Researchers found that among more than 75,000 Massachusetts patients given drug prescriptions over one year, 22 percent of the prescriptions were never filled. The rate was even higher — 28 percent — when the researchers looked only at first-time prescriptions.

Such “non-adherence,” the study found, was common even among patients prescribed drugs for chronic conditions that can have serious health consequences.

Between 28 percent and 31 percent of new prescriptions for diabetes, high blood pressure and high cholesterol, for example, went unfilled, according to findings published in the Journal of General Internal Medicine.

Exactly why many patients did not fill their prescriptions is unclear. One possibility is that, when health problems cause few or no symptoms — as with high blood pressure or high cholesterol — people may not see the need for a medication.

“If they do not fully understand the reason that they are being prescribed the medication, they may be less likely to take it,” lead researcher Dr. Michael A. Fischer, of Brigham and Women’s Hospital in Boston, told Reuters Health in an email.

Cost could also be an issue, Fischer added — particularly when people are unsure of why a drug is being prescribed.

All of the patients in the study had health insurance. But even with coverage, people may have high co-payments for medications or may be prescribed a drug not covered by their plan, Fischer and his colleagues note.

For their study, the researchers used a database of electronic drug prescriptions for patients in two Massachusetts health plans, along with pharmacy claims records to verify whether the prescriptions were filled.

The study found that of almost 196,000 “e-prescriptions” written between 2004 and 2005, about 78 percent were filled. Of the more than 82,000 prescriptions for new drugs, just under 72 percent were filled.

Patients were least likely to pick up prescriptions for pain drugs, with only 45 percent of new prescriptions being filled. Between one- quarter and one-third of new prescriptions for conditions like depression, asthma and gastrointestinal ills also went unfilled.

More studies, according to Fischer, are needed to weed out the reasons why many people never fill their prescriptions — whether cost, worry over side effects, a desire to avoid medications or other issues.

For now, he said, people with questions about their new prescriptions should not hesitate to bring them up with their doctors.

“If you are not sure why you are being prescribed a medication, ask your doctor directly,” he said. “One of our jobs as physicians is to educate and advise our patients, and being sure that they understand their medication regimen is a big part of that job.”

Fischer added that in cases where people have left their prescriptions unfilled, they should not be “afraid” to tell their doctors. “Then they can talk with you about why you are not taking the medication and work with you to find a medication that you can use.”

SOURCE: Journal of General Internal Medicine, online February 4, 2010.

Technorati Tags: prescriptions, prescriptions for diabetes drugs, prescriptions for pain drugs

Ratiopharm could stay in takeover talks with two or even three bidders, as some bids, which had been due by the end of Friday, are seen within a close range of 3 billion euros ($4.11 billion), said the people, who are familiar with the procedure.

That would make the deal the biggest generics takeover since Teva’s $7.5 billion purchase of U.S. rival Barr, announced in July 2008.

The world’s largest drug company Pfizer, previously seen as an unlikely candidate, has re-emerged, defying a relatively unfavorable impression it left with regional law-makers in southwestern Germany, where Ratiopharm is headquartered, according to the people.

Industrial heir Ludwig Merckle is selling Ratiopharm as part of concessions made to creditor banks by his late father Adolf Merckle, who committed suicide in January 2009 after losing control over his business empire to lenders during the financial crisis.

Industry analysts said Teva, the world’s largest generics company, has deeper pockets and stands to gain more from potential cost cuts at family-owned Ratiopharm than does Actavis/EQT.

The Nordic consortium, however — which has enlisted former Ratiopharm Chief Executive Claudio Albrecht for advice — has improved its chances after pledging to protect jobs in the region.

“Teva seems to have a better financial position and the infrastructure to capture cost synergies. However, the smaller size of Actavis may appeal to the family-owned seller,” analysts at Jefferies said in a note. “Also, an Actavis acquisition may be somewhat more job friendly.”

Pfizer has already struck a string of collaborations and acquisitions to bolster its range of generics, particularly off-patent injectable drugs. An alliance with India’s Strides Arcolab Ltd last month marked the latest step.

For its part, Teva has said it plans to more than double total revenue and almost triple sales in Europe by 2015, a venture analysts say would require acquisitions worth $15 billion.

Ratiopharm could become Teva’s fast track to the No. 1 spot in Germany’s generics market, the world’s second-biggest, where Teva now trails Novartis, Ratiopharm, and Stada.

The acquisition would also make Teva the largest generics player in Europe, where its presence has been below Teva’s global average.

