Monday, June 30, 2008

Secret rebates amount to a tax on patients

I usually don't post many opinion pieces, but I thought this one was interesting and worthy of debate. Any comments?

From the Victoria Times Colonist:
The government of British Columbia, in an attempt to save money on its drug purchases, has recently introduced a sole-sourcing strategy in which it receives secret rebates. This strategy is in effect a hidden tax on consumers of those medicines.

The first product for which the government has used this secret-rebate strategy is olanzapine, which is prescribed for various mental disorders including schizophrenia.

Although olanzapine is generically available everywhere else in Canada, the province has struck a deal with Lilly, the manufacturer of the branded version Zyprexa, to make it the only version of olanzapine available in B.C. under PharmaCare. (Virtually everyone in B.C. is a member of PharmaCare, which offers some insurance for drugs, depending on income, age, and total drug expenditure.) ...more

New Thromboembolic Guidelines May Spark Controversy

From Medpage Today:
Most of the recommendations in the eighth edition of antithrombotic guidelines from the American College of Chest Physicians are only incrementally changed, but several are likely to be controversial, according to the authors.

The 2008 guidelines contain 179 new recommendations, as well as new chapters, to deal with areas of care that have seen significant development since the 2004 guidelines were issued, according to Jack Ansell, M.D., chief of medicine at Lennox Hill Hospital in New York and a member of the panel that developed the guidelines.

They are published as a 22-chapter supplement to the June issue of CHEST and are available online.

Dr. Ansell outlined several areas that are likely to be contentious. For instance, he said, "There has been a lot of buzz about the use of pharmacogenetics for drug dosing and warfarin (Coumadin) is one of the major candidates." ...more

Parallel trade in drugs puts EU patients at risk

From the Guardian (UK):
If you suffer from epilepsy and you live in Athens you are less likely to receive the vital drugs you need for treatment than if you live in London, Berlin or Amsterdam. And, says Konstantinos Lourantos, president of the Association of Pharmacies of Attica, the fact that they are freely available in other parts of Europe contributes to their shortage in his country. The reason? Lourantos, whose organisation represents some 3,500 pharmacists in and around Athens, blames companies that buy up medicines in Greece and export them to other EU countries, exploiting the price differences for drugs across the EU.

The UK is one of the largest markets for these companies, known as the parallel pharmaceutical traders (PPTs), along with Germany, Holland and Denmark.

Lourantos says: 'For example, there is a medicine called Lamictal for epilepsy which is imported to Greece but it is re-exported in such a huge quantity that there is very little left.' He says the problem affects supplies of a number of drugs, including Astra Zeneca's Seroqual for treating bipolar disorder and Risperdal, an anti-psychotic treatment. ...more

Managing hypertension at home improves results

From the Chicago Daily Herald:
Patients with high blood pressure controlled the condition better using in-home testing and Internet consultations with a pharmacist than by working with their doctors alone, researchers found.

Almost twice as many patients who relied on testing and the pharmacist to help guide their therapy, in addition to their usual care managed their blood pressure compared with those who only worked with their doctors, according to a study in the Journal of the American Medical Association.

About one in three U.S. adults have been diagnosed with high blood pressure and less than half have the condition under control, according to the researchers. Doctors are searching for new ways for patients to control their hypertension, which can lead to stroke, heart attacks, heart failure and kidney disease if untreated. ...more

Sunday, June 29, 2008

Local pharmacist reappointed president of national regulatory body

From the Grand Falls Windsor (NL) Advertiser:
When Grand Falls-Windsor pharmacist Sandra Carey was reappointed in May to be the returning president of the national pharmacy board, an overseas trip wasn't the first thing on her mind.

But shortly after that, Ms. Carey, who works at the Wal-Mart pharmacy, found herself going to Geneva, Switzerland, at the European headquarters of the United Nations.

She represented the National Association of Pharmacy Regulatory Authorities (NAPRA) at the International Conference for Health Care Professionals, where people in the field from all over the world met to discuss a topic that Newfoundlanders, and the central region in particular, can relate to: a global health care crisis.

"The world is becoming smaller," said Ms. Carey. "People in developing countries are hearing that there's good money to be made in Canada and the U.S. and they're finding that there's a major shift. This is creating a crisis in these developing countries because there are not enough people to look after the people there.

