Tuesday, February 21, 2006

Fewer seniors turning to Canada for prescriptions - Boston.com

From the Boston Globe:
Retired furniture store owner Don Brock quit buying prescription drugs from Canada this year, now that he's signed up for the new federal Medicare drug benefit.

The next time he needs a refill on Lipitor, his daily anti-cholesterol drug, Brock will go to a pharmacy near his home in Litchfield. The 74-year-old says he was saving about $300 annually buying Canadian; now, he figures he'll save about $500 buying through Medicare. ...more

Monday, February 20, 2006

Canada drug-pricing questioned

The latest report from the Vancouver-based Fraser Institute has suggested no less than the total dismantling of the price control system in place on Canadian pharmaceuticals, all in the name of protecting the drug supply from American cross-border shoppers. The Institute suggests that a "temporary" price increase would put internet pharmacies out of business then drug companies would happily go back to previous regulations.

Is it me, or is this simply crazy? In an era of rising health care costs, drugs are one of the fastest growing areas of spending. Canadian pricing controls keep these costs somewhat in check. Meanwhile, Americans pay the highest drug prices in the world. I'd like to see the Fraser Institute convince provincial health ministers that having to double their expenditures on drugs for a couple of years to ensure that Canada doesn't run out of supply. This is like saying we need to double the price of milk for a couple of years because we're worried about the milk supply running out. It's the weirdest economic theory I can think of.

And maybe it's just me, but I think if price controls are removed, the drug companies would be quite reluctant to go back to the old system. After a couple of years of increased profits, it would be hard to convince them to turn back the clock. This would be a dream scenario for drug companies, and a nightmare for provincial governments, medical insurance companies, and individual customers and it would all be in the name of stopping internet pharmacy.

The report fails to mention that the Bush administation along with the FDA are totally against imporation and would never allow the mass imporation that the Fraser folks say would clean out the Canadian supply. So the whole argument is a moot point as I see it.

More on the story in the Calgary Sun article below....

Canada must abandon regulated drug-pricing to stop Americans from draining brand-name prescription medicines through bulk buys from Internet pharmacies, says a report released Wednesday.

The Fraser Institute says such a move could see Canadians temporarily paying more for some drugs, but it would be worth it to prevent widespread shortages. There's no evidence to suggest brand-name drug makers would take advantage of "flexible pricing" and permanently boost the cost of drugs, said report author Brett Skinner. ...more

Province not paying for pricey cancer drug

Here's an interesting story of how procedure can get in the way of the treatment. It seems that an effective drug is not covered by Alberta's provincial coverage plan because it never got a NOC from Health Canada.

From the Edmonton Journal:
As Alberta prepares new legislation to become a leader in the war against cancer, some colon cancer patients are being forced to pick up big bills -- with tabs running as high as five figures -- for chemotherapy.

Alberta is one of three provinces that doesn't fund the drug oxaliplatin, considered an effective therapy for advanced colorectal cancer, because of a patent problem that never saw the drug go through a federal review process. ...more

Maybe it's just me, but can't they make exceptions for products that are approved Canadian drugs with documented therapeutic benefits? These exceptional items should be subject to some kind of appeal process.

Diabetics wanted for program to improve their quality of life

Perhaps someone out there can help this pharmacist with his program...

From the Hope (BC) Standard:
The Hope branch of the Canadian Diabetes Association and it’s president, pharmacist Mike McLoughlin, embarked last November on an ambitious project to improve the quality of life of diabetics. They are continuing to enroll patients.

The project was inspired by research done at the University of Alberta at Edmonton, which showed that “intensive” involvement of pharmacists with their patients showed substantial improvement over “typical” attention from pharmacists. Further inspiration came from the Steno Diabetes Center in Denmark. The average improvement from the extra treatment resulted in an average improvement of a 20-53% decrease in cardiovascular risk. ...more

Wednesday, February 15, 2006

Health Canada Endorsed Important Safety Information on Octreotide Acetate Omega

From Health Canada:
Omega Laboratories, Ltd has initiated a Class I recall of Octreotide Acetate Omega 500 μg/mL. Some vials of Octreotide Acetate Omega 500 μg/mL Lot 5J970 might contain FLUPHENAZINE 100 mg/mL as a result of a labelling error during the manufacturing process.

