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Value-BasedCare:WhyMaketheSwitch?
byAmritaTejwani,P2
Value-basedcareisahotlydebatedtopic withawidearrayofviewpoints.Onthe whole,value-basedcareis“doctorsand otherhealthcareprovidersworkingtogethertomanageaperson’soverallhealth, whileconsideringanindividual’spersonal healthgoals.”1 Thiscontrastswithfee-forserviceinfrastructure,where“healthcare providersarereimbursedforeachservice theydelivertoapatient,”whichistheprimarymethodtocompensateforhealthcare currentlyusedthroughouttheUS.2 In value-basedcare,healthcareprovidersare compensatedaccordingtooverallpatient outcomes,preventingunnecessarycosts fromaccruing,sincehealthcareproviders arenolongerperformingunnecessaryactionstoincreasetheiroverallcompensation.Themainargumentagainstvaluebasedcareisthathealthcareprofessionals willnotadoptitas“nobodyisgoingtoever dopopulationhealthbecausethatrequires compensatingpeopleforwhenthey'retak-
TableofContents
PhotoCredit:https://www.nelsonmullins.com/insights/blogs/healthcare_essentials/corporate_and_transactional/using-a-value-based-enterpriseto-integrate-specialists-and-primary-care-taking-value-based-care-to-the-next-level
ingcareandpreventingdiseasetostartoff with.”3 Itisevidentthatswitchingtovaluebasedcarewilllikelyimprovepatientoutcomesbutisaverychallengingprospectas mosthealthcaresystemsareaccustomedto thefee-for-serviceinfrastructure. Sincemostinsurancecompaniesandother payersprefertorelyonaneasilybillable methodtoeasilycalculatecompensation, convertingtovalue-basedcarefromfeefor-serviceinfrastructureisadifficulttransition.Onemethodsuggestsrunningpilot modelprogramstoultimatelydetermine themosteffectiveapproachestocare.1 Alternativepaymentmodelsreward providersforhighqualitycaresuchas helpingapatientslowtheprogressionofa diseaseorservingthoseinareaswithlimitedhealthcareaccess.Anothereffective methodmayconsistofloopinginpharmaceuticalcompanies.Asaresultoffewer patientsundergoingunnecessarymedical interventions,suppliershaveabenefitof
aligningtheirproductsandserviceswith positivepatientoutcomesatareduced cost.4 XiFin,ahealthcareinformationtechnologycompanythatacquiredOmniSYS, isworkingtobegintheprocessofswitchingtovalue-basedcare.Thiscompany worksinconjunctionwiththepharmaceuticalindustryandpharmaciestohelpserve theirpatientswithclinicalservices,medicalbilling,andrevenuecyclemanagement services.5 It’sevidentthatpharmaceutical companiesareanintegralpartoftheswitch tovalue-basedhealthcare,andcanoffer keyinsightsintopromotingthechange. Althoughitwillbeachallengingtransition,valuebasedcareisstillpossibleby connectingtherightgroupsandincentivizingthebenefits.
Successwithinvalue-basedcarelookslike fewerhospitalizationsandillnesses.3 Patientscanhaveeaseofnavigatingcare,
ByAshleyHuang,P1
ForgetMe Not
Mydecisiontopursueacareerinpharmacy hasbeenadeeplypersonalone,centered aroundagallonsizedziplocbagfilledto thezipperwithambervials.Iwouldwatch thebag’sownermeticulouslylineupthe dozenorsomedicationsforthenextmorning,onebyone,likesoldierspreparingfor battle—anightlyritualcarriedoutwith quietdetermination.
