Study: Derm Drugs See a Major Price Hike

Brand name and generic dermatology drug prices have increased anywhere from 180% to 1,697% in the past 6 years, according to results of a survey of pharmacists at four major chain drugstores.

From 2009 to 2015, 19 brand name prescription medications regularly used to treat dermatologic conditions increased in price by 401%, and a few of those drugs even increased more than 16-fold, reported Steven P. Rosenberg, MD, of Palm Beach Dermatology in West Palm Beach, Fla., and Miranda E. Rosenberg, a medical student at the University of Pennsylvania Perelman School of Medicine in Philadelphia.

The “vast majority of price increases occurring after 2011,” they wrote in JAMA Dermatology.

The Rosenbergs surveyed pharmacists at a Costco, a CVS, a Sam’s Club, and a Walgreens in West Palm Beach, starting in 2009, and then again in 2011, 2014, and 2015.

The surveys were worded to solicit drug pricing information for the purpose of informing prescribing practices to “better serve our patients,” specifically those without insurance or who had high deductible insurance plans, they explained. The response rate was 100%, and surveys were returned within 1 week of distribution.

The initial survey requested pricing for 1-month supplies, or full course of treatment fulfillment, for 72 different brand-name medications. The authors noted that several of the drugs from 2009 had been discontinued or replaced in practice by newer therapies by 2015, and the final analysis focused on 19 drugs for which they had complete data in each survey year.

Some of the drugs included in the study were Altabax (retapamulin), Benzaclin (benzoyl peroxide/clindamycin), Cloderm cream (clocortolone pivalate), Derma-Smoothe FS oil (fluocinolone acetonide), Oracea (doxycycline), Retin-A Micro 0.1% (tretinoin), Solaraze (diclofenac sodium) gel, Tazorac (tazarotene) cream, and Xolegel (ketoconazole).



Fruit-flavored drugs to cut child TB deaths, combat ‘superbugs’

NAIROBI —Children will be more likely to survive tuberculosis (TB), the world’s most deadly infectious disease, once new strawberry- and raspberry-flavored medicines are available early next year, experts say.

TB killed 140,000 children and 1.37 million adults last year and infected a further one million children, according to the World Health Organization (WHO), but a lack of market incentives has hindered the development of drugs for children, the TB Alliance campaign group said.

Many children with TB do not complete their treatment because they have to take several bitter-tasting medicines every day for at least six months. The dosage is often imprecise as parents have to cut and crush adult-sized drugs for their children.

From early 2016, soluble child-sized doses of the three major drugs used to treat TB will be available, helping to save lives.

“The child is really just drinking a fruit-flavored drink,” the chief executive officer of the TB Alliance, Mel Spigelman, told the Thomson Reuters Foundation.

“It will make it so much easier for a child and a parent or caregiver to make sure the child takes the treatment and takes it religiously for the full time.”

When TB patients do not complete their treatment, they fall ill again, often with hard-to-treat drug-resistant “superbug” strains that are rapidly gaining a foothold globally.

Some 32,000 children catch drug-resistant TB each year, and it is often fatal, according to U.S. researchers.

TB is spread by bacteria when someone with untreated TB, often a family member, coughs or sneezes. Children who survive can become blind, deaf, paralysed or mentally disabled.

Almost 10 million people were infected with TB in 2014 and 1.5 million died, surpassing the 1.2 million deaths from HIV/AIDS, according to the WHO.

The two diseases often co-exist, as HIV positive people have weak immune systems which make them suspectible to TB.

Although most new TB cases occur in southeast Asia, Africa has the largest proportion relative to its population.

South Africa has Africa’s highest TB rate, with 400,000 new cases each year, the WHO says, two-thirds of whom also have HIV.

“TB is always concentrated among the poorest of the poor,” as it spreads in overcrowded places with poor sanitation and nutrition, Spigelman said. “TB is an unbelievably neglected disease… probably the quintessential disease of poverty.”

As poor people cannot afford medicines, it does not make business sense for pharmaceutical companies to develop drugs to treat diseases like TB, he said.

The new child-friendly drugs are largely funded by UNITAID, which also funds HIV/AIDS and malaria treatment in developing nations and is hosted by the WHO.



Prices rise for prescription dermatologic drugs

Drugs for skin conditions such as psoriasis have increased in cost.

