Compliance, Pharmacology / 04.04.2025

Keeping patients on track with their medication during clinical trials is extremely important. If they don’t follow the plan, it can throw off results, slow down new treatments, and even put their health at risk. Healthcare providers must be proactive with medication adherence solutions to make sure patients take their meds as prescribed, keeping trials on schedule and producing reliable data.

Understanding the Importance of Medication Adherence in Patient Care

Medication adherence is all about whether patients take their meds as they should. If they stick to the schedule, treatments work better, healthcare costs decrease, and trial data stays accurate. Keeping patients on track is essential for providers to protect trial results and patient well-being. Using medication adherence solutions for healthcare providers helps improve accuracy, build patient trust, and keep trials running smoothly. When patients feel supported, they’re more likely to follow their treatment plan. Clinical trials need precise data to figure out if a treatment actually works. Researchers can't get clear answers if patients skip doses or take the wrong amount. That’s why improving adherence isn’t just a good idea—it’s essential for medical progress. (more…)
Pharmacology / 04.04.2025

In the pharmaceutical industry, precision isn’t just a preference—it’s a necessity. The margin for error in storing temperature-sensitive products such as vaccines, biologics, and critical medications is razor-thin. Even a slight temperature deviation can compromise product integrity, leading to significant financial losses and jeopardizing patient safety. As the global demand for reliable cold storage grows, advanced solutions are becoming more than just beneficial—they’re essential. This is where cutting-edge ultra-low temperature storage systems come into play, offering unmatched control, safety, and efficiency. Today’s pharmaceutical companies need storage that not only meets but exceeds regulatory expectations, all while supporting operational scalability and sustainability goals. (more…)
Addiction, Author Interviews, Mental Health Research / 31.03.2025

Parita K. Ray

Medical Student

Department of Medical Education

Geisinger College of Health Sciences

Scranton, PA 18509

 

MedicalResearch.com: What is the background for this study?

  • Citalopram and escitalopram are two of the most commonly prescribed antidepressants in the U.S. and are widely used for treating major depressive disorder (MDD) and generalized anxiety disorder (GAD), along with various off-label indications. While both medications share similar mechanisms of action, escitalopram was introduced as a purified version of citalopram’s active enantiomer. Despite little evidence showing a clear superiority of escitalopram over citalopram in efficacy or tolerability, prescribing trends appear to favor escitalopram, raising concerns about "evergreening"—a practice where pharmaceutical companies promote newer formulations of existing drugs to extend market exclusivity. Prior research has shown variations in the prescription rates of psychotropic medications across states and within specific populations, particularly among Medicaid and Medicare patients. However, little is known about the long-term prescribing patterns of citalopram versus escitalopram in these populations and whether these trends reflect potential evergreening practices.

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Mental Health Research, Pharmacology / 29.03.2025

Psychological research plays a fundamental role in shaping advancements in mental health care and pharmaceutical developments. By studying cognitive and behavioral patterns, researchers uncover crucial insights that drive the creation of effective treatments. Theodore Rex Walrond notes how these findings inform the development of medications that target neurotransmitter imbalances, improving outcomes for individuals with conditions like depression and anxiety.

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Pharmacology / 24.03.2025

CDMO-drug-development Nearly 70% of Phase II and III clinical trials experience delays, averaging an additional 16 months. Every delay in introducing new drugs means longer development cycles, escalating R&D costs and threats to your competitive advantage. You’re dealing with regulatory checklists and uncertainty, scalability challenges, and supply chain disruptions. All of this unpredictability is not good for your organizational goals or your stress levels. If only there was a way to navigate low predictability and speed up drug development while also improving outcomes.  The right Contract Development and Manufacturing Organization (CDMO) services can actually grant all three wishes. CDMO services eliminate these bottlenecks, aligning expertise, infrastructure, and regulatory depth to fast-track commercialization. 
Challenge How CDMO Services Solve It
Project Complexity Streamline process development from molecule synthesis to clinical trials, ensuring scalability from the start.
Regulatory Uncertainty Maintain compliance with CMC requirements, regional health authorities, and cGMP guidelines for smooth approvals.
Supply Chain Bottlenecks Offer flexible manufacturing capacity, technology transfer support, and risk-mitigated supply chains to prevent disruptions.
Lack of Project Visibility Provide real-time dashboards, milestone tracking, and adaptive workflows for better control and faster iteration.
Cost-Related Hurdles Optimize process efficiency to reduce total cost of ownership without compromising quality or commercial viability.
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Pharmacology / 19.03.2025

