Clinical Conversations

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You surely remember “O-chem” — those late-night undergraduate hours spent grappling with benzene rings and alkanes and all the rest. Well, it turns out that drug makers were paying close attention to things like racemic mixtures and enantiomers. The manufacturers usually release their products as racemic mixtures and then, when patents are about to expire, an enantiomer appears. Voila! New drug, new price!

Dr. Joseph Ross and his crew looked at the implications to Medicare spending of all this. They published an interesting letter in the Annals of Internal Medicine detailing how much money the system could save if we stuck with the racemic mixtures. How much? Well, on the order of $15 billion over 5 to 6 years.

Links:

Annals of Internal Medicine letter

NEJM Journal Watch Pediatrics and Adolescent Medicine coverage of albuterol vs. levalbuterol