The rising price of health care has an important impact on the US economy. With the “Baby boomer” generation coming into their 60s, high health care prices directly affect federal spending, which adds to the national deficit.

The Patient Protection and Affordable Care Act aims to reduce long-term health care spending by focusing on preventive care, patient responsibility and competition among health care professionals.

However, the reform has not succeeded in curbing the rising price of prescription drugs. The result is that medications are becoming less accessible to patients who need them.

The US pays the most per capita of all the Organization for Economic Cooperation and Development (OECD) countries for prescription drugs.

In the current study, Dr. Steven P. Rosenberg, of the Miller School of Medicine at the University of Miami, and colleagues aimed to find out how much prices of commonly prescribed dermatologic medications had changed since 2009, and to identify trends in price increases for different classes of drugs.

They surveyed prescription drug prices at four national chain pharmacies in West Palm Beach, FL, in 2009, 2011, 2014 and 2015.

1,240% rise in price of cancer-preventing antineoplastics

A total of 19 name-brand prescription dermatologic drugs were selected and grouped by treatment indication: acne and rosacea, psoriasis, topical corticosteroids, antiinfectives and antineoplastics.

The antineoplastic class did not include systemic medications for metastatic melanoma or basal cellcarcinoma because such medications were not available in 2009.

Prices increased rapidly between 2009-15, with prices for topical antineoplastic drugs to prevent the spread of cancer cells increasing an average of 1,240%.

The authors found that between 2009-15:

  • Prices of all surveyed classes of brand-name drugs increased by an average of 401%
  • The highest increase was in prices of topical antineoplastic drugs, at nearly 1,240%
  • Psoriasis medications had the smallest average percentage price increase of 180%
  • Seven drugs more than quadrupled in retail price, with most increases occurring after 2011.

The study concludes that prices for multiple, frequently prescribed medications have risen at a pace greater than inflation, national health expenditure growth and increases in reimbursement for physician services.

Why have prices increased?

Specific reasons for the increases in the costs of dermatologic prescription drugs were not detected, nor were they investigated at this stage. However, the team puts forward a number of possible factors.

Mergers and acquisitions enable pharmaceutical companies to corner specific drug markets, thereby using a large market presence to leverage higher prices for products within a therapeutic class.

Fast facts about health spending

  • 9.3% of US national health spending is on prescription drugs
  • 18% of spending on prescription drugs is out of pocket
  • 7.8% of Americans choose not to take prescription drugs to save money.

Learn more about health insurance

Drugs may retain their patent longer than originally intended. The main patent for Enbrel, for example, was due to expire in October 2012, but changes to patent laws mean have extended protection from generic competition through 2028.

Medication shortages because of manufacturing complications and limited availability of active ingredients have been cited as a reason for significant price increases in some cases. However, two such drugs are now readily available and no longer on the US Food and Drug Administration (FDA) list of drug shortages, but their prices have not returned to previous levels.

In some countries, such as France, government health programs can legally negotiate drug prices for beneficiaries; in the US, however, this is only permitted for the Department of Veterans Affairs and the Department of Defense’s Tricare program.

Patients with prescription drug coverage on their insurance may not notice the retail price of medications, but high drug prices are reflected in increasingly expensive monthly insurance premiums.

Patients without insurance pay high retail list prices for their medications. Medicare patients are ineligible for pharmaceutical coupon savings, and even those with insurance are finding that formularies increasingly restrict accessibility to medications, unless they pay out of pocket.

The researchers propose future investigations to focus on reasons for the price increases.

Medical News Today recently reported on a drop in spending on public health in the US.



Why the U.S. Pays More Than Other Countries for Drugs


Norway, an oil producer with one of the world’s richest economies, is an expensive place to live. A Big Mac costs $5.65. A gallon of gasoline costs $6.

But one thing is far cheaper than in the U.S.: prescription drugs.

A vial of the cancer drug Rituxan cost Norway’s taxpayer-funded health system $1,527 in the third quarter of 2015, while the U.S. Medicare program paid $3,678. An injection of the asthma drug Xolair cost Norway $463, which was 46% less than Medicare paid for it.

Drug prices in the U.S. are shrouded in mystery, obscured by confidential rebates, multiple middlemen and the strict guarding of trade secrets. But for certain drugs—those paid for by Medicare Part B—prices are public. By stacking these against pricing in three foreign health systems, as discovered in nonpublic and public data, The Wall Street Journal was able to pinpoint international drug-cost differences and what lies behind them.

