Wednesday, December 31, 2008

Manufacturer warns of serious infections related to psoriasis drug

From CBC News:
The manufacturer of a drug that treats psoriasis has issued new safety information for doctors and patients.

EMD Serono Canada says Raptiva has been associated with a risk of serious infections, including progressive multifocal leukoencephalopathy, a rare and sometimes fatal brain disorder.

Raptiva suppresses the body's immune response to reduce psoriasis inflammation; however, the company says that by diminishing the body's natural defence system, it can also increase the risk of serious infections in some patients.

Signs and symptoms of PML may include difficulty thinking, walking or speaking, or other behavioural changes, weakness, loss of balance or co-ordination, visual impairment, partial paralysis of one side of the body, or seizures.

Other serious infections may be indicated by fever, weakness, cough, flu-like symptoms, warm, red or painful skin, or open sores on the body. ...more

Tuesday, December 30, 2008

Treating the flu isn't easy

From the Owen Sound (Ont.) Times:
Early signs from this flu season suggest doctors face a vexing dilemma in treating the illness. Testing to date in Canada, the United States and Europe shows that nearly all H1N1 viruses are resistant to oseltamivir (sold as Tamiflu) and susceptible to the adamantane drugs, amantadine and rimantadine.

The inverse is true for H3N2 viruses, which are universally resistant to the adamantanes and susceptible to oseltamivir.

Given that in reality little point-of-care testing is done to determine whether a patient actually has influenza, let alone which variety of the bug is behind the illness, the resistance situation could see doctors making choices that lead to treatment failure this season.

"It definitely adds to the complexity of trying to manage influenza,'' said Dr. Maria Zambon, head of the respiratory viruses unit of Britain's Health Protection Agency. ...more

Optimal Warfarin Dosing Improves Anticoagulation Control

From the Washington Post:
While the anticoagulant warfarin can be highly effective in preventing strokes and treating venous thromboembolism, doctors have long struggled with finding the best way manage the drug therapy.

Boston University School of Medicine (BUSM) researchers now claim to have figured out the optimal dosing levels to help patients, according to a study published in December online issue of the Journal of Thrombosis and Haemostasis.

The research team analyzed warfarin use in almost 4,000 patients to determine what are the most effective levels of the drug in a patient's system under different circumstances.

"The study suggests that anticoagulation control could be improved considerably by changing the warfarin dose only when the ratio is 1.7 or lower/3.3 or higher," lead author Dr. Adam Rose, an assistant professor of medicine at BUSM, said in a university news release. "In addition to offering warfarin to as many optimal candidates as possible, we also need to optimize warfarin dose management to fully realize the benefits of anticoagulation." ..more

Monday, December 29, 2008

Anti-smoking law forces retailer to phase out pharmacy

From the Edmonton Journal:
With the final phase of Alberta's Tobacco Reduction Act set to take effect on New Year's Day, Stadium Drug and Food Mart owner Jack Au had a business choice to make.

Either keep his grocery store where more than 50 per cent of sales come from tobacco products or hang on to the less lucrative pharmacy and watch his former smoking customers buy their cigarettes elsewhere.

"So I closed up the pharmacy. It made no sense to continue with that business when over 50 per cent of the business is tobacco here," Au said.

Au now uses the corner where the pharmacy once stood to rent out videos.

When Jan. 1 rolls around, he will permanently seal up the double doors leading to the pharmacy which moved next door.

There will be no access from his store. He intends to be in compliance with the province's anti-smoking legislation, considered by some to be among the toughest in the country.

Under the legislation, all pharmacies, stores that have a pharmacy in them, health-care facilities and post-secondary institutions in Alberta will no longer be allowed to sell tobacco products as of Jan. 1. ...more

Saturday, December 27, 2008

Pharmacists take on expanded role starting January

From Arrow Lakes (BC) News:
As part of a new agreement between the government of B.C. and the B.C. Pharmacy Association, pharmacists will be taking on a bigger role when it comes to prescription medications.

As of Jan. 1, B.C. pharmacists will have the legal authority to renew or adapt existing prescriptions to better suit the patient.

Pharmacist Troy Clark of People’s Pharmacy in Nakusp says it’s a step up for the role of pharmacists.

“[It is] increasing our scope of practice,” says Clark. “It’s something that we’re capable of doing.”

