Sunday, December 23, 2007

Calgary resumes routine vaccinations

From the Globe and Mail:
Routine measles, mumps and rubella vaccinations have resumed for children in Calgary, officials said yesterday, ending the suspension to the program ordered this month after a cluster of serious allergic reactions.

The Calgary Health Region, which is battling a mumps outbreak among young adults that has hit Alberta, said yesterday it has found a new supply of the MMR vaccine. ...more

Doctor faces limits on practice after morphine death

From CTV News:
Quebec's College of Physicians is imposing strict limits on the practice of a Quebec doctor who administered lethal doses of morphine to a terminally ill patient.

In a judgment released Friday in Montreal, the college's discipline committee says it will restrict Genest from clinical practice to protect the public....more

New safety warnings regarding ALERTEC® * (modafinil) and serious rash, allergic reactions, and mental problems

From Health Canada:
Alertec® (modafinil) is used to relieve excessive sleepiness due to medical conditions called narcolepsy (uncontrollable, brief episodes of daytime sleepiness), obstructive sleep apnea/hypopnea syndrome (breathing abnormalities during sleep) and shift work sleep disorder. Shire Canada Inc., in consultation with Health Canada, would like to inform you of new safety information regarding Alertec®:
For Health Professionals
For the Public

Jean Coutu breaks into generic drug manufacturing

From the Globe and Mail:
In a departure from its core business, drugstore chain Jean Coutu Group (PJC) Inc. is diversifying into the manufacturing of generic drugs.

Longueuil, Que.-based Jean Coutu said yesterday it has acquired Pro-Doc Ltée., a small generic drug maker based in Laval, Que. Terms of the deal were not disclosed.

Jean Coutu made the announcement on the same day it learned its stake in U.S. drugstore giant Rite Aid Corp. took a $325-million (U.S.) hit.

"This is a new activity for us. It follows on our having sold our U.S. operations and repaying most of our debt and seeking new growth opportunities," said André Belzile, Jean Coutu's senior vice-president of finance and corporate affairs.

"It's embryonic. We want to learn. We'll see where it takes us," Mr. Belzile said in an interview. ...more

Improper use of fentanyl pain patches linked to more deaths: FDA

From CBC News:
U.S. health officials say improper use of patches that emit the painkiller fentanyl is still killing people.

Today's warning from the U.S. Food and Drug Administration is the second concerning the powerful narcotic in two years.

The FDA blames some of the deaths on the patches being improperly prescribed to certain patients. Fentanyl should be used to control chronic pain in people already used to narcotics, such as some cancer patients. Yet the FDA has found cases where doctors prescribed it for headaches or post-surgical pain. ...more

Wednesday, December 19, 2007

Doctors rely too heavily on drug company data: CMA

From CBC News:
Most of the information doctors receive about prescription drugs comes from the companies making the product, a doctor said Wednesday, pointing to a possible reason doctors continue to prescribe dangerous drugs to seniors.

Dr. John Haggie, a Canadian Medical Association board member who chairs its ad hoc working group on pharmaceutical issues, said government warnings often get lost in the stack of documents physicians routinely receive.

"The average physician is bombarded with written and faxed material in the course of a week.… [Government warnings] tend to get buried sometimes in the noise," Haggie said in an interview with CBC News from Gander, N.L., on Wednesday. ...more

Study: Timing of Pills Might Matter

From Newsday (NY):
Taking a blood pressure pill at bedtime instead of in the morning might be healthier for some high-risk people.

New research suggests that simple switch may normalize patterns of blood pressure in patients at extra risk from the twin epidemics of heart and kidney disease.

Why? When it comes to blood pressure, you want to be a dipper. In healthy people, blood pressure dips at night, by 10 to 20 percent. Scientists don't know why, but suspect the drop gives arteries a little rest.

People with high blood pressure that doesn't dip at night -- the non-dippers -- fare worse than other hypertension sufferers, developing more serious heart disease. Moreover, heart and kidney disease fuel each other -- and the 26 million Americans with chronic kidney disease seem most prone to non-dipping. In addition to heart problems, they're at extra risk of their kidney damage worsening to the point of dialysis. ...more

Doctors warn of potential dangers of OxyContin

From CTV News:
Canadian physicians are warning of the potential dangers of the prescription painkiller OxyContin following a high-profile case in which a Newfoundland and Labrador doctor was convicted of trafficking the potentially addictive narcotic.

On Monday, Dr. Sean Buckingham was convicted of five counts of sexual assault, six counts of trafficking painkillers such as OxyContin and lorazepam (sold under the name Ativan), and one count of assault.

Witnesses testified during the two-month trial that Buckingham provided them with drugs in exchange for money and sexual favours over a two-year period. ...more

Diabetes drug linked in study to heart risk

From the Toronto Star:
A massive "real world" study of the popular diabetes drug Avandia shows it can produce distressing increases in the risks of heart attacks and death, according to Ontario research published yesterday.

And a key study author says the research, which followed some 160,000 diabetics in this province for more than four years, should cause Health Canada to consider new restrictions on its use.

The drug – prescriptions for which are filled more than a million times a year in this country – can increase the risks of heart failure by 60 per cent and of heart attacks by 40 per cent over other medications meant to control Type 2 diabetes, the study says.

"Our study is the first one done in a real-world population that really supports that these drugs are associated with a higher risk of cardiac events," says lead author Dr. Lorraine Lipscombe.

"We hope that the experts at Health Canada will consider our study ... and make some new decisions about the future of these drugs," says Lipscombe, a researcher with the Institute for Clinical Evaluative Sciences. ...more

Town desperate for doctor makes unique offer

Here's an innovative way for a pharmacist to help his town. However, if this was done anyplace that didn't have a physician shortage, there would be suggestions of conflict of interest. Undoubtably, the pharmacist is doing this to help his business, but I think the huge public need for a doctor outweighs those concerns in this situation.

From CTV News:
An Alberta community that has been searching without luck for a doctor is trying to sweeten its offer to potential candidates.

Bragg Creek has been without a doctor for the past six months. In July, their previous physician left and since then local residents have been hunting for a new one. But they've had one rejection after another.

Now, they hope to make an offer too good to pass up.

Any physician who wants to set up shop in the community will have a ready-to-go office waiting upon arrival. It comes equipped with a furnished waiting room, scales, and even medical equipment. ...more

Dangerous drugs continue to be prescribed to seniors: CBC report

From CBC News:
Doctors are continuing to prescribe drugs dangerous to seniors in spite of government warnings, a CBC News investigation reveals.

More than two years ago, CBC News first reported that more than a million seniors were prescribed atypical antipsychotics. Atypical antipsychotics are specific kinds of antipsychotic drugs. They are considered by many experts to be ineffective or even dangerous for elderly patients.

Health Canada followed up with warnings pointing to the drugs' side effects — including a 60 per cent greater risk of death in seniors who were taking the drugs than in patients taking placebos — gleaned from 13 scientific studies. It also warned that elderly patients taking atypical antipsychotics were almost twice as likely to die from side effects such as heart failure. ...more

Monday, December 17, 2007

Pharmacists face dilemma over dispensing narcotics: provincial board

From the (Corner Brook, NF) Western Star:
Pharmacists in this province are finding themselves in a dilemma over dispensing narcotics like OxyContin, the Newfoundland and Labrador Pharmacy Board says.

"The dilemma is you don't want to be sucked in by people abusing it," said Don Rowe, secretary-registrar of the board. "You always have to be vigilant looking for potential abuse or signs of it, but at the same time not making a legitimate customer feel like some kind of a criminal just because they have been prescribed a drug like OxyContin or Percocet or whatever."

The "sucking in" hasn't always come from only patients, as the recent conviction of St. John's physician Dr. Sean Buckingham made evident. Last week, Buckingham was convicted of 12 counts of sexual assault, assault and drug trafficking in Newfoundland Supreme Court. Buckingham, who ran a practice on Queen's Road, was found guilty of having provided several former patients with prescription drugs, including OxyContin and Ativan, in return for sexual favours....more

Women may get pill without prescription

From Reuters (UK):
Women could be able to get the contraceptive pill from their chemist without a prescription, a health minister said on Thursday.

Lord Darzi, a leading surgeon brought into Prime Minister Gordon Brown's government, said the programme could be piloted among pharmacists or nurses.

The pill is currently available only with a prescription from a doctor, although most pharmacies are able to provide the "morning-after pill" without a doctor's authorisation.

Darzi suggested women could be given the oral contraceptive after a full assessment by a trained health professional. ...more

Mumps vaccine being probed for allergy links

From the Globe and Mail:
Health officials across the country are being told to stop using a measles, mumps and rubella vaccine that is now being investigated for possible links to six cases of serious allergic reactions in patients in Alberta.

All six people, who were treated and have fully recovered, received an inoculation from the same batch of a product known as MMR-II, which is sold by Merck Frosst Canada Ltd. They experienced anaphylaxis, a potentially fatal reaction.

But the Quebec-based company said two other lots of the vaccine were made with the same material and are affected by Health Canada's warning to suspend use until a probe is completed. ...more

Sunday, December 16, 2007

Free Trade Zones Ease Passage of Counterfeit Drugs

From the New York Times:
Along a seemingly endless row of identical gray warehouses, a lone guard stands watch over a shuttered storage area with a peeling green and yellow sign: Euro Gulf Trading.

