ramfan60
2 days ago
It will be interesting to see what my personal lab rat lipids look like in a couple weeks......as you may recall, I put myself on a super low carb way of eating. Mostly high fat meat, dairy, and eggs. Prior to this, my standard American Diet lipids had me at LDL=95, TRIGS=40, HDL=80. My BP was hanging around the hypertension levels of 140/90 and they prescribed low dose Lisinopryl. At the 6 month mark, I had LDL=200, TRIGS = 48, HDL=89.......no more Lisinopryl as my BP hovers in the 120's/80s....... so I'll see the vampire next week and see what happens
JRoon71
2 days ago
You're also making a huge assumption that doctors are so emphatically moved by Vascepa that they are willing to push the envelope on script requirements and documentation in droves.
Since this has not happened in the U.S., Canada, the UK, or Spain, what leads you to believe that Italy is somehow different?
All of EU is approved for use, and more than a handful are approved for reimbursement with ZERO scripts written.
I would love to be optimistic, but there is zero evidence that any significant number of doctors, on ANY continent, are prescribing Vascepa like crazy. In fact, the opposite is happening - there are other drugs that are leapfrogging Vascepa in the standard of care regime.
Did you see what was written about Vazkepa by AIFA?
"Although demonstrated in comparison with a placebo probably not completely inert and in a population not treated on top of the drugs recommended for the reduction of LDL cholesterol, the data of the study seem to configure an important added therapeutic value. The certainty of these data, however, is not sufficient as detailed in the section on the quality of the evidence."
QUALITY OF TESTS: Low
COMMENT: The pivotal REDUCE-IT study, a randomized placebo-controlled trial, was considered in the GRADE_Pro assessment. The lack of reproducibility of the results (the only study with results not consistent with those of other drugs in the same class) and the lack of generalizability (patients not treated on top of the drugs recommended for LDL-C reduction and in the absence of information regarding any dietary control) determine the application of two downgradings to the quality of the evidence which is therefore to be considered LOW.
OVERALL JUDGEMENT ON INNOVATION: The drug is not recognized as innovative in light of its moderate therapeutic need, significant added therapeutic value, and low quality of evidence.
This is what doctors are seeing in Italy
Whalatane
3 days ago
Absolutely no risk ?
When prescribing off-label medications in Italy, physicians have several important liability considerations:
Legal Framework
The main law governing off-label prescribing in Italy is Law 94/1998 (also known as the Di Bella Law)1. This law allows off-label prescribing under certain conditions:
It must be for an individual patient
The physician must determine that approved on-label medications cannot effectively treat the patient's condition
There must be scientific evidence supporting the off-label use, including favorable results from completed phase II clinical trials
The patient must provide informed consent
Physician Liability
When prescribing off-label, Italian physicians take on increased responsibility and potential liability:
They have a direct responsibility for the off-label prescription3.
They may be called to respond to any problems arising from the off-label use as if they had done something outside the standard of care1.
The burden of proof rests on the physician to demonstrate the off-label use was appropriate1.
Key Liability Considerations
To mitigate liability risks, physicians should:
Thoroughly document the rationale for off-label use and scientific evidence supporting it
Obtain and document informed consent from the patient, clearly explaining the off-label nature of the prescription4
Closely monitor the patient for adverse effects
Stay up-to-date on the latest evidence and guidelines regarding off-label uses
Potential Consequences
If problems arise from off-label prescribing, physicians may face:
Administrative liability
Potential requirement to personally reimburse costs
Professional disciplinary action
Civil liability claims from patients
However, if proper procedures are followed, off-label prescribing is legally permitted and can be an important treatment option2.
The key is ensuring it is done responsibly with appropriate documentation and patient consent.. my emphasis ...just what MD's want everywhere ...more paper work
Kiwi
CaptBeer
3 days ago
On World Heart Day, it's important to recognize that over 40 million deaths were attributed to cardiovascular diseases (CVD) across six world regions, with 3.4 billion confirmed cases in 2021, as reported by the Global Burden of Disease Database. Fortunately, cardiovascular events can be reduced by 25%, and cardiovascular deaths by 20%.