It looks like a good time to be a student pharmacist

Chain pharmacies are having a bit of trouble finding enough pharmacists, which is especially a problem as they look to expand the kinds of health services they offer.

You could blame burnout, but that’s actually only one part of the problem. The bigger issue is the pipeline, and how it’s not looking good for future hiring.

There’s been a steady drop in applications to pharmacy schools, falling 64% from nearly 100,000 in 2012 to about 36,000 in 2022, according to the American Association of Colleges of Pharmacy.

To help fill that pipeline, chains are looking at restoring pharmacy’s reputation as an attractive career, and one that commands a lot of community respect. And yes, they’re clear on the workload issue. They’re actually hoping to solve two problems at once: “Expanding the services that pharmacists provide, while cutting down other workloads” to attract students. (One tack is working with pharmacy schools to change how students are trained — they’re looking at more “comprehensive education around the business of health care.”)

AI and antidepressants

Antidepressants can be hit-or-miss, and it can take a month or two to determine if a particular one will work for a patient. Unless, of course, you ask an AI to look into it.

Our soon-to-be machine overlords are better at parsing patient data, and Dutch researchers found theirs takes only about a week to tell whether a drug is working. (Well, at least sertraline — that’s all they’ve tested it on so far.)

It uses a combination of brain scans and patients’ reported symptoms. After a week on the drug, the AI takes into account basic patient data and the blood flow to the anterior cingulate cortex to determine how well the sertraline is working. The severity of symptoms — or lack thereof — confirms it, meaning less time taking a drug that doesn’t help.

“With this method, we can already prevent 2/3 of the number of ‘erroneous’ prescriptions of sertraline and thus offer better quality of care for the patient.”

New antibiotic targets UTIs

A new antibiotic for urinary tract infections — GSK’s gepotidacin — did so well in its phase-3 trials that they stopped the trials. Gepotidacin was better than nitrofurantoin, and especially “in patients with uUTIs caused by Escherichia coli, including drug-resistant phenotypes of clinical importance.)

Science, if you’re interested: “[G]epotidacin is a first-in-class triazaacenaphthylene antibiotic that inhibits bacterial DNA replication by a novel mechanism of action.”

The right diabetes-drug message

When it’s time for someone with diabetes to move beyond metformin, what patients want may not be the same as what prescribers think they want.

A University of Maryland study found that doctors tend to think “This medication will lower your glucose and A1C.” Meanwhile, what patients need to hear is “This medication will keep you from dying or going blind.”

In other words, it might be a good idea to tweak the message to include the broader implications — “that it is not just glycemic control that is important but glycemic control in the context of a healthy lifestyle and good overall health.”

Fun fact: Topping patient concerns was preventing blindness (63% called it “very important”), while preventing death was in second place (60%). Take from that what you will.

A drug from the leftovers

Not only does a cancer drug fight cancer (as you would expect), but it seems that when you combine it with its byproduct, you get an even better cancer drug.

The original drug: Rucaparib (for recurrent ovarian, breast and, prostate cancers)

The metabolite by-product: M324

Combining the two: That “increased cancer cell inhibition more than using either compound singly. The biggest difference was seen in the prostate cancer cell line, with a difference in inhibition exceeding 30%.”

But wait, there’s more!

What about M324 on its own? Why that turns out to be a potential treatment for Parkinson’s.

They found that the metabolite effectively reduced the accumulation of ⍺-synuclein, a protein that, when misfolded into aggregates, causes neuroinflammation, neurodegeneration and cell death. It’s been linked genetically and neuropathologically to Parkinson’s disease.

Facebook’s algorithm is hitting pharma ads

Facebook parent Meta is, at least for the moment, cracking down on ads that violate its policy against … geez, who knows? The ones that go against its “so­cial, elec­tion, or po­lit­i­cal ad poli­cies” — that is, whatever the AI thinks make the platforms less “safe.”

The point is that more pharma companies are seeing their ads flagged by the Meta algorithm and removed, even when they’re benign or even positive.

Those in­clud­ed a Gilead ad about ed­u­ca­tion eq­ui­ty in lo­cal com­mu­ni­ties, one from Sanofi with an AI avatar, and sev­er­al from Vi­iV Health­care fea­tur­ing R&D chief Kim­ber­ly Smith dis­cussing top­ics like HIV sta­tus and health in­equities.

It seems that Meta doesn’t want ads that “ad­dressed so­cial is­sues like eq­ui­ty, LGBTQ+ com­mu­ni­ty sup­port, or en­vi­ron­men­tal con­cerns” because that would, in some world, make Facebook and Instagram less safe.

That Gilead ad? It was about the company’s Cre­at­ing Pos­si­ble Fund, “which pro­motes ed­u­ca­tion eq­ui­ty for dis­ad­van­taged stu­dents in lo­cal com­mu­ni­ties.” It was allowed back up once the word “Spon­sored” was replaced by “Paid for by Gilead Sci­ences Inc.,” which is apparently … safer?

Covid deaths are higher than we thought

Officially, Covid-19 has killed about 1.2 million Americans since the pandemic began. But that, Boston University public health researchers say, is almost certainly a big undercount.

Their logic is simple and backed by data: They looked at deaths from natural causes reported during the pandemic (to eliminate accidents, homicide, and suicide) and compared those numbers to previous years.

What they calculated is that Covid deaths may have been undercounted by almost 14%. That is, 14% of excess deaths during the pandemic didn’t have Covid-19 listed as the cause, and it was more prevalent in areas where “political biases or stigma around Covid may have affected whether Covid-19 was listed on a death certificate.”

But could these excess deaths have been causes by delayed care thanks to overcrowded hospitals? Or maybe — as some conspiracy theorists claim — from the vaccine (or Bill Gates’s microchips)? Nope. The excess deaths tracked with Covid deaths, i.e., if it was a vaccine reaction or another cause, they wouldn’t have aligned with Covid peaks and valleys.