Three months ago, when the authorities announced that they had seized a large cache of counterfeit drugs from Euro Gulf’s warehouse deep inside a sprawling free trade zone here, they gave no hint of the raid’s global significance.

But an examination of the case reveals its link to a complex supply chain of fake drugs that ran from China through Hong Kong, the United Arab Emirates, Britain and the Bahamas, ultimately leading to an Internet pharmacy whose American customers believed they were buying medicine from Canada, according to interviews with regulators and drug company investigators in six countries.

The seizure highlights how counterfeit drugs move in a global economy, and why they are so difficult to trace. And it underscores the role played by free trade zones — areas specially designated by a growing number of countries to encourage trade, where tariffs are waived and there is minimal regulatory oversight. ...more

Thursday, December 13, 2007

Pharmacy tycoon makes new bid for Oilers

From the Globe and Mail:
Rexall Founder and Chairman Daryl Katz has made a new offer to purchase the Edmonton Oilers and related assets. The terms of the offer, which were not publicly disclosed, are being delivered directly to the shareholders of the Edmonton Investors Group.

The offer, according to sources, is for $188-million and the difference this time around is, it appears to have a chance of succeeding. Katz's previous offers for the team had fallen on deaf ears.

Katz's offer was made at the encouragement of a number of significant EIG shareholders over the past six months. In particular, Katz called Cal Nichols, Founding Chairman of the Board of EIG on Thursday morning to outline the terms and conditions of the offer. Nichols said that it was an offer that he would enthusiastically support. ...more

New guidelines boost folic acid recommendation

From the Globe and Mail:
Women of childbearing age should increase their intake of folic acid to five milligrams a day to protect against common birth defects, according to new Canadian guidelines.

That is 10 times the level in standard multivitamins and five times that in most prenatal vitamins, but experts say the change reflects the latest science. Boosting intake, even among women who are not planning to get pregnant, could sharply reduce the rate of devastating birth defects such as spina bifida, congenital heart disease and childhood cancers such as neuroblastoma.

"A lot of this heartache can be very easily prevented," said Vyta Senikas, associate executive vice-president of the Society of Obstetricians and Gynaecologists of Canada. "Women just need to take multivitamins containing a little more folic acid."

The guidelines, issued jointly by the SOGC and Motherisk and published in today's edition of the Journal of Obstetrics and Gynaecology of Canada, also call for higher levels of folic acid to be added to commercial food products. ...more

Canadian professionals over-regulated, says competition report

From the Canadian Press:
A new study is recommending Canada's lawyers, real estate agents and other self-regulated professions re-examine their rules to ensure they serve the public good and encourage competition.

The study by the Competition Bureau found rules that limit advertising, set prices and restrict who can offer professional services may go too far.

The bureau says such rules can boost prices, limit choice and restrict access to information consumers need.

Competition commissioner Sheridan Scott says rules are necessary but removing some could benefit consumers and the economy.

Scott notes professions are more regulated in Canada than elsewhere. That could be compromising productivity and Canada's economic growth.

The report focuses on five disciplines - accountants, lawyers, optometrists, pharmacists and real-estate agents - but it says its findings can be applied to any self-regulated profession. ...more

Monday, December 10, 2007

Treatment using antibiotic may help slow MS

From CTV News:
An experimental treatment for multiple sclerosis that uses an antibiotic along with a common MS medication may slow the progress of the disease, finds a preliminary study set to appear in the February 2008 issue of Archives of Neurology.

The treatment involved combining doxycycline and interferon, a commonly prescribed MS medication that boosts the immune system and fights viruses.

Many patients with relapsing-remitting MS -- the most common form of the disease -- take interferon, but many still experience relapses and may continue to develop new areas of damaged brain tissue called lesions, one of the key markers of MS. ...more

J&J, Bayer Pill Caused Fewer Clots Than Sanofi Drug in Study

From Bloomberg:
Bayer AG and Johnson & Johnson's experimental blood thinner led to fewer clots and deaths in patients after hip surgery than a widely used therapy sold by Sanofi-Aventis SA, a study found.

About 1.1 percent of patients had serious blood clots or died on the Bayer and J&J pill, rivaroxaban, compared with 3.7 percent of those taking Sanofi's injected medicine, Lovenox, according to research reported today at the American Society of Hematology meeting in Atlanta. Both drugs had similar rates of bleeding, a side effect of anti-clotting medications.

Rivaroxaban may help J&J and Bayer take market share from the injectable Lovenox, Sanofi's best-seller with $3.5 billion in sales last year. Bayer, Germany's largest drugmaker, asked European regulators to allow sale of the drug under the brand name Xarelto in October, and has projected peak sales of $2.9 billion. J&J, of New Brunswick, New Jersey, has said it will seek U.S. marketing approval in the second half of 2008. ...more

Busy Pharmacy and Over-Worked Pharmacist is Prescription for Error

Here's an interesting opinion regarding pharmacy safety from an American personal injury lawyer. He raises some good points and there are some good tips for patients as well.

Pharmacy error in both the local neighborhood stores and hospital setting is on the rise. The consequences of Pharmacy errors can range from harmless to fatal. More than 100,000 Americans die each year of adverse drug reactions, according to an article in the Journal of The American Medical Association. No one knows for sure how many of those deaths are the direct result of pharmacy/pharmacist's negligence, but we do know that the leading cause for prescription mistake is overworked pharmacists.

Many pharmacies fill over 300 prescriptions a day and some pharmacists are being asked to fill 30 prescriptions an hour and work 12 hour shifts, sometimes back to back. This means that within two minutes the pharmacist must: fill the prescription, check for drug interactions, check for contraindications for use and counsel the patient. It's no wonder mistakes are being made. ...more

Paragon buys assets of Westcoast Central Fill for $5.75M in cash and stock

From Canoe Money:
Paragon Pharmacies Ltd. (TSXV:PGN) has signed a deal to buy the assets of Westcoast Central Fill Ltd. from Westcoast and its parent, Catalyst Healthcare Ltd., for $5.75 million in cash and stock. ...more

FDA eyes 'behind the counter' drug category with greater clinical role for pharmacists

From the American Medical News:
The Food and Drug Administration is contemplating the establishment of a class of medications that would be available only after counseling from a pharmacist but without a physician's prescription. Physicians widely oppose the development, arguing that it could disrupt continuity of care and put patients at risk.

"We're concerned about patient safety," said Rebecca J. Patchin, MD, an American Medical Association trustee. "If a medication requires oversight, it should be available by prescription, and a physician should be involved in prescribing it and monitoring the patient." The AMA testified in opposition to this action at the FDA's Nov. 14 hearing on the subject.

Known as "behind the counter," this category exists in many other countries in various forms. The FDA is considering the possibility for the fourth time since the 1970s because agency officials feel the emergence of the Internet means that consumers are more informed than ever and the time may be right to make this change in the United States. ...more

Saturday, December 08, 2007

Fears over medicine unproven: industry

From the National Post:
It would likely take two to three years before a decision could be made to pull controversial children's cough and cold products from the shelves, says the umbrella association for Canada's non-prescription drug manufacturers.

Defending the remedies against a withering assessment in the influential New England Journal of Medicine that calls for their immediate removal, the spokesman of the Nonprescription Drug Manufacturers Association of Canada (ND-MAC) is confident that science will vindicate the popular decongestants, cough suppressants and expectorants. Before proceeding with their own trials, however, the industry says it needs a clearer direction of evidence needed to satisfy Health Canada that they work.

"We're in a holding pattern -- I don't deny it," said Gerry Harrington, NDMAC's director of public affairs. "But the first step is to decide what will work best as a standard for efficacy." ...more

Recruiting pharmacists called 'shameful'

From the Globe and Mail:
A small group of AIDS activists demonstrated outside a recruitment meeting held by Shoppers Drug Mart in Cape Town last night. The session, at a hotel in the upmarket neighbourhood of Camps Bay, was designed to inform South African pharmacists about opportunities working with Shoppers in Canada. ...more

Pharmacists worry about police requests

I applaud the actions of this Vermont pharmacist. The "War on Drugs" is much more aggressive in the States, but I could see a similar situation occuring in Canada. As pharmacists, we need to ensure that patient info is only released when appropriate.

From the Barre Montpelier (VT) Times Argus:
Law enforcement offices in Vermont are supposed to collect information about the purchase of prescription drugs only when they have a reason to believe a specific crime may have been committed.

But in at least one case last month, Vermont State Police asked for a list of all customers seeking powerful pain medicine, according to a pharmacist.

Fairfax Pharmacy owner Rick Hogle said he refused to hand over a list of his customers prescribed schedule-two drugs, which include medications such as oxycodone, when asked by a state police trooper who was investigating the spread of such drugs on the street.

Hogle, a pharmacist for 16 years, said he felt caught between protecting the privacy of his customers and assisting law enforcement in stopping the illegal sale and use of these medications.