When it comes to medication, one size does not fit all. That's why compound medications have become increasingly popular in customizing treatments for individual patient needs. The process itself is complex and requires extensive knowledge and precision. This is while the concept of formulating compound medications may seem straightforward. Here are four key insights into the process of formulating compound medications. Read on. (more…)
Cost of Health Care, Medication Costs / 05.03.2025

Understanding the Importance of Transparent Communication

The conversation around medication costs is often overlooked, yet it is an essential aspect of effective healthcare management. Transparent communication with your healthcare provider can pave the way for finding affordable options while ensuring that the quality of care is not compromised. Patients often hesitate to bring up financial concerns, fearing it may affect the quality of treatment offered. However, discussing medication costs openly allows your doctor to consider various factors that could lead to more cost-effective treatments. For instance, health providers, with the patient's consent, can explore alternative medications or treatment plans that are equally effective but less expensive. Additionally, transparent communication fosters a stronger doctor-patient relationship where the patient feels supported in all aspects of their care. Using resources like BuzzRx further enhances your ability to find savings on prescriptions, ultimately aiding in more manageable healthcare costs. (more…)
Pharmaceutical Companies, Pharmacology / 14.02.2025

Although each rare disease is uncommon on its own, together, they represent a major global health challenge. With over 7,000 known rare diseases, the global impact is substantial. Currently, around 300 million people worldwide are living with a rare disease.  Unlike more prevalent conditions, rare diseases often receive less research funding, making drug development a lengthy and challenging process. However, recent advancements in antibody drug discovery are transforming this landscape, offering new hope to millions of patients. Antibody drug discovery is an advanced biotechnology field that utilizes the immune system to develop precise treatments. Scientists identify and isolate specific antibodies capable of binding to disease-causing targets. This approach enables the creation of drugs that directly address the root cause of rare diseases, ensuring more effective and personalized therapies. In this article, we will explore the transformative impact of antibody drug discovery on rare disease research. 

Precision Targeting for Effective Treatment

A key advantage of antibody-based therapies is their ability to achieve precision targeting, which is essential for treating rare diseases. Since many rare diseases stem from genetic mutations or protein dysregulation, they are well-suited for highly specific and targeted interventions.  Antibodies can be designed to target disease-causing molecules like misfolded proteins, overactive receptors, or harmful cells while preserving healthy tissues. This precision improves treatment effectiveness and minimizes side effects, which is essential for patients with complex or fragile health conditions. To harness this potential, researchers are increasingly relying on advanced antibody discovery services. These services employ advanced technologies like phage display, single B-cell screening, and AI modeling to identify and refine high-affinity, specific antibodies for rare diseases. Partnering with specialized antibody discovery services helps researchers fast-track tailored therapies, offering hope to patients with untreatable conditions. This collaborative approach is revolutionizing rare disease research, leading to innovative treatments that target the root causes of complex disorders. Alloy Therapeutics recommends collaborating with an expert team to develop ranked bispecific candidates tailored to specific targets. Their comprehensive approach combines advanced technologies with proprietary workflows. This ensures the delivery of precise, high-quality bispecific leads for effective therapeutic development. (more…)
Pharmaceutical Companies / 08.02.2025

Pharmacovigilance and drug safety are critical aspects of the pharmaceutical industry, ensuring that medicines are both effective and safe for public use. At the heart of these efforts is regulatory writing, a specialized field that plays a vital role in documenting, analyzing, and communicating safety data to regulatory authorities. From clinical trial reports to post-marketing safety updates, regulatory writing helps pharmaceutical companies maintain compliance with global health regulations. Understanding Regulatory Writing in Pharmacovigilance Regulatory writing in pharmacovigilance involves the creation of structured, scientifically accurate, and regulatory-compliant documents. These documents serve multiple purposes, including reporting adverse events, assessing drug risk-benefit profiles, and maintaining transparency with regulatory bodies like the U.S. Food and Drug Administration (FDA), the European Medicines Agency (EMA), and other global authorities. Pharmacovigilance documentation must adhere to strict guidelines such as ICH E2E (Pharmacovigilance Planning) and ICH E2C(R2) (Periodic Benefit-Risk Evaluation Reports), ensuring that pharmaceutical companies provide accurate and timely safety updates. (more…)
Pharmacology / 02.02.2025