A pamphlet available at People’s Pharmacy states benefits of the change include allowing your pharmacist to help manage medications for patients between visits to the doctor.

“This medication management thing that’s coming now, the new policy that’s come out, it’s just giving us the authority,” says Clark. “Now we have the legal authority to do some of those things that we were maybe doing already.” ...more

Application of pharmacy standards slackens

From VietNamNet:
Many drugstores at large hospitals have not yet applied the Good Pharmacy Practices (GPP), let alone private pharmacies, although the deadline is only one week away, said HCMC health officials.

The Ministry of Health last year introduced the GPP standard and required all drugstores at hospitals nationwide to brace for the standard before January 1 next year. The standard is aimed at helping State agencies ensure the quality of drugs, better manage drug manufacturing and distribution, protect the people’s health as well as prepare the market for foreign drug distributors who will be allowed to enter the market early next year.

Under the ministry’s requirements, all drugstores must operate in modern facilities, only sell drugs with known origin, employ qualified pharmacists and provide drug consultations. However, even in HCMC where the pharmaceutical market is more developed, the standard has not been attended to by drugstores, said Pham Khanh Phong Lan, deputy director of HCMC’s Department of Health.

She told the Daily that the GPP implementation in hospitals would fall behind the ministry’s deadline given the current progress.

“Up to this month, 52 hospital-based drugstores in HCMC have been completing procedures to apply the GPP plus about 10 district-level hospitals,” she said. Of this figure, only 30 drugstores have successfully deployed the GPP standard. ...more

Pharmac hits back at talk of stinginess

Medicine funding is "not about counting votes" or making popular decisions, says Pharmac chief executive Matthew Brougham.

In the national drug-buying agency's annual review, Mr Brougham hit back at accusations of stinginess.

This month the Government took the unprecedented step of bypassing Pharmac's independent decision-making process to directly fund 12 months' of the costly breast cancer drug Herceptin.

Earlier this year, a group of cancer patients took Pharmac to court over its decision to offer just nine weeks' treatment.

The High Court ordered Pharmac to do more "public consultation", which attracted more than 300 submissions, but did not overturn the original decision.

Mr Brougham said Pharmac was making efforts to improve the way it consulted with and relayed its decisions to the public. ...more

Tuesday, December 23, 2008

PCA wants rules to play by

From the Financial Post:
In all businesses, entrenched interests -- "the club" -- can and do play a large role in ensuring life isn't made easy for a bunch of newcomers, as existing players protect their interests by any and all means.

Enter Peter Suma and Don Waugh, founders of PCA Services, which regards itself as "an innovator of hardware and software for the dispensing and ongoing management of patient drug therapy." PCA (PharmaTrust) recently launched its second dispensary at Toronto's Sunnybrook hospital.

Getting to that stage hasn't been easy. The 40-person company has invested $9-million in a kiosk that allows patients to talk to a pharmacist via video conferencing and enables the pharmacist to monitor and control each step of the dispensing process from a video call centre. Medication is dispensed from the kiosk by the pharmacist in a few minutes. And PCAS has fought numerous battles with the club. "Only a wet baby likes change," said Suma, whose MBA from the University of Chicago makes him a supporter of free and open markets. PCA wants rules to play by

Old-time remedies best when it comes to fighting kids’ colds

From the Lethbridge (AB) Herald:
When coughs and colds hit kids, old remedies may be the best.

That’s the message from local pharmacist Rick Siemens, after Health Canada announced this week that children under six years old shouldn’t be treated with over-the-counter cough and cold medications, because the potential risks outweigh any possible benefits.

Siemens, pharmacy manager at London Drugs in Lethbridge, was busy Friday moving the store’s supply of children’s cough and cold medicine behind the pharmacy counter. He said parents should consult with a pharmacist to determine whether such medicines are the right solution and if so, what kind of dosage to give.

“Those medications, if they’re used properly, are safe. It’s just that the effectiveness has never been proven to be that great for any cough and cold medication,” Siemens explained. ...more

Thursday, December 18, 2008

Health Canada says children under 6 shouldn't get cough and cold medication

From the Canadian Press:
Children under six years old shouldn't be treated with over-the-counter cough and cold medications because the potential risks outweigh any possible benefits, Health Canada says.

The warning follows a recently completed review of scientific data on the products by the federal department, which recommended in October 2007 that children under two shouldn't be given the cough and cold remedies.