"I'm not going to release patient information," Hogle said. "The woman from the state police was very polite and did not throw her weight around, but unless they get a court order, I'm not going to release this information." ...more

Baclofen Aids Abstinence in Alcoholics With Cirrhosis

I found this article really interesting. I've never heard of baclofen being used to help maintain alcohol abstinence before.

From U.S. News and World Report:
The drug baclofen promotes alcohol abstinence in alcoholics with cirrhosis of the liver, says an Italian study in this week's issue of The Lancet.

The study included 84 alcohol-dependent patients with liver cirrhosis who received either oral baclofen (42 patients) or a placebo (42 patients). Total alcohol abstinence and duration of this abstinence were assessed during outpatient visits. Relapse was defined as alcohol intake of more than four standard drinks per day (a standard drink defined as equal to 12 grams of absolute alcohol) or overall consumption of 14 or more standard drinks per week over a period of at least four weeks.

Among those taking baclofen, 71 percent (30 of 42 patients) achieved and maintained alcohol abstinence, compared to 29 percent (12 of 42) of those who took the placebo. The study also found that patients taking baclofen abstained from alcohol for more than twice as long as those taking the placebo -- 62.8 days vs. 30.8 days. ...more

Front-line AIDS drugs show staying power: study

From AFP:
Standard triple-drug treatment for HIV provides long-term protection against the development of full-blown AIDS, according to a study released Friday.

But when this front-line therapy fails, HIV-infected people in poorer nations could find themselves nearly defenceless against AIDS-related disease, it warned.

Data on 7,916 HIV-infected individuals in Britain who began standard triple-drug therapy showed that only 167 developed extensive resistance to all three types of medication, the researchers found.

The risk of such "triple-class" failure at the end of 10 years was estimated at 9.2 percent, according the study, published in the British medical journal The Lancet. ...more

Thursday, December 06, 2007

Isotope shortage leads to cancelled medical exams

From the National Post:
The worldwide supply of medical isotopes used to help diagnose a host of health problems, including cancer and cardiovascular disease, may be in short supply in the weeks and months ahead because of an extended shutdown at a Canadian nuclear reactor.

The reactor in Chalk River, Ont., about 180 kilometres northwest of Ottawa, provides the raw material from which MDS Nordion produces medical isotopes, which are injected into patients to help create images of the body for diagnostic purposes.

However, MDS Nordion announced Wednesday the planned shutdown at the Chalk River facility -- owned by Atomic Energy of Canada Limited -- had to be extended into the new year to conduct additional maintenance work. ...more

Wednesday, December 05, 2007

N.B. tops absenteeism list for Canadian health-care workers

From CBC News:
New Brunswick has the highest rate of absenteeism among health-care workers in Canada while those in Alberta missed the fewest days, according to a Canadian Institute for Health Information study.

Health-care workers in New Brunswick are absent an average of 16.1 days annually, compared to a national average of 12 days a year, according to the study, published Monday. In Alberta, the average was 7.2 days a year.

New Brunswick's health-care workers also far exceeded the national average for workers of all kinds in Canada, who missed an average of seven days of work in 2006. For 20 years, health-care workers have had the highest average of lost work days compared to the rest of the Canadian population, according to the study.

On a national level, the researchers found that nurses are far more likely to be away from work than other health-care professionals — averaging 14.1 days a year. Doctors average 2.8 missed days annually, while those working in therapy and medical assessments average 8.1 days and pharmacists average four. ...more

Tuesday, December 04, 2007

Is Shoppers Drug Mart poaching pharmacists from South Africa?

From the Globe and Mail:
Michael and Berdine Fazakas liked what they heard: that in Canada, they could own a profitable business - really profitable. That there are fewer murders in most Canadian cities each year than there are in a week in Johannesburg, where they live now. Canada has good, free schools for their future kids and vast expanses of nature - "just lots of opportunity," Mr. Fazakas said.

That's what they took away from a meeting held here last week by Shoppers Drug Mart Corp. Canada's largest drugstore chain has a team in South Africa seeking pharmacists to hire and sponsor as immigrants to Canada. The company provides legal assistance and covers the costs associated with immigration for the pharmacists it hires here. There's another Shoppers' information session in Durban tonight and in Cape Town on Thursday.

This is the only developing country where Shoppers recruits, and it's one with a dire shortage of pharmacists: In KwaZulu-Natal province, for example, one in three adults has HIV but 75 per cent of jobs for public pharmacists are vacant.

So meetings like last week's dinner-drinks-and-information session (from which Shoppers' staff barred a Globe and Mail reporter) are controversial. ...more

Life-saving meds wrapped in red tape

From the McGill (Que.) Daily:
Six months after Industry Canada finished its review of legislation that allows Canadian drug manufacturers to produce and export generic medicines, a report of the findings has yet to be completed.

The legislation, known as the Canada Access to Medicines Regime (CAMR), was passed in 2004 to facilitate access to affordable essential medicines in developing countries. But the legislation is widely recognized as flawed – so far, not a single pill has left the country. ...more

Promising new HIV-AIDS drug, 1st in new class, approved for Canadian market

From Canada East:
Health Canada has granted licence approval for a new HIV-AIDS drug, the first in a promising new class of medications.

Drug maker Merck Frosst says it has been given permission to bring Isentress to the Canadian market for treatment of HIV-positive people whose viruses are resistant to multiple other HIV drugs. AIDS expert Dr. Mark Wainberg says there is tremendous optimism about the drug in the community of HIV patients, doctors and researchers.

The drug's generic name is raltegravir.

It is the first in a new class of drugs known as integrase inhibitors to hit the global AIDS drug market; another drug, eltegravir, is in development by Gilead Sciences Inc. of Foster City, CA. ...more

Prescription for shortage?

There's no sign that the pharmacist shortage will end anytime soon. Perhaps one of the highest demand locales for pharmacists in the world is Indiana, where three huge mail order pharmacies will soon open and need to hire hundreds of pharmacists.

From the Indianapolis Star:
Bre Taylor has two more years before she graduates from Butler University with a doctorate in pharmacy, but job recruiters around the country are already deluging her with pitches. Starting salaries range from $75,000 to $100,000, sweetened by signing bonuses and tuition reimbursements.

"There's all kinds of job expos, e-mails, drugstores offering us free gifts, companies offering internships," said Taylor, 22, of Vincennes, dressed in a crisp white coat as she mixed an ointment for an assignment in a Butler lab. "I can pretty much go anywhere in the country and have a job."

The reason: A national shortage of pharmacists, fueled by a surge of retirements, a flurry of hospital and drugstore expansions, an aging population and an increased number of prescriptions written. ...more

Monday, December 03, 2007

Doc-rating U.S. website has Ontario MDs angry

This isn't really a pharmacy story, but I am somewhat fascinated by the website mentioned. I'm pretty sure that the ratings on this website shouldn't be your sole basis of choosing a new MD. However, I feel that it has some value. With the supply/demand curve so extremely weighted on the side of physicians, I think some of them have taken the constant oversupply of patients for granted, and treat their patients accordingly. Maybe this site helps in a small way to bring some accountability into the equation.

From the London (Ont.) Free Press:
Thousands of Londoners have turned to a controversial U.S.-based website to rate their doctors and dentists. lets patients anonymously rate their doctor's performance -- on punctuality, helpfulness and knowledge -- and post comments about their care.

Some doctors are accused on the website of being rude, misdiagnosing ailments -- even falling asleep during appointments.

The site has raised the ire of Ontario's medical community, with the latest issue of the Ontario Medical Association journal advising doctors how to take legal action for defamatory comments on the website. ...more

Common diabetes drug may increase chances of developing osteoporosis

From CBC News:
The popular diabetes drug marketed as Avandia may increase bone thinning, a discovery that could help explain why diabetics can have an increased risk of fractures.

New research raises the possibility that long-term treatment with rosiglitazone, as Avandia is also called, could lead to osteoporosis. The diabetes drug is used to improve response to insulin.

While bones seem solid, they constantly are being broken down and rebuilt by the body. Researchers found that in mice, the drug increased the activity of the cells that degrade bones, according to a report in this week's online issue of Nature Medicine. ...more

HIV infections rise in Canada, fall globally

From the London (Ont.) Free Press:
James Armstrong can't walk. He is blind in his left eye. He has survived cancer, kidney failure and numerous blood and lung infections, but he is happy to be alive.

The 45-year-old Toronto man has been on the verge of dying a dozen times since he began living with HIV in 1986.

In May, he agreed to be pulled off life support in the hospital while suffering from his third bout of pulmonary edema. Armstrong's doctor told him he would have 20 minutes left to live, yet he managed to survive.

"The doctor told my mom at my bedside before he left that it was an honour being my doctor for 12 years and to be sure to let him know when my funeral was -- but somehow I miraculously survived again," Armstrong, who lives at Casey House, said. ...more

Wednesday, November 28, 2007

Liberals play up health reforms

From the Fredericton (NB) Daily Gleaner:
The Liberal government will soon unveil its provincial health plan, which includes help for seniors to stay in their homes, allowing pharmacists to prescribe some medication and regulating midwifery.

There will also be a dial-a-dietician service and more restrictions on the display of tobacco products.