Inthepastfewyears,however,whatwas
onceaconsistentroutinehasbecomedisjointedandwroughtwithconfusion.It shouldcomeasnosurprisethatoneofthe primaryissuesfacingelderlypatientsis adherencetomedicationregimens,especiallyinthefaceofmultiplemorbidities.1 Sincepooradherenceisamajorbarrierin improvingpatientoutcomes,identifying andimplementingthebeststrategiesto improvecomplianceiskey.2 Common
strategiestoimprovecomplianceinclude keepinganupdatedmedicationlist,reducingpolypharmacy,andsettingalarmsor reminders.3 Inmypersonalexperience,utilizingavisualmedicationlistwithphotos ofthedrugfollowedbycleardosinginstructionshasbeenincrediblyhelpful.This visualreferenceservesastheultimate guidebook,answeringquestionssuchas whentotakethemedication,howmuch/ manytotake,whatit’susedfor,andwhen it’snecessary.Ashealthcareprofessionals, and,moreimportantlyaspotentialfriends andfamilytoanelderlypatient,itisbecomingmorepertinenttorecognizethe uniquecognitivechallengeselderlypatientsmayfacewhenmanagingmedications.
References
1.BarryHE,HughesCM.AnUpdateonMedicationUseinOlderAdults:a NarrativeReview.CurrEpidemiolRep.2021;8(3):108-115.doi:10.1007/ s40471-021-00274-5
2.ChristopherCM,BlebilAQ,BhuvanKC,etal.Medicationuseproblems andfactorsaffectingolderadultsinprimaryhealthcare.ResSocialAdm Pharm.2023;19(12):1520-1530.doi:10.1016/j.sapharm.2023.08.001
3.NationalInstituteonAging.TakingMedicinesSafelyasYouAge.NationalInstituteonAging.PublishedSeptember22,2022.https://www.nia.nih.gov/health/medicines-and-medication-management/taking-medicinessafely-you-age
MonopolyMedicine:ThePatentGamesThatKept HumiraonTop
bySakshiShah,P1
Withmonoclonalantibodies(mAbs)becomingoneofthemostpowerfulclassesof drugsinmodernmedicine,theconversationaroundaccessismoreimportantthan ever.Thesebiologicsarenotluxurytreatments;theyareessentialforpatientswith autoimmuneconditions,cancers,and chronicinflammatorydiseases.Unliketraditionalsmall-moleculedrugs,whichare nowrelativelysimpletoreplicatewith generics,newermonoclonalantibodiesare biologicallycomplex,producedinliving cellsandsensitivetoeventheslightest changeinformulation.Developingbiosimilars—genericversionsofbiologics—is farmoredifficultandexpensive.1 Inadditiontothecomplexityofdevelopment,intentionallegalstrategieshavedesignedto keepbiosimilarsoffthemarket,further limitingaccesstothesedrugs.
Adalimumab,brandnameHumira,isa TNF-alphainhibitorapprovedin2002.It’s oneofthemostversatileandwidelyprescribedbiologics,withFDAapprovals
acrossrheumatoidarthritis,Crohn’sdisease,ulcerativecolitis,plaquepsoriasis, andotherautoimmuneconditions.2 More impressivethanitspharmacology,however,isthewayitsmanufacturerAbbVie managedtokeepitatthetopofthemarket formorethantwentyyears.