A spokesman for Ratiopharm declined to comment, as did spokespeople for Teva, Pfizer and EQT. Ratiopharm previously said a deal would be closed in the first quarter at the earliest.

Sources have said that debt-laden Actavis sought backing from EQT for the takeover bid in an aggressive move to boost the Icelandic firm’s market value after it failed to find a new owner last April.

(Reporting by Ludwig Burger, Frank Siebelt, Philipp Halstrick and Alexander Huebner in Frankfurt, Quentin Webb in London; Editing by Keiron Henderson)

Technorati Tags: Actavis, generic drug maker, injectable drugs, Pfizer, Ratiopharm

Those who are allergic to live evergreens may choose to decorate with artificial plants, but both live and artificial trees can trigger symptoms, experts say. They offer the following hints to help people avoid allergy and asthma symptoms over the holiday season:

• Some allergies are triggered by terpene, which is found in the oil or sap of live evergreen trees, wreaths and garlands. Other allergy sufferers may react to mold or pollen on trees and natural decorations. The ACAAI suggests washing pollen and mold off live trees, especially the trunk, with a garden hose and leaving the tree in a bucket of water in the garage or a covered porch while it dries. Wear gloves when handling the tree to protect against contact with sap.
• For those who are allergic to dust and mold, even artificial trees can be a problem if they haven’t been stored properly. Because dust and mold can accumulate on these items, it is a good idea to wash the tree outside before setting it up inside the house for decorating. The best way to store an artificial tree is to place it in an air-tight bag or container.
• Ornaments and other decorations can also gather dust and mold and are best stored in air-tight containers. Thoroughly clean each item before putting it on display.
• Artificial snow spray shouldn’t be used indoors because it can trigger asthma and allergy symptoms. Other potential triggers include scented candles, potpourri and other scents, and wood-burning fireplaces, the ACAAI warns.
• Food allergies are another potential problem during the holidays. Those with food allergies should ask party or dinner hosts about the ingredients used in each dish. It is also a good idea to prepare a dish you know is “safe” for you to eat and bring it along to share. When hosting a gathering, talk to guests in advance about food allergies.
• When traveling, remember to pack your asthma and allergy medications. If the trip requires air travel, keep those items in a carry-on bag. Bringing a pillow and mattress cover is recommended for those affected by dust mites.

Stress doesn’t cause allergies or asthma but can weaken your immune system. Make sure you take time in your busy holiday schedule to stay on top of your allergy and asthma symptoms so that illness doesn’t ruin your holiday plans. People with asthma should talk with their doctor about getting a flu shot, the ACAAI recommends.

Technorati Tags: allergies, asthma, food allergies, prevent alergies, prevent asthma

It says Tamiflu remains highly effective against the vast majority of H1N1 cases.

Four cancer patients in a North Carolina hospital tested positive last week for a type of the flu that was resistant to Tamiflu. Five people at a British hospital also didn’t respond to the drug after contracting the flu.

WHO flu chief Dr. Keiji Fukuda said Thursday that investigations were under way, but that the American and British patients for whom Tamiflu did not work had severely weakened immune systems.

Technorati Tags: H1N1 virus, swinge flu, tamiflu

The vaccine is subject to the same manufacturing and testing oversight as seasonal flu vaccines, the agency said in a news release. The expanded approval also includes CSL’s seasonal flu shots.

“Because children are among those most vulnerable to the 2009 H1N1 virus, having a broader range of children’s vaccines available is an important first step in responding to the H1N1 outbreak,” FDA commissioner of food and drugs Margaret Hamburg said in a statement.

As with any vaccine grown in eggs, people allergic to eggs or egg products shouldn’t get this vaccine, the FDA said.

Common adverse reactions include pain, redness and swelling at the injection site. Less common side effects may include irritability, loss of appetite and drowsiness.

CSL is based in Australia.

Technorati Tags: CSL Limited, flu vaccines, H1N1 virus, influenza vaccine, seasonal flu

Allergic rhinitis, more commonly known as hay fever, is a collection of symptoms (runny nose, sneezing, red itchy and watery eyes, nasal congestion) caused by an allergic reaction to something in the environment such as pollen, dust mites, animal dander, or mold. It can be problem throughout the year (persistent) or only during certain months (seasonal), depending on the individual and the allergic trigger.

While second generation allergy drugs are non-sedating — a big problem with first generation antihistamines — they are generally thought to be less effective in reducing nasal congestion than nasal sprays and decongestants.

