Sunday, April 22, 2007


New posts will resume in the early part of next week, likely around April 29 or 30.

Drug ads would spark $10B frenzy: Study

While I agree that prescription drug advertising would increase sales, I have a hard time believing the numbers in this study. It says in the article that Canadians spent $16.6 billion on prescription drugs in 2005. But to suggest that more advertising would result in a $10 billion increase above current levels seems a bit much to me.

A copy of the study is available at the new online medical journal Open Medicine. The link is here.

From the Toronto Star:
Allowing American-style drug ads in Canada would lead to massive increases in pharmaceutical spending and severely stress an already vulnerable health-care system, a new study suggests.

Canadians might expect to see a $10-billion-a-year increase on drug spending in the aftermath of such mass advertising in this country, says study author Steve Morgan, a University of British Columbia health economist.

"It could increase our total expenditures on pharmaceuticals by 30 per cent," says Morgan, of U.B.C.'s Centre for Health Services and Policy Research.

"That is a staggering amount. You could hire 40,000 doctors and pay them $250,000 a year for that amount." ...more

A date with drugs

From the Toronto Star:
Hack, wheeze, sputter ..... achoo! You feel something coming on.

Swing open the medicine cabinet, reach for the cough syrup and out dribbles sludge.

If it were Buckley’s, the taste is so bad (but effective!), it would be hard to tell if it had gone off.

What about that leftover prescription of antibiotic? Do you ingest it and risk coming down with God knows what?

Spring cleaning target zones may well include your medicine cabinet. Just like the best-before dates on food — to which we pay at least a little attention — there are expiry dates on your prescription and over-the-counter drugs. ...more

Return herbal sleep aid, Health Canada says

From the Kitchener-Waterloo (Ont.) Record:
Health Canada is urging people who bought a specific herbal product that's promoted as a sleep aid to return it to the store where it was purchased.

The product, called Eden Herbal Formulations Serenity Pills II, contains the undeclared drug estazolam, which can be habit-forming when used for a few months, an advisory says.

Users should talk to a health-care professional before they quit taking it because there's a risk of withdrawal symptoms. ...more

Reliability of drugs from Canada questioned

From the Trenton (NJ) Times:

Fred Billingham was waiting to shoot pool at the Hamilton Senior Center. Former U.S. Rep. Jim Greenwood was hundreds of miles away in Washington, D.C., but they were of like minds on one topic: Purchasing cheap medication from Canada scares them.

"I wouldn't trust them," said the 78-year-old retiree, "because you don't know what you're getting."

And Greenwood, a former Bucks County, Pa., legislator who now is president of the trade association the Biotechnology Industry Organization, said, "There is a very legitimate safety issue that has to be taken into consideration."

That safety concern is why state investigators make no apologies for the tactic they used last week to shut down a local company that helped American patients buy lower-cost medications from Canada. ...more

Shoppers ramps up premium cosmetics offerings

From the Globe and Mail:
Shoppers Drug Mart Corp. is expanding its coveted high-end Estée Lauder Inc. cosmetics line, yet another blow to department stores that have depended on those sales to draw customers.

The move comes less than a month after Jurgen Schreiber, a former beauty and health retail executive in Europe, took over the chief executive officer job at Shoppers.

Mr. Schreiber "is having a positive impact on Shoppers Drug Mart's relationships with major prestige cosmetic brand owners," Keith Howlett, retail analyst at Desjardins Securities, wrote in a research note yesterday. ...more

Friday, April 20, 2007

Erythropoiesis-stimulating agents (ESAs), Aranesp (darbepoietin alfa) and Eprex (epoetin alfa)

Health Canada:

The manufacturers of the erythropoiesis-stimulating agents (ESAs), in consultation with Health Canada, would like to inform you of updated safety information and pending label changes based on completed or ongoing clinical studies regarding treatment with ESAs. Two such ESAs, Aranesp® and EPREX, are marketed in Canada.
For Health Professionals
For the Public

Thursday, April 19, 2007

Pharmacists can manage prescriptions under bill

I'm not exactly sure what "manage prescriptions" means, but Missouri pharmacists now have the authority to do so. It's not prescribing, but hopefully it's a mechanism to get pharmacists more involved in patient care.

From the Belleville News Democrat:
Lawmakers gave final approval Thursday to a bill that gives pharmacists greater authority in managing prescriptions.

The measure, approved 154-1 by the House, would allow pharmacists to go beyond just receiving a prescription and filling it. They could work with doctors and patients to evaluate prescriptions and create a "medication therapeutic plan" to help patients taking multiple drugs. Senators previously passed the bill, which now goes to Gov. Matt Blunt.