AbbViebuiltapatentthicketaroundHumira—deliberatelydensewebofpatents
designedtodelayorblockbiosimilarentry.3 WhiletheprimarypatentforHumira expiredin2016,AbbViefiledover250 secondarypatentapplications,themajority ofwhichcameafterthedrugwasonthe market.Thesesecondarypatentscovered surfacechangestoformulations,injection devices,dosingschedules,andmanufacturingprocesses.Intotal,morethan130 patentsweregranted,manyofwhichextendedexclusivityintothe2030s.4 Duetothesepatents,therewasnobiosimilarcompetitionintheU.S.until2023,althoughbiosimilarslaunchedinEurope backin2018.5 Duringthatfive-yeardelay, AbbViecontinuedtoraiseHumira’sprice whilemaintainingamonopolythatgeneratedbillionsinrevenueannually.6
Therearenowmorethan120FDA-approvedmonoclonalantibodies,andthat numbercontinuestogrow.7 IftheHumira strategytaughttheindustryanything,it’s
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PhotoCredit:https://www.southernliving.com/forget-me-nots-care-7098903
Understanding505(b)(2)DrugsandReimbursement
byMariaGhaly,P1 Atthe2025Hematology/OncologyPharmacyAssociation(HOPA)AnnualConference,expertsshedlightontheevolving roleoftheFDA’s505(b)(2)approvalpathwayandimpactondrugreimbursement practices,especiallyinoncology.The 505(b)(2)pathwayallowspharmaceutical companiestomodifyexistingdrugsby changingdosageforms,combiningmedications,oralteringtherouteofadministrationwhilerelyingpartiallyonpreviously establishedsafetyandefficacydata.1 This routehelpsreducedevelopmentcostsand acceleratesthetimetobringmedicationsto market.Between2003and2023,over940 drugswereapprovedviathismethod.1 Whilethispathwaywasoriginallydesignedtofosterinnovation,recentchanges bytheCentersforMedicare&Medicaid Services(CMS)aretransforminghow thesedrugsarereimbursed.Previously, drugsunderthiscategorysharedacommonJ-codeforbillingpurposes.However, asofJanuary2023,CMShasbegunissu-
byAnishaDesai,P2
inguniqueJ-codesto505(b)(2)drugsthat arenotconsideredtherapeuticallyequivalenttotheirreferencedrugs.2
Thispolicyshifthassignificantimplicationsforinfusioncentersandhospitalpharmacies.AccordingtoDr.ScottSoefje,DirectorofPharmacyCancerCareatMayo
Clinic,“Nowthe505(b)(2)manufacturers mayrequesttheFDAtogivethemtherapeuticequivalents,butFDAdoesnotautomaticallydoit.”1 Asaresult,manyofthese drugsarebeingtreatedassole-source products,givingthemuniqueJ-codesand changinghowtheyarereimbursedby CMSandotherpayers.Forpharmacists, especiallythoseworkinginoncologyor institutionalsettings,understandingthe distinctionbetweentherapeuticequivalenceandregulatoryclassificationisessential.The505(b)(2)pathwayoffersflexibilityandexclusivity,butitalsoaddsnew layersofcomplexityinoperationaland billingpracticesthatpharmacistsmust navigatetoensureoptimalpatientcareand institutionalcompliance.
References
1.SoefjeSA,IrvineCA.505(b)(2)Drugs:NewChaosforInfusionCenters. Presentedat:Hematology/OncologyPharmacyAssociation(HOPA)2025 AnnualConference;Portland,Oregon;April9-12,2025.
2.AlanaHippensteele,LeadEditor.“Hopa2025:UnderstandingtheRecent Changesfor505(b)(2)DrugsandReimbursement.”PharmacyTimes,PharmacyTimes,12Apr.2025,www.pharmacytimes.com/view/hopa-2025-understanding-the-recent-changes-for-505-b-2-drugs-and-reimbursement.
RoleofPharmacistsinOncology
Themajorityofoncologypatientsinthe USaretreatedatcommunityoncology centerswiththepriorityofpatientcentered careandlowercosts.Auniquefeatureof manyofthesecentersisanintegrateddispensingpharmacywhereinterdisciplinary teamsarefocusedoncoordinatedcare.Literaturehasshownthatoncologypharmacistscontributetopositiveoutcomesfor patientsbyidentifyingdruginteractions, facilitatingpatientunderstanding,managingsideeffects,andmaintainingadherence.
InasinglecenterstudyatFloridaCancer Specialists&ResearchInstitute,adescriptiveanalysisassessedpharmacist-ledclinicalinterventionsforpatientsreceivingoral oncolytictherapy.1 Interventiondatawas categorizedbythefollowingtypes: strengthanddosing,clarificationofprescriptiondirectionsforuse,drug-druginteractions,treatmentdiscontinuationor hold,treatmentcycle,orlababnormalities.