SkyCell has emerged as a transformative force in pharmaceutical logistics, offering innovative solutions that ensure the safe, secure, and sustainable transportation of temperature-sensitive medicines. It’s not surprising that the company is an industry leader having introduced hybrid containers to the world. Should you work with them?  Find it out in this article

SkyCell's Innovative Hybrid Containers

At the core of SkyCell's offerings are its temperature-controlled hybrid containers, designed to provide superior protection for sensitive pharmaceuticals during transit. These containers feature a patented insulation system that reflects heat radiation, maintaining a consistent internal temperature without the need for external power sources. The 1500X model, for instance, offers enhanced performance with a longer independent run-timeof up to 270 hours, ensuring stability even in extreme ambient temperatures ranging from +70°C to -40°C. (more…)
Pharmaceutical Companies, Technology / 24.12.2024

1. The widespread use of machine learning

In recent years, we have seen the growing prevalence of generative artificial intelligence, as well as devices and platforms powered by machine learning. The healthcare sector isn’t spared from such disruptions as major brands and public institutions are harnessing AI to aid in conducting more accurate and ethical clinical tests and developing new drugs.    There’s no room for downplaying AI’s value to pharmaceutical research as it helps with analyzing molecular structures and patient data to come up with optimal formulations without compromising patient safety. While this would still require companies to tap into their existing knowledge bases, AI can help reduce the time it takes to formulate, test, and approve new products. 

2. Regulatory and ethical challenges remain

The emergence of generative AI in medical research doesn’t come without resistance coming from regulators. Considering that the technology is still at its most primitive despite its impressive capabilities, there is a growing need to enforce regulations addressing AI’s limitations and overreliance. Calls for greater equity in the pharmaceutical sector are also growing as stakeholders demand more affordable products.    The recent assassination of United Health CEO Brian Thompson highlights inequities that are also observed in the pharmaceutical industry, where quality vaccines and life-saving medication remain inaccessible to most low- and middle-income nations. Aside from this, there is also the need for companies to do their part in environmental protection by using technologies such as an effluent decontamination system for compliance and investing in sustainable manufacturing processes. (more…)
Author Interviews, Pharmacology / 12.11.2024

medical medicine box You might have noticed the key details mentioned on medical medicine boxes whenever you pick them up from a pharmacy. Information, precautions, symbols, and brand details mentioned on these boxes are important for individuals who are going to consume these medicines. Custom medicine boxes thus serve as an effective means of conveying the desired insights to the exact audience who is going to benefit from the relevant medicines for curing their specific health issues. Brands make sure to keep the details mentioned on medical medicine boxes highly relevant and assure the safety of individuals at all times while keeping them informed of the right dose of the medicine they are going to consume. This post explores how important are these custom packaging solutions for your pharmaceutical brand and what are the key features of medical medicine boxes. (more…)
Pharmacology / 06.08.2024

 

In today's fast-paced world, healthcare is moving toward more personalized and patient-centric approaches. This trend is evident in the increasing popularity of compounding pharmacies. These specialized pharmacies offer customized solutions tailored to individual patient's needs, making them an essential part of modern healthcare. While healthcare services are diverse and growing, the need for personalized medication is becoming more recognized. This article will explore the top benefits of custom compounding and why it's becoming a cornerstone of personalized healthcare.

Understanding Custom Compounding

Custom compounding refers to the creation of personalized medications by pharmacists to meet the unique needs of individual patients. Unlike traditional pharmacies that dispense mass-produced medications, compounding pharmacies prepare medications from scratch. This allows for a high degree of customization, ensuring that each medication is tailored specifically to the patient's requirements. The practice of compounding dates back to the origins of pharmacy, but it has gained renewed importance in modern healthcare as patients and providers seek more targeted treatment options. (more…)
Asthma, Author Interviews / 03.11.2020