Fluphenazine is an antipsychotic medication used to treat schizophrenia and psychotic symptoms such as hallucinations, delusions, and hostility. Fluphenazine is intended to be administered intramuscularly or subcutaneoulsy and should not be administered intravenously as is intended for Octreotide Acetate. ...more

Health Canada Endorsed Important Safety Information on Octreotide Acetate Omega

From Health Canada:
Omega Laboratories, Ltd has initiated a Class I recall of Octreotide Acetate Omega 500 μg/mL. Some vials of Octreotide Acetate Omega 500 μg/mL Lot 5J970 might contain FLUPHENAZINE 100 mg/mL as a result of a labelling error during the manufacturing process.

Fluphenazine is an antipsychotic medication used to treat schizophrenia and psychotic symptoms such as hallucinations, delusions, and hostility. Fluphenazine is intended to be administered intramuscularly or subcutaneoulsy and should not be administered intravenously as is intended for Octreotide Acetate. ...more

Important Safety Information on BD Logic, BD Latitude and The Link Blood Glucose Monitors

From Health Canada:

Sobeys unhappy with new guidelines

From the Halifax Chronicle Herald:
A major grocery store chain isn’t happy with the province’s move Monday to limit the amount of space pharmacies can use to sell food as part of new regulations on Sunday shopping.

Justice Minister Michael Baker announced that drugstores can’t dedicate more than 2,000 square feet of their retail space for food, nor can they have a retail sales area larger than 20,000 square feet.

But a spokesman for Sobeys says the new regulations don’t go far enough. ...more

Sunday, February 12, 2006

Taking cold medicine off shelves a commercial move, grocers say

From the London Free Press:
Canada's independent grocers say a national pharmacy body's move to ban cold and allergy medicine from grocery shelves is meant to remove a competitor, not prevent the production of the street drug methamphetamine.

"We believe this decision's being made by a pharmacy body to benefit pharmacies," said Gary Sands, vice president of the Canadian Federation of Independent Grocers.

The National Association of Pharmacy Regulatory Authorities, or NAPRA, has recommended almost all cough, cold and allergy medicines be removed from grocery store shelves to fight the production of the illegal drug. ...more

While I am not convinced that removing all pseudoephredrine-containing products from public access areas really makes a big difference in curbing the meth problem, I find it rather unlikely that NAPRA is using this as a cover to squeeze grocery stores out of the picture.

House OKs bill urging importation of medicine

From the Louisville (KY) Courier Journal:
Eleanor Johnson, 79, says she would like to have the chance to buy cheaper medications imported from other countries.

The Kentucky House passed a bill yesterday that could pave the way for that to happen.

House Bill 163, which would require the governor and state health officials to ask the federal government to allow the importation of drugs "from licensed foreign pharmacies, distributors and wholesalers by licensed pharmacies, distributors, and wholesalers," was approved 58 to 35 after a lively 45-minute debate. ...more

Made-to-order medications: Thinking outside the bottle

From the Canadian Jewish News:
Pharmacist Murray Shore is enthusiastic about compounding medications – a growing and sometimes controversial field that creates custom-made drugs to meet individuals’ needs.

For Shore, who owns the Toronto Compounding Shoppe, compounding is a creative endeavour. He works with physicians to solve medication problems – distasteful flavours, ingredient allergies, infants’ tiny doses, nausea drugs that can’t be taken orally – with custom formulations created for individual patients.

“Many pharmacists don’t think out of the box,” Shore says. Compounding calls for “peripheral thinking,” using known drugs precisely to solve unique problems. ...more

CanWest challenging restrictions on drug ads

From the Globe and Mail:
CanWest Global Communications Corp. has launched a court challenge against federal restrictions on drug company advertising in Canada, saying the rules violate its charter rights.

In an application filed in the Ontario Superior Court, CanWest says it wants the laws governing drug advertisements overturned because they threaten freedom of expression in Canada and are unjustifiable "in a free and democratic society."

The court action, launched by the company's MediaWorks division, comes amid a lobbying effort by Canada's broadcasting, newspaper and magazine industries, which have been trying for several years to have the rules changed. ...more

Currently, drugs are advertised mentioning their name only, and don't get into its uses or potential risks. It has caused ad execs to become a bit more creative than in the U.S., but the ads leave a lot open to (mis)interpretation.

My personal pet peeve are the commercials for birth control pills that seem to be advertising attitude more than anything else. Maybe it's time to revisit and update these rules.

Online drug crackdown

Here are a couple more articles talking about the woes of the internet pharmacy biz:

From the Winnipeg Sun:
A recent initiative by U.S. Customs to step up seizures of cheaper Canadian prescription drugs is making for uneasy times on both sides of the border.