While doctor and nurse shortages are a common topic in this province as well as on a global level, that list includes pharmacists as well. ...more

Thursday, June 26, 2008

Parkinson's drugs increase risk of impulse disorders

From CTV News:
A common class of drugs prescribed to control Parkinson's disease symptoms increases the risk of gambling, excess shopping and compulsive sexual behaviour, a new study finds.

Canadian and American researchers found that study subjects who were taking dopamine agonist drugs, which help control movement problems, were two to three times more likely to have at least one of four common impulse control disorders.

About 13 per cent of subjects had at least one disorder, while one third of the subjects had more than one disorder.

The disorders are pathological gambling, compulsive buying, compulsive sexual behaviour and binge eating. ...more

New Anti-Clotting Pill Works Well in Trials

From the Washington Post:
A new anti-clotting drug that could be one of the long-sought alternatives to commonly used blood thinners has performed well in hip and knee replacement patients, physicians report.

The drug, rivaroxaban, was more effective at reducing potentially fatal blood clots than heparin, with no increase in side effects, according to studies by three research teams reporting this week in theNew England Journal of MedicineandThe Lancet.

"It was superior to low molecular weight heparin, one of the two most common prophylaxis modalities in the United States," said Dr. William Geerts, a professor of medicine at the University of Toronto, and a member of a team that tested rivaroxaban after hip replacement surgery.

Prophylaxis in this case means prevention of blood clots. Heparin is commonly used in hospitals because it is easier to manage than Coumadin (warfarin), which requires frequent blood tests for close control. The new drug, rivaroxaban, is an easily swallowed pill that does not require constant monitoring.

In the international trial of 4,541 people who had hip surgery, 1.1 percent of those given rivaroxaban suffered problems such as deep-vein blockage or pulmonary embolism, compared to 3.7 percent of those given enoxaparin, a widely used form of heparin. The incidence of major bleeding was similar in both groups -- six of 2,209 for rivaroxaban, and two of 2,224 for enoxaparin. ...more

Tuesday, June 24, 2008

Shoppers Drug Mart and Jean Coutu may feel the heat from U.S.

From the Financial Post:
He already had a “sell” rating on shares of Shoppers Drug Mart Corp., but a deal last week that appears to signal a U.S. health care player’s push up north gave Octagon Capital analyst Robert Gibson even more reason to be bearish on Canada’s largest pharmacy chain.

On June 19, health care logistics provider McKesson Canada, a division of San Francisco-based McKesson Corp., announced that it is buying Quebec-based Group PharmEssor Inc., which consists of 270 independently-owned pharmacies in Quebec, Ontario and the Atlantic provinces. The chain operates under the Proxim and ProxiMed brands. In the U.S., McKesson runs Health Mart, the number one independent retail pharmacy, Mr. Gibson noted.

“It would appear that this Proxim acquisition is McKesson’s move north with their Health Mart model,” he told clients.

The company’s vertical integration likely means the McKesson-Proxim combination will become a stronger competitor to major chains in Quebec and the Atlantic provinces, including Jean Coutu Group Inc., the analyst said. ...more

Monday, June 23, 2008

Anti-smoking drug Champix may spur depression, agitation

From CBC News:
Health Canada has issued another warning about adverse neuropsychiatric effects linked to Champix, a drug intended to help smokers butt out for good.

A number of patients taking Champix (varenicline tartrate) have experienced unusual feelings of agitation, depressed mood, hostility, changes in behaviour or impulsive or disturbing thoughts, such as ideas of self-harm or of harming others, Health Canada said Friday in an advisory.

The medication acts on sites in the brain affected by nicotine. The drug helps ease withdrawal symptoms and blocks the effects of nicotine if users resume smoking.

Champix, made by Pfizer Inc. and sold under the brand name Chantix in the United States, has been sold in Canada since April 2007. In the year following its approval, 226 Canadian cases of neuropsychiatric adverse events have been reported. In that period, more than 708,500 prescriptions for the drug have been filled across the country. ...more

Drug for treating HIV may raise heart attack risk, manufacturer warns

From the Canadian Press:
A drug used in combination with other antiretrovirals to treat HIV infection has been linked with an increased risk of heart attack, the medication's manufacturer warned Monday.

GlaxoSmithKline, in conjunction with Health Canada, is advising patients taking abacavir-containing products - sold under the brand names Ziagen, Kivexa and Trizivir - of concerns raised by a recent study in The Lancet about the possible elevated heart attack risk.

