Thursday, August 27, 2009
Where's the evidence behind off-label use of drugs?
Depending on your medical specialty, you may write many prescriptions for the off-label use of certain medications. There's nothing illegal about off-label use, but often I wonder: "how strong is the evidence?" The answer really depends on each drug and how it's used.
Many physicians prescribe drugs for off-label use. This happens quite often in the field of oncology because so many clinical studies are exploring various combinations of chemotherapy and targeted biologic agents.
Some patients follow medical news and ask doctors about off-label use when they see something on the news. For instance, some patients have been using certain diabetes drugs like Byetta for weight loss. Did the doctor suggest it, or did the patient do research and ask for it? Byetta isn't indicated for weight loss and it shouldn't be taken lightly because it can lead to some serious problems like pancreatitis.
Do patients really understand the evidence behind off-label use? Insurance companies generally won't pay for drugs that are used off-label, so patients are frequently paying out of their own pockets. Some of these new medications are very expensive, so I often wonder how some people do it.