Vynthera
Drug evidence for busy physicians: search a drug, condition or mechanism and get, in three clicks or fewer, the published evidence, its GRADE certainty, who funded it, and whether the use is off-label. Every claim links to its source.
What it does
- Home search. One box that accepts a drug, condition or mechanism, plus an optional patient condition. A drug name goes straight to its page; a condition or mechanism lists matching drugs (FDA label indications, FDA pharmacologic classes, Open Targets).
- Drug page. A summary card with mechanism, evidence strength (GRADE), cost range and off-label flag. Below it is a summary of the evidence: written by Claude when an API key is set, otherwise quoted from the abstracts. Then six tabs, always in the same order:
- Evidence: GRADE certainty with its reasoning; a plain "what is uncertain" statement; FDA approval status; MEDLINE studies by design; ClinicalTrials.gov trials; badged preprints; funding badges. Generate letter creates a medical necessity letter; patient details stay in the browser.
- Cases: published case reports (and case preprints) with funding badges. Copy citations.
- Manufacturer: brand (NDA/BLA) and generic (ANDA) holders from Drugs@FDA; trials run by the manufacturer; MEDLINE articles with manufacturer-affiliated authors or funding, labelled.
- Costs: summary tiles (pharmacy cost, Medicare cost per patient, Medicare plan coverage); generic and biosimilar availability (Drugs@FDA); Medicare negotiated prices; a prescription calculator (strength, units per day, 30/60/90 days) with the 2026 standard Part D benefit and typical plan copays; coverage by insurer across every Medicare drug plan (plans covering, usual tier, prior authorization, step therapy, typical cost) and by state; an ACA Marketplace lookup by ZIP code (when
MARKETPLACE_API_KEY is set; get a free key at developer.cms.gov/marketplace-api); pharmacy cost per product (NADAC) with a 22-month price trend; Medicare Part D and Part B spending; Part B payment limits (ASP + 6%); VA Federal Supply Schedule prices; cheaper drugs in the same class; ways to save. Copy cost summary.
- Specialists: clinicians in a chosen state, city and specialty who prescribed the drug in Medicare Part D, most experienced first, with NPI Registry-verified specialty, address and a Call button. No messaging through the site.
- Patient info: physician view (boxed warning, mechanism, dosage, side-effect table with frequencies, warnings, trial counts, animal toxicology) and a plain-language patient view (benefits, risks, drawbacks, questions to ask), with Print handout.
Automated jobs (GitHub Actions)
| Workflow | When | What |
|---|
| Import cost data | Mondays 06:17 UTC, or Actions → Import cost data → Run workflow | Downloads the newest NADAC (and last year's, for the price trend), Medicare Part D and Part B Spending, the CMS monthly Part D formulary files (summarized by drug, insurer and state), Part B ASP payment limits, CMS negotiated prices and the VA price list into data/costs/ and commits them. Also records the Part D Prescribers API used by Specialists. If one source fails, last week's data is kept and the run is marked failed. |
| Live smoke test | Manual only | Builds the site and loads every tab against the real APIs, printing what each tab shows and any unavailable source. |
How judgements are made
| Judgement | Rule | Code |
|---|
| Evidence certainty | GRADE starting certainty from study design. Randomized → High (one lone trial → Moderate for imprecision), observational → Low, case reports only → Very low. Preprints are shown but not counted. Risk of bias, inconsistency, indirectness and publication bias are listed as "not assessed". | src/lib/grade.ts |
| Off-label | The condition is matched against the FDA label's Indications and Usage text. Text under "Limitations of Use" never counts as approval. Synonyms can be missed, so the page always links the label. | src/lib/label-status.ts |
| Funding | 1) sponsor class of a linked ClinicalTrials.gov trial; 2) funding agencies on the PubMed record. Anything else is "Funding not reported", never a guess. | src/lib/funding.ts |
| "Credentialed journals" | PubMed medline[sb] (MEDLINE-indexed). Preprints come from Europe PMC (SRC:PPR) and are badged. | src/lib/sources/ |
Run it
npm install
cp .env.example .env.local # all keys optional
npm run dev # http://localhost:3000
npm run dev:demo # offline, with clearly marked placeholder data
npm test && npm run lint && npm run typecheck
Deploy (Vercel free tier)
- Import this GitHub repo at vercel.com/new. The defaults work.
- Under Settings → Environment Variables, add
NCBI_API_KEY and OPENFDA_API_KEY (both free), and later ANTHROPIC_API_KEY.
- Deploy. Source data is cached per server instance for a day (
"use cache" with cacheLife("days")), so repeat searches are fast and stay within the free API limits.
Data sources
openFDA / DailyMed (labels, Drugs@FDA), PubMed E-utilities (MEDLINE literature), Europe PMC (preprints), ClinicalTrials.gov API v2 (trials, sponsors), Open Targets Platform (mechanisms, condition and target → drug), MedlinePlus Connect (patient information), Medicaid NADAC, CMS Medicare Part D and Part B Spending, CMS Part D formulary files, CMS ASP pricing files, CMS negotiated prices, the VA Federal Supply Schedule and the HealthCare.gov Marketplace API (costs and coverage), CMS Part D Prescribers by Provider and Drug and the NPPES NPI Registry (specialists).
Privacy
No database and no accounts. Patient details in the letter tool live only in browser memory. Only public literature is sent to Claude.
Next builds
Physician sign-in with NPI verification, which also enables self-reported experience on the Specialists tab; Medicare plan coverage from CMS formulary files; licensed retail price data for out-of-pocket estimates.