"The current decision expands on those preliminary recommendations," Dr. Marc Berthiaume, director of Health Canada's marketed pharmaceuticals and medical devices bureau at Health Canada, said Thursday from Ottawa.

The review, which included advice from an expert scientific advisory panel, concluded "there is limited evidence supporting the effectiveness of these products in children," the agency said.

"In addition, reports of misuse, overdose and rare side-effects have raised concerns about the use of these medicines in children under six. The rare but serious potential side-effects include convulsions, increased heart rate, decreased level of consciousness, abnormal heart rhythms and hallucinations." ...more

Pushing more doctors to ditch the prescription pad

From the Associated Press:
The push for paperless prescriptions is about to get a boost: Starting in January, doctors who e-prescribe can get bonus pay from Medicare.

For patients, the benefits are obvious — from shorter drugstore waits to increased safety, as pharmacists no longer squint to decipher doctors' messy handwriting.

But persuading U.S. doctors to ditch their prescription pads for electronic prescribing so far has been a long, uphill battle. Only about 10 percent of doctors are taking the plunge like Dr. Ted Epperly in Boise, Idaho, who's adopting the technology now.

Still, the movement is gaining steam as Medicare warns that its bonus payments are for a short time only: Holdouts still sticking to paper in 2012 will find their Medicare payments cut.

And continuing the push for medical information technology is a key part of President-elect Barack Obama's health-reform plans, in hopes that moving to computerized records — not just prescriptions, but all those troublesome paper charts that contribute to medical errors and wasted care — ultimately could save millions of dollars a year. ...more

Pill to be given out by chemists

From BBC News:
A pilot scheme allowing pharmacists to give women the contraceptive pill without a prescription has been given the go-ahead for next year.

Women and girls aged over 16 will be able to get the pill at two London primary care trusts, Southwark and Lewisham, Pulse magazine says.

If the pilots are successful, the pill could become available over the counter like the morning after pill.

Officials say this might help reduce the UK's high teen pregnancies.

Although the teenage pregnancy rate in Britain is falling in many areas, it remains the highest in Western Europe.

A spokeswoman for the Department of Health said: "We want to improve women's access to contraception and help reduce the number of unintended pregnancies without undermining patient safety. ...more

Liver function a concern for lung cancer patients taking Tarceva

From CBC News:
Drug company Hoffman-La Roche is telling doctors prescribing Tarceva to lung cancer patients to closely monitor the liver function of those who recently have taken or who are taking the drug.

The drug Tarceva (erlotinib) is used to treat patients with non-small-cell lung cancer at an advanced stage when chemotherapy has not helped to stop the disease.

The letter issued by Hoffman-La Roche says a study of patients with advanced cancer and moderate liver impairment found that a higher number of patients died during treatment or within 30 days of the last dose, compared to patients with normal liver function. ...more

Seniors' drug plan unveiled

From the Edmonton Journal:
Low-income seniors in Alberta will be paying less and in some cases nothing for prescriptions under a new pharmaceutical plan that will also hike drug costs for high-income seniors and triple the premiums for those on Blue Cross.

"I think it's a good idea," said Patricia O'Reilly, a volunteer at the Seniors Association of Greater Edmonton. She and her husband have an income lower than $42,650, so they won't have to pay for drugs under the new pharmaceutical strategy, which kicks in January 2010.

Currently, seniors have to pay 30 per cent of their prescriptions up to $25 for each drug, no matter what their income. A senior on 10 different drugs, for instance, would be paying $250 or less, depending on the cost of the medications.

Under the new regime, couples earning less than $42,650 and singles earning less than $21,325 won't have to pay anything.

The new program will save O'Reilly, 66, between $45 and $50 each month. "Sometimes, it's a bit tough with the cost of living," she said. "Everything else goes up. I will definitely benefit from it." ...more

No benefit from multiple steroid injections in preterm births: study

From CBC News:
Giving many courses of steroids to women at risk of giving birth prematurely increases the risk of having a smaller-sized baby, a Canadian-led international study suggests.

A single course of corticosteroids has been shown to reduce the risk of death in newborns, respiratory distress and bleeding in the brain of infants born to women at risk of giving birth before 37 weeks of pregnancy.

But doctors have moved beyond what the evidence supported and repeated courses of the prenatal drugs — also known as antenatal — has become common, according to a commentary that accompanies the study in the Dec. 20 issue of the medical journal The Lancet.

