Before the Age of Blockbuster Drugs

2014 ◽  
Author(s):  
Jie Jack Li
Keyword(s):  
Quality Of Life ◽  
Pharmaceutical Companies ◽  
Allergic Reactions ◽  
Socially Responsible ◽  
For Profit ◽  
Drug Companies ◽  
Tremendous Amount ◽  
Antihistamine Drug ◽  
Changing Times

Blockbuster drugs are drugs with annual sales over $1 billion these days. As a testimony of changing times, a blockbuster drug was defined as a drug with more than $500 million in annual sales just a decade ago! While these blockbuster drugs save millions of lives and improve the quality of life for millions of others, pharmaceutical companies make considerable profit. In turn, drug makers then spend a tremendous amount of money on research and development of new blockbuster drugs, looking for new ones that will sustain the “life cycle” for the health of both patients (physical and mental) and the drug companies themselves (financial). Pharmaceutical companies are sometimes known as “merchants of life.” Indeed, their products affect people’s lives in many positive ways. But make no mistake; the drug industry is a for-profit entity, responsible to its shareholders. It must make a profit to survive. This is the contradiction of the pharmaceutical industry. However, things were not always like this until the last few decades. The first antihistamine (the substance that counteracts the effects of histamine; see chapter 4 for more details) was discovered by French pharmacologist Daniel Bovet in 1937. Between 1937 and 1941, Bovet conducted more than 3,000 experiments to find the chemical formulas upon which most of the antihistamines now prescribed are based. Antihistamines are effective in treating allergic reactions. His discovery led to development of the first antihistamine drug, diphenhydramine (Antergan), for treating allergies in 1942, but it did not reach the market because of toxicity issues. In 1944, another one of Bovet’s discoveries, pyrilamine (Neoantergan), was produced as a drug. He did not patent it and did not make a penny out of his important discovery. Not all was lost, however; Bovet won the Nobel Prize in Physiology or Medicine in 1957. General Robert Wood Johnson (1845–1910), one of the three brothers who founded Johnson & Johnson, wrote a credo that codified the company’s socially responsible approach to conducting business.

scholarly journals Closing the Gap in Hospice Utilization for the Minority Medicare Population

2019 ◽  
Vol 5 ◽  
pp. 233372141985566 ◽  
Author(s):  
M. Courtney Hughes ◽  
Erin Vernon
Keyword(s):  
Quality Of Life ◽  
Ethnic Minority ◽  
Ethnic Minorities ◽  
Cost Savings ◽  
Community Outreach ◽  
For Profit ◽  
Medicare Population ◽  
Closing The Gap ◽  
Racial Ethnic

Background: Medicare spends about 20% more on the last year of life for Black and Hispanic people than White people. With lower hospice utilization rates, racial/ethnic minorities receive fewer hospice-related benefits such as lesser symptoms, lower costs, and improved quality of life. For-profit hospices have higher dropout rates than nonprofit hospices, yet target racial/ethnic minority communities more through community outreach. This analysis examined the relationship between hospice utilization and for-profit hospice status and conducted an economic analysis of racial/ethnic minority utilization. Method: Cross-sectional analysis of 2014 Centers for Medicare & Medicaid Services (CMS), U.S. Census, and Hospice Analytics data. Measures included Medicare racial/ethnic minority hospice utilization, for-profit hospice status, estimated cost savings, and several demographic and socioeconomic variables. Results: The prevalence of for-profit hospices was associated with significantly increased hospice utilization among racial/ethnic minorities. With savings of about $2,105 per Medicare hospice enrollee, closing the gap between the White and racial/ethnic minority populations would result in nearly $270 million in annual cost savings. Discussion: Significant disparities in hospice use related to hospice for-profit status exist among the racial/ethnic minority Medicare population. CMS and state policymakers should consider lower racial/ethnic minority hospice utilization and foster better community outreach at all hospices to decrease patient costs and improve quality of life.

scholarly journals Weighing the benefits and risks of oral immunotherapy in clinical practice

