CLINICAL NEWS
Data Stream
15%
12.6% 12.5%
12%
12.7%
12.2%
9%
6%
Hematologists Under the Influence?
3%
0%
Flexible-hour Group
Standard Group
After 4 Years
A cancer doctor who accepts fees from a pharmaceutical manufacturer
is more likely to prescribe a medicine from that company, according to a
review published in The Oncologist that finds that these types of payments
can sway specialists’ prescribing patterns.
Reviewing data from the Centers for Medicare and Medicaid Services Open
Payments System and Medicare Part D program between 2013 and 2015,
researchers found that hematologists/oncologists who received any
industry payments related to a chronic myeloid leukemia drug were
Doc Around the Clock
Despite concerns about how medical trainees’ demanding work hours can affect their ability
to care for patients, longer shifts do not jeopardize patient safety, according to a New
England Journal of Medicine report.
In a randomized noninferiority trial, authors assigned internal-medicine residency programs
to abide standard 16-hour shifts or use flexible duty-hour rules that did not specify limits on
shift length or mandatory time off between shifts.
After 4 years, the changes in 30-day mortality for patients from baseline were minimal with
either shift schedule: 12.6% to 12.5% in the flexible-hour group vs. 12.7% to 12.2% in the
standard group (p=0.03).
“Patients cared for by residents on longer shifts did just as well,” lead author David Asch,
MD, MBA, said. Although people might expect residents on short shifts to be more alert
and do a better job, “there are other competing issues [like ‘passing off of care’]. It’s not
just, ‘Is your doctor tired?’”
22% more likely to prescribe that
company’s drug than doctors who did
not receive payments.
This association was strongest for physicians who consistently received
travel and consulting payments throughout the year and for physicians who
received larger payments.
Source: Mitchell AP, Winn AN, Lund JL, Dusetzina SB. Evaluating the strength of the association
between industry payments and prescribing practices in oncology. Oncologist. 2019 February 6.
[Epub ahead of print]
Drug Shortages in 2018
306
Source: Silber JH, Bellini LM, Shea JA, et al. Patient safety outcomes under flexible and standard resident duty-hour
rules. N Engl J Med. 2019;380:905-14.
I Want an Old Drug
Following a 3-year stretch of decline, drug shortages are making a comeback.
In 2018, there were 306 products on the U.S. Food and Drug
Administration Drug Shortages list, including 186 new
products added that year.
That number was up from 146 new products added in 2017, and is the highest numbers since 2012, when
204 drugs were added.
Many of the products in short supply were basic medicines like sterile surgical fluids and injectable opioids.
Source: American Society of Health-System Pharmacists Drug Shortages Statistics, 2019.
ASHClinicalNews.org
186
new products
added in 2018
ASH Clinical News
25