Supporters say the bill would allow Missouri pharmacists to more fully participate in the new federal drug assistance program Medicare Part D. Several other states already give pharmacists the authority to help manage prescriptions for patients. ...more

Unsafe sleepwalking, sleep driving linked to pills

From CBC News:
Rare, bizarre and potentially dangerous side-effects of some prescription sleeping pills have prompted the U.S. Food and Drug Administration to warn patients and doctors about the medications, including one that is available in Canada.

The FDA has linked the best-selling sleep-inducing drug zopliclone, sold in Canada under the brand name Imovane, to sleepwalking behaviours. The agency has also linked the drug to sleep driving — driving a car while not fully awake after taking a sedative-hypnotic drug, with no memory of doing so.

In the U.S., the FDA said there have been dozens of reports of bizarre behaviour during sleep among people who have taken a sleeping pill called Ambien. While Ambien is approved for use in Canada, it is not available for sale ...more

Wednesday, April 18, 2007

Ottawa urged to provide low-cost drugs for developing world

From the National Post:
Front-line international health workers appealed to MPs Wednesday to fix the fact that not a single pill has left Canada under a three-year-old regime to provide cheap generic drugs to needy countries in Africa and elsewhere.

They said the plan is unnecessarily complex and cumbersome, and does nothing to quell the intimidation of potential importing countries by brand name pharmaceutical companies and the U.S. government. ...more

More adverse drug reactions being reported

A growing number of Canadians are reporting adverse reactions to the drugs they’re taking, a troubling trend that Health Canada says has been on the rise for the last several years.

More than 10,500 new cases of adverse drug reactions were reported to Health Canada in 2006, mainly by health professionals, an increase of 108 cases compared to the previous year. Health Canada also received more than 250,000 reports last year of adverse reactions originating in other countries from drugs that are marketed in Canada, a jump of 43 per cent from 2005. ...more

Cancer patients at risk for dangerous drug interactions: study

This article has a few good points, including some good advice for patients:

Ms. Kwong advises patients to:

—Always carry an up-to-date list of medications and their dosages, including over-the-counter and alternative therapies.

—Try to have prescriptions filled by the same pharmacy: electronic software will alert the druggist of potential drug interactions.

—Make sure to keep different doctors or pharmacists apprised of any changes in prescriptions.
Because of drug interactions, cancer patients can be challenging from a pharmacist perspective. However, solving these types of clinical puzzles can really show that the pharmacist is a drug information specialist.

From the Globe and Mail:
Many cancer patients are at risk for potentially dangerous drug interactions because of the number of different medications they take for multiple conditions, say Canadian researchers, who caution that steps must be taken to avoid these dicey combinations.

In a study appearing Wednesday in the Journal of the National Cancer Institute, researchers at Princess Margaret Hospital in Toronto found that almost 30 per cent of 405 cancer patients studied were taking drugs that put them at risk for at least one adverse drug interaction.

At least 9 per cent of the interactions could have had severe effects — including being potentially fatal — and 77 per cent were of moderate severity and could have resulted in serious health problems, the study showed. About 8 per cent of patients received duplicate medications. ...more

Study in new medical journal compares health outcomes in Canada and U.S.

The website for the new Canadian medical journal is An article discussing its inception is located here. I wanted to add that I have no particular affinity for CBC News, but I find that their links typically stay active longer and remain free after the seven day cutoff that other publishers use. As a result, I tend to link to their stories a bit more.

From CBC News:
Health outcomes for patients in Canada are as good as or better than in the United States, even though per capita spending is higher south of the border, suggest Canadian and U.S. researchers who crunched data from 38 studies.

The findings were published in the inaugural edition of Open Medicine, a new online medical journal launching Wednesday in the aftermath of a rift last year between some editors and the publisher of the Canadian Medical Association Journal. ...more

Jean Coutu's profits surge

I'm going to try to post more Canadian pharmacy business stories when they come up. Does this interest you or should I keep the articles more clinical in nature?

From CBC News:
Quebec-based pharmacy chain Jean Coutu Group reported its best quarterly profit in nine years on Tuesday.

For the third quarter, it earned $184 million US, up almost six-fold from $31.6 million US in the same quarter a year ago.

Jean Coutu three-month trading
The bulk of the gain stems from a rise in shares that Jean Coutu received for selling its 1,850 drugstores in the Brooks and Eckerd chains in the U.S. to Rite Aid. ...more

Tuesday, April 17, 2007

New clot drugs beckon as replacements for warfarin

From Reuters:
A new crop of medicines to prevent stroke and blood clots could emerge within several years, easing dangers and hardships for patients and creating blockbuster sales for drugmakers.

The oral drugs could prove better and safer than injectable medicines such as heparin now widely used to cut the risk of dangerous blood clots in the legs and lungs after major surgery.

But makers of the new drugs say their biggest use would be as an alternative to warfarin, a pill used for decades by people with atrial fibrillation -- or irregular heartbeat -- to prevent strokes. An estimated two million Americans have been diagnosed with the heartbeat problem and the number is expected to double in the next 20 years. ...more

Death rate from breast cancer falling, more women living longer: Cancer Society

From CBC News:
More women with breast cancer are surviving longer than in the past and a significantly smaller proportion are dying from the disease, says the Canadian Cancer Society, which released its latest statistics Wednesday.

A special report in Canadian Cancer Statistics 2007 shows the breast cancer death rate among Canadian women has dropped by 25 per cent in the last two decades and that 86 per cent of women diagnosed with the disease are surviving at least five years. The survival stat excludes Quebec, which collects data differently than other provinces. ...more

Monday, April 16, 2007

At the drugstore, the nurse will see you now

While Bill 102 has typically been looked at with a mixture of concern and fear from the pharmacy community, there might be a bright side. There may be potential for new services and revenue streams as a result of the new cognitive services fees.

From the Globe and Mail:
The latest generation of the Rexall drugstore has a nurse on duty six days a week, podiatrists, chiropractors and other health professionals on hand regularly, and a four-seat classroom for health-related seminars.

Call it the new competitive front in drugstore retailing wars.

Pharmacies have been battling each other for years by flogging more shampoos, cosmetics, food and even electronic gadgets.

Now, with new drug legislation in Ontario that is expected to eventually spread across the country, the outlets are looking to transform themselves into patient counselling centres too. ...more

Health Canada charging huge markup on pot

From the Toronto Star:
The federal government charges patients 15 times more for certified medical marijuana than it pays to buy the weed in bulk from its official supplier, newly released documents show.

Critics say it's unconscionable to charge that high a markup to some of the country's sickest citizens, who have little income and are often cut off from their medical marijuana supply when they can't pay their government dope bills.

Records obtained under the Access to Information Act show that Health Canada pays $328.75 for each kilogram of bulk medical marijuana produced by Prairie Plant Systems Inc. ...more

Thursday, April 12, 2007

Only one class of antibiotics remains effective against gonorrhea: U.S. CDC

From CBC News:
The wily gonorrhea bacterium appears to be en route to vanquishing yet another class of antibiotics, leaving just one last weapon in the arsenal to fight this very common sexually transmitted disease.

The U.S. Centers for Disease Control on Thursday urged American doctors to stop using all antibiotics in the fluoroquinolone class to treat gonorrhea, a decision prompted by rising rates of resistance among gonorrhea strains isolated in the United States and beyond.

Doctors should instead use antibiotics from the cephalosporin class, said Dr. John Douglas, who noted this is the only remaining class of drugs effective against the infection. He also warned there are no new antibiotics in the pharmaceutical pipeline to fight gonorrhea. ...more

Magazine mentions Canada Pharmacy News

I received a copy of the Winter 2007 edition of newpharmacist magazine today. On page 44, is mentioned in the feature "10 Sites to Bookmark." Thanks to Kristan Wolfe and newpharmacist for the mention.

If the article in the magazine brought you here -- welcome to Canada Pharmacy News! If you have any questions about the blog, feel free to contact me at


Tuesday, April 10, 2007

Druggist will fight to keep his licence

It looks like Abadir Nasr wants to get his side of the story in the press. The Hamilton pharmacist, who sold fake Norvasc tablets but was acquitted of criminal charges, answered questions for the Hamilton Spectator today. I find it odd that he answered the questions in writing. Nasr claims he is not fluent in English. I thought pharmacists are required to be able to speak at least one of Canada's official languages. I believe most provinces have language tests that are requirements for licensure. However, I'm not sure specifically about Ontario.

There is no mention of a date for his disciplinary hearing with the Ontario College of Pharmacists. I suspect it will still be a while as the regulatory body will likely need time to gather all of the relevant information.

From the Hamilton Spectator:
The Hamilton pharmacist who was found not guilty of criminal fraud after selling counterfeit heart pills to the public says he never doubted his acquittal on all charges.

