I'm a little ambivalent about news that an FDA advisory committee has recommended banning Percocet and Vicodin. These are drugs used by millions, and I have many patients on each.
While you might think toxicity from excess Tylenol in these medications would be prevalent, I have seen few cases of this in my career. There is a vocal, powerful group of doctors who have been calling for such a ban for many years, and it looks like this time they might get their wish.
This news comes hot on the heels of another announcement that FDA is exploring using a REMS program with the long-acting narcotics like oxycodone and MS-Contin.

Dr. Jenkins--

I have seen your recent comments on providing REMS programs for opioids. Since you are the director of OND, I was hoping to give you some feedback on these programs, and to alert you to the adverse effect on patient care that they can have.

I am a clinical hematologist and oncologist. I have to contend with many drugs under these programs, including Promacta, Nplate, Thalomid, Tysabri, and Revlimid. Looks like opioids are next on the list.

Tamoxifen is one of our best cancer fighting drugs. It successfully prevents the return of ER (estrogen receptor) positive breast cancer in two-thirds of women who take it.

Now the success rate can be improved even further by DNA Testing and careful management of other drugs that are being taken with tamoxifen. Before tamoxifen can go to work blocking the growth of cancer cells it must be activated in the body. Many patients are unable to perform this activation for two reasons:

Hey BRCA testers out there. Love the test right? Sure, what's not to love--a sensitive and specific way to assess breast cancer risk. Sure, it's $4,000, but that's Aetna's problem, right?

Well, the problem is that Myriad owns the patent to BRCA1 and BRCA2. Not just the clinical testing patent. Not just the copyright on the primers they designed. The genes themselves are patented.

ACLU is fired up about this issue, and I am starting to feel the same way. I know they are supposedly a bunch of flag-burning pinkos over there, but this is an issue I can really rally behind.

Shocking news today from WSJ.com: Congress is actually reporting that health insurance companies are underpaying on claims! I wonder why they would want to do that? Or as a doctor I work with likes to say, funny they never seem to make the error in your favor, do they? http://online.wsj.com/article/SB1000142405297020462190457424806175072173...

This is the proverbial man-bites-dog story, a story about the commonplace that is reported as news.

Actually, here's an interesting actual man bites dog story from 2007. The wonders of Wikipedia. http://uk.reuters.com/article/idUKDEL8428320071214?feedType=RSS&feedName...

Today, we opened the first sunscreen of the summer, a Neutrogena stick containing titanium dioxide and zinc sulfate.

Total cost for a small small stick: $7. Ouch! The California Baby version is $15! This works out to something like $1 an ounce, or more.

I personally am trying to avoid using the "synthetic" sunscreens on kids out of concern for estrogen-like effects. I haven't seen correlations with health outcomes per se, but I would rather not add risk, especially in my daughter, where I don't need to.

The titanium based sunscreens do not appear to have a hormonal effect on biology. They also work fairly well.

So the tradeoff is estrogen or dollars. I guess $7 is more than the loss-leader special at Target, but it's a small price to pay for peace of mind.

FDA warns Friday not to eat Toll House cookie dough. There is evidently an E. Coli problem.

This is the price we pay for an industrialized food chain. The benefits are many.

Nestle doesn't even grow its own food, it "sources" raw materials from farmers, then processes and cooks it in its factories. Of course, it charges a hefty markup for this service.

The recall of Toll House cookie dough is a surprise though. You may want to go through your fridge and see if there is a tube of the stuff in there. The recall applies to "all" tubes of the dough, Nestle said.

Oh, elves, how could you? Oh wait, that's Keebler. Still.

http://www.washingtonpost.com/wp-dyn/content/article/2009/06/20/AR200906...

Spending would mean substantial cut of all revenues.

Reuters estimates that the US drug industry, the world's largest, took in $315 billion in sales in 2007.

Today, AP reported that the drug industry agreed to contribute $80 billion towards healthcare reform.

So we're supposed to believe that the industry is contributing 25% of sales (not profits) to reduce the cost of healthcare in America?

Somehow, I doubt the shareholders of these publicly traded companies will let this happen.

(reproduced from Medscape.com, original link: http://www.medscape.com/viewarticle/703926)
June 4, 2009 (Orlando, Florida) — It has been nearly 10 years in coming, but at last there is a positive result with a vaccine approach to follicular lymphoma. Two other phase 3 clinical trials have failed, but the one that succeeded was reported during a plenary session here at the American Society of Clinical Oncology (ASCO) 45th Annual Meeting.