What it found, in the case of Norway, was that U.S. prices were higher for 93% of 40 top branded drugs available in both countries in the third quarter. Similar patterns appeared when U.S. prices were compared with those in England and Canada’s Ontario province. Throughout the developed world, branded prescription drugs are generally cheaper than in the U.S.

The upshot is Americans fund much of the global drug industry’s earnings, and its efforts to find new medicines. “The U.S. is responsible for the majority of profits for most large pharmaceutical companies,” said Richard Evans, a health-care analyst at SSR LLC and a former pricing official at drug maker Roche Holding AG.

The reasons the U.S. pays more are rooted in philosophical and practical differences in the way its health system provides benefits, in the drug industry’s political clout and in many Americans’ deep aversion to the notion of rationing.

The state-run health systems in Norway and many other developed countries drive hard bargains with drug companies: setting price caps, demanding proof of new drugs’ value in comparison to existing ones and sometimes refusing to cover medicines they doubt are worth the cost.

Kristin Svanqvist, left, heads reimbursement at Norway's state health system, which pays for most prescription drugs in the country, controlling prices in part by weighing cost-effectiveness. Helga Festoy, an economist at the state health system, says it is 'working quite well.'ENLARGE
Kristin Svanqvist, left, heads reimbursement at Norway’s state health system, which pays for most prescription drugs in the country, controlling prices in part by weighing cost-effectiveness. Helga Festoy, an economist at the state health system, says it is ‘working quite well.’ PHOTO: SVEINUNG BRATHEN FOR THE WALL STEET JOURNAL

The government systems also are the only large drug buyers in most of these countries, giving them substantial negotiating power. The U.S. market, by contrast, is highly fragmented, with bill payers ranging from employers to insurance companies to federal and state governments.

Medicare, the largest single U.S. payer for prescription drugs, is by law unable to negotiate pricing. For Medicare Part B, companies report the average price at which they sell medicines to doctors’ offices or to distributors that sell to doctors. By law, Medicare adds 6% to these prices before reimbursing the doctors. Beneficiaries are responsible for 20% of the cost.

The arrangement means Medicare is essentially forfeiting its buying power, leaving bargaining to doctors’ offices that have little negotiating heft, said Sean Sullivan, dean of the School of Pharmacy at the University of Washington.

Asked to comment on the higher prices Medicare pays compared with foreign countries, the Centers for Medicare & Medicaid Services said: “The payment rate for Medicare Part B drugs is specified in statute.”

In the U.S., few payers, public or private, cite cost as a reason to deny drug coverage, partly owing to a traditional emphasis in the U.S. on doctor and patient autonomy. “They don’t want to impinge on individual choices,” said Neeraj Sood, a health policy and economics expert at the University of Southern California.

Medicare Part B, for example, typically covers drugs and services deemed “reasonable and necessary.”


“If it’s a [Food and Drug Administration]-approved drug and prescribed by a duly licensed physician, Medicare will cover it,” saidGail Wilensky, who ran Medicare and Medicaid in the 1990s.

U.S. drug prices—showing regular increases, sometimes steep—are increasingly a focus of congressional probes and vocal criticism by insurers, doctors, politicians and consumers, who bear part of the cost.

Renee Andrews, an Oxford, Mich., resident whose son has juvenile arthritis and other conditions, said she can’t believe how low medication costs are for families overseas who post messages in her online support group. “Their out-of-pocket costs are considerably less than what we’re paying,” she said.

Research spending

The pharmaceutical industry says controls such as those seen in Europe discourage investment in research and deny patients access to some drugs. “The U.S. has a competitive biopharmaceutical marketplace that works to control costs while encouraging the development of new treatments and cures,” said Lori Reilly, an executive at the Pharmaceutical Research and Manufacturers of America, a trade association.

If U.S. pricing fell to European levels, the industry would almost certainly cut its R&D spending, said Mr. Evans, the health-care analyst. “Does the U.S. subsidize global research? Absolutely, yes,” he said.



Anti-AIDS drugs can prevent HIV infection if taken before, after sex


Taking just a few pills before and after sex can reduce the risk of HIV infection by 86%, a new study shows.

The pills contain two anti-AIDS medications. People in the study took two pills a few hours before a sexual encounter, a third the next day and a fourth the day after that, according to the study, published online Tuesday in The New England Journal of Medicine. A preliminary version of the study’s results was presented in February at the annual meeting of the Conference on Retroviruses and Opportunistic Infections.