2021 ◽  
Vol 42 (2) ◽  
pp. 118-123
Author(s):  
Aikaterini Anagnostou
Keyword(s):  
Quality Of Life ◽  
Food Allergy ◽  
The United States ◽  
Oral Immunotherapy ◽  
Food Allergies ◽  
Allergic Reactions ◽  
Immune Modulators ◽  
Significant Burden ◽  
Working Together

Food allergies are common and affect 6‐8% of children in the United States; they pose a significant burden on the quality of life of children with allergy and their caregivers due to multiple daily restrictions. Despite the recommended dietary avoidance, reactions tend to occur due to unintentional exposure to the allergenic food trigger. Fear of accidental ingestions with potentially severe reactions, including anaphylaxis and death, creates anxiety in individuals with food allergy. Oral immunotherapy has emerged as a form of active and potentially disease-modifying treatment for common food allergies encountered in childhood. The efficacy of oral immunotherapy is high, with the majority of participants achieving desensitization and, as a result, protection from trace exposures and improved quality of life. The main risk of oral immunotherapy consists of allergic reactions to treatment. In general, rates of allergic reactions and anaphylaxis are reported to be higher in individuals pursuing therapy options, but most subjects who undergo oral immunotherapy will likely experience mild or moderate reactions during treatment. Adverse events tend to reduce in both frequency and number in the maintenance period. The use of immune modulators alongside oral immunotherapy has been suggested, with the aim to improve efficacy and safety, and to facilitate the overall process. It is evident that the landscape of food allergy management is changing and that the future looks brighter, with different options emerging over time. The process of how to choose the appropriate option becomes a discussion between the clinician and the patient, which involves a joint review of the current medical evidence but also the patient's preference for balancing particular attributes of the treatment. By working together, providers and patients will ensure achievement of the best possible outcome for children with food allergies.

Civil Money Penalty Enforcement Actions for Quality Deficiencies in Nursing Homes

2019 ◽  
Vol 60 (5) ◽  
pp. 868-877
Author(s):  
Xiaochuan Wang ◽  
Denise Gammonley ◽  
Felicia Bender
Keyword(s):  
Quality Of Life ◽  
Nursing Homes ◽  
Fixed Effects ◽  
State Level ◽  
Regulatory Oversight ◽  
Cross Sectional ◽  
For Profit ◽  
Profit Status ◽  
Fixed Effects Regression

Abstract Background and Objectives Civil money penalties (CMP) are fines collected by CMS. A portion of these CMPs are redistributed to states for purposes including improving resident care and quality of life through reinvestment in quality improvement projects. This study examined state variation in civil money penalty enforcement actions for quality of life (QOL) and quality of care (QOC) deficiencies in nursing homes. Research Design and Methods 2015–2016 cross-sectional CASPER nursing home survey data obtained from the CMS QCOR database were used to explore the pattern of enforcement actions for QOL and QOC deficiencies across states. Fixed effects regression models examined relationships between state-level characteristics, quality deficiencies, and enforcement actions imposed by states. Results State enforcement actions resulting in a CMP were more likely for QOC deficiencies (M = 0.143, SD = 0.097) than for QOL deficiencies (M = 0.070, SD = 0.056) and states exhibited variability in imposing enforcement actions. The presence of severe QOC deficiencies resulting in actual resident harm contributed to CMP enforcement actions for both QOL and QOC deficiencies. States with primarily for-profit status providers had more enforcement actions. Discussion and Implications The variability noted in state enforcement for quality deficiencies actions parallels inconsistencies in state regulatory oversight of nursing homes.

scholarly journals Ultrasound for Drug Synthesis: A Green Approach

2020 ◽  
Vol 13 (2) ◽  
pp. 23 ◽  
Author(s):  
Micheline Draye ◽  
Gregory Chatel ◽  
Romain Duwald
Keyword(s):  
Quality Of Life ◽  
Energy Efficient ◽  
Bioactive Molecules ◽  
Pharmaceutical Companies ◽  
Drug Candidates ◽  
Environmental Consequences ◽  
Green Approach ◽  
Drug Synthesis ◽  
Energy Consuming

This last century, the development of new medicinal molecules represents a real breakthrough in terms of humans and animal life expectancy and quality of life. However, this success is tainted by negative environmental consequences. Indeed, the synthesis of drug candidates requires the use of many chemicals, solvents, and processes that are very hazardous, toxic, energy consuming, expensive, and generates a large amount of waste. Many large pharmaceutical companies have thus moved to using green chemistry practices for drug discovery, development, and manufacturing. One of them is the use of energy-efficient activation techniques, such as ultrasound. This review summarizes the latest most representative works published on the use of ultrasound for sustainable bioactive molecules synthesis.