"A self-sufficient New Brunswick requires healthy people with access to high-quality and accessible health-care services," said Lt.-Gov Hermenegilde Chiasson, who read the throne speech Tuesday. ...more

Strange Prescription

From Monday Magazine (BC):
The nine members of the provincial government’s new pharmaceutical task force include the head of Canada’s largest drug lobby group, but nobody to represent the interests of patients or the public.

“It’s a good idea to do this, but the compostion of the board is highly debateable,” says Adrian Dix, the NDP health critic. “I think it’s extraordinary and bizarre the pharmaceutical representatives were put on the panel this way. It’s really unfortunate patients are so poorly represented here.”

The highest profile drug industry representative on the task force is Russell Williams, the president of Canada’s Research-based Pharmaceutical Companies (Rx&D), a national lobby group with members from some 50 drug companies and whose directors include the presidents, CEOs and other top officials from 14 of the countries biggest drug manufacturers. ...more

Journal accuses Shoppers Drug Mart of poaching South African pharmacists

I find the concept of recruiting health professionals from other geographic areas a fascinating ethical question. Who is to say that a foreign pharmacist doesn't deserve the opportunity to build a new life in another country? Also, what about luring health professionals from rural areas of Canada to larger urban centres? What if Shoppers recruits the only pharmacist in a small town in northern Manitoba and leaves that town without pharmacy services?

I'm not sure why a physicians group has decided to take Shoppers Drug Mart to task on this. I'd like to hear the Canadian Medical Association's views on urban health regions recruiting in smaller Canadian towns that are already short of physicians.

The last line in the article is very interesting...

"If Shoppers Drug Mart fails to act before World AIDS Day on Dec. 1, CMAJ also believes governments, hospitals and all Canadians should show solidarity for South Africa, and take their business elsewhere."

Does this mean we will see a physician led boycott of Shoppers Drug Mart? Will physicians counsel their patients to not get their prescriptions there? Will they refuse to send new or refill prescription orders to Shoppers? As far as I'm aware, physicians are ethically obliged to not suggest one pharmacy over another to patients.

From the Canadian Press:
Human rights activist and former UN ambassador Stephen Lewis joined one of Canada's pre-eminent medical journals Tuesday in denouncing an iconic drugstore chain for aggressively recruiting South African pharmacists and potentially fuelling a public health disaster.

In an article to be published in its January edition, the Canadian Medical Association Journal takes Shoppers Drug Mart, Canada's largest drugstore chain, to task, accusing it of going after the very pharmacists South Africa desperately needs to dispense drugs to its own population.

For the last three years, Shoppers has dispatched recruiters to the southern African country with aim of luring pharmacists with the promise of a guaranteed $100,000 salary, the journal says.

"This behaviour is not just gauche; it is unethical," the article states. ...more

Number of pharmacists up 33% over 10 years

From CTV News:
he number of pharmacists in Canada grew by more than 7,200 over a 10-year period, according to a new report from the Canadian Institute for Health Information.

This represents an increase of 33 per cent in a decade, compared to a 10 per cent increase in the population.

Prince Edward Island showed the greatest percentage increase, at 42.9 per cent. The Northwest Territories saw a 40.5 per cent drop, with the number of pharmacists in the territory falling from 42 in 1995 to 25 in 2005. Ontario is currently home to almost one-third of the country's 29,471 pharmacists. ...more

Pharmacists on call for medicine questions

From the Edmonton Journal:
People with questions about medication now have access to pharmacists throughout the night to answer them.

Capital Health has launched a new pharmacist telephone line through Capital Health Link. Nurses at Capital Health Link can't answer detailed questions about drug side effects or wrong dosages, but now will be able to transfer those patients to one of 60 pharmacists on call in 10 stores across the city.

The system has been in quiet operation since Oct. 16 and has fielded more than 300 calls, including one from a woman with a rash who wondered what medication wouldn't interfere with her breastfeeding. A man on blood clot medication wondered if he could also take pain medication for a shoulder injury. Another person wondered how to keep pain medication working steadily throughout the night. ...more

Friday, November 23, 2007

Thalidomide resurfaces as treatment for multiple myeloma

From CBC News:
A derivative of thalidomide may prolong life in people with a type of bone marrow cancer called multiple myeloma — if taken with a steroid — a new study finds.

Called lenalidomide, the drug, in combination with the steroid dexamethasone, can slow the progress of the incurable bone marrow cancer and extend the lives of patients with the condition by an average of 10 months, the research suggests.

Multiple myeloma is a cancer of a type of white blood cell in the bone marrow. It is the second most prevalent blood cancer after non-Hodgkin's lymphoma, according to Myeloma Canada, with approximately 14,000 newly diagnosed cases in the United States annually. ...more

Thursday, November 22, 2007

Entre Nous with Mark Wainberg

This is not exactly a pharmacy article, but I had to include it as it's related to HIV/AIDS and it features Mark Wainberg. His group's research in the 80's led to the discovery of 3TC, one of the most important antivirals on the market. Very few people seem to be aware that Canadians discovered this medication.

I've had the opportunity to hear him speak and meet with him. If you ever get the chance to do the same, I'd highly recommend it.

From the McGill (QC) Reporter:
Fresh off the red-eye from L.A. where he was visiting his grandchildren, Mark Wainberg poked fun at our photographer when it was suggested that he change his shirt for the photo shoot. "The New York Times never asked me to change my shirt," laughed the Director of the McGill AIDS Centre, over his shoulder as he hustled to his car to get a change of wardrobe. A leading HIV/AIDS researcher and activist, Wainberg is tireless; meeting with scientists, world leaders, industrialists and Hollywood celebrities in his ongoing quest to raise awareness and shape policies geared toward slowing the spread and, ultimately, eradicating the dreaded disease. Having donned a fresh shirt, Wainberg sat down with the Reporter to talk about where the world stands on the eve of World AIDS Day. ...more

Teens turning to prescription painkillers, survey finds

While alcohol still remains the substance of choice among Canadian teens, a new study in Ontario released Tuesday shows use of prescription painkillers is a growing cause for concern.

According to the Centre for Addiction and Mental Health in Toronto, 21 per cent of students surveyed about their drug use revealed they had tried a prescription pain medication for non-medical purposes at least once in the past year.

More than 75 per cent of teens reported getting the pills from home.

Doug Beirness, manager of research and policy for the Canadian Centre on Substance Abuse said Ontario's youth opioid statistics are the first of their kind in Canada but should serve as a wake-up call across the country. An opioid is a chemical substance that has a morphine-like action in the body and is used for pain relief. ...more

Drug firm help queried

From the London (Ont.) Free Press:
Medical training sponsored by drug companies is often skewed in favour of the company's own products, says a University of Western Ontario study reported on yesterday by the prestigious journal Nature.

Drug companies in Canada and the U.S. pour hundreds of millions into required courses for doctors, footing the bill for more than 60 per cent of continuing medical education training.

The courses are supposed to be objective, but a study by the head of Continuing Medical Education at the Schulich School of Medicine at UWO found that isn't always the case. ...more

Wednesday, November 21, 2007

Canadian drug-benefits provider sues WISH-TV

From the Indianapolis Star:
Canadian pharmacy benefit manager CanaRx Services, which is trying to expand its business in Indiana, sued the parent company of WISH-TV (Channel 8) on Monday, alleging defamation over a broadcast linking CanaRx to sales of counterfeit drugs.

The Windsor-based company sent its president, chief pharmacist and two attorneys to Indianapolis to announce the lawsuit and demand a retraction of statements made in the Nov. 2 broadcast.

The eight-page lawsuit, filed in U.S. District Court, charges that reports in the broadcast were "false, defamatory and constituted commercial disparagement of CanaRx and its business." ...more

Methadone alternative to hit Canadian market

From CBC News:
A new heroin-addiction treatment that many doctors say is safer than methadone can be prescribed in Canada starting this week.

The drug, sold under the names Subutex and Suboxone, contains buprenorphine, an opiate. Manufactured by Schering-Plough Corp., it was approved by Health Canada in 2005.

Dr. Mark Dubé, a private practitioner in Sudbury, Ont., has been prescribing methadone for years. He started prescribing Subutex and Suboxone in August to one of his methadone patients under a special access permit granted by Health Canada. ...more

Saturday, November 17, 2007

Solutions to oxycodone addiction

A Wallaceburg man gets hooked on OxyContin and helps launch a $175-million lawsuit against Purdue Pharma Canada, the maker of the drug.

City hall calls for a $3.7-million, five-year strategy on substance abuse.

Pain specialists suggest more training for family doctors.

Pharmacists ask for tools to track patients.

Addiction experts ask all of us to stop blaming the addicts.

There seem to be dozens of possible solutions to halting widespread and growing abuse of oxycodone-based painkiller drugs in London. ...more

Medicine man wanted Munday officials work to lure pharmacist

Here's an older article that I wanted to post because I don't think I've ever heard of a town be so aggressive in the pursuit of an independent pharmacist.

From the Wichita Falls (Tex.) Times Record:
It was more than a drug store.

It was the center of life in Munday.

For decades, locals drifted into Smith Drug on Main Street for a cup of coffee, a gift for a friend's birthday and - almost as an afterthought - their prescriptions.

