PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Overhaul 'made-to-order' drugs, which cost NHS millions, urges DTB

The use of 'specials' in primary care

2010-10-06
(Press-News.org) The provision of made-to-order drugs ("specials") in primary care is expensive, often unnecessary, and associated with legal pitfalls, says the Drug and Therapeutics Bulletin (DTB).

It calls for a major overhaul of the practice, in a review of the evidence in this month's issue.

Bespoke drugs or "specials" are medicines made specifically to meet the needs of individual patients, so may be prepared in formulations and strengths which differ from those of standard licensed medicines.

They might be prescribed, for example, when a patient can't or won't swallow tablets or is allergic to a particular non-active ingredient in a readily available drug. And they are sometimes used when a particular medicine has been discontinued or is out of stock, or when a non-standard dose is required.

Although made by a licensed manufacturer, these drugs are not themselves licensed. They are therefore not assessed for safety, quality, or effectiveness, warns DTB.

Unwanted effects caused by a licensed medicine, used as intended, are the manufacturer's responsibility. By contrast, prescribers, and potentially, supplying pharmacists, are legally liable for harmful effects caused by a special, unless it can be proved the product is defective, says DTB.

Specials are also expensive. In 2008 the total spend on specials in primary care in England was £63 million. By 2009, this had risen 68% to £109 million - equivalent to 1.4% of the total prescribing budget in primary care.

The cost of an individual special depends on the ingredients and the complexity of the processes involved in its manufacture, to which can be added levies charged by distributors and/or "out of pocket expenses" claimed by pharmacists.

The review provides some examples of prices charged for specials. These include liquid formulations of the painkiller paracetamol, costing £67 for a 100 ml bottle, and topiramate, used to treat epilepsy and prevent migraine, costing over £3,400 for one prescription.

And in 2009, there were over 15,000 prescriptions for special liquid formulations of the indigestion drug omeprazole - costing an average of £250 - despite there being a licensed soluble version of the drug.

In August this year, the legislation was changed to permit manufacturers to produce price lists of unlicensed medicines, including specials. But the bespoke nature of the products means that it will be difficult to include all of them on price lists, suggests DTB.

"This lack of information on pricing means that at the point of prescribing, prescribers are often unable to judge whether a particular product represents value for money," it says, urging doctors to prescribe specials only when there are no suitable licensed or off label alternatives that meet the patient's needs.

"On occasion it may be necessary to meet a particular need through the use of an unlicensed special ... However, this should be a matter of last resort once all the options using licensed products have been explored," it says.

And it concludes: "We believe that the use of specials in primary care requires a major overhaul and much closer scrutiny than it has had to date."

INFORMATION:

END



ELSE PRESS RELEASES FROM THIS DATE:

Persistently noisy workplace more than doubles heart disease risk

2010-10-06
A persistently noisy workplace more than doubles an employee's risk of serious heart disease, suggests research published online in Occupational and Environmental Medicine. Young male smokers seemed to be particularly at risk, the findings showed. The researchers base their findings on a nationally representative sample of more than 6,000 employees, aged from 20 upwards, who had been part of the US National Health and Nutrition Examination Survey (NHANES) between 1999 and 2004. This involved detailed household interviews, to include lifestyle and occupational health, ...

Mice with human body's defenses

2010-10-06
Therapeutic antibodies can be an efficient alternative when common drugs do not work anymore. However, antibodies obtained from blood of animals such as mice could not be used: The human immune system recognizes them as foreign and rejects them. In an international cooperation, scientists from the Helmholtz Centre for Infection Research (HZI) in Braunschweig, Germany have now succeeded in developing a promising approach to solve this problem; with the help of human stem cells they generated mice with a human immune system, which were then vaccinated to produce human monoclonal ...

Powerful free radical causes lung damage from oxygen therapy

Powerful free radical causes lung damage from oxygen therapy
2010-10-06
AUGUSTA, Ga. – The most toxic free radical appears responsible for much of the lung damage that can result from oxygen therapy in the critically ill or injured, Medical College of Georgia researchers report. Within just a few days, ventilators and oxygen chambers used to significantly increase oxygen levels can also dramatically increase levels of peroxynitrite, an oxidant powerful enough to break down DNA and cause proteins to malfunction, said Dr. Yunchao Su, pharmacologist in the MCG Schools of Medicine and Graduate Studies. Oxygen toxicity is the most severe side ...

Is your job making you fat?

2010-10-06
Montreal, October 05, 2010 – Working nine-to-five may be the way to make a living, but it may be padding more than the wallet. According to a new study from the Université de Montréal, office-workers have become less active over the last three decades and this decreased activity may partly explain the rise in obesity. Their findings, published in the early online edition of Preventive Medicine, may have health implications for the millions of people toiling behind their desks. "People eat better and exercise more today than they did in the 1970's, yet obesity rates ...

Breakthrough e-display means electronics with high speed, high readability and low power usage

Breakthrough e-display means electronics with high speed, high readability and low power usage
2010-10-06
Today's Oct. 4 issue of the high-impact journal, Applied Physics Letters, contains a new electrofluidics design from the University of Cincinnati and start-up company Gamma Dynamics that promises to dramatically reshape the image capabilities of electronic devices. This patent-pending electrofluidics breakthrough by the Novel Devices Laboratory at the University of Cincinnati and partner companies Gamma Dynamics, Dupont and Sun Chemical follows about seven years of work. According to lead researcher Jason Heikenfeld, UC associate professor of electrical and computer engineering ...

