What FX? CBC’s Marketplace looks at Cold-fX

I’ve been blogging for over three years and Cold-fX, a popular Canadian ginseng supplement, was one of the first topics I tackled. The omnipresent Canadian advertising, huge pharmacy presence, and impressive-sounding efficacy claims made it an ideal case study. Perhaps not surprisingly, when I reviewed the data, the results didn’t hold up:  I concluded that in a best case scenario, you’d need to take Cold-fX for four cold seasons (about 16 months) to prevent a single cold. And while the manufacturer claimed that Cold-fX could actually stop colds once they’d started, I noted that there was no published evidence to back up that claim. I concluded there was was little rationale to justify supplementing with Cold-fX. The published clinical evidence wasn’t persuasive, and the supplement is not inexpensive. The smarter strategy? Washing your hands regularly is clinically proven, and it’s a lot less expensive.

Since my review, the popularity of Cold-fX has continued unabated. And the manufacturer has branched out into all kinds of supplements: Cell -fX (shark cartilage), Cold Sore fX (bee propolis), Remember-fX (also ginseng), Memory-fX (more ginseng), and Immunity-fX (ginseng again, but with with reishi mushroom). Skeptical yet? So was CBC’s Marketplace, which scrutinized Cold-FX in a episode broadcast earlier this month. (I can’t embed the video, so you’ll need to watch the video at the CBC’s site.) For those of you that haven’t seen Marketplace, it’s a consumer affairs/consumer advocacy show that takes on medical topics from time-to-time. Last year it did an excellent investigation of the elaborate placebo system known as homeopathy. The producers are clearly science and consumer advocates, making natural health products low-hanging fruit. So Cold-fX was a fitting topic. Their investigation focused on several issues: Continue reading

Third year anniversary!

I recently asked a colleague for search advice on a topic I was researching. When I told her it was for a blog post, she was intrigued. “How much do you get paid to blog?” she asked. When I told her that blogging didn’t provide any revenue, she was dumfounded. “Even writing for [big pharmacy trade magazine] will pay you a few hundred dollars per article! Why would you write something, and then just give it away?” I told her I wasn’t interested in writing 5000 words on someone else’s topic, waiting months to see it in print, and then wondering if anyone even read it. “Blogging provides immediate gratification,” I replied, “That model seems hopelessly outdated. If there’s a therapeutic controversy, or pharmacy practice issue, I want to discuss it now – not in six months, or a year.” And blogging provides a level of feedback that’s unheralded compared to traditional publication models. Sure, you may be called a Nazi, a Communist, or a Big Pharma Shill, but that comes with the territory when you criticize quackery and call out pseudoscience. Continue reading

Generic Drugs: Are they Equivalent?

With healthcare costs continuing to rise, generic drugs are looking more attractive than ever. The prospect of getting the same drug at a lower cost is tempting to anyone with a large drug bill — patient or insurer alike. The savings are massive: Lipitor lost patent protection in the USA last month — it was a $10 billion drug worldwide, and the generic versions are priced at a fraction of the original cost. In 2012, Plavix and Seroquel, two other blockbusters, will lose patent protection too — that’s another $10 billion in drug costs that will shrink. This “patent cliff” will shrivel about $255 billion in worldwide patented drug sales over the next five years. If you’re taking a prescription drug and not already on a generic, you probably will be soon. And depending on where you live, you may be automatically switched to a generic version of your prescription drug as soon as it’s available.

Pharmacists are responsible for most of the switches from brand to generic drugs. National, state, or provincial regulations may specify which drugs and brands may be automatically substituted — that is, without patient or prescriber consent. Consequently, pharmacists do spend time speaking with patients about generic drugs. Misconceptions are common, ranging from manufacturing standards (“they’re weaker!”) to efficacy (“the drugs don’t work!”). Pharmacists, with exposure to pharmacokinetics and drug design in pharmacy school, generally understand the science of how generics are approved. Patients, consumers, and other health professionals, however, may not understand why pharmacists are so confident substituting between brands.  So today’s post is directed at anyone interested in how generic drugs are evaluated and approved for sale. Specifically, I want to review the concept of bioequivalence, the confirmation of which assures us of the interchangeability of different drugs — that is, one can be substituted for another. Continue reading