Biogen’s belly flop

What happens when you have a drug with little proof it works, a crazy-high price tag, and your only marketing angle is “Well, it’s FDA-approved”?

You have Biogen’s Aduhelm —”potentially the worst drug launch of all time.”

Aduhelm (aducanumab) made just $300,000 in the three-month period from July to September, against analysts’ estimates of $12 million, suggesting that few patients are being treated with the $56,000 a year therapy.

(Amusingly, the company’s CEO blamed the “lack of clarity on reimbursement.”)

File under “That’s nice”

Pfizer and BioNTech says their Covid booster gives 95.6% efficacy against the virus, including Delta. The outstanding question about any booster, though, is “How long will it last?”

Speaking of giving vaccinations…

Pharmacists! Pharmacy techs! With booster shots coming, you need to be the best immunizer ever — just like you swore to be when you were a little kid.

Good news: GPhA is offering the hot courses you need in early December, giving you plenty of time to plan.

For technicians there’s GPhA’s Immunization Delivery Training for Pharmacy Technicians — a 6.0 hour CE program consisting of both home-study and live training. It’s on Saturday, December 4, from 9:00 am to noon at the GPhA World Headquarters classroom in Sandy Springs. (Of course it’s PTCB-recognized!) Click here for the details and to register now.

For pharmacists, we’ve got APhA’s Pharmacy-Based Immunization Delivery: A Certificate Program for Pharmacists on Sunday December 5, 8:00am to 5:00pm. It’s part of the 20-hour certificate program (including self-study). That’s also in the GPhA classroom. Get the details and register today.

Remember: Because these are in-person programs, space is limited!

Prozac vs blindness

This is unexpected. UVA researchers found that fluoxetine, aka Prozac, seems to protect older people from age-related macular degeneration. Examining insurance databases teased out the connection between fluoxetine and AMD, then lab research uncovered what they think is the mechanism. It seems that fluoxetine binds to a particular protein that would normally activate an inflammatory response, keeping that at bay.

You know the drill, of course: More research is needed.

Still not sure why they’re doing this

A new letter in the New England Journal of Medicine looks at the rising number of poisoning cases from people taking ivermectin because they somehow think it will prevent or treat Covid-19. Spoiler: It won’t. The only evidence in the parasite treatment’s favor came from an Egyptian study that was withdrawn after it was shown to have falsified data.

It appeared that the authors had run entire paragraphs from press releases and websites about ivermectin and Covid-19 through a thesaurus to change key words.

One issue, beyond the dosage size, is that ivermectin has a lot of interactions with other medications. Between that, overdosing (at once or over time), or just not having a good reaction, the researchers found people were admitted to the hospital for a number of the drug’s side effects. In one sample:

Symptoms were gastrointestinal distress in 4 persons, confusion in 3, ataxia and weakness in 2, hypotension in 2, and seizures in 1. Of the persons who were not admitted to a hospital, most had gastrointestinal distress, dizziness, confusion, vision symptoms, or rash.

Good news: None of them died.

DEA forms: three out, one in

Just a reminder that, after October 30, the single-sheet DEA 222 form is in, and the triplicate order form is out (if you’re ordering or transferring C-I or C-II drugs). Order your new forms here.

The Long Read: NfL and brain injury edition

When someone has a head injury, it’s tough to tell whether, when, and how much they’ll recover. They could be perfectly fine, severely impaired, or with just enough brain damage to, say, voluntarily read the YouTube comments section.

But now neurologists have a clue: a blood protein called NfL (neurofilament light) that is essentially spit out by neurons after injury. In a nutshell: “Increased levels of NfL are a sign that something is amiss in the nervous system.”

We’re a long way from detecting small amounts of NfL via point-of-care devices like glucose monitors, but he expects an increasing number of hospitals to add neural proteins to routine panels in head injuries.