In the largest trial to date, Dr. Kellie Murphy of the department of obstetrics and gynecology at Toronto's Mount Sinai and her colleagues analyzed data on more than 1,800 women at risk of preterm birth who received one course of prenatal corticosteroids 14 to 21 days before the study began. ...more

Wednesday, December 17, 2008

On-site pharmacy must monitor care home's drugs, owner says

From the Globe and Mail:
Sunridge Place residents whose medication costs have shot up since they were forced to move out of Duncan's Cowichan Lodge care home can complain all they want. But whether it's vitamins, minerals, herbal remedies or prescription medications, there's no way around purchasing the pills they need from the private-care home's on-site pharmacy.

According to Bob Mehr, owner of Pacific Compounding Pharmacy, the company under contract to Sunridge Place, said the B.C. College of Pharmacists requires that the same designated provider supply all medications for long-term care residents.

"When you have a contract with a particular nursing home, you are responsible for all the medications provided at that particular nursing home, including vitamins and over-the-counter medications," said Mr. Mehr, who owns nine pharmacies on Vancouver Island, including three that are located in P3 long-term care homes.

"Where you are in a care facility, everything the patient gets has to be prescribed by a physician and the pharmacy is obligated to supply that. If we don't we are interfering with the doctor's care." ...more

Tuesday, December 16, 2008

Medical schools urge limits to drug makers' influence on students

From CBC News:
There may soon be no more free lunches — or fridges to store them in — in the student lounges of Canadian medical schools.

No talks given by physicians' experts paid handsomely by pharmaceutical companies. Or unsupervised meetings with drug reps.

The association that represents Canada's medical schools announced Tuesday it is endorsing the principles that lie at the core of rules such as these introduced by its American counterpart earlier this year.

The Association of Faculties of Medicine of Canada said the aim is to limit the influence the pharmaceutical industry has on medical students and residents and assuage the public's concerns about the perceived cosiness between medical schools and drug makers.

"There's no question that the environment within which you're trained will have some sort of impact on the way you perceive these issues," Irving Gold, the association's vice-president of government relations and external affairs, said from Ottawa. ...more

Indonesia scraps plans to tag HIV patients

From the International Herald Tribune:
An Indonesian province beleaguered by a spiraling HIV infection rate scrapped plans to implant microchips in those with full-blown AIDS on Tuesday, following strong opposition from government officials, health workers and rights activists.

Papua's parliament agreed to drop a section of the health development bill that supported the tagging of some HIV patients with small computer chips inserted beneath the skin — part of extreme efforts to monitor the disease, lawmaker Weinard Watori said. ...more

Monday, December 15, 2008

Generic drug maker suit against federal government reaches trial stage

From the Canadian Press:
Federal regulations that bar Canada's generic drug makers from copying brand-name products for eight years after patents expire will come under the judicial microscope Tuesday as a two-year-old lawsuit reaches Federal Court.

The generic drug makers want the court to set aside rules that they argue cost consumers $115 million in extra drug costs every year.

The regulations, implemented in 2006 under the Food and Drugs Act, were designed to protect the extensive and expensive data that manufacturers need to seek approval for a drug. The data include the results of studies and clinical trials.

The rules prohibit Health Canada from licensing a generic version - generally cheaper than the brand-name equivalent - until after the eight-year period for those drugs where patent protections have lapsed. ...more

Tuesday, December 09, 2008

Most Alberta seniors to pay less under new drug plan

From CBC News:
About 60 per cent of Alberta's seniors will see their prescription drug costs lowered or eliminated starting in January 2010, but others will pay more, Alberta Health announced Monday.

Single seniors with an annual income of less than $21,325 and senior families with an annual combined income below $42,650 will not have to pay for medication.

But other seniors who have high incomes will pay more for drug coverage.

Deductibles will be based on a sliding scale and the highest earners could pay up to $7,500 a year if they have high medication costs.

Alberta Health Minister Ron Liepert said the change will make the system fairer to everyone.

"We have a philosophy in government that we need to — and it's our responsibility to — ensure that those who can't afford it or don't have it, that there are programs in place by government," he said. ...more

Pharmacist wins national award

From the South Shore (NS) Now:
A dispensary manager at a Mahone Bay drugstore has received a national award for patient care.