But in March 2006, the out-of-town owners of the store closed the business, creating a huge void that city leaders are working hard to fill, said Munday City Manager Dwayne Bearden.

"People need a pharmacy," he said. "We have one 12 miles away (in Knox City), but it's not as good as having one here. Somebody would be a hero if they could get one here."

The city, along with the Development Corporation of Munday, have been actively trying to lure a pharmacist to town by offering incentives for anyone willing to relocate and reopen the business. ...more

Lack of sympathy greets drug advertising debate

From the Toronto Star:
To say that prescription drugs are not like other products – and so should not be marketed like they are – is just plain patronizing, a public debate on whether to loosen Canada's advertising restrictions on medication heard yesterday.

"No one makes better decisions about what's best for you than you," said Ruth Corbin, who runs a research company specializing in intellectual property, such as drugs.

Speaking to a largely unsympathetic crowd at Ryerson University, Corbin said patients need advertising to help them discuss treatment options with their doctors. ...more

A popular placebo

From the Ottawa Citizen:
They've been a mainstay on drug store shelves for decades. They come in many flavours -- cherry, grape, bubblegum -- all tailored to a child's sugar-loving palate. And when your little one had an up-all-night cough or a nose runnier than a soft-boiled egg, you probably bought one of these over-the-counter (OTC) infant cough or cold medicines. Because they work. Right?

Dani Donders, an Ottawa mother of two, thought so. She's given her sons Tylenol Infant Cold, and while the results weren't spectacular, she believed it must do something; otherwise, drug stores wouldn't sell it.

Andrea Tomkins, who lives with her husband and two daughters in Westboro, also thought children's cold medicines worked. At least a little. If one of her daughters had a nasty cough, Tomkins reached for an off-the-shelf remedy. Who wouldn't? ...more

Living longer with HIV

From the Toronto Star:
"You can't live your life with a gun to your head," says 52-year-old Gary, who tested positive for HIV in 1985. "At some point, you have to look away and get on with things."

While Gary is rigorous about his drug routines and follows his doctor's orders, he no longer wastes time speculating about when he'll die.

"I stopped asking my doctors how long I had to live 20 years ago," says the Toronto house painter. (Gary asked us not to use his last name.) "And I stopped paying attention to survival time statistics because, especially in the beginning, it was a pretty safe assumption that I wasn't going to live very long."

A lot has changed since then. Not only are people living longer with HIV, in the final analysis most of them will not die of AIDS at all. ...more

Merck agrees to US$4.85B settlement over Vioxx

From CTV News:
Merck & Co. has offered to pay US$4.85 billion to end litigation with thousands of U.S. plaintiffs over its painkiller Vioxx.

The agreement applies only to U.S. legal residents and those who allege that a heart attack or stroke they experienced while taking Vioxx occurred in the United States.

In Canada, negotiations continue in a number of class-action cases against the makers of Vioxx.

Mike Peerless, of Siskinds LLP, a law firm that represents hundreds of Canadian plaintiffs in Vioxx class actions, tells CTV that the settlement in the U.S. is a good sign and suggests that the company will want to quickly settle its Vioxx cases in Canada. ...more

Pharmacist shortage dangerous: association

From the Montreal Gazette:
Quebec's hospitals are suffering from a severe shortage of pharmacists - a situation that could lead to medication errors, the president of a pharmacists' association is warning.

There are 1,250 pharmacists working in Quebec hospitals and other health-care establishments. But hospitals need another 200 pharmacists to properly serve patients, said Francine Lussier-Labelle, president of the Association des pharmaciens des établissements de santé du Québec. ...more

FDA Hears Pros, Cons of Pharmacist-to-Patient Drug Sales

From Forbes:
During a day-long public hearing Wednesday on whether to allow certain drugs to be sold by pharmacists without a prescription, U.S. Food and Drug Administration officials listened to arguments for and against the proposal by representatives of various medical and public interest groups.

But at the day's end, the FDA officials said they weren't ready to make a decision on whether to create a new class of drugs that pharmacists could sell "behind-the-counter." And, they wouldn't speculate on a timetable for such a decision. ...more

Anti-obesity drugs provide only modest weight loss

From CTV News:
Anti-obesity medications can only help obese patients lose a "modest" amount of weight, report Canadian researchers in a review of a group of studies on the long-term effectiveness of the drugs.

The researchers from the University of Alberta and the University of Calgary reviewed 30 placebo-controlled studies in which adults took anti-obesity drugs for a year or longer. ...more

Federal drug approvals plunge

The American and Canadian drug approval systems often share information and make similar decisions. I suspect the decrease in approvals of new products in the States has likely resulted in some of these products not being approved in Canada. Quite often, these drugs have received approval in other Western countries. Examples would include rimonabant and Arcoxia.

The pendulum has swung regarding North American drug approvals. In the wake of the Vioxx scandal, I suppose it was inevitable. But I wonder how many benficial new medications won't be approved because of the now exceedingly cautious regulatory bodies?

From CNN Money:
Federal drug approvals have plummeted by nearly a third in 2007, according to a report issued Thursday that is likely to fuel complaints that regulators are stymieing efforts to get new treatments on the market.

The Food and Drug Administration approved 59 new drugs through October, down 29 percent from the same period last year, according to a report from James Kumpel, an industry analyst at Friedman, Billings, Ramsey Group.

Significantly, the report says that the problem is not in the industry pipeline.

Kumpel said that the ratio of applications to approvals in 2007 is shaping up to hit a 13-year low. The FDA is on track to approve 60 percent of applications for new drugs this year, compared to 76 percent in 2006.

"While some pundits have argued that the pipeline [of applications] submitted to the FDA by the pharmaceutical industry has been weak in recent years, the facts dispute such claims," said Kumpel, in his report, released on Thursday.

Kumpel found an 18 percent decline in approvals of a key category of drugs - those that are in a brand-new molecular class. The FDA approved only 14 of these new drugs, which represent the most significant medical advances because they do not piggyback onto existing treatments. ...more

Friday, November 16, 2007

Personalized medicine slowly taking shape

I find the concept of basing drug therapy on genetics to be fascinating. I've actually seen it in my practice already, and I expect in a few years we'll see a lot more of it.

Personalized medicine -- tailoring treatments to an individual's genetic profile -- has been one of the main dreams of the gene revolution, but putting it into practice is proving tough.

While advances are being made in a few areas, so-called pharmacogenetics will not change the commercial landscape for the bulk of pharmaceuticals for several years, drugmakers told the Reuters Health Summit in New York this week.

"Pharmacogenetics is not going to transform this market any time soon," said Jean-Pierre Garnier, chief executive of GlaxoSmithKline Plc.

"Let's be clear -- it's going to take 20 years plus. Does that mean you are going to have zero happening? No. It's already happening. But it is going to be very specific examples." ...more

The demise of the corner drugstore

From the Globe and Mail:
For years, John Girgis ran a profitable drugstore in Mississauga, and felt he was doing something good for the community. But today, Mr. Girgis's store is losing so much money he's thinking about selling it to one of the big chains or closing down.

Mr. Girgis blames changes to Ontario's drug pricing regime that prohibited an estimated $500-million in annual rebates that flowed to him and other pharmacists from generic drug companies. Since the new law came into effect this year, Mr. Girgis was cut off from thousands of dollars a year, a crucial stream of revenue for his pharmacy.

"We've been here 11 years and we're part of the community - just to pack up and leave would be devastating to a lot of people," he says. While his business has slid into the red, a Shoppers Drug Mart down the street seems to be thriving.

Mr. Girgis isn't the only independent pharmacist to feel the heat. A study on generic drug pricing issued last week by the federal Competition Bureau will give druggists across Canada more reason to fret. ...more

Thursday, November 15, 2007

Feds 'paranoid' about pain drug, doctors say

From the Ottawa Sun:
Canadian pain doctors are calling for Health Canada to avoid "paranoid scheduling" of tramadol, a popular prescription drug that could end up being put on a list of controlled substances.

Dr. Roman Jovey said the Canadian Pain Society's aggressive opposition to Health Canada's proposal is "unique," but the association believes the feds are making a grave mistake by grouping tramadol with already restricted narcotics, such as morphine and codeine.

"The question is, where do you draw the line?" asked Jovey, past-president of the pain society.

However, Health Canada spokesman Paul Duchesne said the agency believes tramadol "may be abused" like other painkillers listed in the controlled substances list. ...more

FDA Weighs Behind-the-Counter Drugs

I've already posted a few articles regarding the "behind the counter" issue in the States. I thought I'd add this one as well as it has some information I haven't seen elsewhere.

From WebMD:
For at least the fourth time, federal regulators are considering whether pharmacists should be allowed to regularly dispense medications without a doctor's prescription.

Three times since the 1970s, the FDA has rejected the idea of adding a new "behind the counter" class of drugs to existing prescription-only and over-the-counter medication, which can be bought with no professional supervision.

But the new class is once again on the FDA's docket, spurred in part by big drug companies looking for a new way to sell prescription products that the agency has rejected for nonprescription sales. ...more

Wednesday, November 14, 2007

MDs uncover another weapon to wield in the cancer fight

From the Ottawa Citizen:
A Canadian-led international study of patients with advanced colorectal cancer has added "one more tool" for them: a drug that extends their lives by an average of six weeks, and which may also help to cure patients if it's used early in the disease.

