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CLINICAL NEWS Take It or Leave It The Rules of Retraction Skyrocketing prices for prescription medications have an unintended negative effect: Many patients are abandoning treatment. In a study of more than 38,000 patients newly diagnosed with cancer in 2014 or 2015 who required treatment with any of 38 oral cancer drugs: Journal article retractions are on the rise, and according to a review of the retracted articles from the past 25 years, the reasons for retraction – and how the journal articles were handled – varied. % Of 1,339 retracted articles from PubMed and the Retraction Watch website between 1980 and 2016, the most common reasons for retraction included: % misconduct (51%; n=685) errors (14%; n=193) % duplicate publication (13%; n=169) % % Handling of retractions varied greatly: 13.5% of journals completely withdrew the article, but 86.5% still had the article available. There was no indication of the retraction on about one-third (34.1%) of the retracted articles. % “More efforts are needed to improve the consistency and transparency of journal practices toward article retractions,” the authors concluded. % Source: Li G, Kamel M, Jin Y, et al. Exploring the characteristics, global distribution and reasons for retraction of published articles involving human research participants: a literature survey. J Multidiscip Healthc. 2018;11:39-47. % rates of unfilled prescriptions ranged from 13 % to 67 % rates of treatment abandonment ranged from 10 % to 49 % rates of delayed initiation ranged from 3 % to 18 % These rates all increased with higher out-of-pocket costs (p<0.001 for all). “Imagine leaving your doctor’s office with a plan, ready to start treatment, only to find you can’t afford it. It adds more stress to what is already a stressful and scary time,” said lead author Jalpa A. Doshi, PhD, from the Perelman School of Medicine at the University of Pennsylvania, in a press release. “Our results highlight the pressing need for all stakeholders … to identify fiscally sustainable strategies to improve patient access to cancer medications.” Source: Doshi JA, Li P, Huo H, et al. Association of patient out-of-pocket costs with prescription abandonment and delay in fills of novel oral anticancer agents. J Clin Oncol. 2018;36:476-82. Hemorrhaging Blood Products The U.S. exports a surprising amount of blood products overseas, according to data from the Atlas of Economic Complexity from the Center for International Development at Harvard University. In 2016, the overall exports of human and animal blood prepared for therapeutic, prophylactic, or diagnostic uses totaled 20.3 BILLION, or a 15% SHARE $ of the international blood-export economy. European countries controlled most of the blood-export industry, with Germany alone accounting for 16.6% of the total exports in 2016. Sources: World’s Top Exports, “Top Blood Exporters by Country,” November 25, 2017; Atlas of Economic Complexity. BLOOD BLOOD ASHClinicalNews.org BLOOD BLOOD BLOOD BLOOD BLOOD BLOOD BLOOD BLOOD ASH Clinical News 29