This week PLOS Medicine publishes the following articles:
“Evergreening” strategies, where pharmaceutical companies slightly change the formulation of their brand drug into “follow on” drugs by combining formulations or producing slow-release forms, can extend drug patents substantially. In an analysis of pharmacy invoice data in one Swiss Canton from 2000 to 2008, Nathalie Vernaz and colleagues find that evergreening strategies successfully maintain drug market share, offset generic competition and cost containment policies, and contribute to increased overall healthcare costs. Rising health care costs and pharmaceutical “life-cycle management” are discussed in an accompanying perspective by Aaron Kesselheim.
Using Mendelian randomization to study genes known to modify serum iron levels, Cosetta Minelli and colleagues find that increased iron levels may be causally associated with a decreased risk of developing Parkinson’s disease. While the causes of Parkinson’s disease are currently unknown, a combination of genetic and environmental factors are said to be attributed to the disease.
Household air pollution (HAP) from solid fuel combustion is the leading environmental cause of death and disability in the world. Addressing the burden of HAP has led to the implementation of many important interventions to promote access to improved stoves and clean fuels, but there is little demonstrated evidence of health benefits from most of these programs or technologies. William Martin and colleagues identify research gaps and priorities in seven key areas related to the health effects of HAP and unsafe stoves.