So far, Cetuximab has only been tested in patients for whom all other treatments have failed. Their cancer has spread, and chemotherapy no longer helps.

The patients in the study lived an average of six months on the drug Cetuximab as opposed to an average of four and a half months without it. However, while it helped 31 per cent of them significantly, it didn't help the rest at all. A mutation in one gene appears to make the difference. ...more

A hard act to follow

This article is a great recap of the battle between the big pharmacy chains in Canada. I also liked the analysis as to why Walgreens or CVS are probably not looking north in the near future.

From the Globe and Mail:
The mundane name aside, Store No. 1206 is not your typical pharmacy.

In fact, at first, second and third blush, the new Burlington, Ont., outlet of Shoppers Drug Mart looks like anything but a suburban drug mart. Right at the door there's the beauty section, lined with glass shelves of facial creams, makeup and a blue-glass jar of Guerlain cream at $435. Just beyond that is the sweet scent of Chanel No. 5 perfume ($126) and the smile of a cosmetician eager to assess your beauty challenges.

Then there's the more predictable line of Christmas decorations and a display of the chain's private label Le Chocolat, a premium line of imported Belgian chocolates selling this week for $16.99 a box. All that before one reaches the store's namesake - the almost forgotten drug counter at the back - and a route to the cash that passes today's most pressing consumer needs, from $3.99 milk to a $229 MP3 player.

For Shoppers Drug Mart Corp., this is all by design. The big drugstore chains have reinvented themselves - again - in order to dominate the middle ground between high-margin convenience stores and high-volume department stores. They have transformed into retail players, and are barely recognizable as the local pharmacies where your grandparents bought medicine and cod liver oil. Today, the big chains focus on cosmetics and private labels, whose gross profit margins are thought to be two or three times that of many prescription medications.

For François Jean Coutu, chief executive officer of Jean Coutu Group (PJC) Inc., it comes down to one word: destination. ...more

Tuesday, November 13, 2007

FDA Mulls Direct Pharmacist-to-Patient Drug Sales

From the Washington Post:
Experts at the U.S. Food and Drug Administration are meeting Wednesday to hear arguments on whether or not pharmacists might someday bypass doctors and directly provide consumers with certain drugs that now require a prescription.

If this plan were to go ahead, it would create a new class of drugs that could be sold by pharmacists "behind-the-counter." Such drugs might include birth control pills, cholesterol drugs and migraine medicine, experts said. Their sales would require that patients discuss these purchases with the pharmacist first.

"We believe having certain drugs behind the counter, but available only after a consultation with a pharmacist, could significantly increase patient access," Ilisa Bernstein, the FDA's director of pharmacy affairs, told theLos Angeles Times.

Wednesday's hearing marks another chapter in the behind-the-counter saga. In 2005, the agency rejected a proposal to allow the cholesterol-lowering drug Mevacor to be sold without a prescription. At the time, however, some of the FDA's scientific advisers said it might be possible for pharmacists to sell the drug if they could help select which customers bought the pills. ...more

Drug Cap

I thought I'd start my return to posting this week with a Barbados news story. If I see any global pharmacy story that's interesting and/or has potential parallels to Canada, I'll post it. I'd still expect 90+% of stories to be Canadian.

What if a provincial drug plan decided that it wouldn't allow new pharmacies to bill their plans for seniors/social services/etc? Well, it's happening right now in Barbados, all in the name of containing costs. It doesn't make a lot of sense to me or the owners of the new pharmacies.

From the (Bridgetown, Barbados) Nation News:
The Barbados Drug Service has placed a cap on the number of private pharmacies contracted to dispense drugs under its drug service scheme.

But while director Maryam Hinds says the action is part of the service's restructuring efforts, some affected pharmacists are calling it unfair and detrimental to the people needing the drugs.

Daily Nation investigations reveal that about nine pharmacies which started up within the past two years were turned down when they applied for the contracts.

Under the Drug Service programme, pharmacists dispense certain drugs free or at reduced prices to the elderly, children and persons suffering from diseases like diabetes. They are then reimbursed by Government. It is understood some pharmacists get over 50 per cent of their business from the scheme.

Two of the pharmacists, who did not want to be identified, reported that they were informed by an official of the Drug Service that no new contracts would be issued because the service's bill was too high. ...more

Friday, November 09, 2007

Pharmacists happy NDP drug plan dead

From the Saskatoon Star Phoenix:
A day after the provincial election, the Pharmacists Association of Saskatchewan is relieved it won't have the headache of dealing with the NDP's proposed universal drug plan.

"We're much relieved that the planned $15 co-pay that Lorne Calvert came out with will not be going forward," said Brett Filson, executive director of PAS. "(Saskatchewan Party Leader) Brad Wall made that clear early on in the election campaign."

Any major changes to the drug plan cause problems for pharmacists, he said.

"Pharmacists have to explain the changes to every patient every time, month after month," Filson said. "We try and instil that reminder to the government every opportunity we get: 'Do anything you want, but remember who has to explain it.' " ...more

NSAIDs Protect Against Parkinson's Disease

From US News and World Report:
Taking over-the-counter pain medicines called non-steroidal anti-inflammatory drugs (NSAIDs) may reduce the risk of Parkinson's disease, according to a study by researchers at the UCLA School of Public Health in Los Angeles.

The study included 579 men and women (half with Parkinson's disease) who were asked if they'd taken aspirin or non-aspirin NSAIDs (such as ibuprofen) once a week or more for at least a month at any time in their lives.

Those who took two or more pills (either aspirin or a non-aspirin NSAID) a week for at least a month were classified as regular users, while those who took fewer pills were non-regular users. ...more

Thursday, November 08, 2007

Succession Remedy

From Time:
Patrick Rurka's business should be struggling. He owns and manages an independent Value Drug Mart store in rural Rimbey, Alta. (pop. 2,100). He competes with a big regional chain store that offers conveniences like Sunday hours. Rurka stays closed on Sundays--unless a customer calls him with a medication emergency and meets him at the back door for a prescription refill.

But Rurka, a 32-year-old pharmacist, is thriving. Sales have grown 10% each year since he bought the store in 2004. He draws a comfortable salary to support his wife and children. And he's on track to pay off his debt on the business, including a comprehensive renovation, by 2014. "I'm getting exactly what I want out of life," Rurka says. He hopes to buy another Value Drug Mart store in a few years.

Rurka is not alone. Four other rural Value Drug Mart stores have been sold to young Albertan entrepreneurs since 2004. In each case, despite minuscule collateral and a cautious lending environment, pharmacists with big dreams have secured financing in excess of $1 million. In the process, they're building what could be a promising model for helping Canada sustain legions of potentially vulnerable mom-and-pop businesses. ...more

Leftover medicine? Pilot project in U.S. advises mixing it with cat litter

This is a new concept. Frankly, I like how our pharmacies accept medications back for disposal better.

From CBC News:
It's time to pooper-scoop your leftover medicine.

Mixing cough syrup, Vicodin or Lipitor with cat litter is the new advice in the United States on getting rid of unused medications. Preferably used cat litter.

It's a compromise, better for the environment than flushing - and one that renders dangerous medicines too yucky to try if children, pets or drug abusers stumble through the trash.

In Canada, the advice might differ as Health Canada tells people not to throw medications into the garbage or toilet, and individual municipalities have their own rules about what can and can't go into landfill sites. Usually, people are urged to take unused medicines back to pharmacies for proper disposal. ...more

Bayer plans largest-ever study for blood-clot drug

From Reuters:
Bayer is planning a late-stage study for its promising blood-clot drug rivaroxaban for hospitalised patients with internal diseases, the German drugs and chemicals group said on Tuesday.

"It is planned for a total of about 50,000 patients to take part in these studies, making it the largest clinical study programme Bayer has ever undertaken," Chief Executive Werner Wenning told reporters. Wenning said rivaroxaban, which the company wants to market under the trade name Xarelto, is the most promising product in its pipeline.

Rivaroxaban's current indications are prevention of venous thromboembolism, treatment of deep-vein thrombosis, stroke prevention in atrial fibrillation and acute coronary syndrome. ...more

How Safe Is Your Prescription?

This is an American article, but I thought I'd include it because I like the part which tells patients what they should do to help pharmacist avoid errors.

From Consumer Affairs:
As an expectant mom, Kendra of Brooklyn, New York wanted the best for herself and her baby. Part of that care was a prenatal vitamin.

“My doctor gave me a prescription for the prenatal vitamin, Primacare One,” wrote Kendra. “I dropped off my prescription at the CVS pharmacy and when I returned to pick up the prescription, I was instead given Prednisone.”

The problem Kendra encountered is one of the most common prescription errors -- the kind that occurs when a pharmacist can’t read the prescription properly. Instead of contacting the authorizing physician to confirm the prescription, the pharmacist plays Russian roulette with someone else’s life. ...more

Manufacturer restricts use of diabetes drug Avandia

From CBC News:
The manufacturer of a drug for treating Type 2 diabetes has placed new restrictions on use of the medication based on a Health Canada review of clinical data pointing to an increased risk of heart-related problems in some patients.

GlaxoSmithKline Inc., in consultation with Health Canada, is updating prescribing information on products made from or containing the drug rosiglitazone: Avandia, Avandamet and AvandarylTM.

Once touted as the gold standard for preventing Type 2 diabetes in high-risk patients, rosiglitazone lost its glitter after a study published in the New England Journal of Medicine in May showed Avandia significantly raised the risk of heart attack and possible death. ...more

Private labels key to Shoppers

From the Globe and Mail:
Shoppers Drug Mart Corp. will add more than 200 private label organic foods to its shelves early next year, as well as more premium cosmetics, as the chain bolsters its position as a neighbourhood mini-department store.

The company is expanding into higher margin non-prescription categories in its bid to take on large competitors such as discounter Wal-Mart Canada Corp. and grocer Loblaw Cos. Ltd., which have moved more aggressively into the territory of pharmacies.

Jurgen Schreiber, chief executive officer at Shoppers, said yesterday that private labels, such as Life, now make up about 15 per cent of its overall sales and "next year we will definitely increase that again." He has set a long-term goal of more than doubling that level. ...more

Wednesday, November 07, 2007

Sex & drugs case hurts pain care: MDs

From the National Review of Medicine:
Whether St John's, NL, family physician Dr Sean Buckingham gave drug addicts opioid prescriptions in exchange for sex is for the jury in his ongoing trial to decide. But pain care physicians from across Newfoundland and Canada fear his alleged crimes have already done their damage by making MDs too afraid to prescribe strong pain meds.

Dr Buckingham was first arrested in May 2005 after a long-running investigation by police that involved wire-tapping, raids and 24-hour surveillance, called Operation Remedy. He is currently facing 23 charges, ranging from drug trafficking to sexual assault. During the last week of October, the jury heard shocking testimony from three women who allege they had sex with Dr Buckingham in exchange for prescriptions for opioids painkillers. ...more

Prescription power from the pharmacist

Look for a lot more news regarding "behind the counter" status in the United States next week as the FDA starts hearings on November 14. I noticed that the same concerns that physicians have voiced re: pharmacist prescribing in Canada are mentioned in this American debate.

From the Wilmington (DE) News Journal:
Someday soon, you may be able to walk into your local pharmacy and walk out with prescription-strength drugs without ever having seen a doctor.

The Food and Drug Administration is considering creating a new category of drugs that would no longer require a doctor's prescription. The category -- midway between prescription and non-prescription drugs -- would be accessible only after consulting with a pharmacist.

It's far from clear how the FDA's proposed "behind-the-counter" classification would work, but even the idea is stirring up controversy in the health care field. While no drugs have been identified as candidates, experts think drugs such as birth-control pills and migraine pain relievers -- those that patients already take with little physician supervision -- could be among the first to be considered.

Some consumer groups and pharmacists say not having to go through a physician would make it more convenient for patients to get needed drugs. Physicians' groups, on the other hand, have raised patient safety concerns in lining up against the proposal. ...more

New restrictions on the use of rosiglitazone products due to cardiac safety concerns (Avandia, Avandamet, Avandaryl)

From Health Canada:

GlaxoSmithKline Inc., in consultation with Health Canada, would like to inform you of important new restrictions on the treatment of type 2 diabetes mellitus with the rosiglitazone-containing products: AVANDIA® (rosiglitazone), AVANDAMET® (rosiglitazone and metformin), and AVANDARYLTM (rosiglitazone and glimepiride).

Further to a Health Canada assessment of adverse event reports, published articles* and other available information on congestive heart failure, myocardial infarction, and related events, the Canadian Product Monographs for rosiglitazone-containing products are being updated and will include the following new usage restrictions: ...more

Shoppers Drug Mart's profits jump

From the Toronto Star:
Shoppers Drug Mart Corp. (TSX: SC), the country's largest drug store operator, said Tuesday that further forays into organic foods, beauty brands and a stepped up focus on private label brands are on the horizon next year after a strong third quarter.

"We had a very good Q3 and will look forward to a very strong Q4, too, and we look forward to a very strong Q1 next year," Shoppers president and CEO Jurgen Schreiber said during a conference call.

Strong growth across Canada led by gains in Western Canada and Quebec helped Shoppers increase its third quarter profits and sales, the company reported Tuesday.

The Toronto company said third quarter profits rose 15.1 per cent to $143 million from $124 million the previous year on a sales jump of more than nine per cent. ...more

Tuesday, November 06, 2007

Pharmacists hold key to cheaper drugs

There is so many inaccuracies in this article it's ridiculous. I'm going to break it down, but before I go any farther, I have one question. If pharmacists are to blame for high drug prices, why didn't the reporter actually talk to a pharmacist to get their responses to the physician's totally baseless claims?

But Dempsey said the doctors don't normally know drug costs.

"We don't actually get any information about drug prices," the Belleville pediatrician said.

"There's no mechanism to educate doctors about costs of drugs."

Well, physicians could ask the question of price to the local pharmacist and/or the drug rep of a product. In some provinces, pharmacy organizations publish easy to use charts with commonly used drug prices on them.

For example, he said, some drugs require the brand name to be taken only once a day, whereas the generic must be taken two or three times in the same period to achieve the same effect.

Generics are copies of brand name products. They're the same -- including frequency of dosing. Sure, a brand name company may come out with an extended release product to counteract the effect of the generic entering the market, but this article makes it sound like generics don't have the same duration of action, which is totally wrong.

Doctors will often write the name of a well-known drug in a prescription. Zantac, a drug for heartburn, is recognized by most people, Dempsey said.

But if a physician wrote the generic brand, Ranitidine, that person might call back to the doctor's office and ask if a mistake had been made, he said.

It is then up to the pharmacist to substitute the generic for Zantac if the doctor did not tick the no-substitution box, Dempsey said.

I'm supposed to believe that the patient would question the written Rx if it was written for ranitidine instead of Zantac. That's highly unlikely. And the MD makes it sound like pharmacists don't make the generic substitution when available. In Canada, it's almost always done.

Here's the complete article:

From the Belleville (Ont.) Intelligencer:
There are mechanisms in place that could help save Canadians money on prescription drugs, says a local physician.

Dr. Paul Dempsey, head of the 268-doctor Professional Staff Association at Quinte Health Care, said oft-times pharmacies can substitute a cheaper generic replacement, even if the name brand drug is specified in the prescription.

"On a prescription pad there's a box to check off for no substitutions," he said.

If that box is not ticked, pharmacies can fill the order with the cheaper generic drug, Dempsey said.

A recently-released study commissioned for Industry Canada found that Canadian physicians are generally oblivious to drug prices and often prescribe an expensive pharmaceutical when a cheap one would do the job. ...more

Canadian drug sales slow

From the Philadelphia Inquirer:
Ann Griffith doesn't fit the stereotype of a criminal.

At 81, the Plymouth Meeting resident has been buying the thyroid medication Synthroid for three years from a Canadian Internet pharmacy. She shaved 40 percent off the U.S. price.

But from July to September, the Food and Drug Administration detained three of her packages at the Seattle-Tacoma airport. Agency letters stopped short of accusing her of breaking the law but required her to write or travel personally to Washington state to prove that the packages were legal.

"These laws are designed to protect you," one letter said.

Griffith, who said she never had any health problems with Canadian drugs, scoffed at the agency's actions. "The big drug companies don't want to lose anything," she said. "That's the whole thing."

Canadian drug sales to U.S. patients like Griffith were once a hot trend. But a variety of factors have stifled this continental trade, making it more like curling than hockey. Drug firms such as Pfizer Inc. and GlaxoSmithKline P.L.C. have threatened to cut off supplies to Canadian pharmacies catering to the U.S. market. ...more

Bayer Stops Sales of Trasylol Globally

I think this article would be a good one to file in the memory banks. The next time American experts say there is no drug research being done in Canada, here's an example that contradicts that statement.

From the Associated Press:
Bayer AG halted worldwide sales Monday of its anti-bleeding drug Trasylol at the request of U.S. and foreign health officials pending further analysis of a Canadian study that suggests it's linked to a 50 percent higher risk of death than the other drugs in the clinical trial.

The Food and Drug Administration asked the company to stop selling the drug, used to prevent excessive bleeding during heart bypass surgery, until it could receive and review further results from the study. The study comparing the safety and efficacy of the drug with two others was recently halted.

"FDA cannot identify a specific patient population where we believe the benefits of using Trasylol outweighs the risk," said Dr. John Jenkins, director of the agency's Office of New Drugs, during a briefing Monday. ...more

Monday, November 05, 2007

Foul Taste Is Part of the Cure

A classic Canadian OTC product goes south...

From the Wall Street Journal:
When drug makers come out with new cough medicines, they typically tout characteristics such as extra strength or improved flavor. But when Novartis starts marketing a Canadian cough mixture in the U.S. today, it will focus on a different feature that it hopes will help the product stand out from the crowd: the medicine's foul taste.
Buckley's ad campaign embraces the foul taste of its cough syrup as a selling point.