Susan Beresford of Kinburn Pharmasave in Mahone Bay recently earned the award for overall patient care in the 2008 Commitment to Care and Service Awards Program, sponsored by Pharmacy Practice and Drugstore Canada magazines.

In a recent press release marking the announcement, representatives of the two magazines cited Ms Beresford for her 30-year career as a pharmacist, saying the model she exemplifies of accessible, informative and supportive services "has embraced a collaborative approach to aiding patients." ...more

Alberta will fund drugs to treat rare diseases

From the Globe and Mail:
As Ontario was defending its refusal to fund a costly drug for an ailing man, Alberta ushered in a new strategy that will ensure those with rare, genetic diseases are provided medicine - even for drugs that cost $1-million a year.

Alberta's move yesterday is believed to be the first in Canada for rare diseases and will provide coverage starting in April.

Eligible patients will be required to pay premiums and make co-payments for the drugs, which typically total $250,000 to $1-million annually for each patient and are often the only medicine approved for their condition.

"Currently, today, we don't have a policy in place, and quite frankly, it becomes a pick and choose by the Minister, and the Minister isn't going to choose for somebody to die," Alberta's Minister of Health and Wellness, Ron Liepert, said in a telephone interview yesterday. "This way, it's part of our drug policy." ...more

Sympathy, but no help for a rare disorder

From the Globe and Mail:
Once a husky machinist, Greg Troy is a diminished figure who fights for every breath. He navigates his home in Waterloo, Ont., by grasping pieces of furniture. He can sleep only when attached to a ventilator.

The 62-year-old inherited a rare metabolic disease called Pompe that causes excessive amounts of glycogen to accumulate in the body, disabling skeletal muscles and damaging the heart.

Although there is a drug to treat the often fatal illness - costing up to $600,000 a year - access to it in Canada is unequal. Ontario has a policy to provide it only to babies, where it has been shown to improve survival significantly. Quebec is paying for one infant to receive it, while Alberta funds three patients of various ages under a special grant.

Mr. Troy was refused the enzyme-replacement drug, called Myozyme. In rejecting his request, the Ontario Ministry of Health said in a Sept. 12 letter that there is a lack of evidence concerning the efficacy of the drug in adults - but that it extended its "full sympathy" to Mr. Troy. ...more

Rx plan cuts Montgomery County costs nearly in half

From the Schenectady (NY) Daily Gazette:
The cost of prescription medications for employees of Montgomery County and the city of Amsterdam has been cut nearly in half since they began participating in the CanaRx prescription drug plan.

More than 5,000 prescriptions have been issued since the program’s start in 2006 for participants, according to statistics provided by CSEA Local 829 President Eddie Russo.

The cost for 5,403 prescriptions under a typical U.S. prescription plan is estimated at $1.97 million, but instead cost roughly $1 million through the end of October, according to the report from CanaRx.

Including employees, their family members and retired employees, 1,474 people are covered under the Canadian drug plan. ...more

Lawsuit filed against Bayer over drug risks

From CTV News:
Lawyers have filed a multi-million dollar lawsuit against drug giant Bayer Inc. and related companies because one of its drugs, which was given to patients to inhibit bleeding during cardiac surgery, has been linked to a higher risk of death.

Bayer voluntarily withdrew the drug, known as Trasylol, from the market a year ago after a clinical trial found that patients treated with the drug were 53 per cent more likely to die than those treated with older, less expensive anti-bleeding medications.

That study, known as the BART trial, was stopped early and Trasylol was pulled from the market in several countries, including Canada. However, the drug is still available in Canada to some doctors via special-access programs.

Trasylol was originally approved for patients who were at an increased risk of blood loss and blood transfusion while undergoing heart surgery, particularly cardiopulmonary bypass. It is estimated that 4.3 million patients worldwide were given the drug since it was approved in 1993. ...more

Diabetes drugs double women's fracture risk

From USA Today:
Long-term use of a popular class of oral diabetes drugs doubles the risk of bone fractures in women with type 2 diabetes, a new study reports.

According to researchers at Wake Forest University School of Medicine who reviewed 10 previous drug trials, for every 20 women in their 70s with type 2 diabetes who took thiazolidinediones — rosiglitgizone (brand name Avandia) and pioglitazone (brand name Actos) — for at least one year, one of them has a chance of suffering a fracture. In women in their mid-50s, the figure equals one fracture in every 55 women. That's more than double the normal risk for those age groups. ...more

Check your medicine cabinet

From the Saskatoon Star Phoenix:
It's the middle of the night when your bedroom door creaks open. Here it comes: "Mommy, I don't feel good."

