Drug-withdrawal news spread via mobile technology

Physician subscribers to clinical content provider Epocrates Inc. (San Mateo, CA) information services learned via iPhone and BlackBerry of the early April voluntary phased withdrawal of Raptiva (efalizumab), the psoriasis treatment from Genentech.

“Within hours of the withdrawal, Epocrates updated its drug databases and released the content to 225,000 U.S. physicians who actively use its mobile and online products,” according to a company announcement.

Raptiva was withdrawn due to safety concerns of a rare and usually fatal brain infection called progressive multifocal leukoencephalopathy (PML). The April 8 withdrawal announcement followed a mid-February FDA public health advisory of three confirmed reports of the infection in Raptiva users. The previous fall, a boxed warning was added to the Raptiva label to highlight the infection risk. FDA directed Genentech to develop a risk evaluation and mitigation strategy for the drug.

Physicians were advised in the withdrawal announcement to issue no new prescriptions for Raptiva and to promptly contact patients using the drug to assess treatment alternatives. Raptiva will no longer be available after June 8, 2009. Genentech estimates that 2,000 U.S. patients were receiving Raptiva for chronic plaque psoriasis at the time of the withdrawal, with 46,000 patients worldwide having been treated since FDA approval of the drug in 2003.

Epocrates says it has some 600,000 active subscribers worldwide. Among them are more than one in three U.S. physicians and more than one in three U.S. medical students.

Its premium products for mobile devices include Essentials, which integrates drug, disease, and diagnostics information for $149 per year, and Essentials Deluxe, which adds drug coding references and a medical dictionary ($199 per year). The Rx Pro product is a drug reference with treatment guide for $60 per year.

Among other offerings, the company provides market research, including its QuickSurvey service, via a verified opt-in panel of 134,000 U.S. physicians and 392,000 healthcare professionals. It also provides formulary hosting to hospitals and health plans, so providers can verify formulary status and co-payment tiers, view alternative and generic substitutions, check quantity limits, and look up prior authorization requirements. Epocrates also provides delivery of continuing medical education programs.