Thestudyprimarilyaimedtomeasurethe numberofinterventionsandsecondarily theinterventionacceptancerates. Resultsshowedatotalof3528clinical interventionsidentified,withthegreatest percentagebeingstrengthsanddosing,followedbytreatmentdiscontinuationor
PhotoCredit:https://www.onlymyhealth.com/trends-to-look-out-for-in-radiation-oncology-1688465917
hold.1 Themedicationswiththemostfrequentinterventionswerechemotherapies administeredincyclesordrugsthatsignificantlyaffectbloodcounts. Capecitabinewasthemostfrequentlyintervenedondrug.1
Atotalof2910interventionswereaccepted,correspondingtoan82%acceptancerate.1 The618interventionsnotacceptedweremostlikelyduetodiscussions withtheproviderthatdeterminedthebest routeoftreatmentwastocontinuewith carefulobservation.Factorsthatmustalso
beconsideredinoncologicalcareinclude off-labelindicationsandpalliativecare measures,allofwhichmayimpactdosing andschedulingstrategies.
Theresultshighlightedtheimportanceof pharmacistsinoncologytoprovidehighqualitycoordinatedcare.Pharmacistshave theabilitytoprovideclinicallyrelevant interventionsinsettingswheretheyhave accesstopatient’smedicalissues.
PhotoCredit:https://www.evotec.com/therapeutic-areas/oncologyimmuno-oncology
TheOtherPill:YCT-529asaProspectiveMale Contraceptive
bySamJacob,P1
PhotoCredit:https://femtechinsider.com/yourchoice-therapeutics-advances-hormone-free-male-birth-control-pill-to-second-human-study/
Intoday’smarket,theonlyoptionsfor malecontraceptivesarecondoms–withan 87%successratewithaverageuse—and vasectomies—whichareusedasapermanentoption.Comparedtothemultitudeof optionsthatwomenhaveforbirthcontrol, rangingfromthepill,ring,injections,and implants,medicationdevelopmentcontinuestomaketheargumentthattheburden ofcontrollingreproductionfallson women.Developinganoptionthatgives mentheopportunitytousepharmaceutical contraceptivesnotonlyshiftsthisimbalancebutalsogivesmentheautonomyin controllingifandwhentheywanttobecomefathersontheirownterms.Pharmaceuticalcompaniesareawareofhowbeneficialamalebirthcontroloptioncouldbe andhavededicatedresearchtowardsdevelopingsuchadrug.Unfortunately,past effortshaveencounteredaseriesofcomplicationsthathavemadetheendeavorunfavorable.
Underdevelopmentisahighlyselective non-hormonalretinoicacidreceptorantagonist,YCT-529,whichtargetsRARα Retinoicacid,ametaboliteofvitaminA,is vitalforspermatogenesis,secretedbySertolicellstopromptspermatogoniatodifferentiateandentermeiosis.1 Whensilencingthegenesthatencodetheretinoicacid receptors,RARα,RARβ,andRARγ,effectsonmalefertilityinmicemostclosely resemblevitaminAdeficiencyintheabsenceofspecificallytheretinoicacidreceptor α. 2 Byselectivelyinhibitingthisreceptor,YCT-529wasproventobe99% effectiveatpreventingpregnanciesinpreclinicaltrialsdoneonmiceandonprimates.2 Fullfertilitywasalsoregainedafter endingthetreatmentwithin10-15weeks. Thiswasnotthefirsttimethatretinoicacid signalinginhibitionwasinvestigatedforits effectonmalegermcelldevelopment. WIN-18446wasanexperimentalmedica-
Continuedfrompage1 trainingorothereducationalresources,accesstooptions,andopportunitiestoparticipateindiseasepreventionprograms.1 Althoughimplementingvalue-basedcare maybechallengingatfirst,itisevidentthat itisakeychangenecessarytopromotethe healthandwellbeingofpatients.