Whatever ailment has wakened your child, getting a fix on it is easier when you keep a few kid-friendly remedies stocked in your medicine cabinet. It's often dependent on what kids are already prone to -- pharmacist Margaret Leenders has kids with sensitive skin, so hydrocortisone cream is a must.

Adult medicine is "a really big no-no" unless parents are extremely well versed in translating milligrams into child-size doses, warns physician Mark Sherman. Children need much smaller doses due to their size but also because they metabolize drugs differently. ...more

Expect vaccine to inhibit HIV within 5 years: Nobel winner

From CBC News:
A therapeutic vaccine to inhibit the spread of HIV will be available within five years, according to a Nobel Prize-winning scientist who helped discover the virus.

Luc Montagnier, director of the World Foundation for AIDS Research and Prevention, said he thinks it is "a matter of four to five years" before such a vaccine is developed. Restricting the transmission of HIV, he said, would change how the disease is managed and controlled.

Montagnier, 76, said a therapeutic vaccine, to be given to those who are already infected in order to inhibit the likelihood of transmission, would be a key step in fighting the virus. By comparison, a preventative vaccine would protect people from contracting HIV in the first place. ...more

Saturday, December 06, 2008

Windsor's born-again pharmacist

From the Financial Post:
Rocco D'Angelo is a born-again pharmacist.

He used to own a Wyandotte Street pharmacy that was flush with business. They filled 800 prescriptions a day at a hectic pace. Then he and his pharmacist wife got divorced and he started travelling around the province working at pharmacies on short-term contracts. D'Angelo, a father of two daughters, soul searched and decided to return to the roots of his profession.

"I didn't go to pharmacy school to sell shampoo or motor oil," D'Angelo said. "I went to study chemistry and help people."

He bought a condominium downtown and opened Royal Windsor Pharmacy, a tiny storefront at the corner of Park and Pelissier streets. The shelves are stocked with over-the-counter medications and vitamins that D'Angelo recommends. There isn't a bottle of shampoo or pack of batteries in sight.

D'Angelo, 55, dove into his new life. His business is small, and while he wants it to grow, he doesn't want to expand too much, otherwise he wouldn't be able to spend as much time with patients. ...more

Grads ‘not fully competent’

This is not much of an endorsement of new pharmacy graduates...

From the Irish Medical News:
Pharmacy graduates are only 60 per cent competent one year after graduating from university, according to Prof Ian Bates, School of Pharmacy, University of London, who spoke at the Pharmaceutical Society of Ireland (PSI) council meeting held at Trinity College Dublin (TCD) last week.

Prof Bates suggested that there is a mismatch with what graduates think they should learn and what they need to learn. He also stated that the learning experience of pharmacy students across the world in countries such as Bangladesh, Canada, the UK, Switzerland and Japan vary from one another even though they should be showing similar trends.

The need for “life-long learning” among pharmacists is critical to a sturdy pharmacy service in Ireland, he said. The Pharmacy Act of 2007 allows for continued professional development and competence to be upheld in Ireland. ...more

Pharmacies 'join the chain'

From the Cape Town (S.Afr.) Independent:
A body representing the country's pharmacies wants to meet Health Minister Barbara Hogan to propose that pharmacies become part of the supply network, so allowing state patients to collect their medication there, rather than at state health facilities where long queues are problematic.

In an open letter to Hogan, United South African Pharmacies (Usap) asked that community pharmacists be allowed to distribute and fill prescriptions issued by public sector health services in an effort to reduce medicine costs, improve access to medication and eliminate long queues at overcrowded hospitals.

One of their proposals was that they be paid subsidies or delivery fees by the government in return for the service. ...more

Ministry says 85 City chemists meet standards

From Viet Nam News:
Around 85 drug stores in HCM City are qualified to meet the new Good Pharmacy Practices (GPP) standard.

This follows an order from the Ministry of Health last year that requires all pharmacies to meet the GPP standard by 2011 in order to remain in operation.

The GPP standard requires pharmacy owners to have a pharmacist’s certificate and a pharmacist always on duty. It further requires that drugs clearly display their origin of manufacture and instructions for storage and use.

Out of the 85 GPP-compliant drug stores, 41 are managed by city hospitals, with the rest being privately-owned.

Recently, the HCM City Department of Health has set a target to get 100 percent of the city’s pharmacies GPP-compliant in 2009. Out of the country’s approximate 3,816 pharmacies, 70 percent are in HCM City. ...more

Thursday, December 04, 2008

Drugs, drugs, drugs

From the Kawartha Lakes (Ont.) This Week:
As a third generation pharmacist, Marc Scanlon has seen the profession evolve since his grandfather's time.

In 1925 when Mr. Scanlon's grandfather began his career, pharmacists were not even allowed to print the names of the drugs on the prescriptions' labels, he says. But things have changed and they continue to change.

In a report to the Minister of Health and Long-term Care released in September, the Health Professions Regulatory Advisory Council is recommending expanding the power of pharmacists to include some services that normally require a doctor.

"In this upcoming holiday season I will probably see people every day in my pharmacy who need medication that they need to see a doctor for, and their doctor is away," says Mr. Scanlon of the Clinic Pharmacy--Pharmasave in the Peterborough Clinic. ...more

Tuesday, December 02, 2008

Canadians fall through cracks without pharmacare: report

From CBC News:
The rising cost of drugs prevents some Canadians from getting the treatments they need, the Canadian Health Coalition says in renewing its call for a national pharmacare plan.

The group held public hearings across the country from October 2007 through last March, with more than 250 Canadians talking about the difficulties faced with the cost, effectiveness or availability of prescription drugs.

Brenda Young of Prince Edward Island told the hearings that she and her husband work hard to support themselves and their two teenage children, but they live paycheque to paycheque.

"When I go for surgery, everything is covered," said Young, who has neurofibromatosis, an inherited condition involving fibre-like growths of the nerves and skin.

"But as soon as I am out of the hospital, there is no money for ongoing drugs or physical therapy.… If the children need prescriptions, I sometimes have to tell them to wait until payday." ...more

Change to GP dispensing opposed

This is more evidence that there are turf wars between pharmacists and physicians throughout the world. The battles involve different topics: pharmacist prescribing in Canada has been covered here before. The article below talks about physician dispensing in the U.K.

From BBC News:
Patients are opposed to any plans to reduce the ability of rural GPs in England to provide drugs directly to their patients, a poll suggests.

There are fears that plans laid out in a government White Paper will threaten the future of GP dispensaries.

The Dispensing Doctors Association surveyed more than 6,000 patients who currently get their drugs this way.

They found 95% would find it difficult or inconvenient if their surgery stopped dispensing.

The Pharmacy White Paper - designed to increase the role chemists play in providing care for patients - includes a number of options to reform the existing rules which govern dispensing by doctors.

Currently, patients who live more than a mile from a chemist can choose to have their medicines dispensed by their GP. ...more

Kids' cholesterol pills worry MDs

Canada's top medical journal is warning doctors about giving cholesterol pills to children, saying there is scant direct evidence statins are safe for children and that doctors risk committing kids to "decades of therapy."

Millions of Canadian adults take the cholesterol reducers to lower their risk of heart attacks and cardiovascular disease.

Now, the American Academy of Pediatrics says the drugs should be considered for children as young as eight who have high concentrations of LDL, or low-density lipoprotein, the "bad" cholesterol.

But a leading editorial in this week's Canadian Medical Association Journal says statins haven't been widely tested in children, most studies involved kids whose high cholesterol is due to an

inherited blood disorder -- not obesity -- and that only one study followed children for more than a year.

The journal calls it the latest example of "age indication creep" -- giving drugs approved for adults to kids. ...more

Swiss approve pioneering legal heroin program

From the Associated Press:
The world's most comprehensive legalized heroin program became permanent Sunday with overwhelming approval from Swiss voters who simultaneously rejected the decriminalization of marijuana.

The heroin program, started in 1994, is offered in 23 centers across Switzerland. It has helped eliminate scenes of large groups of drug users shooting up openly in parks that marred Swiss cities in the 1980s and 1990s and is credited with reducing crime and improving the health and daily lives of addicts.

The nearly 1,300 selected addicts, who have been unhelped by other therapies, visit one of the centers twice a day to receive the carefully measured dose of heroin produced by a government-approved laboratory.

