Dangerous Doses

The use of pharmaceutical medications is an essential element of the American health care system. For many people these prescribed drugs help to treat acute illnesses and maintain control of chronic conditions. However, medication use can also result in side effects. These may occur when treatment goes beyond the desired effect such as a hemorrhage triggered by the use of anticoagulants like warfarin or heparin; or problems that occur in addition to the desired therapeutic effect i.e. the nausea, vomiting, fatigue and  hair loss associated with chemotherapy drugs used to treat cancer.

In other words, side effects can occur as a result of unintentional overdosing by the patient, medication errors such as incorrect prescribing and dosing and even when drugs are taken as directed.

Even so, SRxA’s Word on Health was shocked to read the latest News and Numbers from the Agency for Healthcare Research and Quality (AHRQ).

It seems the rates of medication-related adverse outcomes are increasing. More worrisome, this trend is likely to continue with the aging of the population, the growth in the number of comorbidities, and so called polypharmacy – when patients take multiple drugs, often way more than they need.

According to the report released last week, the number of people treated in U.S. hospitals for illnesses and injuries resulting from taking medicines jumped 52%  between 2004 and 2008.

They now estimate that each year close to 1.9 million Americans suffer either medication side effects or injuries caused by being given the wrong medicine or dosage.

The top 5 categories of medicines that resulted in people being treated and released from emergency departments were:

  • unspecified medicines  
  • pain killers
  • antibiotics
  • tranquilizers and antidepressants
  • corticosteroids and other hormones

For patients admitted to the hospital, the top five categories causing side effects and injuries were: corticosteroids, painkillers, blood-thinners, drugs to treat cancer and immune system disorders and heart and blood pressure medicines.

More than half of hospitalized patients were age 65 or older, while only 3% were under age 18. Children and teenagers accounted for 22% of emergency cases.

The increase in medication side effects coupled with the ensuing massive drain of healthcare finances and manpower suggest to us that pharmaceutical companies need to dedicate more resources to ensure that both doctors and patients are educated about side effects and how to recognize, minimize and manage them.

How do you talk when physicians won’t listen?

In general those who have nothing to say contrive to spend the longest time in doing it” said American poet, James Russell Lowell

But when it comes to the  pharmaceutical industry,  companies have plenty to say but less and less time and opportunity to convey or control the message.  Amid news this week that Pfizer is providing a $3 million grant to Stanford University for CME  programs, with no strings attached, it is clear that drug companies are facing some of the greatest challenges in their history.

Although there are pockets of real growth and development, worldwide revenues are dropping.  After a series of public relations disasters, the industry’s reputation is tarnished.  And despite an estimated $70 billion worth of drugs going off patent globally by 2012, pipelines hold fewer and fewer truly innovative new products.

Then there’s diminishing physician interactions due to an increasingly restrictive regulatory environment, along with the increasing power payers have over the market’s access to drugs. The ever-growing number of  “no see” doctors is a challenge for every pharmaceutical company’s sales and marketing departments.  Even those doctors who would like to see reps find themselves unable to do so either due to lack of time or strict institutional policies. With lunches, dinners and other forms of hospitality now all but banned, the question is: How do you talk when physicians won’t or can’t listen?