References
1.CentersforMedicare&MedicaidServices.Value-BasedCare.www.cms. gov.PublishedAugust14,2023.https://www.cms.gov/priorities/innovation/ key-concepts/value-based-care
2.Ahmed,Tufayel.“Fee-For-ServicevsValue-BasedCare:Understanding theKeyDifferences(2023)-StreamlineHealth.”StreamlineHealthSolutions,31Aug.2023,streamlinehealth.net/fee-for-service-vs-value-basedcare/.Accessed15Oct.2024.
tionthatwasresearchedinthelate1950s. ItalteredretinoidmetabolismandirreversiblyinhibitedALDH1A2,which blockstheproductionofretinoicacid,and itseffectsonfertilitywerecompletelyreversiblewhendrugadministration stopped.3 However,duetoanadditional sideeffectonALDH2,anenzymeresponsibleforalcoholmetabolism,drugdevelopmentforWIN-18446wasstopped.Patientswhodrankalcoholwhiletakingthis medicationbuiltupacetaldehydeand wouldexperienceanassortmentofsymptoms,suchasvomiting,nausea,headache, andfacialflushing.3 Sincethemedication disruptedbothformsofthisenzyme,it couldnolongerbeinvestigatedasapotentialcontraceptive.
Adverseeffectslikethesehavehalteda multitudeofprospectivecontraceptives meanttobemarketedtomen.Femalebirth controloftengetsawaywithitslaundrylist ofsideeffectsbecauseitpreventsthemany seriouscomplicationsofpregnancy.4 For women,adrugthathasanincreasedriskof bloodclotsisstillanacceptablerisksince theriskofbloodclotsisevenhigherin pregnancy;inmen,thereisnosuchcomparison.4 Inthiscontext,fortheFDAto approveamalecontraceptive,itwould havetobewithoutanyoftherisksthat comewiththefemalealternativescurrently onthemarket.Thisisthereasonthatthere arenotestosteroneortestosteronederivativesonthemarket.Althoughresearched, hormonalcontraceptivesimpactmany pathologicalsystems,sothatdevelopment insuchadrugformenwithconcerning riskswasunfavorabletoinvestin.
Thereisstillpotentialforthesuccessof YCT-529asanon-hormonaldrug.Preclinicalstudiesproducednosignificant changesintestosterone,inhibinBorFSH, andtrialsproceededwithlittletonoside effects.5 Asaresultofitssuccessinthese pre-clinicaltrials,thedrugwasableto completephaseIclinicaltrials.Whilethe
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3.Ang,Adam.“KeytoImplementingValue-BasedCareatNationalScale.” HealthcareITNews,HIMSSMedia,14Oct.2024,www.healthcareitnews. com/news/asia/key-implementing-value-based-care-national-scale
4.NEJMCatalyst.WhatIsValue-BasedHealthcare?NEJM,ed.TheNew EnglandJournalofMedicine.PublishedonlineJanuary1,2017
5.NowosielskiB.Q&A:HowPharmacistsStandintheGapforValue-Based Care.DrugTopics.PublishedOctober15,2024.https://www.drugtopics. com/view/how-pharmacists-stand-in-the-gap-for-value-based-care
BehavioralAddictions
byVinayakShende,P1
Amongmanyresearchersandclinicians, “addiction”hascometorefertoadisorder inwhichanindividualbecomesintensely preoccupiedwithabehaviorthatatfirst providesadesiredorappetitiveeffect. Behavioraladdictionisamentalhealthissueinwhichanindividualbecomesobsessedwithabehaviorthattheythinkis rewardingand/orrelaxing.Thisdiffers fromtraditionalsubstanceaddictionbecauseabehavioraladdictiondoesnotneed toinvolveaspecificlegalorillegalsubstance.Whilebehavioraladdictionsdonot causetheirusersdirectphysicalharm,they canstillhaveasevereimpactontheirmentalhealthandqualityoflife.Themost widelyrecognizedbehavioraladdictionis PathologicalGambling,whichisadiagnosabledisorderbytheDSM-5andICD10.1 Otherbehavioraldisorders,suchas socialmediaaddictionandcompulsive