Patients should not stop taking any of the abacavir-containing medications without first consulting their doctor, the company said in a release. Patients should also discuss any serious, pre-existing cardiovascular disease with their physician.

"Health-care professionals thoroughly consider the overall benefit versus the risk of a medication for each individual patient before prescribing," the company said. "If patients have questions regarding their current prescription, they are asked to contact their doctor." ...more

Thursday, June 19, 2008

Hormone replacement use down in Canadian women

From the Toronto Sun:
Hormone replacement therapy use by older Canadian women has dropped dramatically since a major study published in 2002 linked HRT use to higher rates of heart attack and stroke, a study has found.

Analysis of data from five provinces shows that use among senior women dropped to five per cent in 2006-2007 from 14 per cent in 2001-2002.

The Canadian Institute for Health Information study, released Thursday, looked only at women 65 and older, and therefore reflects only a small part of the picture of what happened to HRT use in Canada in the wake of the publication of the Women’s Health Initiative study.

Hormone replacement therapy is generally prescribed for the symptoms of menopause, which women typically go through in their late 40s and early 50s. ...more

NHL governors approve sale of Oilers to Edmonton billionaire Daryl Katz

From the Canadian Press:
Canadian pharmacy billionaire Daryl Katz has received the final OK from the National Hockey League to purchase the Edmonton Oilers.

"I am very pleased to have received the Board of Governors' unanimous approval," Katz said in an e-mail to reporters Wednesday. "We look forward to closing the transaction on or before June 30th and gearing up for the coming season."

The league's board also approved the sale of the Tampa Bay Lightning to a group of investors led by Oren Koules and Len Barrie.

The approval of both deals was granted pending the closing of the transactions by the prospective purchasers.

Katz, a reclusive 46-year-old Edmonton resident, took over the Oilers franchise in February after all 34 members of the team's then-ownership group agreed to sell it to him in a C$200-million deal. ...more

Wednesday, June 18, 2008

Health Canada warns consumers not to use the dietary supplements 6-OXO and 1-AD due to potential serious health risks

From Health Canada:
Health Canada is warning consumers not to use the dietary supplements 6-OXO (4-androstene-3,6,17-trione) and 1-AD (1-androstenediol), or any other supplements containing the ingredients 4-androstene-3,6,17-trione or 1-androstenediol, due to potentially serious health risks such as seizures and blood clots in the brain that can lead to disability.

Both 6-OXO and 1-AD are manufactured by ErgoPharm / Proviant Technologies in Champaign, Illinois. They are promoted as dietary supplements for body building, and are not authorized for sale in Canada. Health Canada has received one domestic adverse reaction case report in which an individual with no known predisposing medical conditions developed seizures and blood clots in his brain, associated with the use of 6-OXO and 1-AD. ...more

Increased risk of marked hepatic enzyme elevations in patients taking SOMAVERT® (pegvisomant) in combination with a somatostatin analogue

From Health Canada:
In a global post-marketing combination study with a somatostatin analogue, one out of 25 patients in the pegvisomant group and 1 out of 27 in the octreotide acetate group had transaminases greater than three or more times the upper limit of normal (ULN). Three patients out of 26 treated with the combination were found to have serum concentrations of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ranging from 13 to 45 times the ULN within 3 months of starting this treatment. Two of these patients received supratherapeutic doses of octreotide acetate (30 mg every 2 weeks) combined with a normal dose of SOMAVERT (10 mg daily). All three patients completely recovered after discontinuation of treatment.
For Health Professionals
For the Public

New Safety Information regarding Liver Injury and Hypersensitivity associated with TYSABRI (natalizumab)

From Health Canada:
Biogen Idec Canada Inc., in consultation with Health Canada, would like to inform you about new safety information regarding the risk of liver injury and hypersensitivity in patients receiving TYSABRI (natalizumab).
Tysabri For Health Professionals
For the Public

Tuesday, June 17, 2008

Fake erectile dysfunction drugs flooding Vancouver

From the Vancouver Sun:
Police and customs agencies are intercepting frequent shipments of counterfeit erectile dysfunction drugs coming into Canada through Vancouver, an RCMP expert attempting to rein in the illegal industry said Monday.

Some of the counterfeit drugs are as much as 50-per-cent stronger than the genuine product, said Cpl. Norm Massie of the RCMP's Border Integrity Program. Others are less than half the recommended strength.

