Drugs and Supplements

The very high cost of very low cholesterol

Gregory Curfman, MD
Gregory Curfman, MD, Editor in Chief, Harvard Health Publications

The FDA recently approved two new drugs that quickly and effectively lower LDL cholesterol levels. This exciting development is tempered by the very high cost of these drugs. These costs can even trickle down to others on the same insurance plan as people taking these new drugs. Several politicians and institutions have spoken out against these high costs, but it is unlikely that the prices will be lowered anytime soon. For now, these drugs should be reserved only for those whose other efforts to reduce LDL have been unsuccessful.

The placebo effect: Amazing and real

Robert Shmerling, M.D.
Robert Shmerling, M.D., Faculty Editor, Harvard Health Publications

Many people believe that the placebo effect is solely a psychological phenomenon. But for some people, a placebo can have real, measurable therapeutic benefits. The power of the placebo effect is significant enough that it can actually skew study results. Additional research is needed to better understand how to leverage the placebo effect and when doing so might offer real benefits to patients.

The problem with prescription painkillers

Wynne Armand, MD
Wynne Armand, MD, Contributing Editor

Opioids are effective pain relievers. But sometimes people can develop a tolerance to these drugs, requiring increasingly higher doses of medication to achieve the same pain relief. And physical dependence — withdrawal symptoms when the drug is stopped — is also common. The increased availability of these drugs has put many people at risk for addiction, overdose, and even death.

Why many generic drugs are becoming so expensive

Ameet Sarpatwari, JD, PhD
Ameet Sarpatwari, JD, PhD, Contributing Editor

Generic drugs used to be a reliable lower-cost alternative to many brand-name drugs. But thanks to a combination of market forces, the cost of many generics is rising quickly — and steeply. This trend will increase the burden of health care costs for insurers, governments, and individuals. Find out why this is happening, as well as what you can do to help sidestep these costs and advocate for policies that can stem this tide.

Harmful effects of supplements can send you to the emergency department

Susan Farrell, MD
Susan Farrell, MD, Contributing Editor

Many people take vitamins, supplements, and complementary nutritional products in an attempt to optimize health or help prevent disease. Like prescription drugs, these products can have adverse effects, some of which prompt people to seek emergency care. It is important to be a wise consumer if you choose to use these products. An important part of that is making sure your doctors knows exactly what vitamins, supplements, and nutritional products you take.

How well does calcium intake really protect your bones?

Beverly Merz
Beverly Merz, Executive Editor, Harvard Women's Health Watch

How much calcium do you really need for strong, healthy bones? The answer isn’t as clear as we once thought. Recent analyses suggest that neither dietary calcium nor calcium supplements reduce the risk of fractures. In the absence of a clear deficiency, it’s impossible to know how exactly much calcium a person needs. Ideally, you should get most of your calcium through food. Be sure you’re getting adequate vitamin D as well.

Turning to drugs and treatments before they are “ready for prime time”

Amy Ship, MD
Amy Ship, MD, Contributing Editor

Having a terminal illness or debilitating disease is devastating. Imagine, then, being in that situation and exhausting the available treatment options — or having limited options to begin with. It’s understandable that people in these circumstances might welcome the opportunity to try experimental drugs or treatments. But it is not always easy or expedient to gain access to such therapies. So called “right-to-try” laws are supposed to help doctors and patients access these treatments. However, it isn’t clear that right-to-try laws will actually help, and they can create additional dilemmas in what are already complicated situations.

What “off-label” use of a drug really is, and why you need to know about it

Gregory Curfman, MD
Gregory Curfman, MD, Editor in Chief, Harvard Health Publications

You might be surprised to learn that, on average, one in five prescriptions are written for an “off-label” use of a drug. That means the doctor believes that the recommended drug will help a patient, even though that drug has not been FDA-approved for that patient’s particular condition or symptoms. This practice is legal and common. Historically, the FDA has restricted the ability of pharmaceutical companies to advertise drugs for off-label uses. However, two recent court cases have opened the door to proactive promotion of drugs for off-label uses. Physicians and consumers need to be aware of this shift when it comes to using drugs safely for off-label purposes.

Direct-to-consumer drug advertising — beyond what you see on TV

Nancy Ferrari
Nancy Ferrari, Senior editor, Harvard Health

Consumers are barraged by ads for prescription drugs on television and in print. Twenty years ago, people who knew the names of the drugs available for their health conditions, and knew to ask for new drugs by name, were few and far between. But today, direct-to-consumer ads encourage patients to ask their doctors for new (and often pricey) medications. While it isn’t bad to inform people about new and potentially better medications, this tidal wave of advertising has a downside. Potential side effects and risks are not always completely and plainly explained and the cost of these drugs is often not made clear. While it is fine to ask your doctor about a drug you’ve seen on TV or elsewhere, be aware that a new medicine is not necessarily a better medicine — or the right one for you.

It’s NOT a “pink Viagra”

Hope Ricciotti, MD
Hope Ricciotti, MD, Editor in Chief, Harvard Women's Health Watch

Women of all ages have questions and concerns about their sex lives. These issues often come up after having a baby, during perimenopause, and well into later life, too. Women’s sexuality is very complex. Brain chemistry, mood, hormones, and the nature of a woman’s relationship with her sexual partner are all important influences. This week, the FDA approved the drug flibanserin for treatment of low sex drive in premenopausal women. This drug is no “pink Viagra,” and its effect on women’s sexual function may be small, but it may be a step in the right direction simply because it draws attention to the value of a satisfying sex life for women and acknowledges it as a legitimate health concern.