AFP DEPARTMENT COLLECTION
This department includes information about new drugs from the perspective of the five attributes to be considered when weighing the advantages of one drug over another: Safety, Tolerability, Effectiveness, Price, and Simplicity.
Jun 15, 2017 Issue
Idarucizumab (Praxbind) for Dabigatran (Pradaxa) Anticoagulant Reversal
Idarucizumab is the only anticoagulant reversal agent for dabigatran. Because of its high cost and limited data regarding clinical benefit, therapy should be reserved for patients taking dabigatran who have life-threatening bleeding or are in need of emergency surgery.
May 15, 2017 Issue
Sofosbuvir/Velpatasvir (Epclusa) for Hepatitis C
Sofosbuvir/velpatasvir is an effective treatment for patients with HCV and has minimal adverse effects. It is the preferred treatment for patients with genotype 2 or 3. As with other curative treatments, it is very expensive.
Apr 15, 2017 Issue
Albiglutide (Tanzeum) for Diabetes Mellitus
Reductions in A1C are less with albiglutide than with the first-line therapy metformin, and albiglutide costs significantly more than metformin and sulfonylureas. Albiglutide's ability to reduce diabetes-related morbidity and major cardiovascular events is unknown.
Mar 15, 2017 Issue
Elbasvir/Grazoprevir (Zepatier) for Hepatitis C Virus Infection
Elbasvir/grazoprevir is a safe and effective treatment for HCV genotypes 1 and 4, with or without compensated cirrhosis or HIV-1 coinfection. Patients with renal impairment, including those on hemodialysis, can use the medication.
Feb 15, 2017 Issue
Rifaximin (Xifaxan) for Irritable Bowel Syndrome
Rifaximin has good overall tolerability. A relatively short course of treatment results in sustained clinical benefit for at least 10 weeks, eliminating the need for continued therapy, with an NNT of 10. However, it is expensive and should be reserved for patients who cannot tolerate or did not respond to more affordable therapies.
Jan 15, 2017 Issue
Umeclidinium (Incruse Ellipta) for COPD
Umeclidinium is an easy-to-use, once-daily, well-tolerated, and relatively low-cost anti-cholinergic agent for maintenance therapy in patients with moderate to severe COPD.
Dec 15, 2016 Issue
Empagliflozin (Jardiance) for Type 2 Diabetes Mellitus
Empagliflozin can be added to existing type 2 diabetes treatment to lower A1C levels, although there are less expensive options. In older patients with preexisting cardiovascular disease, empagliflozin can decrease all-cause mortality, cardiovascular mortality, and hospitalization for heart failure.
Nov 15, 2016 Issue
Evolocumab (Repatha) for the Treatment of Hyperlipidemia
Evolocumab is generally safe and effective at lowering serum LDL cholesterol levels for select patients who need marked cholesterol reduction and can tolerate injections. However, it remains unknown whether evolocumab prevents premature death from cardiovascular events.
Oct 15, 2016 Issue
Sacubitril/Valsartan (Entresto) for Heart Failure
Sacubitril/valsartan provides a small mortality benefit and decreases heart failure–related hospitalizations over and above an ACE inhibitor. It may be used in place of an ACE inhibitor in patients receiving optimal doses of guideline-directed medical therapy that includes ACE inhibitors, beta blockers, and aldosterone antagonists.
Sep 15, 2016 Issue
Ivermectin 1% Cream (Soolantra) for Inflammatory Lesions of Rosacea
Ivermectin cream is an effective treatment for moderate to severe pustular rosacea, but it is more expensive than some other available treatments and has not been studied in patients with milder forms of rosacea. Generic metronidazole cream is a less expensive alternative, and long-term oral doxycycline may be suitable for patients who want a more affordable alternative to a topical agent.