How great are co-pay coupons?

Not great at all, actually. It turns out that while they can cut costs for patients at the counter, they totally clobber the companies (i.e., insurers) paying the bills — and that, of course, just rolls downhill to employers and patients.

That’s what health economists at the National Bureau of Economic Research found when they crunched data on drug pricing from a large, unnamed PBM. In fact,

The researchers estimated the health care system could save $1 billion annually if copay cards were banned — and that’s just for multiple sclerosis drugs. (Emphasis ours.)

And the payback would be substantial. Yes, banning coupons would raise co-pays, “but we estimate the savings for insurers would be nearly 4 times as large.” The trick would be to make insurers return some of those savings to patients, which, they say, could be solved with legislation.

Don’t overreact to that paper cut

Small cuts, even if they bleed, don’t need an antibiotic ointment, says the American Academy of Dermatology.

If it ain’t full of pus, crusty, purple, or hot, just wash it out, put some Vaseline on it (preferably from a tube, not a jar), and cover it with a bandage or Band-Aid. Using antibiotics won’t help, it says, and is more likely to cause irritation and contact dermatitis.

FDA warning backfires

In 2003, the FDA began warning that antidepressants could cause suicidal thoughts in young people. In fact, it even made that a serious ‘black box’ warning.

Small problem: There was no evidence that antidepressants caused suicide. (In fact, the FDA used the ambiguous word suicidality — meaning “suicidal thinking or behavior,” but not actually, er, following through.)

Antidepressant prescriptions for kids dropped.

Big problem: 17 years later, the data show that suicides among young people are up.

We found that during the pre-warning period, there was a 13-year stable downward trend in youth suicides, following availability of new and safer antidepressants.

That trend reversed, we found, soon after the FDA began antidepressant warnings in late 2003. Youth suicide deaths increased significantly.

Crystal ball reading

Not content to wait till December, the Cleveland Clinic has already released its “Top 10 Medical Innovations for 2022”. Click that link for the details, but (spoiler!) here’s the list:

1. Next Generation of mRNA Vaccinology
2. PSMA-Targeted Therapy in Prostate Cancer
3. New Treatment for the Reduction of LDL
4. Novel Drug for Treatment of Type 2 Diabetes
5. Breakthrough Treatment for Postpartum Depression
6. Targeted Medication for Hypertrophic Cardiomyopathy
7. Non-Hormonal Alternatives for Menopause
8. Implantable for Severe Paralysis
9. AI for Early Detection of Sepsis
10. Predictive Analytics and Hypertension

An interesting story about sulfur drugs that I can’t come up with a snappy headline for

Making new sulfur drugs would be a good thing, but there’s usually a roadblock on the path to discovery: chirality. The same molecule’s left- or right-handed version could have very different effects, and ‘generating’ molecules can be an inexact science.

Chemists in Singapore have apparently found a way to fix that — a way to create compounds and control that chirality. And that means a smoother path to creating new molecules for sulfur-based drugs.

The process of drug discovery […] involves testing drug candidates with different pharmacophores until a certain combination proves to be effective in modulating a biological pathway. We essentially developed a method that could allow us to make many different types of sulfur-based pharmacophores that are compatible with different drug compounds.

Corn vs. cancer

Japanese researchers got a happy surprise when studying nanoparticles derived from corn*: They can fight cancer.

Nanoparticles vs. cancer isn’t new — they can carry drugs directly to tumors. One of the most efficient ways to produce them is via plants. Tokyo University of Science scientists were checking out corn as a source because it’s, well, everywhere.

When testing to see how cells were affected by these corn-based nanoparticles (cNPs) they got a shock: Not only did these cNPs go straight for the tumors (“indicating their selectivity for carcinogenic cell lines”), they also got other cells to release cancer-killing tumor necrosis factor alpha (TNF-α) molecules.

The result was astounding enough to get a Japanese scientist to use an exclamation point:

“These cNPs exhibit excellent anti-tumor properties, are easy to develop, and are economically viable. Moreover, they do not exhibit any serious adverse effects, at least in mice so far!”

* Maize outside North America.

Lidocaine without the lidocaine

For someone having a heart attack, lidocaine can be a life saver, holding off ischemia and ventricular fibrillation. Downside: The side effects can be so bad that lidocaine is only administered in a hospital via IV.

But British scientists at Kings College London have found what they think is an alternative: A drug with the not-at-all-confusing name “OCT2013” that has a neat trick: It converts to lidocaine when oxygen is limited, i.e., when it reaches the part of the heart undergoing ischemia. The kicker: “OCT2013 itself is inactive so it has no effects elsewhere, and therefore no side effects.”

The latest psilocybin news

Treatment with psilocybin — when combined with psychotherapy — may last at least a year … at least for some patients.

“[L]arge decreases in depression, and that depression severity remained low one, three, six, and 12 months after treatment,” reported Johns Hopkins researchers after experimenting on 27 patients.

In fact, it might last longer — they just didn’t test for that. But, they caution, that doesn’t mean people should go out popping magic mushrooms.

“[T]he results we see are in a research setting and require quite a lot of preparation and structured support from trained clinicians and therapists, and people should not attempt to try it on their own.”

Speaking of which…

“Burnt-out doctors are being recruited to try ‘magic’ mushrooms for pandemic-related depression and anxiety” to “disrupt the cycle of negative thoughts built up over 2 years of pandemic.”