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