Pharma: May 2008 Archives

 

May 14, 2008

The NYT has an article, about the transition from CFC to HFA metered dose asthma inhalers (because of the negative effect of CFCs on the ozone layer). [See here for calculations about the total amount of CFC emissions from MDIs]. There have been some problems, including:

  • The HFA inhalers have a weaker spray than the CFC inhalers so people worry that they're not getting a full dose. This is a particular problem since the old CFC inhalers tended to produce a weaker spray when they were just about empty.
  • Ventolin HFA has a dose counter so you know whether you are getting down to the end of the inhaler.
  • This spray is particularly weak with the ProAir, which, for some reason, is preferred by a lot of health insurance plans. I've used the ProAir and can attest to having had some concern about whether it's working or not. ProAir, unfortunately, does not have a dose counter.
  • The new albuterol HFA inhalers aren't available in generic, so this increases people's costs significantly.

It's just not the albuterol inhalers which have been changed over. The inhaled corticosteroids are transitioning over as well, but because they're not used as rescue inhalers, I guess people are less sensitive about whether they're working or not.

In other pharma news, generic omeprazole (Prilosec) is now on the market, though prices don't seem to be much less than the brand name version. I wonder if eventually it will come in huge jars for $.01 a pill like ibuprofen.

 

May 1, 2008

In the NYT, Gina Kolata reports on a study that found that a substantial number of athletes show negative results on urine tests for testosterone, even when they're doping:
The 55 men in a drug doping study in Sweden were normal and healthy. And all agreed, for the sake of science, to be injected with testosterone and then undergo the standard urine test to screen for doping with the hormone.

The results were unambiguous: the test worked for most of the men, showing that they had taken the drug. But 17 of the men tested negative. Their urine seemed fine, with no excess testosterone even though the men clearly had taken the drug.

It was, researchers say, a striking demonstration of a genetic discovery. Those 17 men can build muscles with testosterone, they respond normally to the hormone, but they are missing both copies of a gene used to convert the testosterone into a form that dissolves in urine. The result is that they may be able to take testosterone with impunity.

...

Men with the gene deletion still metabolize testosterone, Dr. Schulze says. But, she adds, she does not know where the hormone goes. "We have no idea," she said. "That's what we're trying to find out."

If you've got this gene deletion, you've potentially got an enormous advantage in terms of being able to dope without getting caught. Even for those who don't have the gene deletion, I wonder whether there's some chemistry you could use to force testosterone metabolism down whatever alternate pathway is involved here (or alternately to disable the standard pathway), producing a masking effect for even those with normal genetic profiles.