Price isn’t the only difference between brand-name meds and generics

brand generic meds optIt should comes as no surprise to learn that pharmaceutical research and development isn’t cheap.

Developing one cancer drug to the point of FDA approval, for example, can take as long as 15 years and cost as much as much as $2.6 billion, according to one JAMA analysis. From 2007 to 2014, the US pharma industry as a whole spent between $47.9 and $53.3 billion dollars per year developing new medicines.

Patent law gives manufacturers 17-year-long monopolies to earn back that cost and make some profit. After that, anyone can legally make generic versions with the same active ingredients – and sell them at markedly lower prices. That’s why 90% of prescriptions filled are for generics.

But price can be just one of several differences – some of which are visible and some of which aren’t.

How safe is surgery for older patients?

surgery optWhen it comes to surgery for older adults, there’s good news and bad news.

The good news is that “In modern surgery, it’s a rare event to die from surgery,” according to Dr. Emily Finlayson, director of the University of California San Francisco’s Center for Surgery in Older Adults.

The bad news is what might happen afterwards, particularly for patients older than 80.

As people age, so do their bodies’ heart, lings, kidneys and other organ functions, making it harder to bounce back from the intense stress of a surgical procedure. Age also slows down the body’s overall healing processes – even for something as trivial as a scratch or scrape. So older patients are vulnerable to virtually every potential post-op complication, including not only infection, but also heart, lung or kidney problems.

“Replacing someone’s hip when they’re 85 is harder than when they’re 50,” explains Dr. Clifford Ko, director of research and optimal patient care at the American College of Surgeons. “You body takes longer to recover.”

That’s bad news.

But there’s also good news:

Can COVID-19 cause heart attack deaths?

can covid optIn a few cases, yes. But many, many more deaths are caused by the fear of the coronavirus.

“Nearly everyone dying of COVID-19 has concurrent health problems,” writes Dr. Joel Zinberg, associate clinical professor of surgery at the Mount Sinai Icahn School of Medicine in New York. Hypertension, heart disease, respiratory diseases, and diabetes are the most common. Their presence and interaction, Dr. Zinberg adds, are “what sometimes changes COVID-19 from a relatively benign disease into a killer.”

But these conditions don’t need a coronavirus to be fatal.

When VCU and Yale researchers analyzed the causes of over 87,000 excess deaths during March and April, they found that some 30,450 of those deaths were not from COVID-19.

Growing older doesn’t have to mean growing frailer

frailer optAccording to a 2015 John Hopkins University study, about 15 percent of adults 65 and over are frail.

And according to Dr. Linda Fried, geriatrician, dean of Columbia University’s Mailman School of Public health and a pioneer in the medical study of frailty, this means that they live with at least three of the following conditions:

  • Low physical activity
  • Weak grip strength
  • Low energy
  • Slow walking speed
  • Non-deliberate weight loss

Another 28 to 44 percent of older adults, with two of these markers, are pre-frail, according to Dr. Fried and colleagues’ research.

Chronic conditions including diabetes, heart disease, lung disease and stroke can double the risk of frailty, while dementia can multiply it tenfold.

Coronavirus or not, keeping these four health appointments is Important.

keeping health appointments optIf you subtract the statistics from just three states – New York, New Jersey and Massachusetts, which account for 10% of the population but 42% of COVID deaths – the remaining 47 states’ death rates are about as low as Luxembourg’s and Macedonia’s. But while the coronavirus may be less fatal than thought, it’s still every bit as scary.

Maybe this is why so many Americans have been putting off screenings and other health appointments they’d be better off keeping.

As of mid-April, the number of colonoscopies was down 90% from 2019. Mammograms and Pap tests were each down 94% compared to the 2016-2019 average. And the CDC estimates that there were a million fewer emergency room visits each week from March through mid-April.

For most people worried about COVID infection, putting off screenings and blood tests won’t do much harm over the short term. But the short term has a nasty way of turning into the long term. And over the long term cancers can grow to the point where they’re harder and more invasive to treat. A neglected cavity in a tooth can lead to a root canal. Blood coagulant levels can change from one week to the next.

That’s why it’s a good idea to keep these kinds of appointments: