Friday, August 31, 2007

MD faked billings, got pills for drug ring

From the Toronto Star:
A Toronto family doctor admitted yesterday to pumping more than 130,000 prescription sedatives into the black market and defrauding Ontario's health care system of more than $750,000.

Dr. John Kitakufe, in his late 50s and slightly hunched, mumbled the word "guilty" in court yesterday, responding to his lawyer Jenny Stephenson's nod after Justice Peter Harris asked for his plea.

Kitakufe, a Canadian landed immigrant, who was convicted of similar offences in Illinois nearly 20 years ago, was charged with conspiracy to defraud the Ministry of Health and Long-Term Care, defrauding the ministry and conspiracy to traffic in the narcotic-based painkiller OxyContin. ...more

Wednesday, August 29, 2007

Alta. pharmacists want prescribing privileges

I'm glad that I'm in the group of 30 to 40 Alberta pharmacists that are applying for advanced prescribing. I mailed in my application yesterday. It's still not clear when the applications will be approved, but it won't be until more steps in the process are completed in late September. Watch this blog for more updates.

From the Saskatoon Star Phoenix:
A handful of Alberta pharmacists will make Canadian history -- and likely stir a fresh round of debate about their new role -- when they apply for controversial prescribing privileges early next month.

Between 30 and 40 pharmacists in the province will undergo an assessment in the coming weeks to ensure they are qualified to write new prescriptions, adjust dosages and change drug therapies.

"This group of pharmacists will have a larger tool box, a broader spectrum of drugs for the conditions they are already treating," says Greg Eberhart, registrar of the Alberta College of Pharmacists. ...more

A prescription for change

From the Portage (Man.) Daily Graphic:
Pharmacists in Manitoba may be able to prescribe drugs in certain cases if the province has its way.

Pharmacists, doctors and patients are being consulted as new regulations are being drafted in accordance with Manitoba’s Pharmaceutical Act passed last fall. The Act gives pharmacists the authorization to write prescriptions in cases such as when a patient with a chronic condition needs a refill or when a patient has developed a reaction to a prescribed drug and requires a substitute.

“Pharmacists are not interested in taking over the job of doctors and, in Manitoba, doctors are not interested in inhibiting a pharmacist’s ability to help his or her client,” said Health Minister Theresa Oswald yesterday.

“We’re not trying to discourage people from getting the care they need. It just means in some circumstances where patients would go to the doctor for a routine signature that would not have to happen.”

The province has tried to assure opponents of the legislation it will make sure all the appropriate checks and balances are in place so neither pharmacists nor patients abuse the system with regard to visits and prescriptions. ...more

Tuesday, August 28, 2007

Heart attack drug may ward off Alzheimer’s

From the (London, UK) Times:
Taking statins may help to prevent Alzheimer’s disease, a study has directly suggested for the first time.

Researchers in the US claim to have uncovered clear evidence that the cholesterol-lowering drugs – taken daily by about three million people in Britain – could ward off the illness. The large-scale study, conducted at Boston University from 2002, found that the drugs may cut the risk of getting Alzheimer’s by as much as 79 per cent, even in people thought to be genetically susceptible to the disease. The lead author, Gail Li, said the study was the first to compare the brains of people who had received statins with those who had not.

Previous research has indicated that Alzheimer’s may be caused by poor blood flow and vascular changes in the brain, which statins may help to prevent. Dr Li, from the University of Washington School of Medicine in Seattle, and her colleagues examined the brains of 110 Americans who had died aged between 65 and 79, and had donated their organs for research. ...more

Health Canada Endorsed Important Safety Information on THELIN (sitaxsentan sodium)

From Health Canada:
Encysive Pharmaceuticals Inc., in consultation with Health Canada, wishes to highlight important safety information for the safe and appropriate prescribing and use of THELIN™ (sitaxsentan sodium).

THELIN (sitaxsentan sodium) is indicated for treatment of primary pulmonary arterial hypertension or pulmonary hypertension secondary to connective tissue disease, in patients with WHO functional class III who have not responded to conventional therapy. THELIN is also indicated in patients with WHO functional class II who did not respond to conventional therapy and for whom no appropriate alternative can be identified.
For Health Professionals

Rite Aid is key to Coutu's share health

From the Globe and Mail:
Most Canadian investors have never heard of Rite Aid Corp., even though plenty own shares in it. It's the third biggest drugstore chain in the United States and its biggest shareholder is Jean Coutu Group, the Quebec-based pharmacy chain.

If you own Jean Coutu stock, or if you're thinking about it, looking long and hard at Rite Aid ought to be top of mind because it will likely make or break your investment - and that's becoming more true by the day.

Jean Coutu's investment in Rite Aid, which accounts for a third of the U.S. company's stock, stems from a deal the two companies struck designed to let Jean Coutu extricate itself from a mess.

The Canadian company made its first big foray into the United States 13 years ago with the purchase of a chain of drugstores on Rhode Island called Brooks. That went pretty well. But in 2004, the company made a much bigger, bolder move by buying 1,500 Eckerd stores up and down the eastern seaboard. ...more

Only doctors may prescribe, CMA resolves

From the Globe and Mail:
Canada's doctors are bitterly denouncing the idea that pharmacists be allowed to prescribe drugs independently, saying such a practice places patients at risk.

Independent prescribing by pharmacists, nurse-practitioners and midwives is already permitted, to varying degrees, in six provinces.

Members of the Canadian Medical Association, gathered for their general council meeting in Vancouver, passed a series of motions yesterday, saying only physicians should prescribe, either directly or by delegating their powers to another health professional.

Groups representing pharmacists and nurses condemned the position, calling doctors paternalistic, paranoid and pathetically desperate to protect their turf.

"Despite their obvious skills, pharmacists don't have the totality of skills to make sound clinical judgments," said Gordon Pugsley, president of Doctors Nova Scotia. "It's an enormous leap of faith to think that care can be delivered at the same high level by someone other than a physician." ...more

Wednesday, August 22, 2007

1 in 4 patients prescribed unproven drug mix

When I see this article, it screams out at me: a lot of physicians aren't treating their patients optimally because they are not up to date on the latest regimens. Sounds like they might benefit by collaborating closer with a pharmacist...

From the Globe and Mail:
Patients with high blood pressure are increasingly being treated with powerful combinations of drugs.

And according to a new Canadian study, one in four patients are being prescribed unproven - and probably ineffective - combinations by their doctors.

"It's a good thing that there's more polytherapy," Karen Tu, a scientist at the Toronto-based Institute for Clinical Evaluative Sciences and co-author of the study, said in interview.

"[But] unfortunately, it appears that not all physicians are completely aware of the drug combinations that work best for their patients."

The research, published in today's edition of the Canadian Journal of Cardiology, sheds light on treatment for hypertension, a critical but rapidly changing field of medicine. ...more

Doctors at national meeting oppose pharmacists prescribing medication

Here's a similar article as below, but this one has some additional information.

From CBC News:
The majority of doctors attending a convention of the Canadian Medical Association have voted against allowing pharmacists to prescribe medication when they're part of a team caring for patients.

Fifty-six per cent of the 268 delegates at Tuesday's meeting opposed a motion by their national lobby group to let pharmacists have an expanded role within collaborative care teams.

Doctors said they should lead such teams and prescribe medication because they're adequately trained to take a patient's medical history, do a physical exam, order and interpret tests and come up with a diagnosis.

The Canadian Pharmacists Association says an expanded role for pharmacists is an international trend that includes an effective use of health professionals. ...more

Tuesday, August 21, 2007

MDs reluctant to expand role of pharmacists

I'm disapointed but not surprised regarding the results of this vote. It will be even more interesting once the first Alberta pharmacists are given the ability to prescribe beyond the current modification and adaptation of physician's prescriptions.

From the Globe and Mail:
A majority of doctors attending a convention of the Canadian Medical Association in Vancouver don't support an expanded role by pharmacists to manage and monitor medication when patients are cared for by a team of health professionals.

Fifty-six per cent of 268 doctors voted against giving pharmacists a larger role within such teams.

Many of the delegates at the meeting say doctors should lead a collaborative care team and they should be the ones prescribing medication.

The Canadian Pharmacists Association says an expanded role for pharmacists is an international trend that includes primary health-care reform. ...more

Monday, August 20, 2007

U.S. orders genetic data on blood-thinner risks

From Reuters:
Widely used blood thinner warfarin will come with new instructions explaining that people with certain genes may need a lower dose to take the drug safely, U.S. health officials said on Thursday.

The change is part of a move toward personalized medicine in which doctors tailor treatment based on genetic makeup, the Food and Drug Administration said.

Warfarin is sold by several generic makers and by Bristol-Myers Squibb under the brand name Coumadin. An estimated 2 million U.S. patients start taking the drug each year to prevent blood clots that may cause heart attacks and strokes.

Some patients, however, experience dangerous bleeding. Experts say about two in 100 patients taking warfarin will have a serious hemorrhage. Excessive bleeding from the drug is one of the most common prescription-related causes of emergency room visits, studies have shown. ...more

Codeine can be toxic to breastfed babies: FDA

From CTV News:
The U.S. Food and Drug Administration is warning that nursing infants may be at risk of morphine overdose if their mothers take codeine and have a genetic mutation that makes them ultra-rapid metabolizers of the painkiller.

The agency issued the warning Friday after reviewing information on the subject, including a medical journal report about the death of a 13-day old breastfed infant who died from morphine overdose.

The morphine levels in the mother's milk were found to be abnormally high after taking small doses of codeine prescribed to treat pain for an episiotomy (a procedure to enlarge the vaginal opening before childbirth.). ...more

Health Canada orders Parkinson drug off market

From CTV News:
Health Canada is ordering a drug used for treatment of Parkinson's disease off the market.

The department has told maker Eli Lilly that sales of the drug Permax (pergolide mesylate) must cease as of Aug. 30. Studies have shown the drug can cause serious heart valve damage in some users.

Eli Lilly voluntarily withdrew the drug from the U.S. market in late March after studies in the New England Journal of Medicine underscored the valve problem risk.

Health Canada says there are alternatives to Permax available to people with Parkinson's disease. ..more

Sunday, August 19, 2007

Report details risks some Canadian patients may face

A new analysis by the Canadian Institute for Health Information on patient safety has revealed that while problems developing during treatments or procedures are comparatively rare, some do occur more frequently.

For example, in 2005, one in 10 adults with health problems reported receiving the wrong medication or wrong dose in the previous year, according to the CIHI report — which studied data from 2003 to 2006.

Adverse blood transfusion events are reported much less often — about one in 4,100 cases in 2003.

The report noted in a survey, conducted in 2006, eight per cent of primary care doctors reported that patients had received the wrong drug or dose in the last 12 months.

In 2005, 18 per cent of nurses surveyed reported patients in their care had occasionally or frequently received the wrong medication or dose in the previous year. ...more

Saturday, August 18, 2007

Ontario hospital sued by Bayer

From the National Post:
A major pharmaceutical company has taken the unusual step of suing an Ontario hospital for patent infringement, alleging the institution effectively duplicated a patented Bayer Inc. antibiotic by diluting a more concentrated, generic version of the same drug.

The case is an extraordinary example of the lengths to which pharmaceutical companies will go to defend their intellectual property - and is likely to succeed in court, said medical and patent-law experts. However, the lawsuit may well backfire on the public relations front, they predicted.

"I think this is going to look, from Bayer's point of view, pretty petty," said Joel Lexchin, an emergency doctor and health policy professor at Toronto's York University.

The hospital is probably doing this for a small number of patients, costing Bayer almost zilch in terms of lost sales. If this drives up hospital costs, Bayer, I don't think, would look very good." ...more

The new pill

From the Vancouver Sun:
As the birth control pill approaches its 50th birthday, the now ubiquitous medication is getting a facelift -- a brand new image with provocative implications.

Once marketed for severe menstrual disorders but quietly sold as a contraceptive, the birth control pill is now being pitched as a means of reducing or eliminating menstrual periods.

It is the stuff of huge controversy and massive marketing budgets, and pits gynecologists against some of the continent's top hormone researchers and sexual health educators. ...more

Friday, August 17, 2007

E-Prescribing Becomes Legal In All 50 States

Every state in the U.S.A. now allows e-prescribing. As far as I know, not even one Canadian province has legalized the practice yet.

From Information Week:
Alaska, the 50th state to join the union, this week also became the last state to legalize e-prescribing.

The milestone means that pharmacists and doctors in all 50 states, plus Washington, D.C., can legally exchange drug prescription information electronically.

E-prescribing is designed to reduce drug errors by eliminating illegible handwriting, automatically checking for medication interactions, red-flagging drug allergies, as well as streamline prescription renewals and refill processes.

The Institute of Medicine estimates that health IT, such as e-prescriptions, can prevent about 1.5 million medication errors in the U.S. annually. ...more

Thursday, August 16, 2007

Health Canada reviews osteoarthritis drug after Australia concerns

From the Globe and Mail:
Health Canada says it is reviewing safety information for the drug Prexige (lumiracoxib) after Australian health authorities withdrew the drug from that market due to reports of serious liver problems, including two deaths, in eight people who had taken the drug.

Health Canada says it has asked for information about adverse events involving the liver from the drug's manufacturer, Novartis, and will update recommendations to the public and health care professionals if necessary.

Prexige is a member of the troubled cox-2 inhibitor class of drugs, a class which includes the now withdrawn drug Vioxx. Prexige is used for treatment of osteoarthritis in adults.

Australia's Therapeutic Goods Administration recently withdrew market authorization for Prexige due to eight reports of serious liver adverse events linked to the drug in that country, including two deaths and two liver transplants. ...more

Genetic testing cited for blood thinner

From the Williston (NDak) Herald News Daily:
Federal health officials are stopping short of recommending genetic tests for patients on the blood-thinner warfarin, even though they have said such screenings could prevent thousands of complications each year.

"This means personalized medicine is no longer an abstract concept but has moved into the mainstream," the Food and Drug Administration‘s clinical pharmacology chief, Larry Lesko, said in announcing the label change.

The FDA has not changed its dosing recommendations for the drug, and tailoring the proper dosage remains largely a matter of trial and error.

Genetic testing can reveal which patients may require less of the drug and lead doctors to recommend doses closer to the lower end of the scale, FDA officials said. ...more

FDA warns parents about cough, cold medicines

From CTV News:
The U.S. government is warning parents never to give cough and cold medicines to children under the age of two unless instructed to do so by a doctor.

The warning is part of a broad plan to reassess the safety of the medicines, which have been blamed for hundreds of hospitalization and a handful of deaths in U.S. toddlers and infants.

The Food and Drug Administration announced Wednesday it will convene a panel of independent experts on Oct. 18 to discuss whether warnings are warranted or whether sales of the medications should be restricted. ...more

U.S. drug ad spending jumps 330 per cent in 10 years: study

From CBC News:
Spending on direct-to-consumer drug advertising in the United States rose by a staggering 330 per cent in the first decade after drug companies were freed to pitch their wares directly to the public, rising to just under $30 billion US for the year 2005, a new study shows.

The work, published Thursday's issue in the New England Journal of Medicine, revealed that new ad campaigns typically start within a year of a drug's arrival on the market — a time when it has been suggested that drug companies should not be allowed to advertise a drug.

Earlier this year, a report published by the U.S. Institute of Medicine recommended that the American drug regulator, the Food and Drug Administration, bar drug companies from advertising prescription drugs in the first two years after they come to market. It is during that period when a drug first starts to be broadly used that side-effects not seen in clinical trials can become evident. ...more

Tuesday, August 14, 2007

'Sleepees' herbal pills contain prescription drugs

From CTV News:
Thousands of Canadians turn to herbal remedies to help them get a good night's sleep, believing that because the products are all-natural, there's no risk of addiction.

But some have found this is not always the case. Health Canada has recalled five herbal products in recent months because they contained potentially addictive prescription drugs. That's sparked a number of class action lawsuits against the manufacturers as well as worries that many Canadians may still be using these potentially addictive products.

Leslie Alexander and Brenda Connell suffered from insomnia, as many Canadians do. According to a recent study by Statistics Canada, one in every seven Canadians aged 15 or older -- about 3.3 million of us -- have trouble going to sleep or staying asleep. ...more

Catching up on some older news

I've posted a few articles from a week or so ago. I didn't get them up on the site at the time, but thought they were worth adding to the archive.

Cancer vaccine to be made available to Ontario school girls

Ontario announced Thursday it will begin to offer a vaccine that could help prevent cervical cancer to girls in Grade 8, a day after an article in the Canadian Medical Association Journal argued it is premature to offer the immunizations on a universal basis.

Ontario's free and voluntary program, which is to commence in classrooms this fall, will offer the Gardasil vaccine to about 84,000 young women at a cost of about $39 million a year or $117 million over three years -- Ontario's share of the $300 million announced in the last federal budget for the vaccine.

Gardasil is administered in three doses over six months. "By the end of this school year, all of our Grade 8 girls will get it if they choose," said Sandra Pupatello, Ontario's Minister Responsible for Women's Issues. ...more

Judge tells Genpharm to keep arms length from sales firm

From the Montreal Gazette:
A major Canadian drug manufacturer has been told to keep its hands off the employees and clients of the company handling its Quebec sales.

A Quebec Superior Court judge yesterday ordered Genpharm Inc. to continue paying Louis Pilon's Brossard-based sales company and to cease communicating with his clients.

Pilon, president of Gennium Pharmaceutical Products Inc., has alleged that Genpharm breached the terms of their decade-long business arrangement after less than three years - even though his efforts led to record sales during April, May and June. ...more

Jean Coutu to retire again as CEO of pharmacy chain after closing U.S. sale

From CBC News:
Jean Coutu has no plans to permanently hang up his ubiquitous white lab coat even as he once again hands the management reins of the drugstore chain he founded 38 years ago to his son Francois.

"He will remain as chairman of the board and he always likes to wear his white jacket, anyhow," Francois said in an interview Friday after the company released its fourth-quarter and 2007 fiscal year results.

The Montreal-area pharmacy chain posted a US$6.9-million quarterly net loss, but earned US$140.8 million for the year.

Francois will assume the title of chief executive officer after the annual meeting in October. It was a position he held in 2002 before relinquishing it three years later as he was demoted to president and head of Canadian operations amid problems in a massive U.S. acquisition. ...more

Pfizer wins U.S. approval for new HIV drug

My understanding is that Selzentry will likely be approved in Canada later this year.

From the Financial Post:
Pfizer Inc said on Monday that U.S. regulators approved its AIDS drug, Selzentry, the first in a new class of oral HIV medicines.

Selzentry is the first drug designed to keep the HIV virus that causes AIDS from entering healthy immune cells. Older AIDS medicines attack the virus itself.

The drug, also known as maraviroc, blocks the CCR5 co-receptor that serves as a main doorway for the HIV virus into immune cells.

The U.S. Food and Drug Administration approved Selzentry for use in patients who have tried other medicines and for those for whom a diagnostic test has confirmed their HIV strain is linked to the CCR5 receptor. About 50 percent to 60 percent of patients who have been treated with other AIDS drugs meet that definition, the FDA said.

Selzentry will come with a "black box" warning, the strongest for prescription drugs, about the risk of liver toxicity, the FDA said. ...more

Monday, August 13, 2007

Consumers miss out on generic-drug savings

This is from a few days ago, but since I haven't been updating the site quite as regularly as I should be, I didn't post anything about the growing controversy about generic drug prices. I have a feeling that this issue isn't going to go away.

From the Montreal Gazette:
A federal investigation into why Canada's generic drugs cost so much more than those in other countries has concluded there is plenty of competition between generic manufacturers - but patients, taxpayers and insurers are not benefitting from the resulting price war.

A burgeoning number of generic companies vying for space on drugstore shelves gives pharmacies rebates of up to 80 per cent off the wholesale price, the Competition Bureau says in a draft report obtained by the National Post. Those discounts, however, are not passed on by the retailers to governments or consumers, the agency says.

Tony Clement, federal minister of health, suggested last week that a few generic-drug companies have formed a virtual oligopoly that keeps prices inflated. ...more

Health Canada Endorsed Important Safety Information on Rituxan (rituximab)

From Health Canada:
Hoffmann-La Roche Limited, in consultation with Health Canada, has informed Canadian healthcare professionals of important new safety information concerning RITUXAN (rituximab).

RITUXAN is authorized in Canada for the treatment of non-Hodgkin’s lymphoma (a cancer of the lymph nodes) and rheumatoid arthritis (an inflammatory disease of the joints).
For health care professionals
For the public

Friday, August 10, 2007

Health Canada investigates Losec, Nexium for heart risks

From CBC News:
Health Canada is alerting consumers who take Losec and Nexium, two prescription medications primarily used to treat acid-related stomach disorders, that it is investigating the drugs' links to serious cardiac problems.