Participants in the 400-person study took an average of 15 pills a month. Doctors followed them for an average of 9.3 months. Everyone in the study received counseling about reducing their HIV risk, along with free condoms and screening and treatment for sexually transmitted diseases, according to the report.

Doctors have known for several years that people can reduce their risk of HIV infection by taking a daily pill called Truvada. This prevention strategy, called pre-exposure prophylaxis, or PrEP, has been shown to reduce the risk of HIV transmission by 92% in studies of men who have sex with men. PrEP also reduced the risk of HIV infection by 70% in a study of intravenous drug users.

Until now, however, doctors didn’t know if taking PrEP “on demand” — geared around particular sexual encounters –worked as well as taking the pills everyday.

The new study adds to a growing list of HIV prevention strategies.

In the early years of the AIDS epidemic, public health officials focused on getting people to change their behavior: having sex only with a monogamous, HIV-negative partner; using condoms correctly and consistently; or abstaining from sex altogether.

In more recent years, medications have become a critical part of HIV prevention.

Research has shown that treating HIV can prevent its spread. People who control the disease with anti-AIDS medications can reduce the amount of virus in their blood to levels too low to be detectable with standard tests. These individuals have almost no risk of transmitting the virus to others, according to the Centers for Disease Control and Prevention.

Actor Charlie Sheen, who last month disclosed that he has HIV, said that his level of virus is undetectable, making it extremely unlikely that he would transmit the virus to his sexual partners. Sheen also said that his sexual partners have been under the care of his doctor. One former girlfriend, Amanda Bruce, has publicly said that she took medication to prevent becoming infected with HIV.

In Africa, studies have found that circumcision can reduce a man’s risk of becoming infected with HIV by 60%, according to the World Health Organization. Circumcision has been promoted as a relatively cost-effective strategy to combat HIV in developing countries, where a one-time surgery can be more accessible and affordable than daily medications.

In the USA, PrEP is a good option for people who don’t use condoms consistently, said Mark Milano, an HIV educator at ACRIA, a New York-based AIDS service organization.

Yet PrEP isn’t for everyone.

Although few people have serious side effects while taking PrEP, the pills can cause bone and kidney problems. In the new study, 18% of those taking on-demand PrEP developed kidney problems, compared to 10% of those given placebos, according to the study.

And unlike condoms — which help prevent pregnancy and a variety of sexually transmitted infections — PrEP doesn’t prevent diseases other than HIV. In the new report, 33% to 41% of participants developed a sexually transmitted infection during the study. PrEP doesn’t prevent pregnancy.

Milano notes that most people can’t predict when their next sexual encounter will be, making it difficult to take the first two PrEP pills in advance.

To take on-demand PrEP properly, “you have to know when you’re going to have sex,” said Milano, who cited studies showing that people aren’t very good at predicting the timing of their next sexual encounter. “Sex is often impulsive.”

Milano, who has HIV, said his partner of 13 years has chosen not to take PrEP, because both men are committed to using condoms consistently. Milano is now taking HIV medications that have made his virus levels undetectable, which further reduces his risk of transmitting the virus.

Doctors still have unanswered questions about on-demand PrEP.

The new study included only men who have sex with men or transgender women, who were born male but identify as female. Men in the study also had frequent sex.

The CDC notes that no one knows how well on-demand PrEP would work for women, injection drug users or gay or bisexual men who have sex less frequently than those in the study.

For these reasons, the CDC recommends taking PrEP daily, not on-demand.

In a study released last week, the CDC reported that very few of the 1.2 million Americans at high risk for HIV are taking any sort of PrEP regimen.

About 40,000 Americans are diagnosed with HIV every year — a rate that has fallen steadily for the past five years, according to the CDC.

In a study published in September, researchers reported on the use of PrEP in the “real world” — not just in tightly structured clinical trials — by describing the experiences of 657 people taking daily PrEP at Kaiser Permanente clinics.

Some doctors have been concerned that PrEP could give users a false sense of security, leading them to take more risks.

In the study, 74% of patients on daily PrEP said their number of sexual partners hadn’t changed. The number of sexual partners decreased in 15% of patients but increased in 11%, according to the study, published in Clinical Infectious Diseases. Condom use was unchanged in 56% of people in the study; decreased in 41%; and increased in 3%.

