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.
Jul 15, 2007 Issue
Varenicline (Chantix) for Smoking Cessation
For every nine highly-motivated patients who use varenicline instead of placebo, one will not be smoking one year later. Although the cost of therapy is a limitation (total cost is approximately $360 for a three-month course), the easy dosage titration, lack of drug interactions, and favorable side-effect profile make varenicline an appealing alternative to sustained-release bupropion for smoking cessation.
Jun 15, 2007 Issue
Herpes Zoster Virus Vaccine (Zostavax) for the Prevention of Shingles
Herpes zoster vaccine decreases the incidences of shingles and postherpetic neuralgia. Despite unresolved questions about cost-effectiveness, and pending issues regarding reimbursement, it is an effective vaccine that should be offered to patients who are 60 years or older.
May 15, 2007 Issue
Insulin Inhalation Powder (Exubera) for Diabetes Mellitus
Inhaled insulin provides an alternative route of administration for rapid-acting insulin but offers no other benefit over available insulin therapy. It may reduce, but not eliminate, the need for self-injection in patients with type 1 diabetes. In patients with type 2 diabetes, the risk of hypoglycemia significantly increases when inhaled insulin is added to or substituted for oral agents.
Apr 15, 2007 Issue
Pramipexole (Mirapex) for Restless Legs Syndrome
Although many patients with RLS do not need pharmacologic therapy, pramipexole is one option for treating moderate to severe symptoms. As with other agents used to manage RLS, potentially serious adverse reactions are possible.
Feb 15, 2007 Issue
Ranolazine (Ranexa) for Chronic Angina
Ranolazine will provide a small benefit in symptom control in patients with chronic angina and persistent symptoms despite medical therapy. It generally should be used in combination with amlodipine, beta blockers, or long-acting nitrates.
Jan 15, 2007 Issue
Levalbuterol Tartrate (Xopenex HFA) for the Treatment of Bronchospasm
Levalbuterol tartrate appears to be no more effective and offers no improvement in the side-effect profile compared with albuterol. The higher cost may make it appropriate for only a limited group of patients.
Dec 15, 2006 Issue
Pregabalin (Lyrica) for the Management of Pain Associated with Diabetic Neuropathy
Pregabalin is safe and effective for the management of neuropathic pain associated with diabetic peripheral neuropathy. Drawbacks include the cost and the lack of studies demonstrating equivalence or superiority to other treatments. However, pregabalin’s ease of dosing titration, minimal drug interactions, and favorable side effect profile make it appealing for those who cannot tolerate less-expensive alternatives.
Nov 15, 2006 Issue
Tetravalent Meningococcal Conjugate Vaccine (Menactra) for the Prevention of Meningococcal Disease
MCV4 is as effective and as safe as the older MPSV4. It is recommended by the ACIP for children 11 to 12 years of age, college freshmen living in dormitories, and other high-risk populations. MCV4 should provide effective and longer-lasting immunity, but at significant expense to vaccinate the recommended target population.
Oct 15, 2006 Issue
Lubiprostone (Amitiza) for Chronic Idiopathic Constipation
Although bulk or osmotic laxatives are less expensive first options for treating patients with chronic idiopathic constipation, lubiprostone is an alternative for those who do not tolerate or respond to these agents, or in patients older than 65 years in whom tegaserod use is not recommended.
Sep 15, 2006 Issue
Rotavirus Vaccine, Live, Oral, Pentavalent (Rotateq) for Prevention of Rotavirus Gastroenteritis
Although costly, rotavirus pentavalent vaccine has been shown to be safe, with no increased risk of intussusception. It also has shown to reduce the need for hospitalization and emergency department visits connected with rotavirus gastroenteritis, decrease office visits associated with rotavirus, and reduce lost work days for parents or guardians.