MedicalResearch.com Interview with: https://www.gsk.com/en-gb/home/Beth Hahn, PhD, Director U.S. Value Evidence and Outcomes, GlaxoSmithKline, Research Triangle Park, NC MedicalResearch.com: What is the background for this study? Response: Biologic therapies are increasing as a treatment for patients with severe asthma, with multiple therapies approved by the FDA.  There is also an increasing understanding of the factors influencing preference for and adherence to biologic therapies for patients with severe asthma; however, little is known about why patients discontinue biologic therapy. In patients who have access to biologic treatment, understanding the circumstances and asthma characteristics associated with discontinuation of biologic therapy may allow for the identification of barriers to treatment success . The objective of this study of cross-sectional physician and patient survey data was to assess the patient characteristics and the given reasons for treatment discontinuation in a US patient cohort with severe asthma treated with biologic therapy. A total of 117 physicians and 285 patients completed surveys with 70% of patients continuing biologic therapy (N=200). This study included a number of different FDA approved biologics. From the perspectives of the physicians included in the current study (85 providing a rationale for discontinuation), the majority reported a lack of symptom control, particularly shortness of breath (46%), exacerbations (26%) and other chronic symptoms (29%), as a key reason for discontinuing biologic therapy in severe asthma. Symptom control was also key for patients, with these three symptom categories among their top six reasons for biologic discontinuation. The cost of biologic treatment was also an important factor, cited as the 5th most common reason for discontinuation among physicians and the 3rd among patients. (more…)
Author Interviews / 24.07.2020

MedicalResearch.com Interview with: Brian Shoichet, Professor UCSF http://www.bkslab.org/contact.php  MedicalResearch.com: What is the background for this study? Response: Excipients are ubiquitous in drug formulations.  What most people consider "drugs" are formulations of active and "inactive" ingredients--the excipients.  These "inactive" ingredients, which you can find on the label of all of the drugs you use, play crucial roles in drug stability, as antioxidants, as colorants to help patients distinguish among them, as anti-microbials to keep them from getting infected with bacteria, helping to make the soluble  in the patient, among other functions. They are considered "inactive" because they do not have observable toxicity in animal and sometimes histological studies, but few of them have been evaluated in a modern way.  This would involve testing the excipients for activity on individual receptors and enzymes that are involved in biological responses, which is what happens for drugs.  Doing this was the focus of this study (more…)
Author Interviews, Cost of Health Care / 10.03.2020

MedicalResearch.com Interview with: Olivier Wouters, Ph.D. Assistant Professor of Health Policy Department of Health Policy London School of Economics and Political Science London MedicalResearch.com: What is the background for this study? Response: Although both Democrats and Republicans consider lowering prescription drug prices a priority, lobbyists and campaign donors in the pharmaceutical industry may counteract efforts by federal and state governments to decrease these costs. In this study, I tracked every dollar spent by the pharmaceutical and health product industry on lobbying and campaign contributions in the US from 1999 to 2018. These data were obtained from the Center for Responsive Politics and the National Institute on Money in Politics—two non-profit, non-partisan US organizations.  (more…)
Author Interviews, Cost of Health Care, JAMA, Pharmaceutical Companies / 04.03.2020

MedicalResearch.com Interview with: Olivier Wouters, Ph.D. Assistant Professor of Health Policy Department of Health Policy (COW 2.06) London School of Economics and Political Science MedicalResearch.com: What is the background for this study? What are the main findings? Response: Drug companies often point to high research and development costs as justification for the rising prices of new medicines. Yet most prior analyses of research and development costs have been based on confidential data voluntarily supplied by drug companies to researchers with financial ties to the industry. Independent teams have not been able to verify those findings. (more…)
Author Interviews, Cost of Health Care, Emergency Care / 22.02.2020

MedicalResearch.com Interview with: Collin Tebo BA Georgetown University School of Medicine Washington, DCCollin Tebo BA Georgetown University School of Medicine Washington, DC MedicalResearch.com: What is the background for this study? Response: The growing cost of pharmaceuticals is an issue of increasing concern in the United States where a large portion of the nation’s Gross Domestic Product is health care spending. During the past decade, visits to Emergency Departments (EDs) have increased considerably. Pharmaceutical drugs are utilized in the care of most patients who visit the ED therefore, rising drug prices are a concern for emergency medicine physicians, administrators, and patients throughout the US. (more…)
ASCO, Author Interviews, Bayer, Cancer Research / 11.02.2020

