Medications account for the majority of health care costs. Generic utilization can save patients millions, and formulary management can drive dramatic savings.
Ensuring access to essential medication – a set of medicines that satisfy the priority healthcare needs of a population – is critical for global health and development. But it is a challenge.
Abiraterone
The results of the LATITUDE and STAMPEDE trials suggest that adding abiraterone to hormone therapy can improve overall survival for patients with advanced disease. The benefits were similar for patients with or without metastases at diagnosis. In addition, abiraterone significantly extended radiographic progression-free survival and reduced the time to the first serious adverse event (SRE) in mCRPC patients with bone metastases.
However, these benefits have not been observed in men with nonmetastatic mCRPC, and the addition of abiraterone to standard treatment can result in severe side effects. For example, abiraterone can cause fluid retention and edema, and it can increase the chance of a heart attack or stroke. These risks may be higher if patients take other medications that interact with abiraterone, including some over-the-counter and herbal products.
Adding abiraterone to standard hormone therapy could halve the number of deaths from advanced prostate cancer, according to research by researchers at UCL Cancer Institute. The study, published in the Lancet, is based on data from two large trials funded by Cancer Research UK and the Medical Research Council (MRC). Both the LATITUDE and STAMPEDE studies included more than 52,000 men with advanced prostate cancer that had spread to other parts of the body. Some of these patients were at high risk because their disease had not yet responded to hormone therapy and had a Gleason score of 8 or higher.
Lapatinib
Lapatinib is a medication used to treat breast cancer by slowing the growth of tumor cells. It is a type of tyrosine kinase inhibitor and is also known by the brand name Tykerb. It works by blocking a protein called HER2. This helps prevent the tumor cells from growing and spreading.
Your doctor will monitor your heart function regularly while you are taking this medication. This includes tests to check your blood pressure, and a monitoring device called an electrocardiograph or ECG (also called an EKG).
If you have any medical conditions, tell your doctor before taking Tykerb. This includes liver disease, a history of heart failure, an imbalance of electrolytes (low potassium or magnesium), and a personal or family history of long QT syndrome. You should also avoid alcohol and certain foods while taking this medication.
This medication is not safe to use during pregnancy. It can harm an unborn baby or cause birth defects. Both men and women should use effective birth control while taking this medicine, and for at least 1 week after the final dose. Tell your doctor right away if you become pregnant during treatment. Also, tell your doctor if you are breastfeeding. This drug can pass into breast milk and may harm a nursing baby.
Etoposide
Etoposide is an antineoplastic drug that targets DNA topoisomerase II. This enzyme controls the structural integrity of DNA by introducing temporary breaks into the DNA molecule, and is involved in several fundamental biological processes including transcription, cell division and DNA repair. Etoposide inhibits the activity of this enzyme, resulting in DNA degradation and cell death. It is usually given in combination with other chemotherapeutic agents, and has shown promising results in the treatment of certain cancers and leukaemia.
Swiss pharmacologist Hartmann F. Stahelin was credited with the discovery of etoposide in the late 1950s, working for Sandoz at the time. The compound was developed by his team to produce the leukaemia drug teniposide and its salt, etoposide phosphate, which began clinical trials in 1971.
It is a highly effective chemotherapy agent, and its antineoplastic effects are due to the inhibition of DNA topoisomerase II activities, causing double-strand breaks in the DNA molecule and leading to apoptosis in cancer cells.
Manufacturer of etoposide can weaken your immune system, so you should take care to avoid infection while receiving it. It is important to wash your hands regularly, especially after using the toilet and before eating or drinking, and to avoid crowds or people who are sick. You should also tell your doctor or nurse if you develop a fever, chills or sore throat.
Methadone
Methadone is an important medication in the treatment of opioid use disorder (OUD). This is because it works to reduce withdrawal symptoms and cravings. Moreover, it is an effective pain reliever.
It is safe to take methadone during pregnancy. However, it is important to tell your doctor if you have certain medical conditions. For example, you should not take methadone if you have a rare condition called long QT interval. This condition can cause a slow heartbeat and fainting. You should also avoid taking other medications that interact with methadone, such as St. John’s wort and tryptophan.
When taken as directed, methadone is safe and effective. But, if you are experiencing serious side effects, such as breathing problems or a coma, call your doctor or emergency services right away. It is also important to report any side effects you experience to the FDA’s MEDWatch program.
While methadone does not cure OUD, it can help people stop using heroin and other narcotics. It is an integral part of a comprehensive addiction treatment strategy, combining counseling and other therapies. Moreover, it can help people suffering from chronic pain by interrupting the pain-reward cycle. It can also act as a deterrent against the use of codeine and heroin by obstructing their pleasurable effects. It is an ideal option for individuals with painful nerve diseases, such as neuropathic pain.
Buprenorphine
Buprenorphine is a life-saving medication that treats pain and opioid addiction. It is available as a skin patch that lasts seven days or as pills absorbed under the tongue (sublingual). Buprenorphine is a partial agonist at the mu-opioid receptor and an antagonist at the kappa-opioid receptor. Its tight binding and slow dissociation kinetics result in a ceiling effect, which limits physical dependence and cravings. It also inhibits the reinforcing effects of exogenous opioids.
It is important to know that buprenorphine has potentially serious side effects, including hypotension, hepatotoxicity, and sedation.
In addition, buprenorphine can interact with medications that interfere with the metabolism of the drug. For instance, CYP3A4 inhibitors, such as carbamazepine, phenytoin, indinavir, rifampin, and saquinavir can reduce the effectiveness of buprenorphine by increasing its clearance. This can lead to reduced blood levels and decreased therapeutic efficacy.
Fortunately, the Medication Access and Training Expansion (MAT) Act will help remove these barriers by allowing all healthcare professionals with a standard controlled substance license to prescribe buprenorphine for OUD. This will increase access to MAT and allow providers to deliver the treatment in an office setting rather than requiring patients to go to a specialized methadone clinic.