Backlash on the Border: Conservatism and the Rise of the New Economy in the San Diego–Tijuana Corridor

2018 ◽  
Vol 46 (3) ◽  
pp. 561-578
Author(s):  
Daniel Elkin
Keyword(s):  
Quality Of Life ◽  
Middle Class ◽  
San Diego ◽  
New Economy ◽  
The United States ◽  
International Capital ◽  
For Profit ◽  
White Middle Class ◽  
Neoliberal Governance

The cities of San Diego and Tijuana have long been economically interdependent. Today, each represents the bifurcated character of the new economy wherein low wage labor in Mexico is used to underwrite the quality of life for the middle class in the United States. This article traces the political origin of this economic structure. Instead of a top-down orchestration of neoliberal governance, the contours of the New Economy were formed through a process of contestation: a battle between international capital and its demands for profit and San Diego’s white middle class homeowners dedicated to maintaining their quality of life by resisting border integration.

scholarly journals Novel strategies and therapeutic options for the management of primary biliary cholangitis

2017 ◽  
Vol 10 (10) ◽  
pp. 791-803 ◽  
Author(s):  
Amardeep Khanna ◽  
David E. Jones
Keyword(s):  
Quality Of Life ◽  
Liver Transplantation ◽  
Review Article ◽  
Primary Biliary Cholangitis ◽  
Pharmaceutical Companies ◽  
The Novel ◽  
Aggressive Disease ◽  
Therapeutic Molecules ◽  
Novel Therapeutic

Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease. It has a varied course of progression ranging from being completely asymptomatic to aggressive disease leading to cirrhosis and resulting in liver transplantation. In addition, symptoms can be debilitating and can have a major impact on quality of life. For decades, there was only one anti-cholestatic agent available to target this disease and that was only effective in around half of patients, with little or no effect on symptoms. With increasing understanding of the pathogenic mechanisms of PBC and potential targets for drug treatment, pharmaceutical companies have shown a greater interest in this rare disease. A large number of novel therapeutic molecules have been developed and are currently being evaluated. In this review article all the novel molecules in use and in trials targeting cholestasis and symptoms in PBC are discussed.

scholarly journals Burden of drug induced allergic reactions: a 3-year experience in a tertiary care hospital

2020 ◽  
Vol 9 (1) ◽  
pp. 200
Author(s):  
Shatavisa Mukherjee ◽  
Santanu Kumar Tripathi
Keyword(s):  
Quality Of Life ◽  
Wide Spectrum ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Allergic Reactions ◽  
Care Hospital ◽  
Drug Induced ◽  
Patient Counselling ◽  
Severity Grading

Background: DIARs includes a wide spectrum of immunologically-mediated hypersensitivity reactions with varied mechanisms and clinical manifestations. Besides affecting a patient’s quality of life, it may also lead to increased treatment cost and length of hospitalization. The present study aims to provide an overview of drug induced allergic reactions experienced in a tertiary care set-up.Methods: A prospective observational outcome research was conducted over a 3-year period on patients encountering drug induced allergic reactions, who has been analysed for their spectrum of presentation, clinical outcomes (including severity, management and outcome of reaction), economic outcomes (including cost of treatment) and humanistic outcomes (including assessment of quality of life).Results: Drug induced allergic reactions accounts for 2.71% of total hospitalization in this study period. While majority reactions were moderate in severity grading, most were preventable. Direct cost of treating such preventable reactions were much higher along with increased indirect cost (due to prolonged hospitalization) adding to economic burden. Quality of life in patients encountering such reactions was also compromised as assessed using EQ-VAS.Conclusions: Prompt identification, consultation, cessation of culprit drug, management and patient counselling can act as strategies to minimize the burden of these reactions on society and healthcare system at large.

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