In the current study, French and Swedish researchers randomly assigned 584 people with allergic rhinitis to desloratadine (5 milligrams daily) or inactive placebo. Over the 28-day trial, the allergy sufferers kept symptom diaries and answered quality-of-life questions weekly. Unlike many previous studies, the researchers included nasal congestion as a measured symptom.

According to a report in the journal Allergy, desloratadine was significantly better than placebo in reducing both the runny nose and congestion of seasonal and persistent allergic rhinitis.

Desloratadine led to significant symptom relief by the end of day three in both seasonal and persistent allergy sufferers, the study team found. The full extent of symptom relief was reached after two weeks on the drug.

At various times during the trial and at its conclusion, the group taking desloratadine felt better and slept better compared to the placebo group, the researchers report.

Previous studies have demonstrated much slower onset of action of other second generation antihistamines in persistent allergic rhinitis, but “the present study emphasizes the rapid relief of nasal congestion” with desloratadine in these patients, the investigators note.

Clarinex (desloratadine) is the prescription version of the over-the-counter drug Claritin (loratadine), which is available in generic form. As with loratadine, desloratadine it is taken in pill form daily.

Cost may be the biggest difference between the two drugs with desloratadine costing about twice the generic loratadine. A generic version of desloratadine will not be available until 2012 at the earliest.

Study co-author Dr. Philippe Devillier of Foch Hospital in Suresnes, France, told Reuters Health that there’s no demonstrated difference in the clinical efficacy of desloratadine and loratadine but that desloratadine may pose less risk of interacting with other drugs.

The study was funded by Schering-Plough, maker of Clarinex. Four of the study’s seven authors were Schering-Plough employees.

The most common allergic illness in the United States, allergic rhinitis affects about 40 million people every year resulting in 5.5 million sick days away from school or work.

In 2000, Americans spent about $9 billion for symptom relief medications.

SOURCE: Allergy, November 2009.

Technorati Tags: Allergic rhinitis, allergic trigger, allergy drug, Clarinex, desloratadine

These shifts in the microbial environment, reported in the Nov. 11 edition of Science Translational Medicine, might mean that experts should look more closely at the billions of microorganisms residing in human guts to better understand and perhaps even treat the epidemic of obesity plaguing the modern world.

“Although how much you eat and how much you exercise are dominant drivers of your energy balance, it’s possible that microbial communities and how they work also comprise a factor that determines your risk for obesity or risk for malnutrition,” said study senior author Dr. Jeffrey I. Gordon, director of the Center for Genome Sciences at Washington University School of Medicine in St. Louis.

The researchers plan to use the mouse model, or “humanized” mouse, to further study the diverse organisms that reside in people’s guts and how their presence might effect their hosts’ health.

“There are 10 times more microbial cells associated with adult human bodies than there are human cells, so we are 90 percent microbial and 10 percent human,” Gordon said. The bacteria can help people digest and absorb food that might otherwise be indigestible.

But the denizens of the digestive system are hard to study, given the complex environmental, genetic and cultural factors that affect digestion and obesity.

To devise a better way to study these microorganisms, Gordon and his fellow researchers transplanted microbes from human feces into mice that, courtesy of genetic manipulation, had no gut microorganisms of their own.

“When we switched these humanized animals [from a low-fat] to a junk-food diet, high in fat with lots of simple sugars, the structure of the microbial community changed dramatically and very rapidly, not only in terms of who’s there or which species but the proportional representation of species changed very abruptly within 24 hours,” Gordon explained. “These mice also became obese on Western diets.”

“The microbes can adjust with astonishing speed to different types of diets,” he said.

And transplanting the microbes to another set of microbe-free mice also caused the new mice to gain weight, even though they were on a low-fat feeding plan.

“They also showed that the microbiota passes from generation to generation,” said Jun Sun, an assistant professor of microbiology and immunology at the University of Rochester School of Medicine and Dentistry in New York. “This raises the question of whether we can pass microbiota from mothers to children, and the answer seems to be yes.”

The “21st century medicine cabinet,” then, might be composed of microbes themselves or drugs targeting particular sets of microbes to modify how they work in a person’s gut, Gordon said. “We can identify the human genes that are manipulated by microbes and those themselves could become therapeutic targets.”

The findings also helped advance science, Sun said.

“In the past, scientists published very descriptive studies of the flora, but the big question was how to apply the research,” she said. “I think we have jumped a big step forward. Now scientists have an established, well-controlled model of the gut flora.”