shopping,arenotformallydiagnosabledue toalackofcriteriaanddata. Inthepast,pharmaceuticaltherapieshave helpedpatientsimprovetheirqualityof life.ImipramineandIsoniazid,medicationsdiscoveredinthe1950s,helped healthcareprofessionalsrecognizeand treatdepression.Thefurtherdevelopment ofmedicationfortreatingneurologicaldisorderscreatedpsychopharmacologyand theviewpointthatmentalhealthdisorders maybetreatedinabiologicalmanner.In the1990s,FluoxetineandotherSSRIsfurtheradvancedthetreatmentofdepression withamildersideeffectprofilethanolder drugs.2 Whiledrugshavebecomeanimportantpartofmentalhealthtreatment,patientsstillrequireotherformsoftreatment totrulygetbetter.
Continuedfrompage4 resultsofthesetrialsarenotknowntothe public,theresultsweresufficientforYCT529toenterphaseIIasofSeptember2024. Theimportanceofsuchabirthcontroloptionisunderscoredwhenconsideringthe originsofthefemalecontraceptive.The originaloraltabletwasamedicationthat wasinitiallyindicatedformenstrualdisorders,onlyrecognizedbytheFDAasacontraceptiveyearsafteritwasonthemarket.6 Thedecisionwasbasedonatrialdoneon impoverishedPuertoRicanwomenwho werenotfullyinformedoftherisksand reportedaslewofsideeffects.7 Atthat
PhotoCredit:https://devtechnosys.com/insights/build-an-app-for-de-addiction/
Behavioraladdictionshavebecomeincreasinglyprevalentinthepastcoupleof years,duetoseveralreasons.Duringthe COVID-19pandemic,theisolationof quarantineandthelackofsocialoptions leadpeopletousetechnologicaldevices andsocialmediamorefrequently.Studies conductedduringthepandemicfounda correlationbetweenexcessivesocialmedia andgamingusewithanincreaseindepression,anxiety,andothermentalhealth problems.1 Additionally,the2018 SupremeCourtdecisiontoreversetheban onsportsgamblinghasledto38states legalizingsportsbetting,theprevalenceof whichisreflectedincommercialsfrom multibilliondollarentitiessuchasthe NBA.Thesefactorshaveledtoanincreasedneedfordiagnosticcriteriaand treatmentoptionsforbehavioraladdictions.
Currently,mostdatahasbeencollectedon pathologicalgamblingdisorders.While therearenoformalindicationsforgamblingtreatmentyet,opioidantagonists suchasNaltrexonehaveproducedresults. However,moredataisneededbeforeopi-
stageofdevelopment,theoralcontraceptivewasahigherdoseandhadahigher likelihoodofadverseeffectsthanthatof themodernpilldue.Duringthestudyin PuertoRico,thedosageofnorethynodrel was5mgbutresultedinseveresideeffects, causinga66-foldreductionofdoseof norethynodrelto75mcg.7 Withinoneyear ofthecontraceptive’sapproval,sixfatal casesandtwentynon-fatalcasesofthrombosiswerereportedtotheFDA.Since then,thedosagehasbeenprogressively loweredovertime.6 Thenatureofdrug trialsandtheprocessforacceptingmedica-
oidantagonistscanbeconsideredaclinical treatmentoption.Othermedicationclasses, suchasSSRIsandGlutamateagents,have alsobeentested.3,4 However,theyhave producedlesssureresults,andmoredatais neededbeforetheycanbeconsideredclinicaltreatmentoptions.Forotherbehavioral addictions,suchassocialmediaandonline shopping,itisdifficulttoobtaindataas thereisnoformaldiagnosticcriteria. Overall,behavioraladdictionshavebeen gettingmoreattentioninthepastdecade, duetochangesinthelawandworldwide events.Thesepatternsofbehaviorhave beenshowntoimpactpatienthealthnegativelyandwhilemedicationssuchasNaltrexonehaveshownpromiseinresearch trials,theyarenotclinicaltreatmentsat thispointintime.
