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April 2014

Features

In a retrospective chart review of adult patients admitted to an academic medical center, 15% of the 317 patients identified as being subject to automatic therapeutic substitution for one of five drug classes were not returned to original outpatient therapy upon discharge, and 16% were receiving a cost-prohibitive drug.
Unlike a generic drug, a “generic” biologic won’t be identical to the branded product. Manufacturers are divided over whether pharmacists should have to tell doctors when they prescribe one of the “biosimilars” that will soon appear on the market.
Q&A
The prognosis for patients with pancreatic cancer remains poor, but a widely recognized expert on pancreatic and biliary surgery at Massachusetts General Hospital and Harvard Medical School expresses optimism about improvements in the next decade.
Viewpoint
Many hypertension patients want to learn about ways to reduce reliance on pharmaceuticals, says functional medicine practitioner Mark Houston, who believes it is often possible to reduce or eliminate reliance on drugs using nutrition and nutraceuticals.

Departments

Medication Errors
For warnings, “do this” may be better than “don’t do that.”
Prescription: Washington
Investigators question 340B contract pharmacy programs.
FDA approvals, drug indications, and updates
Ibrutinib (Imbruvica) for chronic lymphocytic leukemia, tasimelteon (Hetlioz) for non-24-hour sleep–wake disorder, and anti-inhibitor coagulant complex (Feiba) to prevent or reduce bleeding in hemophilia A or B
Drug Forecast
Suvorexant, a dual orexin receptor antagonist for the management of insomnia