Technorati Tags: Gut Bacteria, microbiota, obesity, Western diets

First, talk to your pharmacist, advised Carriann Richey, director of outreach and assistant professor of pharmacy practice at Butler’s College of Pharmacy and Health Sciences. Pharmacists may be able to recommend a lower-cost generic drug or an alternative, less expensive drug. Many pharmacies have low-cost options such as $4 generics or free antibiotics and prenatal vitamins. If your pharmacy doesn’t have this program, ask if they will match other pharmacies’ lower pricing, Richey suggested.

Here are some other strategies:

• Go to a reduced-cost or free clinic, where health care providers are trained to consider lower-cost alternatives and may be able to provide prescriptions at reduced cost or no cost.
• Look into drug manufacturer or government programs. Some drug makers offer discount cards or programs for brand-name medications free or at reduced-cost. There are a number of Web sites that provide information about these programs, including www.benefitscheckup.org. In addition, some government agencies offer drug discount programs, and most states offer senior assistance plans. (for example, discount code b2eb735754 available for online pharmacy broker PharmacyTouch.com which gives up to 10% discount)
• Online and mail-order pharmacies that offer lower prices on prescription drugs may be helpful for people with chronic conditions. However, because of the time it takes to fill and ship orders, this approach isn’t ideal for people with acute conditions. Look for online pharmacies with the VIPPS seal, which indicates the site is approved by the National Association of Boards of Pharmacy.
• In some cases, tablet-splitting can help reduce costs. But not all medications can be split, and not all tablet-splitting will save money. Patients should check with their pharmacist or physician before using this approach.
• Getting food or heating assistance could free up money that could be used to pay for prescription drugs. Check into this type of help by contacting social service organizations such as the United Way.
• Lifestyle changes, such as getting more exercise and eating healthier foods, may reduce the need for medications.

Technorati Tags: generic drug, prescription drugs, prescription medications, save on drugs

In post-treatment surveys of 1,425 cancer survivors, 34 percent indicated having five or more unmet physical or mental health needs, researchers report in the Journal of Clinical Oncology.

A similar survey completed 6 months later found 60 percent of these survivors with similarly unmet needs, Dr. Jo Armes, of King’s College in London, and colleagues report.

The survey participants were 61 years old on average and most (69 percent) were women. Most of those surveyed had breast (56 percent) and prostate (23 percent) cancers. Forty percent also had other health problems such as heart or bone and muscle disease.

Both surveys generally revealed patients’ fears and concerns about their disease and its impact on their future and their loved ones.

As many as 20 percent initially felt ill informed about the control of their cancer and the actions they could take to improve recovery, and 6 months later 16 percent felt the same, the researchers found.

Cancer survivors on hormone therapy and those who had post-treatment or other medical complications between the first and second surveys, were much more likely than others to report continuing moderate to severe unmet needs.

Therefore, Armes and colleagues suggest targeting support to these individuals who appear most in need of continued mental and physical care.

SOURCE: Journal of Clinical Oncology, published online November 2, 2009

Technorati Tags: cancer, cancer treatment, muscle disease, Post-cancer treatment

From April 2005 to October 2008, the FDA received 78 reports of kidney function problems in patients taking Byetta. Most of the problems occurred in patients with pre-existing kidney disease or one or more risk factors for developing kidney problems. Byetta is prescribed for type 2 diabetes; 7 million prescriptions were filled between April 2005 and September 2008, according to the agency

“Health-care professionals and patients taking Byetta should pay close attention to any signs or symptoms of kidney problems,” Dr. Amy Egan, of the Division of Metabolism and Endocrinology Products at the FDA’s Center for Drug Evaluation and Research, said in an FDA news release.

“Patients also should be aware that problems with kidney function could lead to changes in urine color, frequency of urination or the amount of urine, unexplained swelling of the hands or feet, fatigue, changes in appetite or digestion, or dull ache in the mid- to lower back,” Egan said.

She advised patients with any of these symptoms to immediately consult with a health-care professional.

Byetta, made by San Diego-based Amylin Pharmaceuticals Inc., is used to control blood sugar levels.

Nausea, vomiting and diarrhea are the most common side effects associated with the drug. These side effects may contribute to the development of kidney malfunction, which can lead to a build-up of waste products in the blood, resulting in serious illness and potentially life-threatening conditions.

Technorati Tags: Amylin Pharmaceuticals, Byetta, diabetes drug, Food and Drug Administration, kidney problems