and the prognosis was grim. Combination therapy may lead to an improved survival benefit.
The latest salvo in the War on Cancer is a program to explore the feasibility of producing the Ca... more The latest salvo in the War on Cancer is a program to explore the feasibility of producing the Cancer Genome Atlas, with the expectation of improved therapies to follow. Though noble, the effort will be time-and labor-intensive, raising the question of whether a prolonged application of preventive measures would ultimately prove to be more effective than resource-consuming molecule-to-molecule combat.
Now that we have the first race-based FDA indication, more may follow. Is diversity necessarily a... more Now that we have the first race-based FDA indication, more may follow. Is diversity necessarily a function of biology - and thus a cause of health-outcomes disparities - or are we fixing molecules at the expense of fixing society?
Eventually, gene therapy will become a staple of 21st century medicine. But some experts say soci... more Eventually, gene therapy will become a staple of 21st century medicine. But some experts say society will be better served if medical researchers proceed more slowly and prudently.
For patients, poor adherence to biologics can increase risks of morbidity and mortality. For paye... more For patients, poor adherence to biologics can increase risks of morbidity and mortality. For payers, it means money down the drain. Here's a tool that proponents say can help change patient behavior.
Previously, this series described distribution channels through which specialty drugs move to pat... more Previously, this series described distribution channels through which specialty drugs move to patients. This installment discusses changes and challenges that lie ahead, especially at the dispensing end.
With worldwide concerns about the influenza virus on the rise, interest in point-of-care tests is... more With worldwide concerns about the influenza virus on the rise, interest in point-of-care tests is peaking. While complex tests necessitate specialized personnel with specific laboratory skills, simpler, safe tests becoming available are yielding fast results.
P & T : a peer-reviewed journal for formulary management, 2016
Dr. White, known worldwide as an expert in the use of 24-hour ambulatory blood pressure monitorin... more Dr. White, known worldwide as an expert in the use of 24-hour ambulatory blood pressure monitoring (ABPM), discusses hypertension, the importance of accurate measurement, and the utility of ABPM for effective diagnoses and treatment.
Some are using the word "cure" for chimeric antigen receptor T cells. The modular natur... more Some are using the word "cure" for chimeric antigen receptor T cells. The modular nature of CAR T cells could provide novel strategies to combat resistance and convert more initial complete responses into lasting complete responses. Problems include: cytokine release syndrome, resistance, and finding ways to produce them more efficiently.
P & T : a peer-reviewed journal for formulary management, 2015
Women with hormone receptor-positive, human epidermal growth factor receptor 2- negative breast c... more Women with hormone receptor-positive, human epidermal growth factor receptor 2- negative breast cancer-the most common subtype-have new options as palbociclib and similar drugs debut. This article outlines the rationale and evidence for their use.
By some measures, the financial and health toll from inflammatory bowel disease, rheumatoid arthr... more By some measures, the financial and health toll from inflammatory bowel disease, rheumatoid arthritis, and psoriasis is comparable to stroke and lower back pain. Collectively, they affect about 10 million patients in the United States. They are chronic conditions characterized by immune-mediated inflammation of unknown etiology and for which there is no cure.
Next year marks the 30th anniversary of the discovery by Milstein and Köhler of a technique for p... more Next year marks the 30th anniversary of the discovery by Milstein and Köhler of a technique for producing monoclonal antibodies (mAbs). This achievement, for which they won the 1984 Nobel Prize, also helped launch the biotech industry. With the recent approval of ImClone’s Erbitux and Genentech’s Avastin, 17 mAbs have been approved by the U.S. Food and Drug Administration for therapeutic use. What’s the rationale behind mAb treatment?
P & T : a peer-reviewed journal for formulary management, 2015
Dr. Tanabe, Chief of the Division of Surgical Oncology at Massachusetts General Hospital, studies... more Dr. Tanabe, Chief of the Division of Surgical Oncology at Massachusetts General Hospital, studies preventing and treating hepatocellular carcinoma, the most rapidly rising cause of cancer-related mortality. Promising developments are on the horizon.
P & T : a peer-reviewed journal for formulary management, 2014
The prognosis for patients with pancreatic cancer remains poor, but a widely recognized expert on... more The prognosis for patients with pancreatic cancer remains poor, but a widely recognized expert on pancreatic and biliary surgery at Massachusetts General Hospital and Harvard Medical School expresses optimism about improvements in the next decade.
For doctors at Memorial Sloan-Kettering Cancer Center in late 2012, it was an easy call. The drug... more For doctors at Memorial Sloan-Kettering Cancer Center in late 2012, it was an easy call. The drug Zaltrap, new on the market (Bach 2012) for treatment of patients with metastatic colorectal cancer, promised to provide an overall survival benefit of 1.4 months compared with a standard chemotherapy regimen. But so did Avastin (bevacizumab) — and the two drugs had similar mechanisms of action, preventing the interaction of VEGF with its receptors. The chief difference was that Zaltrap, initially priced at $11,000 for one month of treatment, cost more than twice as much as Avastin. So the oncologists decided not to use this costly drug. And from the perspective of the cancer center, the story has a happy ending: The marketers of Zaltrap began offering the drug to hospitals at a 50% discount. But other comparisons of oncology products are not so straightforward. A new drug may offer a modest improvement in overall survival quality of life in the absence of a survival benefit. What then? Outside the United States, policymakers turn to a measurement unit called the “quality-adjusted lifeyear,” (see “What’s a QALY?” on page 33), though with less enthusiasm than in years past to inform decisions on allocating resources to new drugs. And some experts think it may be time for QALY’s American debut. Could QALYs Help in Assessing High-Priced Cancer Treatments?
P & T : a peer-reviewed journal for formulary management, 2013
The arrival of ipilimumab and vemurafenib has provided oncologists with new choices in a field in... more The arrival of ipilimumab and vemurafenib has provided oncologists with new choices in a field in which options were slim and the prognosis was grim. Combination therapy may lead to an improved survival benefit.
The latest salvo in the War on Cancer is a program to explore the feasibility of producing the Ca... more The latest salvo in the War on Cancer is a program to explore the feasibility of producing the Cancer Genome Atlas, with the expectation of improved therapies to follow. Though noble, the effort will be time-and labor-intensive, raising the question of whether a prolonged application of preventive measures would ultimately prove to be more effective than resource-consuming molecule-to-molecule combat.
Now that we have the first race-based FDA indication, more may follow. Is diversity necessarily a... more Now that we have the first race-based FDA indication, more may follow. Is diversity necessarily a function of biology - and thus a cause of health-outcomes disparities - or are we fixing molecules at the expense of fixing society?
Eventually, gene therapy will become a staple of 21st century medicine. But some experts say soci... more Eventually, gene therapy will become a staple of 21st century medicine. But some experts say society will be better served if medical researchers proceed more slowly and prudently.
For patients, poor adherence to biologics can increase risks of morbidity and mortality. For paye... more For patients, poor adherence to biologics can increase risks of morbidity and mortality. For payers, it means money down the drain. Here's a tool that proponents say can help change patient behavior.
Previously, this series described distribution channels through which specialty drugs move to pat... more Previously, this series described distribution channels through which specialty drugs move to patients. This installment discusses changes and challenges that lie ahead, especially at the dispensing end.
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