Neither the $1-billion online drug industry nor the millions of U.S. patients who depend on the timely delivery of their medications say they can afford any kind of sustained U.S. government crackdown.

The lobby group representing most of the biggest players in the Internet pharmacy industry said yesterday that it first started noticing an increase in calls from panicky patients last December. ...more

From the Brandon Sun:
A double whammy has hit Manitoba’s estimated $1-billion Internet pharmacy business, with thousands of American online buyers forsaking Canadian drugs to purchase their medicine south of the border.

Following increased Medicare prescription drug coverage for some American seniors as well as more cross-border crackdowns by U.S. border officials on drug shipments, the president of the Canadian International Pharmacy Association said business for Canadian companies has crashed an estimated 10 to 30 per cent since December. ..more

Minnesota prescription drug program falling far short of goal

From Minnesota Public Radio:
Minnesotans are importing fewer prescription drugs from Canada because of the new Medicare benefit that offers cheaper drugs. Both the state and the senior advocacy group the Minnesota Senior Federation give Minnesotans the chance to buy drugs from Canadian pharmacies at lower prices than in the United States. The two groups say the new Medicare drug benefit is mostly responsible for the dropoff, but the U.S. Customs Service also seized more drugs. ...more

FDA: Discount Drugs Aren't Always From Canada

From WCCO-TV (Minn.):
A recent inspection by the U.S. Food and Drug Administration found some of the drugs Minnesotans order from Canada may not be from the country at all.

Each month, thousands of people save money buying prescription drugs from Canadian pharmacies. The state government even sponsors a Web site to help people save money on medicine by ordering it from Canada.

Buying prescription drugs from abroad is illegal. For years, federal officials allowed people such as Wallace Greenfield to import medication for his own use. ...more

Prescription for trouble

From the Toronto Star:
A 31-year-old Toronto woman visited 17 different doctors in the span of a year and was prescribed 13,959 narcotic pills dispensed to her at nine different pharmacies throughout Ontario.

She might never have been caught had the "scrips" not been fraudulently billed to the Ontario Drug Benefit Plan, police allege. She's in court next week facing 223 counts of double doctoring, contrary to the Controlled Drug and Substances Act, and Criminal Code charges of fraud and uttering a forged document. ...more

Increased seizures by U.S. Customs

The Los Angeles Times and other news sources have reported an increase in seizures of packages from Canadian pharmacies.

The U.S. government apparently is stepping up seizures of cheap drugs ordered by Americans — mainly seniors — from abroad, Canadian pharmacies say.

The pharmacies, which sell drugs by mail and over the Internet, say their shipments are being intercepted by U.S. Customs officials around the country where foreign mail is handled.

"It's huge — we've had over 800 seizures in January," up from 15 in a typical month, said Barney Britton, president of Calgary-based MinitDrugs.

Other pharmacies reported four- to five-fold increases. An informal survey of 30 Canadian pharmacies that cater to American customers, conducted by a senior-citizen advocacy website, showed that the rise began in November, doubled in December and doubled again in January....more

U.S. Customs has always stopped a small percentage of packages but this is different than before. Some people think there is no coincidence that this crackdown is occuring at the same time as new Medicare program is being implemented in the States.

From the Palm Beach Post:
"It's a disgrace that our government is trying to coerce us into the program," said Muriel Zuckerman of Florida ...more

I'm inclined to agree that this is no coincidence. The Canadian pharmacies have lost business due to increased drug costs, the less favorable exchange rate, and the new Medicare program. This could be the straw that breaks the camel's back for some of the pharmacies. Plus, increased seizures will make American consumers think twice about ordering from Canada if for no other reason than convienience. Sounds like a good stategy for an American administration that wants the Canadian pharmacies to go away.

Monday, February 06, 2006

Health Canada going after medical pot users for almost $170,000 in bad debts

From the Canadian Press:
Like any dope dealer, Health Canada has its share of marijuana customers who just don't pay their bills.

But unlike street pushers, the department avoids tire irons and switchblades to recover its bad debts in favour of stern letters and collection agencies.

As of last month, 127 people authorized to buy government-certified marijuana for various medical problems were officially in arrears, with bills unpaid for more than 90 days. ...more

Does anyone know the method that the pot is distributed to these patients? It seems to me that it would be a lot easier for the patients if it was dispensed through designated pharmacies.