Abadir Nasr, 29, said he intends to fight for his licence and his right to own another drugstore when he goes before a future disciplinary hearing of the Ontario College of Pharmacists.

"As God knows, I never had the intent to harm anybody so I was completely sure that not guilty would be the (outcome) of this case," said Nasr. ...more

Will generic drug policy hit Shoppers?

Here's a timely article regarding the new generic rebate restrictions (Bill 102) in Ontario. I think these changes will hurt the bottom line in all types of pharacies in Ontario, from the small independent to the biggest chain. There is no doubt that it could affect Shoppers stock price. However, I'm pretty sure that they will ultimately land on their feet as a business since they have a lot of non-prescription items to profit from.

My biggest concern about Bill 102 is that it's going to devastate smaller, service-oriented, clinical pharmacies that heavily rely on prescription sales. They can't run the pharmacy department at a break-even or loss leader pass and reap their profits selling cosmetics or groceries. We've seen the independent pharmacy pretty much disappear in the United States. Bill 102 could make the Ontario pharmacy scene very American-looking: nothing but big chains and grocery stores with almost no independents. If these boutique pharmacies disappear, so will some of the unique professional services they offer. That lack of choice won't be good for either the average Ontarian or the pharmacists that serve them.

From the Globe and Mail:
There is mounting concern that Shoppers Drug Mart Corp. will be hurt by generic drug pricing changes in Ontario, home to more than half of the retailer's stores.

Analyst Keith Howlett at Desjardins Securities said Monday he can't see how the legislative reforms, which reduce the price the province will pay for generic drugs, “cannot have an impact on the largest retail pharmacy chain in the province.”

The drug policy could slice as much as $38.3-million a year off of Shoppers' profit in Ontario, or $75,000 a store, he estimated in a report. (That is earnings before interest, taxes, depreciation and amortization.) Shoppers has 511 pharmacies in Ontario and almost 1,000 across the country.

Mr. Howlett's concerns add to earlier ones raised by at least one other retail analyst, as well as pharmacists and other groups, about the impact of the new law. It came into force in October although parts of it have been phased in over the past few months — and some provisions took effect as recently as April 1. ...more

Monday, April 09, 2007

Pharmacist restores piece of the past - nasty drugs and all

From the Kitchener-Waterloo (Ont.) Record:
There's enough strychnine in the handful of vials to send most of the town into convulsions.

Then again, many of the drugs in Mike Bain's basement are cringe-inducing by modern medical standards.

Besides the strychnine, a lethal poison once used as a stimulant, the Castor, Alta., pharmacist is fond of Stillman's Freckle Cream and Codol, a cough syrup. ...more

Sunday, April 08, 2007

Pharmacists await training in new role

This isn't really a surprise. A lot of people are going to expect that the pharmacist can help them circumvent seeing a physician, and this really isn't the case. Extending prescriptions can be done, but it's still not going to be really straightforward.

Considering the current views of most physicians, I'd be hesitant to extend a prescription for any patient who I didn't know their physician well. While you might be within your scope to make that extension, is it worth it if their physician reacts badly and you've make an enemy? Don't forget that a pharmacist is mandated to inform the prescribing physician that they've extended the order. I can imagine that some physicians will be protesting every extension on principle alone.

Also, I have yet to hear much talk about fees relating to prescribing. If it was appropriate and a pharmacist extended a prescription, would a patient pay a separate cognitive fee? The Alberta Pharmacists Association has recommended a cognitive fee of $16-$17, which isn't covered by Alberta Health. Are patients willing to pay that, or are they just going to go to their physician where there are no fees involved?

By the way, I was asked why narcotics and controlled drugs are excluded from the legislation. This was not a choice by the Alberta College of Pharmacists. Controlled prescription drugs are federally regulated, so if the federal government doesn't recognize a type of prescriber in the controlled drugs laws, they can't prescribe these drugs. This is why podiatrists in Alberta can prescribe everything except controlled drugs.

From the Edmonton Journal:
People who tried to obtain new prescriptions directly from pharmacists left empty-handed Sunday, the day new provincial rules kicked in to give the pharmacists broader powers.

By early afternoon, about five people had asked the staff at Rexall Drugs in Clareview to dole out medications without a doctor's visit.

"They were upset that they didn't get what they wanted," said Peter Nguyen, the pharmacy technician who referred patients back to their physicians. ...more

Addiction’s heavy toll

From the Halifax Chronicle Herald:
Using pliers to rip out healthy teeth just to get a narcotics prescription. Twelve-year-olds having sex with men in exchange for narcotics.

