Aaron Mitchell
@thewonkologist.bsky.social
Medical oncologist and health services researcher. Focusing on health care costs, physician-industry COI, and oncology reimbursement reform. Opinions mine.
"Of these 52 drugs, 36 (69.2%) experienced any FDA postmarketing safety action, including 33 (63.5%) new warnings and precautions, 6 (11.5%) new boxed warnings, 4 (7.7%) drug safety communications, and 2 (3.8%) safety-related market withdrawals"
January 14, 2026 at 10:09 PM
"Of these 52 drugs, 36 (69.2%) experienced any FDA postmarketing safety action, including 33 (63.5%) new warnings and precautions, 6 (11.5%) new boxed warnings, 4 (7.7%) drug safety communications, and 2 (3.8%) safety-related market withdrawals"
Summary findings:
Post-market safety actions are very common.
SERIOUS safety actions (new black box warnings or market withdrawal) were much less common.
Post-market safety actions are very common.
SERIOUS safety actions (new black box warnings or market withdrawal) were much less common.
January 14, 2026 at 10:09 PM
Summary findings:
Post-market safety actions are very common.
SERIOUS safety actions (new black box warnings or market withdrawal) were much less common.
Post-market safety actions are very common.
SERIOUS safety actions (new black box warnings or market withdrawal) were much less common.
We hope to have more findings regarding the interaction of competing industry payments - and on payments promoting the less-than-optimal treatment options - forthcoming soon!
This work led by rockstar student Helen Keetley!
Thanks to @profgenkanter.bsky.social for all your input.
6/
This work led by rockstar student Helen Keetley!
Thanks to @profgenkanter.bsky.social for all your input.
6/
January 12, 2026 at 4:48 PM
We hope to have more findings regarding the interaction of competing industry payments - and on payments promoting the less-than-optimal treatment options - forthcoming soon!
This work led by rockstar student Helen Keetley!
Thanks to @profgenkanter.bsky.social for all your input.
6/
This work led by rockstar student Helen Keetley!
Thanks to @profgenkanter.bsky.social for all your input.
6/
We also saw some concerning signals regarding payment bias.
My understanding is that osimertinib is superior to earlier-gen EGFRis.
We observed that MDs who received payments for osimertinib AND afatinib were more likely to Rx afatinib (vs. those with payments for osimertinib alone)
5/
My understanding is that osimertinib is superior to earlier-gen EGFRis.
We observed that MDs who received payments for osimertinib AND afatinib were more likely to Rx afatinib (vs. those with payments for osimertinib alone)
5/
January 12, 2026 at 4:48 PM
We also saw some concerning signals regarding payment bias.
My understanding is that osimertinib is superior to earlier-gen EGFRis.
We observed that MDs who received payments for osimertinib AND afatinib were more likely to Rx afatinib (vs. those with payments for osimertinib alone)
5/
My understanding is that osimertinib is superior to earlier-gen EGFRis.
We observed that MDs who received payments for osimertinib AND afatinib were more likely to Rx afatinib (vs. those with payments for osimertinib alone)
5/
And these payments DO cause biased prescribing, as we have written about extensively:
pubmed.ncbi.nlm.nih.gov/33226858/
pubmed.ncbi.nlm.nih.gov/37879723/
archinte.jamanetwork.com/article.aspx...
4/
pubmed.ncbi.nlm.nih.gov/33226858/
pubmed.ncbi.nlm.nih.gov/37879723/
archinte.jamanetwork.com/article.aspx...
4/
Are Financial Payments From the Pharmaceutical Industry Associated With Physician Prescribing? : A Systematic Review - PubMed
National Cancer Institute.
pubmed.ncbi.nlm.nih.gov
January 12, 2026 at 4:48 PM
And these payments DO cause biased prescribing, as we have written about extensively:
pubmed.ncbi.nlm.nih.gov/33226858/
pubmed.ncbi.nlm.nih.gov/37879723/
archinte.jamanetwork.com/article.aspx...
4/
pubmed.ncbi.nlm.nih.gov/33226858/
pubmed.ncbi.nlm.nih.gov/37879723/
archinte.jamanetwork.com/article.aspx...
4/
...at the same time, a larger proportion of oncologists received payments from only 1 or 2 of the 3 competing companies, leaving more than enough room for "unbalanced" payments (and potentially biased prescribing).
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3/
January 12, 2026 at 4:48 PM
...at the same time, a larger proportion of oncologists received payments from only 1 or 2 of the 3 competing companies, leaving more than enough room for "unbalanced" payments (and potentially biased prescribing).
3/
3/
We found that this actually does happen relatively frequently.
We looked at 3 sets of 3 competing drug.
For CDK4/6i and BCR-ABL TKIs, about 1/4-1/3 of oncologists had received $$$ from all companies over a 3yr period.
(less often for EGFRi, due to gefitinib payments being rare)
We looked at 3 sets of 3 competing drug.
For CDK4/6i and BCR-ABL TKIs, about 1/4-1/3 of oncologists had received $$$ from all companies over a 3yr period.
(less often for EGFRi, due to gefitinib payments being rare)
January 12, 2026 at 4:48 PM
We found that this actually does happen relatively frequently.
We looked at 3 sets of 3 competing drug.
For CDK4/6i and BCR-ABL TKIs, about 1/4-1/3 of oncologists had received $$$ from all companies over a 3yr period.
(less often for EGFRi, due to gefitinib payments being rare)
We looked at 3 sets of 3 competing drug.
For CDK4/6i and BCR-ABL TKIs, about 1/4-1/3 of oncologists had received $$$ from all companies over a 3yr period.
(less often for EGFRi, due to gefitinib payments being rare)
lol, “proliferating healthy connection at scale”
January 7, 2026 at 6:34 AM
lol, “proliferating healthy connection at scale”
Smashing the Blowfish
December 30, 2025 at 5:00 AM
Smashing the Blowfish