Fish oil linked to increased risk of colon cancer in mice

2010-10-06
EAST LANSING, Mich. — Fish oil – long encouraged by doctors as a supplement to support heart and joint health, among other benefits – induced severe colitis and colon cancer in mice in research led by Michigan State University and published this month in the journal Cancer Research. Jenifer Fenton, a food science and human nutrition researcher at MSU, led the research that supports establishing a dose limit for docosahexaenoic acid (DHA), one of the omega-3 fatty acids present in fish oil, particularly in people suffering from chronic conditions such as inflammatory bowel ...

'Paradigm shift' in how physicians treat peripheral artery disease

2010-10-06
A balloon angioplasty device that sucks up dangerous plaque debris could trigger a "paradigm shift" in how physicians treat peripheral artery disease, researchers write in the current issue of Endovascular Today. "We will see a shift in how we treat lesions," write Dr. Robert Dieter of Loyola University Health System and Dr. Aravinda Nanjundappa of West Virginia University. In two clinical trials totaling 123 patients, the device had a success rate of 97 percent to 99 percent and consistently outperformed filter devices typically used to capture debris particles, Dieter ...

Shortfalls in carotenoid intake may impact women's health

2010-10-06
GRAND RAPIDS, MICH., Oct. 5, 2010 – Only about a third of American women are meeting their fruit and vegetable intake recommendations, which means they are likely missing out on potentially important breast and ovarian health benefits (1). Along with vitamins, minerals and fiber, fruits and vegetables contain a type of phytonutrient called carotenoids, which research suggests help support women's health including breast and ovarian health. Based on a new report called America's Phytonutrient Report: Women's Health by Color, older women have total carotenoid intakes ...

ORNL uses new technologies to take steam out of wasted energy

2010-10-06
OAK RIDGE, Tenn., Oct. 5, 2010 -- By installing wireless sensors and replacing faulty traps along the 12 miles of steam lines at Oak Ridge National Laboratory, officials expect to save as much as $675,000 per year. With 1,600 steam traps, which normally open slightly to discharge condensed steam with a negligible loss of live steam, the problem occurs when a trap fails and that failure goes undetected and unrepaired, said Teja Kuruganti, a member of the Computational Sciences and Engineering Division. Manual inspections of each trap is a daunting and sometimes dangerous ...

SMU geothermal mapping project reveals large, green energy source in coal country

SMU geothermal mapping project reveals large, green energy source in coal country
2010-10-06
DALLAS (SMU) – New research produced by Southern Methodist University's Geothermal Laboratory, funded by a grant from Google.org, suggests that the temperature of the Earth beneath the state of West Virginia is significantly higher than previously estimated and capable of supporting commercial baseload geothermal energy production. Geothermal energy is the use of the Earth's heat to produce heat and electricity. "Geothermal is an extremely reliable form of energy, and it generates power 24/7, which makes it a baseload source like coal or nuclear," said David Blackwell, ...

LAST 30 PRESS RELEASES:

Sensitive ceramics for soft robotics

Trends in hospitalizations and liver transplants associated with alcohol-induced liver disease

Spinal cord stimulation vs medical management for chronic back and leg pain

Engineered receptors help the immune system home in on cancer

How conflicting memories of sex and starvation compete to drive behavior

Scientists discover ‘entirely unanticipated’ role of protein netrin1 in spinal cord development

Novel SOURCE study examining development of early COPD in ages 30 to 55

NRL completes development of robotics capable of servicing satellites, enabling resilience for the U.S. space infrastructure

Clinical trial shows positive results for potential treatment to combat a challenging rare disease

New research shows relationship between heart shape and risk of cardiovascular disease

Increase in crisis coverage, but not the number of crisis news events

New study provides first evidence of African children with severe malaria experiencing partial resistance to world’s most powerful malaria drug

Texting abbreviations makes senders seem insincere, study finds

Living microbes discovered in Earth’s driest desert

Artemisinin partial resistance in Ugandan children with complicated malaria

When is a hole not a hole? Researchers investigate the mystery of 'latent pores'

ETRI, demonstration of 8-photon qubit chip for quantum computation

Remote telemedicine tool found highly accurate in diagnosing melanoma

New roles in infectious process for molecule that inhibits flu

Transforming anion exchange membranes in water electrolysis for green hydrogen production

AI method can spot potential disease faster, better than humans

A development by Graz University of Technology makes concreting more reliable, safer and more economical

Pinpointing hydrogen isotopes in titanium hydride nanofilms

Political abuse on X is a global, widespread, and cross-partisan phenomenon, suggests new study

Reintroduction of resistant frogs facilitates landscape-scale recovery in the presence of a lethal fungal disease

Scientists compile library for evaluating exoplanet water

Updated first aid guidelines enhance care for opioid overdose, bleeding, other emergencies

Revolutionizing biology education: Scientists film ‘giant’ mimivirus in action

Genetic variation enhances cancer drug sensitivity

Protective genetic mutation offers new hope for understanding autism and brain development

[Press-News.org] Overhaul 'made-to-order' drugs, which cost NHS millions, urges DTB
The use of 'specials' in primary care