They keep their paraphernalia in cups labeled with their names and use the equipment and clean needles to inject themselves — four at a time — under the supervision of a nurse, and also receive counseling from psychiatrists and social workers. ...more

More time on the side of treating stroke

From the London (Ont.) Free Press:
The window for delivering critical clotbusting drugs after a stroke is slightly bigger than was thought, updated guidelines for stroke care suggest.

The revised best practice recommendations say the drugs, which can prevent or minimize the damage from a stroke, can be given within 4.5 hours of a stroke. Previous guidelines suggested the drugs had to be administered within three hours to be effective.

The larger window may mean more people who have strokes get care, a welcome development if it occurs.

It's estimated that less than a third of people who have had a stroke get drugs that can break up the blood clots clogging an artery and cutting off blood supply to a part of the brain.

If untreated within the optimal window, that damage becomes permanent and can lead to speech and motor difficulties and cognitive impairments.

It's why those who work in stroke medicine use the adage "time is brain."

Even though the new guidelines suggest there's more time than was thought, that shouldn't slow anyone's pace, suggested Dr. Stephen Phillips, head of the expert panel that revised the recommendations. ...more

Anti-bleeding drug alternatives less risky, cheaper and nearly as effective: study

From the Canadian Press:
A new analysis of clinical trials of a controversial anti-bleeding drug used in heart surgery says that cheaper, safer alternatives work nearly as well and should be recommended.

The review was rushed to print Tuesday by the Canadian Medical Association Journal in advance of a hearing Wednesday of a panel of experts who have been asked to advise Health Canada on future use of the drug, aprotinin.

"For routine use there is no clear advantage of aprotinin that justifies the apparent increase in mortality and the undoubted increase in cost," said Dr. David Henry, lead author of the review and CEO of the Institute of Clinical Evaluative Sciences in Toronto.

"So that in routine clinical practice, there is not now a role for this drug as an adjunct to cardiac surgery."

Aprotinin - which is sold under the brand name Trasylol - was used to reduce bleeding and minimize the need for blood transfusions during coronary artery bypass surgery. Made by pharmaceutical giant Bayer Inc., the drug was thought to be more effective than older anti-bleeding therapies tranexamic acid and aminocaproic acid.

But a landmark clinical trial comparing aprotinin to the alternatives was stopped in October 2007 when it was found that the rate of deaths among people who were given the drug was higher than that of people who got the older, cheaper drugs. ...more

Monday, December 01, 2008

More female physicians, pharmacists working in Canada: reports

From CBC News:
More women are joining the health-care occupations in Canada, including the traditionally male-dominated professions of medicine and pharmacy, according to a report released on Monday.

The Canadian Institute for Health Information said women make up about 80 per cent of the health care workforce, which includes more than one million people. The reports included information on the supply, distribution, migration, education and demographic trends for:

* Doctors.
* Regulated nurses — registered nurses (RNs), licensed practical nurses (LPNs) and registered psychiatric nurses (RPNs).
* Pharmacists.
* Occupational therapists.
* Physiotherapists.

In 2007 for example, 56 per cent of family physicians under the age of 40 were women, compared with 16 per cent of family doctors aged 60 and over, the institute said.

There were 63,682 active physicians in Canada in 2007, and the total ratio of physicians to 100,000 population increased to 192 last year from 187 in 2003, report said.

Among pharmacists under the age of 40, 64 per cent were women, compared to 27 per cent of those over 60. More than 75 per cent of pharmacists worked in the community setting, while fewer than 20 per cent worked in hospitals. ...more

Drive-through drugstore opens

From the Regina Leader Post:
There won't be any supersizing and you won't be able to get fries with that order, but Regina now has its first drive-through pharmacy.

Rexall Drug Store at 420 Albert St. has a two-lane drive-through to accommodate people who would prefer not to leave the comfort of their vehicle when dropping off prescriptions or picking them up. The service is restricted to prescriptions only.

Kevin Melnyk, regional pharmacy director for Saskatchewan, said there had been some earlier attempts at drive-through pharmacies in the city, but "this one is state of the art. Our whole store is designed with the drive-through in mind." Unlike the usual order screen and drive-through window at a fast-food outlet, this drive-through relies on a hatch system for dropoffs and pickups. There is no open window. All communication is handled through a phone.

He said the drive-throughs have proven popular in places like Alberta and Ontario, so the time had come for Regina. ...more