Discovery, development, regulation and marketing of the medications that are used in health care and the economics of the pharmaceutical industry.

Treatments Administered To The First 9152 Reported Cases Of COVID-19: A Systematic Review

May. 27, 2020

David C. Fajgenbaum, Johnson S. Khor, Alexander Gorzewski, Mark-Avery Tamakloe, Victoria Powers, Joseph J. Kakkis, Mileva Repasky, Anne Taylor, Alexander Beschloss, Laura Hernandez-Miyares, Beatrice Go, Vivek Nimgaonkar, Madison S. McCarthy, Casey J. Kim, Ruth-Anne Langan Pai, ...

Abstract [from journal]

The emergence of SARS-CoV-2/2019 novel coronavirus (COVID-19) has created a global pandemic with no approved treatments or vaccines. Many treatments have already been administered to COVID-19 patients but have not been systematically evaluated. We performed a systematic literature review to identify all treatments reported to be administered to COVID-19 patients and to assess time to clinically meaningful response for treatments with sufficient data. We searched PubMed, BioRxiv, MedRxiv, and ChinaXiv for articles reporting treatments


Sulfonylureas and Metformin were not Associated with an Increased Rate of Serious Bleeding in Warfarin Users: A Self-Controlled Case Series Study

Sean Hennessy
May. 11, 2020

Young Hee Nam, Xu Han, Colleen M. Brensinger, Warren B. Bilker, Charles E. Leonard, Sean Hennessy

Abstract [from journal]

Drug interactions between warfarin and sulfonylureas are suggested by pharmacokinetic information and prior studies. However, clinical evidence on the association of such interactions and the risk of bleeding is lacking. Using health care claims data from five US Medicaid programs from 1999-2011 and a self-controlled case series design with warfarin as an object drug, we examined confounder-adjusted rate ratios (RRs) for three outcomes separately: 1) serious bleeding as a composite outcome of gastrointestinal bleeding (GIB) and non-traumatic


Nudging Clinicians Toward Higher-Value Cancer Care

May. 5, 2020

In a new study published in JAMA Oncology, my colleagues and I find that behavioral nudges can promote high-value, evidence-based prescribing of specialty drugs in cancer care. For patients with breast, lung, and prostate cancer with bone metastases, clinicians face a decision between two therapies of comparable effectiveness but dramatically different cost.

Ophthalmic Medication Expenditures and Out-of-pocket Spending: An analysis of US prescriptions from 2007-2016

Apr. 28, 2020

Evan M. Chen, Ninani Kombo, Christopher C. Teng, Prithvi Mruthyunjaya, Kristen Nwanyanwu, Ravi Parikh

Abstract [from journal]

Objective: To estimate temporal trends in total and out-of-pocket (OOP) expenditures for ophthalmic prescription medications among adults in the United States.

Design: A retrospective longitudinal cohort study.

Participants: Participants in the 2007-2016 Medical Expenditure Panel Survey (MEPS), age 18 years or older. The MEPS is a nationally representative survey of the noninstitutionalized, civilian US population.

Methods: We estimated trends in national and per


Management of Early Pregnancy Loss with Mifepristone and Misoprostol: Clinical Predictors of Success from a Randomized Trial

Apr. 16, 2020

Sarita Sonalkar, Nathanael Koelper, Mitchell D. Creinin, Jessica M. Atrio, Mary D. Sammel, Arden McAllister, Courtney A. Schreiber

Abstract [from journal]

Background: Early pregnancy loss (EPL) is a common event in the first trimester, occurring in 15-20% of recognized pregnancies. A common evidence-based medical regimen for EPL management uses the prostaglandin E1 analogue misoprostol 800 mcg self-administered vaginally. The clinical utility of this regimen is limited by suboptimal effectiveness in women with a closed cervical os, with 29% of women with EPL requiring a second dose after three days, and 16% eventually requiring a uterine aspiration procedure.



Brief Report: Biosimilar Uptake in the Academic and Veterans Health Administration Settings: Influence of Institutional Incentives

Apr. 6, 2020

Joshua F. Baker, Charles E. Leonard, Vincent Lo Re III, Michael H. Weisman, Michael D. George, Jonathan Kay

Abstract [from journal]

Objective: To compare uptake in the ordering of biosimilars at a Veterans' Affairs medical center (VAMC) to that at an academic medical center, where institutional incentives for infused medications differ.

Methods: We performed a cross-sectional study of medical record data and estimated institutional financial incentives at two medical centers in Philadelphia: 1) the University of Pennsylvania Health System (UPHS) and 2) the local VAMC. All ordering events for filgrastim or infliximab products were quantified


The Risk of Sudden Cardiac Arrest and Ventricular Arrhythmia with Rosiglitazone Versus Pioglitazone: Real-World Evidence on Thiazolidinedione Safety

Sean Hennessy
Feb. 25, 2020

Charles E. Leonard, Colleen M. Brensinger, Ghadeer K. Dawwas, Rajat Deo, Warren B. Bilker, Samantha E. Soprano, Neil Dhopeshwarkar, James H. Flory, Zachary T. Bloomgarden, Joshua J. Gagne, Christina L. Aquilante, Stephen E. Kimmel, Sean...

Abstract [from journal]

Background: The low cost of thiazolidinediones makes them a potentially valuable therapeutic option for the > 300 million economically disadvantaged persons worldwide with type 2 diabetes mellitus. Differential selectivity of thiazolidinediones for peroxisome proliferator-activated receptors in the myocardium may lead to disparate arrhythmogenic effects. We examined real-world effects of thiazolidinediones on outpatient-originating sudden cardiac arrest (SCA) and


Prescribing Medical Cannabis: Ethical Considerations for Primary Care Providers

Dec. 18, 2019

Aaron Glickman, Dominic Sisti

Abstract [from journal]

Medical cannabis is widely available in the USA and legalisation is likely to expand. Despite the increased accessibility and use of medical cannabis, physicians have significant knowledge gaps regarding evidence of clinical benefits and potential harms. We argue that primary care providers have an ethical obligation to develop competency to provide cannabis to appropriate patients. Furthermore, specific ethical considerations should guide the recommendation of medical cannabis. In many cases, these ethical considerations are extensions of well-...

Long-Term Use of Hydrocodone vs. Oxycodone in Primary Care

Dec. 1, 2019

Rebecca Arden Harris, Henry R. Kranzler, Kyong-Mi Chang, Chyke A. Doubeni, Robert Gross

Abstract [from journal]

Background: Hydrocodone and oxycodone are the Schedule II opioids most often prescribed in primary care. Notwithstanding the dangers of prescription opioid use, the likelihood of long-term use with either drug is presently unknown.

Methods: Using a retrospective cohort design and data from a commerical healthcare claims repository, we compared the likelihood of long-term use of hydrocodone and oxycodone in primary care patients presenting with acute back pain. Treatment