After six months on daily PrEP, 30% of users had been diagnosed with at least one sexually transmitted infection. There was no comparison group of patients in the study, so researchers don’t know how many people would have been diagnosed with a sexually transmitted infection without going on PrEP.



Blood Test Identifies Mutations Behind Drug Resistance in Patients Taking Anti androgen for Prostate Cancer

Scientists developed a blood test that can identify key mutations driving resistance to a widely used prostate cancer drug and which patients will not respond to the treatment in advance. This study may allow a blood test to inform prostate cancer treatment in the future so only patients whose tumors are free of resistance mutations will take abiraterone.

The study is also a proof of principle that testing for cancer DNA in the bloodstream can detect drug resistance mutations. This allows patients who will not benefit from one drug to receive an alternative treatment instead.

Researchers at The Institute of Cancer Research, London, the Royal Marsden NHS Foundation Trust, and the University of Trento, Italy, analyzed 274 blood samples from 97 patients using state-of-the-art DNA sequencing techniques. They found that mutations in the androgen receptor (AR) predicted resistance to the prostate cancer drug abiraterone, and that patients with these mutations had poorer survival.

The new study was published in Science Translational Medicine (doi:10.1126/scitranslmed.aac9511), and it was funded by Cancer Research UK, Prostate Cancer UK, the NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research (ICR), and the University of Trento.

Abiraterone, which was discovered at the ICR, is now standard treatment for men with advanced prostate cancer, but although it is highly effective in many patients, 30% to 60% do not respond.

Investigators have been searching for a marker that will help predict in advance which men will benefit from the drug, and who should be given a different treatment.

They discovered that men who harbor either a specific mutation or an increase in the number of copies of the AR gene were 7.8 times less likely to have a reduction of more than 90% in their prostate-specific antigen (PSA) levels.

In 13% of the tumors that progressed on abiraterone, 1 of 2 point mutations was acquired as the drug stopped working. These occurred in men who did not have either mutation before starting treatment, and the mutations appeared in the bloodstream several months before patients developed any symptoms.

Blood tests are particularly valuable in cancer patients because biopsies are often difficult to perform and can carry risks. Even when biopsies are possible, they only give a snapshot of cancer genetics in a small specific area, whereas blood tests can give information that is more representative of multiple different tumors around the body.

“We’re delighted to have developed a test that appears to predict very accurately whether a patient will respond to abiraterone, and that it can be performed on blood samples, removing the need to take a biopsy,” said Gerhardt Attard, MD, PhD, clinician scientist at The Institute of Cancer Research, London, and Consultant Medical Oncologist at The Royal Marsden NHS Foundation Trust in the United Kingdom.



Parkinson’s Drug Shows Promise Against Macular Degeneration

eye patch

By Randy Dotinga
HealthDay Reporter

THURSDAY, Nov. 12, 2015 (HealthDay News) — A common Parkinson’s disease medication might hold potential for preventing or treating macular degeneration, the leading cause of vision loss in the elderly, new research suggests.

At this stage, no one is recommending that patients take the drug, levodopa (L-dopa), to thwart eye disease. But the findings are intriguing, researchers said.

“Patients taking L-dopa for any reason are much less likely to develop age-related macular degeneration. If they do, they develop the disease much later in life than those not taking L-dopa,” said study lead author Brian McKay, an associate professor of ophthalmology and vision science at the University of Arizona.

However, the study doesn’t actually prove that levodopa causes a lower incidence of age-related macular degeneration. It only uncovered an association between the two.

Age-related macular degeneration affects about 30 percent of those older than 75, McKay said. It is caused by deterioration of the macula, the center part of the retina, and by affecting vision, it can severely limit the ability to perform everyday activities. Treatments can slow its progression but there is no cure, and it can lead to blindness.

“This disease robs people of close vision,” McKay said. A preventive treatment “will allow many to see their families and grandchildren as they age, and allow the aging population to keep their independence and drive, read, cook and watch TV,” he said.

In the body, levodopa turns into dopamine, a naturally occurring chemical that appears linked to normal function of the retina, McKay said. In Parkinson’s, insufficient dopamine contributes to movement problems.

For the study, researchers analyzed medical records of 37,000 patients from a Wisconsin clinic. The researchers looked for signs whether or not those who took levodopa had lower rates of age-related macular degeneration. They also examined a medical database of 87 million people.