MedicalResearch.com Interview with: bayer-pharmaceuticalsDr. Kirhan Ozgurdal Global Medical Affairs Physician Oncology, Bayer MedicalResearch.com: What is the background for this study? What are the main findings?
  • Regorafenib is an oral multi-kinase inhibitor that potently blocks multiple protein kinases involved in tumor angiogenesis, oncogenesis, metastasis and tumor immunity. It is approved for the treatment of patients with hepatocellular carcinoma (HCC) who have previously been treated with sorafenib. The safety and effectiveness of regorafenib is being evaluated in patients with unresectable hepatocellular carcinoma (uHCC),a liver tumor not eligible for curative treatment approaches such as surgery, given the extent of disease.
  • Following the Phase 3 RESORCE trial, which showed that regorafenib significantly improves overall survival versus placebo in patients with uHCC who progressed on prior sorafenib therapy, we conducted an interim analysis (the first 500 of 1000 patients) of the global REFINE observational trial to evaluate the safety and effectiveness of regorafenib in uHCC in the real-world setting.
  • The REFINE study shows a more varied patient population than the Phase 3 RESORCE trial, including a higher proportion of patients with ECOG performance status ≥1, and a higher proportion with Child–Pugh B liver function.
  • The incidence of regorafenib-related grade ≥3 treatment-emergent adverse events were lower than that reported in the RESORCE trial, possibly indicating improved adverse event management with the use of regorafenib in clinical practice.
  • The median overall survival was longer than that reported in RESORCE, but the proportion of censored patients was high in this interim analysis; the median progression free survival was similar to that reported in RESORCE.
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Author Interviews, Dartmouth, JAMA, Pharmaceutical Companies, Primary Care / 27.01.2020

MedicalResearch.com Interview with: Steven Woloshin, MD, MS Professor of Medicine and Community and Family Medicine Professor, The Dartmouth Institute for Health Policy and Clinical Practice MedicalResearch.com: What is the background for this study? Response: Industry spends more on detailing visits and free samples than any other form of prescription drug marketing.  There is good evidence that these activities can lead to more use of expensive new drugs over equally effective cheaper options.  Given these concerns there have been efforts by some hospitalls and practices to restrict these forms of marketing. We asked physicians in group practices delivering primary care about how often pharmaceutical reps visit their practice and whether they have a free sample closet.  (more…)
Addiction, Author Interviews, CDC, Emory / 20.03.2019

MedicalResearch.com Interview with: CDR Andrew Geller, MD Medical Officer, Medication Safety Program Division of Healthcare Quality Promotion, CDC Atlanta GA 30329 MedicalResearch.com: What is the background for this study? Response: There has been a lot of recent attention on drug overdoses in the United States, particularly fatal overdoses which involve opioids. But the overall frequency with which patients end up in the emergency department (ED) due to nonmedical use of medications across the US is unknown.
  • Nonmedical use refers to a spectrum of circumstances, including intentionally using more medication than is recommended in an attempt to treat a health condition (therapeutic misuse) to using medication to attain euphoria or get “high” (abuse).
With this analysis, we wanted to focus on the acute harms to individual patients from nonmedical use of all medications, in order to help target prevention efforts.
  • Specifically, we used data from a nationally-representative sample of hospital EDs to identify the medications with the highest numbers of emergency visits for harms following nonmedical use of medications and to identify the patient groups with the highest risks. 
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Author Interviews, Cost of Health Care, JAMA / 30.10.2018

MedicalResearch.com Interview with: Samir C. Grover MD, MEd, FRCPC Division of Gastroenterology Program Director Division of Gastroenterology Education Program University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that physician-industry interactions are commonplace. Because of this, there has been a movement to make the presence of these relationships more transparent. For clinical practice guidelines, this is especially important as these documents are meant to be objectively created, evidence based, and intended to guide clinical practice. The standard in the US come from the National Academy of Medicine report, "Clinical Practice Guidelines We Can Trust", which suggests that guideline chairs should be free of conflicts of interest, less than half of the guideline committee should have conflicts, and that guideline panel members should declare conflicts transparently. Other studies, however, have shown that some guidelines don't adhere to this advice and have committee members who don't disclose all conflicts. We thought to look at this topic among medications that generate the most revenue, hypothesizing that undeclared conflicts would be especially prevalent in this setting. We found that, among 18 guidelines from 10 high revenue medications written by 160 authors, more than (57%) had a financial conflict of interest, meaning they received payments from pharmaceutical companies that make or market medications recommended in that guideline. About a quarter of authors also received, and didn't disclose payments from one of these companies. Almost all the guidelines did not adhere to National Academy of Medicine standards. (more…)
Author Interviews, Pharmaceutical Companies / 31.05.2018