Studies of the two medications reveal that patients using Losec or Nexium to treat gastroesophageal reflux disease (GERD) instead of surgery "may have experienced more heart attacks or cardiac deaths than patients who had the surgery," reads the advisory.

It also notes that many patients who developed cardiac problems had risk factors prior to beginning treatment. ...more

Thursday, August 09, 2007

Canadian companies agree to share generic AIDS drugs with Rwanda

From the Globe and Mail:
AIDS drugs could be heading for Rwanda as soon as November under a Canadian program that allows generic-drug companies to send copies of brand-name medicines to poor countries.

GlaxoSmithKline Inc. said yesterday it had given consent to Apotex Inc. to manufacture an antiretroviral medication for the treatment of HIV/AIDS patients in Rwanda. Consent, through Canada's Access to Medicines Regime, was needed as GSK has patent rights for two of the three molecules in the medication.

"We have made a commitment, we have the drug and if we can get the green light, we will move quickly on it," said Elie Betito, director of public and government affairs for Apotex Inc. ...more

Wednesday, August 08, 2007

Skin patches have their down side

From the Toronto Star:
Morag Dickie liked the convenience. She could just slap the nitroglycerin patch onto her body in the morning and not worry about popping pills.

"I could feel a consistent flow of energy," says Toronto resident Dickie, 55, a heart patient.

That's the idea behind a skin patch – an easy-to-use method with smooth, controlled drug release, not the peaks and valleys of ingested medicine. In the U.S. last month, the Food and Drug Administration approved the first skin patch to treat Alzheimer's disease. In May, it gave the green light to a drug patch for Parkinson's disease. Last year, medicinal patches were approved Attention Deficit Hyperactivity Disorder and depression. ...more

Health Canada approves cannabis-derived pain drug for certain cancer patients

From Canada East:
A cannabis-derived drug that's been on the market for two years in Canada to relieve pain in multiple sclerosis patients is now approved for use by certain patients with cancer.

Health Canada has approved Sativex as an added pain relief treatment for adults with advanced cancer who have moderate to severe pain when using the highest tolerated dose of strong opioid therapy, said a statement Tuesday from Bayer Inc.

Patients can self-administer Sativex by spraying it into the mouth - under the tongue or on the inside of the cheek.

Advanced cancers usually cannot be cured, and many of these patients will experience moderate to severe pain, according to various pain studies. ...more

Wednesday, August 01, 2007

Experts raise worries about HPV vaccine

From CTV News:
A group of Canadian public health professionals says there remain a number of unanswered questions about the HPV vaccine and that a universal vaccination program in Canada "is premature and could have unintended negative consequences."

Abby Lippman, a professor of epidemiology at McGill University, and colleagues, conducted a review of the current literature on the HPV the vaccine and summarize their conclusions in an editorial in the Canadian Medical Association Journal.

They found that while it appears that the vaccine is highly effective in preventing infection with HPV types 16 and 18 (currently thought to be the cause of about 70% of cervical cancer cases), it's still not clear whether reducing such infections will translate into fewer cervical cancer deaths in the long run. ...more

B.C. to fund new treatment for kidney cancer

From CTV News:
Victims of a rare form of advanced kidney cancer are getting help from the B.C government, which is the first province to fully fund a new and expensive drug treatment.

Dr. Susan O'Reilly of the B.C. Cancer Agency says this type of renal cancer has been difficult to treat and does not respond to chemotherapy.

About 130 patients will benefit from the decision to spend more than three million dollars annually to fund treatment with a drug marketed under the name Sutent. ...more

Crocs clampdown sparks health-care debate

This isn't a pharmacy story, but I know it could potentially affect a lot of hospital pharmacists.

From CTV News:
The popularity of colourful rubberized foam clogs among health workers has sparked a heated debate across North America.

Health-care workers have been wearing footwear manufactured by Crocs because of their comfort for working long shifts. Hospital staff had long worn footwear resembling clogs, but unlike the most popular version of Crocs footwear these clogs had closed toes.

Despite the fact that the shoes have many holes in their most popular design, the shoes are popular with health care workers like Sarah Coughlin, an operating room attendant at the Hospital for Sick Children in Toronto. ...more