"It’s the worst kind of nightmare," said Mike McDonald, who just completed a four-week internship with Indian Brook’s outreach worker. "Our people are in real trouble and the worst part is, the kids are being hit bad." ...more

Complacency about disease is dangerous

From the Ottawa Citizen:
Paul Thorn has seen the monster that's coming for us. He's been in a hospital bed with it. It attacked his body and nearly drove him out of his mind.

Ten years later, he's cured of the multi-drug-resistant tuberculosis that attacked him in a hospital in London. Seven people died in that outbreak. He's the only survivor. What makes his survival more impressive is that he was already infected with HIV....more

Health Canada reviewing link between Parkinson's drug Permax and heart valve conditions

From Health Canada:
Health Canada is informing Canadians that Permax, a drug used for the treatment of Parkinson's disease, has been withdrawn from the U.S. market amidst concerns about an association with cardiac valvulopathy, a condition involving inflammation or stiffening of the heart valves.

Permax (a brand name of the drug pergolide) has been marketed in Canada since 1991 for the treatment of Parkinson's disease. The risk of heart valve problems has been known with this drug and is in the current labelling. Health Canada communicated information regarding this risk to Canadian healthcare providers and patients in 2003 and again in 2004.
For the public

Voluntary suspension of sales of Zelnorm due to cardiovascular ischemic events

From Health Canada:
At Health Canada’s request, Novartis Pharmaceuticals Canada Inc. is suspending marketing and sales of Zelnorm* (tegaserod hydrogen maleate) tablets in Canada to permit further evaluation of important safety information.
For health care professionals
For the public

Pharmacies offer smokers chance to butt out

From the Mississauga News:
Two Shoppers Drug Marts in Mississauga are among 55 pharmacies across Ontario that have signed on to help smokers kick the habit.

The stores will supply five weeks' worth of free nicotine replacement therapy (NRT) to selected smokers who want to quit.

In a promotion announced yesterday, the Ontario Pharmacists' Association (OPA), the Centre for Addiction and Mental Health (CAMH) and the Ministry of Health said as many as 5,000 Ontarians will receive the free therapy. The effort is part of a Smoking Treatment for Ontario Patients (STOP) study. ...more

Study probes genetic link to drug reactions

From the Vancouver Sun:
A B.C.-led study into tailoring drug therapy for individual patients based on their genetic makeup is the only research of its kind in the world.

The study will identify the genetic makeup and variations in children who suffer adverse reactions to medications.

Researchers will then turn their attention to developing tests, called predictive biomarkers, that would be given to pediatric and adult patients before they take drugs so that those susceptible to such reactions would either be given different agents or the indicated drugs, in smaller or larger doses. ...more

Thursday, April 05, 2007

Updates over long weekend

Look for a bunch of posts over the long weekend as I catch up on the news over the last week or so.

New laws give Alberta pharmacists prescribing power

From the Canadian Press:
Pharmacists in Alberta now have the precedent-setting power to prescribe medications, but grave concerns remain over their ability to make the right diagnoses.

Laws that took effect Sunday morning make Alberta pharmacists the first in North America to be legally and independently allowed to prescribe drugs for minor conditions or in urgent situations.

They will also be entitled to modify or alter the dosages and duration of prescriptions written by doctors. ...more

New HIV Drug May Be More Effective

FYI: Prezista has also been approved for use in Canada.

From CBS News:
A new HIV drug called Prezista helps curb HIV in patients who don't respond to other HIV drugs, a new study shows.

Prezista belongs to a class of drugs called protease inhibitors, which block HIV (the virus that causes AIDS) from multiplying.

The FDA approved Prezista in June 2006 for use with a protease inhibitor called Norvir and other anti-HIV drugs in adults whose HIV infection hasn't responded to other treatments. ...more

Wednesday, April 04, 2007

Certain lots of Salivart Oral Moisturizer contaminated with mould or yeast

From Health Canada:
Health Canada is advising consumers not to use certain lots of Salivart Oral Moisturizer, because the product may be contaminated with mould or yeast. Using the affected product may cause health problems such as nausea, vomiting, and diarrhea. Consumers with reduced immunity due to illness or immunosuppressant medications may be at increased risk of more severe reactions.

Salivart Oral Moisturizer is promoted as a natural treatment for dry mouth. One lot of the affected product has been distributed in Canada. The lot number is 06BB002, with an expiration date of 06-08. The lot number and expiration date are located at the bottom of the product container. ...more