The researchers found that diagnosis of age-related macular degeneration occurred, in general, around age 71. But among those who took levodopa, it occurred much later, at around age 79.

According to McKay, the drug may affect development of age-related macular degeneration by protecting parts of the eye known as photoreceptors. These neurons help the body sense light.

Levodopa, however, might not be the major player here. It’s possible, McKay said, that Parkinson’s disease itself could reduce the risk of age-related macular degeneration. Or there could be another scenario.

McKay mentioned that having red hair is linked to higher risks of both Parkinson’s disease and age-related macular degeneration. This suggests a connection. “I am not sure the diseases are completely independent,” he said.

In Parkinson’s patients, levodopa causes side effects such as nausea and low blood pressure, but McKay said side effects in people without Parkinson’s are unknown. He said the drug is sold over the counter and taken by body builders, among others.

Levodopa is inexpensive, and that may be a big problem, said Dr. Paul Bernstein, a professor of ophthalmology and visual sciences at the University of Utah School of Medicine. He wasn’t involved with the study.

Since it’s cheap, “many drug companies won’t be interested in repurposing it,” he said, noting that could spell trouble for research.

Bernstein also cautioned that this study doesn’t confirm that levodopa will help people with age-related macular degeneration or those at risk for developing it.

“This is a first step,” Bernstein said. “It may point to doing future studies. But I wouldn’t recommend that my patients take L-dopa now. It could be dangerous.”

If future research proves it is effective against macular degeneration, the drug potentially could be used to treat or prevent the condition, although it’s unlikely to reverse existing eye damage, McKay said.

Clinical trials are the next step, he added, but they will take a few years. No clinical trial is currently in progress, but researchers are looking for funding to start one.

What causes macular degeneration is unknown, although genetics, being overweight and smoking are thought to play a role, according to the American Macular Degeneration Foundation. Whites are more vulnerable than blacks and Hispanics to the condition.

The study was published Nov. 9 in the American Journal of Medicine.



Medication errors, adverse drug reactions occur in half of surgeries

Medication errors or adverse drug events occur in 1 in 2 surgeries.
Medication errors or adverse drug events occur in 1 in 2 surgeries.

A medication error and/or adverse drug reaction occurs in approximately 1 in 2 surgeries and in 1 in 20 observed drug administrations, according to findings published in Anesthesiology.

The study, which is the first to investigate the incidence of medication errors and adverse drug events during the perioperative period, found that more than one-third of medication errors resulted in adverse drug events or harm to patients.

To conduct this observational study, 4 anesthesia-trained researchers observed 225 anesthesia providers during 227 randomly selected operations at Massachusetts General Hospital (MGH). The researchers observed the providers from the time they took responsibility for a patient in the preoperative area until the patient arrived in the recovery room or intensive care unit. The investigators also reviewed chart data to identify additional events and to confirm events that they saw were indeed errors.

“Given that MGH is a national leader in patient safety and had already implemented approaches to improve safety in the operating room, perioperative medication error rates are probably at least as high at many other hospitals,” said Karen C. Nanji, MD, MPH, of the MGH Department of Anesthesia, Critical Care, & Pain Medicine.

The researchers identified at least one medication error or adverse drug event in 124 of 277 observed operations. During the 277 operations, there were 3,671 medication administrations, 193 (5.3%) of which involved a medication error and/or an adverse drug reaction. Of these 193 events, 153 (79.3%) included a medical error and 91 (47.2%) included adverse drug reactions. A total of 153 (79.3%) of these errors were deemed preventable.

While 32 (20.9%) had little potential for harm, 51 (33.3%) of the errors led to an adverse drug event, and another 70 (45.8%) of the errors had the potential for harm. The researchers also measured the severity of the errors: 99 (64.7%) were serious, 51 (33.35) were significant, and 3 (2.0%) were life-threatening.

“Prior to our study, the literature on perioperative medication error rates was sparse and consisted largely of self-reported data, which we know under-represents true error rates,” said Dr. Nanji. “Now that we have a better idea of the actual rate and causes of the most common errors, we can focus in developing solutions to address the problems.”



How to use the medicines database

Assorted medical pills and tablets in shape of drug capsule

The NetDoctor team of pharmacists have compiled the medicines database exclusively for In the database you will find factsheets on most medicines that are available in the UK. The factsheets contain important information about each product, such as its uses and possible side effects, all described in a clear, precise and easy to understand way.


