This report out from CNN
http://www.cnn.com/2017/10/12/health/nuedexta-nursing-homes-invs/index.html
It’s a long story but sadly a repetitive one. It has all the elements of a modern pharmaceutical success story (if you are a investor).
- Find some old generic drugs lying on the shelf not being used too much anymore
- Combine 2 of them into a “New” drug
- Find a rare “disease” to treat
- Fund a small study showing it sort of works, possibly, maybe.
- Hire a bunch of good looking sales reps to court doctors into pushing the drug
- Have the doctors overdiagnose the aforementioned rare disease
- Hire the doctors and pharmacists to give talks about how you can prescribe this “new” medicine for all kinds of “off label” problems too
- Sell your small company to a mega company for billions
- Quit before the FDA and News media catch on to your scam
This particular version involved an old, almost never used, cardiac drug called quinidine and a cough suppressant called dextromethorphan. Quinidine was a crappy heart drug that we used years ago when we didn’t have anything better. It was supposed to stop heart arrhythmias but often made things worse and had a lot of interactions with other drugs. Dextromethorphan is the right handed molecules of an opioid type molecule that really doesn’t work that great for coughing anyway but does have a nice sedative effect. That’s probably why Nuedexta “works.” It’s probably just a sedative!
The rare disease they decided to push is REALLY rare. I’ve NEVER seen a case and I’ve been doing this for 25 years! Pseudobulbar affect even sounds fishy! Maybe a “pseudo” disease? The company states there are 1.8 million patients. I find that hard to fathom. OK maybe there are a few real cases but not enough to warrant medicare spending tons of cash ($9,198/yr) on a barely palpable effect other than sedation.
Moral of the story is if your friend/relative is in a nursing home and you want to be their advocate, get a real doctor that you trust to look over the med list and get out the pharmacologic pruners. Just because a wandering, company funded psychiatrist is trolling the halls with a prescription pad and a kickback scheme doesn’t mean you have to take it.