MedicalResearch.com Interview with: “pills” by Dominique Godbout is licensed under CC BY 2.0George P. Ball PhD Operations and Decision Technologies Department Kelley School of Business, Indiana University Bloomington, IN 47405, MedicalResearch.com: What is the background for this study? What are the main findings? Response: We sought to examine how the intense pressure on firms to produce generic drugs more cheaply might influence product quality. We find that the greater proportion of generic drugs a firm manufactures, the more severe product recalls they experience, because of an apparent relaxation of manufacturing quality standards. Additionally, they experience fewer less severe recalls, which may also result from forces of competition. When the opportunity exists to not announce a recall that has high discretion, competition may lead firms to forgo the recall to avoid negative ramifications associated with recalls. (more…)
Author Interviews, Cancer Research, Cost of Health Care, JAMA, Pharmaceutical Companies / 09.04.2018

MedicalResearch.com Interview with: Aaron Mitchell, MD Division of Hematology/Oncology, Department of Medicine, Lineberger Comprehensive Cancer Center The Cecil G. Sheps Center for Health Services Research The University of North Carolina at Chapel Hill MedicalResearch.com: What is the background for this study? What are the main findings? Response: Financial relationships between physicians and the pharmaceutical industry are very common. However, we are just beginning to figure out whether these relationships may lead to potentially concerning changes in physician behavior - whether physicians tend to prescribe more of the drugs made by a company that has given them money. We decided to ask whether oncologists who receive money from drugmakers are more likely to use the cancer drugs made by companies that have given them money in the past. In studying two specific groups of cancer drugs, one for kidney cancer and one for chronic myeloid leukemia (CML), we found that oncologists who had received payments such as meals, consulting fees, travel & lodging expenses from the manufacturer of one of these drugs tended to use that drug more. When looking at oncologists who received payments for research, we found increased prescribing among the kidney cancer drugs but not the CML drugs. (more…)
Author Interviews, Pain Research, Pharmacology, PLoS / 17.08.2017

MedicalResearch.com Interview with: Harsha Shanthanna MBBS, MD, MSc Associate Professor, Anesthesiology Chronic Pain Physician St Joseph's Healthcare,McMaster University Hamilton, Canada Diplomate in National Board, Anesthesiology (India) Fellow in Interventional Pain Practice (WIP) European Diplomate in Regional Anesthesia and Pain MedicalResearch.com: What is the background for this study? Response: Pregabalin (PG) and gabapentin (GB) are increasingly used for nonspecific Chronic Low Back Pain (CLBP) despite a lack of evidence. There have been concerns expressed over their increased prescribing for various non cancer pain indications in recent years. Their use requires slow titration to therapeutic doses and establishing maintenance on a long-term basis. With prolonged treatment, the potential gain over possible adverse effects and risks could become unclear. We searched Cochrane, MEDLINE and EMBASE databases for randomized control trials reporting the use of gabapentinoids for chronic lower back pain treatment of 3 months or more in adult patients. (more…)
Author Interviews, Cost of Health Care, JAMA, Lipids, University of Pittsburgh / 07.08.2017

MedicalResearch.com Interview with: Inmaculada Hernandez, PharmD, PhD Assistant Professor of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh, PA 1526 MedicalResearch.com: What is the background for this study? Response: A few months ago, the results of the FOURIER trial were published. This trial was the first one to evaluate the efficacy of PCSK9 inhibitors in the prevention of cardiovascular events, since the approval of these agents was based on trials that evaluated their efficacy in reducing levels of LDL-C. The results of the FOURIER trial did not meet the expectations generated by prior studies that had simulated how much the risk of cardiovascular events should decrease based on the observed reduction in LDL-C levels. A few hours after the publication of the results of the FOURIER trial, Amgen (evolocumab´s manufacturer) announced that it would be willing to engage in contracts where the cost of evolocumab would be refunded for those patients who suffer a heart attack or a stroke while using the drug. (more…)