Made from camphor, pine needle oil, menthol and Canadian fir balsam gum, Buckley's Cough Mixture has been available since 1919 in Canada, where it has become what Novartis calls the country's "best-selling and worst-tasting" cough medicine. It doesn't contain sugar or alcohol, which other brands use to dull the medicinal flavor.

Novartis, which bought the Buckley's brand in 2002, hopes to convince consumers that the bad taste proves the syrup's effectiveness. "It Tastes Awful. And it Works," is the tagline of the television, print, radio and Internet ads designed by Publicis Groupe's Saatchi & Saatchi in New York. ...more

Wednesday, October 31, 2007

FDA proposes new class of medicines

This is an old article, but I thought it was interesting to see that the FDA is considering a "behind the counter" status, much as we have in Canada.

From the Dallas Morning News:
Physicians might be losing their lock on Americans' medicine cabinets.

For years, consumers either showed up at the drugstore with a doctor's prescription or settled for less powerful medications sold over the counter.

Now the U.S. Food and Drug Administration is considering creating a class of medicines dubbed "behind the counter." It would let consumers buy routine medicines that could include birth control pills, cholesterol drugs and migraine medicine without a prescription – as long as they discuss it with a pharmacist first.

Pharmacists and drug companies like the idea; doctors think it's dangerous. If approved, the new drug classification could go into effect as early as next year.

"We believe having certain drugs behind the counter but available only after a consultation with a pharmacist could significantly increase patient access," said Ilisa Bernstein, the FDA's director of pharmacy affairs. ...more

Misadventures in medicating

From the Victoria (BC) Times Colonist:
Many of the patients filling Canada's crowded hospitals are there because of side effects and other problems with their medication -- and most of those drug "misadventures" could be prevented, a new study suggests.

Almost one in four admissions to the internal-medicine ward of British Columbia's largest hospital was the result of adverse drug reactions, doctors prescribing the wrong medicine or similar glitches, the study found.

The lead researcher says he expects similar results from a follow-up look at emergency cases that has just been completed. ...more

A few older posts below

The next four posts below are from a couple of weeks ago that are interesting reads and are not really that time sensitive.

Be aware of cough syrup abuse, parents told

From the Whitehorse (YT) Star:
Porter Creek Secondary School’s drug awareness co-ordinator is warning parents to watch for any over-the-counter medications their kids are bringing home.

Doug Green began his three-year contract for the Canines for Safer Schools program in September.

During an interview Tuesday, he said it’s become clear there are students who are using high doses of what’s known as DXM, or dextromthorphan (the active ingredient in many cough syrups and cold medications), to get high.

“It was one of the first things that hit my radar when I came up here and it wasn’t exclusive to this school,” he said.

Already, he’s spoken to two students about using DXM, but Green stressed it’s not exclusive to Porter Creek Secondary School or even Whitehorse.

It’s an issue in many regions as Internet forums and web pages have sprung up on the subject.

Many of the pro-use sites include suggestions on how much to use to get high given a person’s weight, but don’t point to the negative effects which come with the drug use. ...more

Study questions long-term use of Alzheimer’s drugs

From the National Post:
As the main class of drugs licensed to treat Alzheimer's disease in Canada, they have limited impact on the devastating illness at the best of times. Now a troubling new study suggests that cholinesterase inhibitors may often be prescribed long after they can do any good, potentially exposing patients to unpleasant side effects for no real reason and burdening taxpayer-funded drug plans.

As well, more than a third of patients in the Ontario-based study were at the same time taking other drugs that would counteract the Alzheimer's pills' positive effects.

"We're using them much longer than they've ever been studied for and we're using them longer than they are in other locations," said Dr. Nathan Hermann, the study's lead author and head of the psychiatry division at Toronto's Sunnybrook Health Sciences Centre. ...more

Tuesday, October 30, 2007

Extend dental coverage, doctors urge

From the National Post:
Something must be done to extend health insurance for dental care and prescription drugs to the millions of Canadians who lack such coverage now - even if taxpayers end up footing the bill, the president of Canada's largest doctors group said yesterday.

Brian Day is best known for wanting to give the private sector a bigger role in health care, but after a speech in Toronto, the new head of the Canadian Medical Association advocated essentially expanding the public system. He lamented the fact that some Canadians have health insurance through their workplace that pays for dental care, medication and other health needs not covered by government plans - while many have no such coverage.

"There is something wrong with 30% not getting their drugs paid for, getting a bill when an ambulance takes them to a hospital, not having their crutches paid for," Dr. Day told reporters. "I think they should get it, somehow. And if they can't afford to pay the premiums, the government should pay the premiums for them." ...more

Drug body's advice against provinces paying for MS drugs seen as unfair

From the Canadian Press:
An expert panel's advice that provinces and territories not cover the cost of two Multiple Sclerosis drugs creates a system of two-tiered care, MS advocates say.

They view the recommendation as leaving people with the disease, who don't have private drug insurance, unable to afford medication that could slow progression of the condition and ease the pain they suffer.

Late last month, the Common Drug Review advised that governments not put the MS pain medication Sativex on the list of medicines that provincial and territorial drug plans cover for eligible people. That follows a "do not list" recommendation issued in the spring for Tysabri, a drug that slows progression of the disease.

Those decisions put these drugs out of reach for many people with MS, an expert and a spokesperson for the MS Society argue. ...more

Pharmacy rebates should make generics cheaper for patients: Competition Bureau

From the Canadian Press:
Many generic drug companies compete for space on pharmacists' shelves by offering rebates to the retailers - but those benefits are not finding their way into consumers' wallets in the form of lower prices, a study by the Competition Bureau has found.

The study by the independent agency found that rebates average about 40 per cent of the price the pharmacy is charged on paper for various generic drugs.

"Rebates provide incentives for pharmacies to select a particular manufacturer's product," bureau commissioner Sheridan Scott said Monday in releasing the study results.

Scott said that public sources of information and interviews conducted as part of the study show prices actually paid by pharmacies in most provinces were "on average at least 40 per cent below what the pharmacy was invoiced." ...more

Pope urges pharmacists to reject abortion pill

I thought this was relevant as I'm sure a notable percentage of Canadian pharmacists are Catholic.

From Reuters:
Pharmacists must be allowed to refuse to supply drugs that cause abortion or euthanasia, Pope Benedict said on Monday, calling on health professionals to be "conscientious objectors" against such practices.

The Pope told a convention of Roman Catholic pharmacists that part of their job was to help protect human life from conception until natural death -- the Church teaching that rules out any deliberate termination of pregnancy or euthanasia.

"It is not possible to anaesthetise the conscience, for example, when it comes to molecules whose aim is to stop an embryo implanting or to cut short someone's life," the Pope said. ...more

Monday, October 29, 2007

Chronically ill lobby for national drug plan

From the Edmonton Journal:
Early retirement doesn't look so rosy to George Rozon, when it means the end of his employee drug insurance plan that pays thousands of dollars on his medication bills.

Rozon's plan has been paying the $7,500 annual cost for his diabetes and heart medication, as well as covering drug costs for his wife.

Moving to Nova Scotia to be closer to family is also a concern. Alberta covers his $2,000 monthly bill for anti-rejection drugs needed after a kidney transplant in 2001. He doesn't know if he will qualify for such coverage in the Maritimes. ...more

Pharmacists caught in the squeeze

From the London (Ont.) Free Press:
When the pharmacist leaves his store for a break, he makes sure to take off the white jacket that identifies his profession.

"I don't want people to know I am a pharmacist," he says. "I have kids coming up to me and bugging me. 'Can you get me some Oxy?' "

It can be just as tense inside the pharmacy.

Occasionally, obvious members of outlaw motorcycle clubs have come in with legitimate doctor's prescriptions for large amounts of OxyContin, he says.

Rather than question them or the doctor, he has filled them out. ...more

New Zealand example touted at hearing on universal drug plan

From the Saskatoon Star Phoenix:
The campaign for a national drug plan arrived in Saskatoon smack in the middle of a provincial election where drug coverage is an issue.

"It is a coincidence that we are here during an election campaign," said Michael McBane of the Canadian Health Coalition in Saskatoon on Thursday.

The Saskatoon stop is the first of 13 in a cross-Canada tour designed to gather personal stories from people about their struggles to pay for prescription drugs. Planning for the hearings began last January, said McBane.

And while those making presentations on Thursday were reminded to not use the hearing for partisan purposes, NDP Premier Lorne Calvert was one of about a dozen presenters. ...more

Study to probe whether acne drug can slow MS

From CTV News:
Researchers in Calgary are preparing to begin a new study to see whether a commonly available acne medication could help delay the crippling effects of multiple sclerosis.

The medication, called minocycline, has been available for over 30 years. If it's proven effective in delaying the progress of MS, it could offer an inexpensive option for the treatment of early stages of the disease.

A small study on 10 patients a few years ago yielded promising results. Now, clinical researchers in 14 Canadian centres will be taking an in-depth look at the drug in a $4-million, two-year study funded by the MS Society of Canada.

Minocycline is a prescription antibiotic used to control acne by killing the germs that prompt outbreaks. But the drug also offers anti-inflammatory properties, which researchers believe are responsible for its ability to slow the progress of MS. ...more