In the last decade, billions of dollars have been spent to develop hundreds of new prescription drugs. While some drugs may not necessarily save lives (a prescription for longer eyelashes, anyone?), a handful of drugs have literally stopped major diseases in their tracks. Imagine that just ten years ago a patient might not be alive months or years after a diagnosis, whereas today a simple pill can cure or prevent a deadly disease.
From my perspective as an internal medicine doctor, here are five meds that have changed the game for doctors and their patients.
- Enbrel (etanercept). Enbrel paved the way for a new class of medications called “biologics” that have transformed the future of those suffering from conditions like arthritis and ulcerative colitis (a form of inflammatory bowel disease). If you ask rheumatologists which medication they think single-handedly changed the lives of their patients, it’s Enbrel. Enbrel blocks the effects of tumor necrosis factor and given as an injection once or twice a week it drastically improves symptoms, including debilitating joint pain, in over 75 percent of patients with rheumatoid arthritis. It is not an exaggeration to say that twenty-year-old women confined to wheelchairs as a result of debilitating pain are now able to walk and function as a result of Enbrel. Amazing.
- Harvoni (ledipasvir and sofosbuvir). In the United States, chronic hepatitis C virus (HCV) infection is the most common cause of liver disease and the most frequent reason for liver transplantation. HCV infection is now a curable condition thanks to new medications that spare folks the difficult and less effective interferon drugs that were the previous standard. Think about this: a chronic medical condition that is now curable. Curable. More than 70 percent of HCV in the U.S. is genotype 1 and the combination drug Harvoni (Sovaldi makes up half of Harvoni) cures nearly all genotype 1 patients, a startling 97 percent. Harvoni inhibits a protein necessary for HCV replication and is a bada*s player in the Hepatitis C fight.
- Truvada (emtricitabine and tenofovir). Truvada is the main medication used as PrEP (pre-exposure prophylaxis) for the prevention of HIV. Before touching on the controversy surrounding Truvada, remember that two million new HIV infections occur each year worldwide. PrEP is one of the strategies used to prevent HIV infection in uninfected high-risk folks. Taken once daily, Truvada prevents the transmission of HIV. Studies have shown that PrEP is 90 – 96 percent effective, but only if taken at least four times per week. There are several indications for PrEP including high risk individuals (those with partners known to be HIV infected) or those who engage in sexual activity in a high prevalence area. The controversy here is that using Truvada may add to high risk behavior and steer folks away from safe sex practices. That fear does not appear to be playing out in current Truvada users.
- Herceptin (trastuzumab). When we think of advances in science, we often think of cancer, and Herceptin stands out as a giant in altering lives through cancer treatment. For the 15 – 20 percent of breast cancer patients whose tumors overexpress HER2, Herceptin is important in the treatment of both early and late stage disease. Herceptin has been around for a few years so its impact is now being fully realized. Added to other chemotherapies, Herceptin improves overall survival by 37 percent and has boosted disease-free survival by 40 percent. The long-term benefit of Herceptin in reducing cancer recurrence and improving survival has been a huge ray of hope in the cancer fight.
- Gleevec (imatinib). Ten percent of all leukemias are chronic myelogenous leukemia (CML). Even as recently as year 2000, less than 20 percent of CML patients lived 5 years after diagnosis, yet now 90 percent live at least 5 years—and 87 percent at least 8 years. That is because of Gleevec. CML is associated with the Philadelphia chromosome, a genetic abnormality that results in the formation of a product called BCR-ABL which leads to a cascade of bad things. Gleevec is the initial treatment in patients with CML and it shuts down the activity of that cancer-causing cascade.