Category Archives: Science/Technology

The high cost of a new drug

Via Forbes: The Truly Staggering Cost Of Inventing New Drugs

Having worked in and with Clinical Trials, I can first hand attest to the costs involved in Clinical Trials.

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These are trials in humans, which means a compound has already passed the rigorous screening process in the lab and in animals.

There’s a myriad of regulations for clinical trials. Not only that, there are additional regulations (computer system validation, filings, audits) that add to the costs.

Ultimately, every drug that makes it to the market not only has to pay for its own development–but

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also for all the previously attempted developments.

Arguments with the vendor

Suffice it to say, I’m anything but a fan of the EMR system we utilize at the office.

Besides the simple fact that the software doesn’t really fit our practice (it was implemented before I cam aboard)–what really kills me is the poor support.

For example today I sent in a form to enroll for Electronic Remittance Advice. I get a response from the vendor, telling me that the clearinghouse which their software uses doesn’t offer ERAs. Funny, but I’ve used the same clearinghouse elsewhere and get ERAs just fine….

It’ll keep me occupied tomorrow….

Seen in the fridge

The sister got some sort of gift or promotional samples of some organic vegetable/fruit juice blends.

[Personally, I'd rather eat my veggies and fruits in solid form]

Being curious, I perused the ingredients. The recurring theme on them all was the appearance of “Alkalized Water”

Now being a science person, it’s known that the pH of water is neutral–7.0

[Yes, I know that tap water may not be exactly at 7.0, but we're not talking about a chemistry or molecular biology lab here!]

Thus, one can only wonder, what make’s “alkalized water” more alkaline? How do they magically ad more hydroxyl (-OH) groups to water?

Structure of Sodium Channels

In an exciting development, in the online version of the journal Nature this new significant study has been published

The crystal structure of a voltage-gated sodium channel

A couple years back, R. McKinnon received a nobel prize for determining the crystal structure of the potassium channel–if that helps explain the potential magnitude of this discovery.

I’m going to see if I can get my hands on a copy of this paper to read it!

Blast from the past

Yesterday, for work, I was surfing the web on a 56K dial-up internet connection.

It was s…….o…….s…….l……o……w

+++No Carrier+++

It brought back memories of my early days online. Freenet anyone? Dialing into the SHPL/CCPL to do research for school.

Especially since I had to use it to download files in order to access a new web based FTP client (go figure). Apparently the previous (stand alone special FTP client) wasn’t sufficient or something, so users had to migrate to a new portal.

All this had to be done over a special VPN, hence the dial-up. Yes, there is a broadband option available but for an office like the one I work in, it’s not cost efficient.

Oh, and why yes, of course this technology was for Medicare claims

Not the whole story

The Sister was actually home last night and had on the

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Emmys. The Sister seems to like keeping the TV volume up rather high, so I could hear it in my room. No biggie. I barely watch network TV, so I didn’t really know what most of the shows winning awards were. Let me rephrase that, I know of them but I doubt that I’ve watched them.

At one point during the commercials, an ad for United Healthcare ran. It featured people lamenting how they always have to fill out the same kind of paperwork at different doctors offices.

I groaned.

True, the paperwork is a pain for both the patient and the office staff (the latter having to try and get the patients to complete the forms)> Alas, they’re somewhat necessary (registration, privacy rules, etc)–but still a pain.

The commercial seemed to be hinting at an electronic repository of sorts of information that would be available to all providers. That would be nice from a providers standpoint. Alas, it also alluded to the idea of seamless EMR intergration.

As I’ve learned, that’s easier said than done. EMR systems for doctors are rather pricey (for the software alone–not including the hardware to host and run the systems). Include the cost of migrating to electronic records, staff training, physician training, the hours spent in training and migration. The costs add up! Furthermore in an industry where costs are rising but reimbursements are staying level or decreasing–for many a provider an EMR platform is but a dream.

Blast from the past

Had to retrieve some old (10+ years old) medical records today.

Found ‘em.

On a 3.5″ floppy disk! Remember those?

More

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difficult was finding a PC with a 3.5″ drive in the office!

Correlation does not equal causation

Here’s a story the anti-vaccine crowd is sure to jump on:

“Finland Suspends H1N1 Vaccine

The Finnish National Institute for Health (THL) proposed suspending vaccinations for H1N1 swine flu, due to suspected links to increased narcolepsy in children and adolescents, the body announced this week.

Six cases of narcolepsy, a chronic disorder causing excessive daytime sleepiness and extreme fatigue, have been reported after patients had been receiving the Pandemrix vaccine.

Six cases of narcolepsy is consistent with annual averages, reports THL, but all of these patients were affected after being vaccinated, and there are nine additional cases that have not yet been confirmed.

Now since this is a mainstream media article versus a scientific publication, there are some questions that definitely need to be answered.

Was the diagnosis of Narcolepsy made by combination of history plus multiple sleep latency test?

Were any of

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said patients displaying any symptoms preceeding vaccination?

Did these individuals have either lumbar punctures or blood tests performed to detect the HLA-DQB1*0602.marker?
[This while not a diagnostic tool per say would however provide interesting immunological evidence]

What makes this all interesting, is that increasing research seems to be pointing towards Narcolepsy having an auto-immune origin in the body. In the simplest terms, individuals with narcolepsy commonly lack hypocretin/orexin [hcrt/ox] producing neurons. The lack of hcrt leads to a disruption in the normal neuro-chemical functioning of the brain which leads to the symptoms of the disorder. [A discussion of which is beyond the scope of this blog--however I can provide references]

Fun with the work PC

So my PC at work is a bit on the old side…4+ years old (at least) The thing is a clunker, even without all the applications it has to run (including MS SQL Server 2008)
It takes ~10 min to start up and then another 10 to load the basic applications.

Last week my computer somehow got infected with a Trojan which generated these annoying pop ups from a malicious piece of software called “xp defender pro” (lgt removal instructions). So the IT guy came downstairs and removed it–so it’s back to the normal, (painfully slow) status quo.

Then late yesterday afternoon the trojan re-appears as I attempt to visit an insurance company website. I email IT, but it’s too late in the day, so they come to my desk this AM. They start working on the machine and remove the malware. Two hours later–bam–it’s back!

They come down again to fix things. Meanwhile, I’m story of stuck. How can I do most of my work without a PC? I attempt to accomplish all non-computer busywork that I can and even then I’m wandering around wasting time.

Next the spy-ware is gone. Thank goodness. I try to load up our medical billing software to take care of some routine billing–it won’t load. I try MS Word–won’t load. Excel–zip. Nothing except IE and Outlook would run.

Called back up to the IT guys (who must hate me now) and tell them what happened. One comes down and tries some things–to no avail. He has to research what’s going on. At least I have IE–and can take care of some research I needed to do.

Finally they figure out the answer–a file they had me delete from the desktop earlier (it had a suspicious sounding name) was actually meant to be run! So we did so–and it’s back ot the previous status quo.

[Fortunately, they've found a spare PC in the office and they'll be swapping out my old one! Much to my excitement, as well as the physicians and Managers for whom I work]

Quote of the day

Public trust is something scientists must work hard to maintain. When it comes to science and public policy, the average citizen usually has to trust scientists—whose word he or she has to take on faith almost as much as a religious believer takes the word of a priest. Once that trust is undermined, as it has been in recent years, science becomes a casualty of politics.”

–Cathy Young, When Science Becomes a Casualty of Politics