The Long Run

It’s been a tough few weeks for music fans with the deaths of David Bowie to liver cancer and Glen Frey to complications from rheumatoid arthritis and ulcerative colitis. These are just two of the millions of people worldwide suffering from these diseases, but I’m sure I’m not the only one who felt a sense of loss from the passing of these two men. Both profoundly influenced my adolescence and early adulthood through their music.

In the days following the news of Frey’s death, news stories emerged sourcing his longtime manager Irving Azoff and medical professionals unrelated to his treatment that assigned some degree of blame on Frey’s death to the medications he was taking to treat his conditions.

As someone deeply immersed in the issues of drug safety and side effects, I sometimes take it for granted that everyone knows that “serious” drugs can have equally “serious” side effects. But judging from the media reaction and the online commentary it seems that many were shocked that the very medications Mr. Frey was taking to heal him may have ended up hurting him.
To be clear, I have yet to find an article citing the specific medication he was taking or providing the details of his treatment regimen that may or may not have led to his passing. Nonetheless, it seems a good time to remind people that yes, unfortunately, serious side effects — up to and including death — do happen. In 2014 alone, there were nearly 95,000 deaths reported to FDA from drug side effects.

How many of those could have prevented through alternative therapies is one of the pressing questions that underlies all of the work we do here at Advera Health Analytics. We don’t profess to know more than the healthcare providers on the frontline treating their patients, but we do have insights that they largely do not — we get to see the big picture on the frequency, incidence, seriousness, and outcomes of side effects within any particular class of drugs or set of drugs used to treat a particular indication.
To make those data more accessible and actionable by patients and physicians alike, we developed RxScore. RxScore functions like a FICO score for drug safety — aggregating and weighting multiple variables that contribute to the overall safety profile of a drug and then assign that drug a numerical score on a 1-to-100 scale (with the higher number indicating a less safe drug). Late last year our methodologies and findings for RxScore (and our related costing methodology RxCost) in the Journal of Managed Care and Specialty Pharmacy.

Using our Adverse Events Explorer platform, we can quickly look at an indication to see how the different drugs used to treat that indication compare on safety. Below is a screen shot of the Ulcerative Colitis indication. You can see that certain drugs — including the widely prescribed Humira and Remicade — are among those with the highest scores, indicating that they are less safe compared to their peers.

Would having access to these scores (and the data underlying the scores) have changed the treatment decisions made by Mr. Frey’s medical team? Would it have prolonged or saved his life? That’s really impossible to know, especially when dealing with chronic and debilitating conditions.

We do know that more and more hospital systems and health plans are starting to deploy these data into their decision making processes at both the formulary and prescription levels. And having access to these data provide physicians and other healthcare providers with a global view on safety that they simply aren’t otherwise able to grasp from the relative confines of their own practices or from alternative data sources.

I didn’t know Mr. Frey or Mr. Bowie, but have long felt like I did know something of them from the music they shared with the world. I can only hope that the work we do here at Advera Health Analytics will someday play a small part in helping to improve the fate of others suffering from similar inflictions.

To learn more about RxScore and how health plans and systems nationwide are using it to make better safety decisions, please click here.