Resources
1.Alimoradi,Z.,Broström,A.,Potenza,M.N.etal.AssociationsBetweenBehavioralAddictionsandMentalHealthConcernsDuringtheCOVID-19Pandemic:ASystematicReviewand Meta-analysis.CurrAddictRep11,565–587(2024).https://doi.org/10.1007/s40429-02400555-1
2.BraslowJT,MarderSR.HistoryofPsychopharmacology.AnnuRevClinPsychol.2019 May7;15:25-50.doi:10.1146/annurev-clinpsy-050718-095514.Epub2019Feb20.PMID: 30786241.
3.Brand,M.,Antons,S.,Bőthe,B.,Demetrovics,Z.,Fineberg,N.A.,Jimenez-Murcia,S.,… Potenza,M.N.(2025).CurrentAdvancesinBehavioralAddictions:FromFundamentalResearchtoClinicalPractice.AmericanJournalofPsychiatry,182(2),155–163. https://doi.org/10.1176/appi.ajp.20240092
4.Grant,J.E.,Chamberlain,S.R.PharmacotherapyforBehavioralAddictions.CurrBehav NeurosciRep3,67–72(2016). https://doi.org/10.1007/s40473-016-0065-6
tionshaveevolvedsince,butthestained historyoffemalecontraceptivesstillcontributetothecurrentlackofbalanceconcerningtheburdenoftakingbirthcontrol.
References
1.Zhao,Yue,etal.“Theroleofretinoicacidinspermatogenesisanditsapplicationinmalereproduction.”Cells,vol.13,no.13,24June2024,p.1092,https://doi.org/10.3390/ cells13131092.
2.Mannowetz,Nadja,etal.“TargetingtheretinoidsignalingpathwaywithYCT-529foreffectiveandreversibleoralcontraceptioninmiceandprimates.”CommunicationsMedicine, vol.5,no.1,13Mar.2025,https://doi.org/10.1038/s43856-025-00752-7.
3.Paik,Jisun,etal.“InhibitionofRetinoicAcidBiosynthesisbytheBisdichloroacetyldiamine Win18,446MarkedlySuppressesSpermatogenesisandAltersRetinoidMetabolisminMice.” TheJournalofBiologicalChemistry,U.S.NationalLibraryofMedicine,23May2014,www. ncbi.nlm.nih.gov/pmc/articles/PMC4031560/.
4.Anthes,Emily.“WhyWeCan’tHavetheMalePill.”Bloomberg,Bloomberg,3Aug.2017, www.bloomberg.com/news/features/2017-08-03/why-we-can-t-have-the-male-pill. 5.FirstHormone-FreeMaleBirthControlPillClearsAnotherMilestone,UniversityofMinnesota,26Mar.2025,twin-cities.umn.edu/news-events/first-hormone-free-male-birth-controlpill-clears-another-milestone.
6.Kao,Audiey.“Historyoforalcontraception.”AMAJournalofEthics,vol.2,no.6,1June 2000,https://doi.org/10.1001/virtualmentor.2000.2.6.dykn1-0006. 7.Christin-Maitre,Sophie.“Historyoforalcontraceptivedrugsandtheiruseworldwide.”Best Practice&ResearchClinicalEndocrinology&Metabolism,vol.27,no.1,Feb. 2013,pp.3–12,https://doi.org/10.1016/j.beem.2012.11.004.