Online pharmacists hope to make fresh start with new Tory government

From the Canadian Press:
After spending more than a year in fear of a Liberal crackdown on their industry, online pharmacists are welcoming the incoming federal Conservative government as a chance to make a fresh start.

But there is also caution that the party that has supported the cross-border trade from the Opposition benches may now be swayed by brand-name drug makers and other opponents who see it as a threat to the Canadian drug supply. ...more

I think the new Tory government is going to have a lot of other things on their plate before they deal with internet pharmacy. It seems clear that Harper has his priority items that he will deal with first. The only thing that may bring the issue to the table would be if an opposition party wants something done in exchange for support on another bill. While I think the opposition parties are generally against internet pharmacy, I don't see them making it a top priority either.

Sunday, February 05, 2006

Flu drug shortage has wide-ranging impact

From the Globe and Mail:
Doctors, nurses and other emergency workers are unlikely to receive preventive doses of a drug that is predicted to be the best defence against infection during an influenza pandemic because the existing stock will be needed to treat the seriously ill.

This is the reality, officials say, despite the fact that Canada's pandemic influenza plan states that antiviral drugs, in particularly oseltamivir (marketed as Tamiflu), could be used as a "prophylactic" to prevent or reduce the severity of the disease among people essential to keeping society functioning. These include firefighters, police, elected officials, funeral directors, utility workers and even truck drivers who transport food and medicine. ...more

Plan B in Manitoba

Here are a couple of articles from the Winnipeg Sun regarding Plan B being sold without a prescription in Manitoba. The first one talks about the reluctance of some pharmacists to dispense the product. There is mention that some pharmacists are not properly trained to dispense the product...more. The article suggests this might be a convienient excuse for pharmacists to not dispense the product.

The next article talks about a Manitoba obudsman's report. The report questions the information gathering protocols prior to dispensing Plan B...more

Friday, February 03, 2006

Wealthy Alberta lags in access to cancer drugs

From the Saskatoon Star Phoenix:
Despite the province's prosperity, cancer patients in Alberta have only "modest access" to new cancer drugs compared to people in other parts of Canada, according to a study by a national cancer watchdog group.

The Cancer Advocacy Coalition also says provincial differences in access to life-enhancing drugs could be contrary to the spirit of the Canada Health Act, and calls for a national strategy to improve access for cancer patients across Canada. ...more

Thursday, February 02, 2006

Morning-after pill may head over the counter

From the Georgia Strait (BC):
Thirty years ago, Caryn Duncan remembers, you couldn’t buy condoms without first talking to a pharmacist. Ditto yeast-infection cream. That was ridiculous, she said. Now, just as outrageous, Duncan added, the morning-after pill is still stuck behind the counter, with a prying pharmacist sometimes blocking access to the drug.

“Women are smart enough to figure out when and how to take it,” the Vancouver Women’s Health Collective member told the Georgia Straight. “Why can’t we just walk into a store and buy it?” ...more

Combining antipsychotic drugs has no benefit for severe schizophrenia: study

From Canada.com:
Prescribing more than one antipsychotic drug in an effort to help hard-to-treat schizophrenia appears to have no benefit and should be dropped from psychiatric practice, a Canadian-led international study concludes.

Up to one-third of schizophrenics continue to have disturbing symptoms such as auditory hallucinations even when receiving treatment, said Dr. William Honer of the University of British Columbia's department of psychiatry. The treatment of choice for such patients is usually the drug clozapine. ...more

Most ignore drug labels

From the London Free Press:
Every container of over-the-counter pain relief comes with warnings and instructions, but 60 per cent of Canadians never take the time to read them, a new survey suggests.

The Ipsos Reid survey, released yesterday, suggests as many as 10 million Canadians are at risk for serious side effects because they ignore the labels when taking aspirin, ibuprofen or acetaminophen, misuse the medication or combine it with other drugs. ...more

Victims fight government, too

From the Ottawa Sun:
Doug Emerson says his father would be alive today if the cancer drugs available in other provinces were approved for use in Ontario.

His beliefs are backed by a new study by the Cancer Advocacy Group of Canada which says cancer patients in western Canada are more likely to survive than patients in the east because not as many drugs are approved for use in provinces like Ontario.

In B.C., 21 cancer drugs have been approved compared to only six in Ontario, said the study which was released yesterday. ...more

Can someone remind me why they call Canada's health system "universal health care" with equal access?