Even more potentially dangerous is that they could contain untested products.

"We do not even know what else is in there," Massie said of the drugs, which are being seized at both the border and the post office. He added that there are almost daily seizures of the drugs.

Massie said the booming erectile dysfunction industry is a major revenue provider for criminals looking to profit by counterfeiting goods researched, copyrighted and produced by legitimate companies. ...more

Canadians getting fleeced on generic drugs: report

From the Vancouver Sun:
Canadians are getting gouged more than ever on generic prescription drugs, a study by the Fraser Institute reported Monday.

The report's author called for reforms that would see consumers shopping around for the best drug prices.

The conservative think-tank found Canadian prices for generic - non-brand name, off-patent - medications are an average of 112 per cent higher than those in the U.S. In 2003, the Fraser Institute found prices here were 78 per cent higher than in the U.S.

At the same time, Canadian prices on brand-name drugs are an average of 53 per cent lower than American prices, a result of federal caps on drug costs.

The Fraser Institute report compared Canadian and American retail prices for a few hundred commonly prescribed drugs, half brand-name and the other half generics. ...more

Proposed drug changes could cost N.B. millions

From the Fredericton (NB) Daily Gleaner:
Regulatory changes proposed by the federal government that would delay the introduction of generic versions of brand-name drugs could mean millions of dollars in extra costs for New Brunswick's drug plan.

The Conservative government introduced changes to Canada's drug patent rules in April that critics claim would allow pharmaceutical companies to extend exclusive rights on some drugs beyond the current 20-year term.

New Brunswick Health Minister Mike Murphy said Thursday the proposed changes may delay the introduction of generic versions of popular drugs such as cholesterol-lowering medication Lipitor, blood-pressure drug Norvasc, and Celebrex.

He said the province spent more than $14 million on the trio of medications last year, adding generic versions would slash prices by up to 50 per cent.

Medication for seniors and nursing-home residents, among others, costs the drug plan more than $160 million annually. ...more

Bone loss screening can be less frequent, study finds

From CBC News:
Elderly men and women are at high risk of hip fracture due to bone loss, say researchers, but given rates of bone loss, screening can occur as infrequently as every five years.

Bone loss can lead to osteoporosis, a condition in which the bones become brittle and more prone to fracture.

The study, which tracked 9,423 participants between the ages of 25 and 85, found bone loss among women aged 50 to 54, which data showed had the most pronounced bone loss of all age groups, was 1.3 per cent.

According to the researchers, this decrease is within the margin or error of most bone densitometry machines, meaning that the loss is not as significant as once thought.

"The extent of the bone loss that we observed suggests that repeat measurements of bone density could be delayed to intervals of up to five years in the absence of other risk factors," they write. ...more

Firms back campaign against health bill

From the National Post:
When Tony Clement, the Health Minister, agreed last week to revamp a contentious health-products bill, he cited an opposition movement that had spread virus-like across the Internet, garnered broad and sympathetic media attention and spawned protests from Penticton to Parliament Hill.

The Web-based campaign touched a nerve with its dire warnings of an impending clampdown on users of herbs and other natural remedies.

But was the crusade that prompted Mr. Clement's climbdown truly the citizen uprising it appeared to be?

In fact, some of the campaign's alarming criticisms of Bill C-51 were themselves a matter of debate. And the seemingly grassroots movement has been driven largely by two controversial natural-health companies embroiled in drawn-out legal battles with Health Canada. One sells an unlicensed vitamin treatment for bipolar disorder, the other herbal "heart drops" for cardiac disease. ...more

About-face on natural health products

From the Victoria Times Colonist:
In a surprising about-face, Health Minister Tony Clement has agreed to key demands of the natural health products industry after the sector launched a grassroots campaign against restrictions on homeopathic medicines and herbal remedies in new legislation.

When Clement proposed amendments to the Food and Drugs Act in April, natural medicines were lumped in with pharmaceutical drugs, raising concerns they would be subject to the same type of oversight. He now admits it was a mistake not to create a separate category under the law.

"My attitude is a bill is a work in progress. Let's see whether we are clearly getting out the things that we want to do in a particular bill. In this case, obviously protecting the health and safety of Canadians was and remains the motive for the bill," Clement said in an interview Friday. ...more

Rite Aid deal a bitter pill for Jean Coutu in first year after sale

From the Providence (RI) Journal:
The family that controlled the Warwick-based Brooks drugstore chain has seen the value of its stock holdings melt away in the year since it sold the company to a rival pharmacy operator.

Canada’s Jean Coutu Group (PJC.A:TSX) last year sold more than 1,850 Brooks and Eckerd drugstores and 6 distribution centers to Rite Aid Corp. for $3.9 billion in cash and stock in a deal that closed June 4, 2007.

Under the deal, Rite Aid paid $2.3 billion in cash to Jean Coutu and issued the company headquartered in Longueuil, Quebec, about 252 million shares, according to filings made last year to the U.S. Securities and Exchange Commission. The acquisition made Jean Coutu Group the largest Rite Aid shareholder, with 32 percent of common stock and about 30 percent of voting power. Jean Coutu’s holding in the third-largest American drugstore chain remains unchanged. ...more

Trial for controversial doctor Huerto comes to close

From the Saskatoon Star Phoenix:
Seven years after investigators with the College of Physicians and Surgeons of Saskatchewan started gathering evidence against controversial Saskatoon Dr. Carlos Huerto, lawyers for the Crown and defence made their final statements in his criminal fraud trial Thursday.

The very fact that prescription drugs labelled with the names of more than 400 of his patients were seized from Huerto's home in June 2001 is enough to prove him guilty of defrauding Health Canada and Saskatchewan Health, which paid for the drugs with taxpayer funds, Crown prosecutor Brent Klause argued in an 83-page written brief obtained by The StarPhoenix.

"Huerto gained access to an unlimited amount of free medical supplies by taking advantage of the trusting nature of his patients, his pharmacy and his own staff," Klause wrote.

"The method in which Huerto defeated the system and obtained these prescriptions was dishonest and deprived Health Canada and Saskatchewan Health of the funds they are entrusted to distribute on behalf of their clients." ...more

Monday, June 16, 2008

Hospital Pharmacists Shortage Getting Worse

From CJAD (QC):
The shortage of hospital pharmacists is getting worse: The association representing the province's 12-hundred-and-50 hospital-pharmacists estimates the system needs 220 more of them.

The head of the Association of Hospital Pharmacists, Linda Vaillant, worries that the shortage persists, while hospital needs are growing due to the aging of the population and the requirements of increasingly complex treatments.

She says the shortage isn't just affecting institutions in Quebec's outlying regions, it's causing problems in urban areas as well. ...more

Sunday, June 15, 2008

Pharmacies slow to adopt standards

From the Viet Nam News:
Lack of equipment and business competence could prevent the cities of Da Nang and Can Tho from setting up 30 pharmacies with Good Pharmacy Practice (GPP) standards by the end of this year.

The target was set by the Ministry of Health and affects four major cities, including Ha Noi and HCM City. It is part of a new plan to make sure all pharmacies nationwide by 2012 have a pharmacist’s certificate, drugs stored at below 30 degrees Celsius, proper pricing for goods and clear labelling for medicines showing the origin and instructions for use. If a drug store does not meet these standards in the allotted time, it will be shut down.

While Ha Noi has built 45 GPP pharmacies and HCM City 21, there have been no new drug stores set up in Da Nang or Can Tho, according to a recent report by the Drug Administration of Viet Nam. ...more

New powers for pharmacists on the cards

From the Australian Broadcasting Corporation:
Pharmacists may one day gain limited prescription powers to ease pressure on GPs.

Advocates say pharmacists are well qualified for the extra role.

Tasmania's Health Minister, Lara Giddings, says GP numbers are expected to fall as demand grows.

She says pharmacy prescription is one of several solutions that should be considered. ...more

Thursday, June 12, 2008

A prescription to improve health care

This is a decent article regarding pharmacist prescribing, but I thought I'd point out that the example cited in the early part of the article is a very poor one. Pharmacists would not be diagnosing bladder infections at the local pharmacy counter as Ms. Bessette would prefer. Diagnosing is a physician's area while optimally managing drug therapy once diagnosed is where a pharmacist can shine.

From the North Bay (Ont.) Nugget:
Tina Bessette has been at the mercy of a doctor shortage.

And she doesn’t like it.

The idea of giving pharmacists, nurse practitioners, midwives and optometrists more prescribing power couldn’t come at a better time, Bessette said Tuesday.