More than 2800 products are listed in the database, including both branded and generic and prescription and over-the-counter medicines. These are regularly reviewed and updated, and new products are being added continuously, to ensure the information we provide remains accurate and up to date.

How do I find a medicine factsheet?

You can search for a medicine either by its brand name, or by its generic name (the name of the active ingredient in the medicine). The search will find factsheets for all medicines with that name or containing that active ingredient, as well as other articles that mention that medicine, for example articles about the condition the medicine is used to treat, ask the expert questions or news features.

You can also search for a medicine using the condition it is used to treat, for example searching for ‘treatments for acne’ will find you a page that lists all the different types of medicines that are used to treat acne.

What references are used to produce the factsheets?

Our pharmacists strive to produce evidence-based, trustworthy and easy to understand information about medicines. The medicine factsheets are written and reviewed using the latest pharmaceutical, pharmacological and medical scientific literature. A wide range of reputable reference sources are used to produce the information, including the following (in all cases the most up to date edition at the time of writing or reviewing the factsheet is used):

  • Summaries of Product Characteristics (SPCs) from the pharmaceutical companies that make the medicine.
  • Patient Information Leaflets from the pharmaceutical companies that make the medicine.
  • British National Formulary (BNF).
  • British National Formulary for children (BNFc).
  • Stockley’s Drug Interactions.
  • Drug Safety Updates from the Medicines and Healthcare Regulatory Authority (MHRA).
  • Drugs in Pregnancy and Lactation – Briggs, Freeman and Yaffe.
  • Drugs and Lactation Database (LactMed).
  • UK Drugs in Lactation Advisory Service.
  • NICE guidance.
  • Clinical Knowledge Summaries.
  • Martindale – The Complete Drug Reference.
  • Therapeutic Drugs – Dollery.

How is the medicine database kept up to date?

Our pharmacists keep abreast of developments in the world of medicine and identify any factsheets that require an update on a daily basis. Medicine factsheets are reviewed and amended immediately if necessary. This ensures our information remains accurate and up-to-date.

The medicine factsheets are also systematically reviewed for clinical accuracy on a continuous basis. The date of last review is displayed on each factsheet.

Factsheets on newly launched medicines are also added on a weekly basis.

For an explanation of what information is included under each heading in the medicines factsheets please.

It is important to remember that the database has been compiled for information purposes only and is intended to complement and not replace the advice you receive from your doctor or pharmacist.





screen322x572screen322x572 (1)Healthcare providers and consumers need HIV-related drug information and, increasingly, they depend on mobile devices to access that information. AIDSinfois meeting both needs with the release of the AIDSinfo Drug App. Using data from the AIDSinfo Drug Database, the drug app provides information on more than 100 HIV-related Food and Drug Administration (FDA)-approved and investigational drugs. The AIDSinfo Drug App—provided free from the National Library of Medicine at the National Institutes of Health—is available for iOS and Android devices.

The information on the AIDSinfo Drug App, offered in English and Spanish, is tailored to meet the needs of both healthcare providers and consumers. The app works offline, ensuring that healthcare providers and consumers can access vital drug information anywhere—even in healthcare facilities that may not have an Internet connection.

The AIDSinfo Drug App pulls FDA labels from Daily Med for approved HIV-related drugs. The app also integrates information on drug nomenclature and chemical structure fromChemIDplus. Information from the labels is condensed in easy-to-understand summaries in English and Spanish for consumers.

Users can also access information on HIV-related drugs under investigation via the AIDSinfoDrug App. The investigational drug summaries, which are developed from the latest clinical trial results, are tailored by audience: technical, more detailed summaries for healthcare providers and less complex summaries in English and Spanish for consumers.

Users can also personalize the AIDSinfo Drug App. According to their needs, users can set pill reminders, bookmark drugs, or add personal notes:

  • Set pill reminders: Medication adherence is crucial to successful HIV treatment, and the app’s medication reminder can help those taking HIV medicines stay on schedule. Choosing from a menu of alarms, app users can set pill reminders for any time of the day and any day of the week.
  • Bookmark drugs: Busy users can bookmark frequently referenced drugs. No more searching for the same drugs again and again.
  • Add notes: App users can also customize drugs with personal notes. For example, patients can add notes during medical visits; healthcare providers can add relevant information useful at the point of care.

Stay tuned as AIDSinfo updates the app with additional features.