“It’s really frustrating, especially for those who are waiting hours at a walk-in clinic just to get their medications refilled,” she said.

“It would be really helpful for the patient if more medical professionals could prescribe drugs. It’s exactly what we need and it will certainly help because right now the situation is horrible.”

Most recently, Bessette has had to wait seven days before she could get the necessary medication she needed for a bladder infection.

“The nurse practitioner who treated me didn’t have the authority to prescribe medication so I had to make a doctor’s appointment and the earliest I could get one was about seven days later,” she said.

“We need these types of people to be able to prescribe medication. Doctors are so busy, many times you can’t get hold of them to make an appointment or it’s not soon enough.” ...more

Clement calls natural-health claim "absurd"

From the Georgia (BC) Straight:
Health Minister Tony Clement has struck back at claims by lawyer Shawn Buckley in last week’s Georgia Straight that his proposed regulations in Bill C-51 would result in a Canada-wide death toll of “tens of thousands” or more.

“It’s absurd, it really is,” Clement told the Straight by phone on June 9. “We can disagree on public policy, but to use that kind of language is really over the top and regrettable.”

Buckley, a Kamloops-based constitutional lawyer, spoke at a June 2 downtown event organized by the Health Action Network Society in opposition to Clement’s health bill before the House of Commons.

During his speech, Buckley—also president of a group called the Natural Health Products Protection Association—claimed that Clement’s bill would result in more natural health products (or NHPs) being regulated off the market due to strict licensing and labelling laws as well as more stringent policing of the industry and greater Health Canada enforcement powers. ...more

Low vitamin D levels linked to greater risk of heart attacks in men

From the Globe and Mail:
Having low levels of vitamin D is associated with a doubling of the risk of heart attacks in men and an even greater risk of dying from the cardiac condition, according to a new study.

The findings, published yesterday in the journal Archives of Internal Medicine, may help shed light on why many people with no known risk factors - such as high blood pressure or smoking - inexplicably develop heart attacks. It also suggests it may be possible to reduce the incidence of the often fatal condition by popping an inexpensive pill that is widely available in pharmacies and supplement stores.

"It's an important finding," says Edward Giovannucci, professor of nutrition and epidemiology at the Harvard School of Public Health in Boston, one of the researchers.

"It does indicate that even individuals without the standard risk factors for heart disease may be at somewhat higher risk if they have lower vitamin D levels," he said.

Dr. Giovannucci said vitamin D may be beneficial by reducing the buildup of plaque in arteries, one of the causes of heart attacks. ...more

Thursday, June 05, 2008

Rheumatoid arthritis drug may increase cancer risk

From CBC News:
Sufferers of rheumatoid arthritis who take the antirheumatic drug methotrexate increase their risk of developing certain types of cancer, suggests new research.

Rheumatoid arthritis is a chronic inflammatory illness that affects the joints, as well as internal organs such as the eyes, lungs or heart. It affects one in 100 Canadians, according to the Arthritis Society of Canada.

Methotrexate suppresses the immune system, which in rheumatoid arthritis is overactive.

Australian researchers studied 459 rheumatoid arthritis patients — 309 women and 150 men — who started taking methotrexate before June 1986.

After 4,273 person-years of followup, which averaged 9.3 years per patient, they found 87 malignancies.

They discovered that the risk of developing non-Hodgkin's lymphoma in RA patients was five times higher than in the general population. ...more

Wednesday, June 04, 2008

Ontario pharmacists could soon prescribe drugs

From the Globe and Mail:
Ontario patients could soon get drug prescriptions from their local pharmacist as the governing Liberals look to join other provinces and expand the prescribing powers of pharmacists, nurses and other non-physicians.

Despite concern from the country's doctors, Health Minister George Smitherman is asking for advice on who should be allowed to prescribe drugs and whether nurse practitioners — who have some prescribing power — should be able to write prescriptions for a wider array of medication.

“You are seeing more and more the capability of the pharmacists being unlocked to serve patients,” Mr. Smitherman said.

“I think it's an appropriate thing to take a look at. Obviously it's got to be done with . . . an abundance of caution on behalf of patients but also recognizing that, for patients, it can be a matter of extraordinary convenience.”

The Ministry of Health is quietly commissioning a study which would examine whether those who have prescription authority now — like midwives, optometrists and nurse practitioners — should be able to prescribe more classes of drugs. ...more