Tuesday, April 28, 2009

Canada's swine flu cases jump to 13, all mild

From Reuters:
The number of confirmed cases of swine flu in Canada increased to 13 on Tuesday, as Canadians were urged to avoid unnecessary travel to Mexico and tour operators postponed flights between the countries.

Ontario, the country's most populous province, confirmed its first four swine flu cases, and Alberta said it now had two cases. British Columbia, which already had two cases, said it now had three.

"Thankfully all of these cases have been mild," said Federal Health Minister Leona Aqlukkag.

Provincial health officials said all the people who have contracted the flu had recently travelled to Mexico, which is a popular holiday destination for Canadians.

Canada has predicted the number of confirmed swine flu cases in the country would increase as screening continued. ..more

Taming a deadly disease

From the Globe and Mail:
Twenty-five years after the discovery of the AIDS virus, the deadly disease has been halted in its tracks – so much so that sufferers are now dying at a ripe old age.

Nearly 85 per cent of patients being treated for HIV-AIDS with drug cocktails have undetectable levels of virus in their bloodstream, according to new data from the B.C. Centre for Excellence in HIV-AIDS in Vancouver.

“People with HIV are not exempt from destiny,” Dr. Julio Montaner, the centre's director, said in an interview, “but they are no longer dying from AIDS.” That fact, he said, “really tells the story of how far we've come with treatment.”

When Margaret Heckler, then secretary-general of the U.S. Health and Human Services Department, announced at a Washington news conference on April 23, 1984, that the “probable cause” of AIDS had been found, she boldly predicted a vaccine within two years and eradication of the disease by 1990.

If only it were so.

There is still no vaccine, no cure, and HIV-AIDS continues to spread relentlessly, with 2.7 million new infections worldwide last year and 33 million people living with the virus. ...more

Shoppers Drug Mart profit rises on prescriptions

From Reuters:
Shoppers Drug Mart (SC.TO), Canada's biggest pharmacy chain, reported a higher quarterly profit on Tuesday as sales of prescription drugs and beauty care products rose.

Shoppers said it earned C$106.8 million ($87.5 million), or 49 Canadian cents a share, for the quarter ended March 28, up from C$100.7 million, or 46 Canadian cents a share, for the same period last year, which included the high-sales Easter weekend. The Easter holiday weekend did not fall in the first quarter this year.

Revenue rose 8.5 percent to C$2.2 billion, with same store sales rising 4 percent.

Analysts were expecting, on average, earnings per share of 48 Canadian cents before items and revenue of C$2.16 billion.

The company's shares, which have fallen 11.4 percent in the past year, were up 2.7 percent at C$45.34 on the Toronto Stock Exchange on Tuesday. ...more

To vaccinate or not to vaccinate

From Canada.com:
To vaccinate or not to vaccinate.

That is one of a host of difficult questions that Canadian public-health officials will face if the swine-flu outbreak escalates into a full-blown pandemic.

In 1976, then U.S. president Gerald Ford ordered a national vaccination campaign in response to an outbreak of swine flu at a military base in New Jersey. In the end, only one person died from swine flu, while roughly 25 people died from a rare neurological syndrome believed to have been a side-effect of the vaccine. The program, now considered a case study in how not to handle a flu outbreak, cost roughly $500 million U.S. in today's dollars.

Working with the World Health Organization, an international network of scientists is racing to develop a vaccine for the new swine-flu strain. Canada is one of the few countries in the world that has a drug manufacturer on contract to supply the vaccine once it is developed.

But the Public Health Agency of Canada estimates it will take as long as six months to produce a vaccine, and some experts believe it could take even longer. ...more

Key players implicated in scheme to boost generic drug profits

From the Globe and Mail:
Many of the largest players in Canada's generic drug industry have been implicated in an illegal scheme that involved wholesalers and pharmacies collecting inflated rebates by selling the same product over and over.

The Ontario government yesterday ordered seven of Canada's largest generic drug makers, four wholesalers and a retail pharmacy to reimburse the province a total of $33.8-million - the amount it alleges that patients were overcharged for generic prescription drugs.

"It's a multimillion-dollar abuse of the system," assistant deputy health minister Helen Stevenson said at a news conference yesterday.

The government alleges that wholesalers and retailers bought more drugs than they needed and resold the excess among themselves, collecting a rebate or "professional allowance" from the manufacturer on each transaction.

"We call that drug recycling," Ms. Stevenson said.

The full extent of the problem will not be known until the government completes forensic audits of other industry players, including retail pharmacies, she said. ...more

Automated calls help patients taking blood thinners

From CBC News:
Hearing a human say blood-thinner doses are correct may be reassuring, but an automated system can be equally effective for some, a new study suggests.

In Monday's online issue of the Canadian Medical Association Journal, researchers concluded that an automated voice response system reduced the workload by 33 per cent and was almost as effective as a phone call from a human.

About five per cent of seniors take oral anticoagulants such as warfarin for blood clotting disorders. Patients need to take regular blood tests to make sure they're taking the right dose — too little doesn't work, and too much can cause serious bleeding problems including a deadly form of stroke.

The dose has to be individualized and monitored closely, said study author Dr. Alan Forster, a patient safety expert with the Ottawa Hospital Research Institute and the University of Ottawa.

The study was designed to test whether computer algorithms can predict the right dose better than a human.

"The interactive voice response system was effective in communicating complex information as 77.8 per cent of messages were successfully delivered and did not require input from staff," Forster and his coauthors wrote. ...more

Jean Coutu to boost store size as loss widens

From Reuters:
Jean Coutu Group plans to increase the size of its stores by almost 9 percent this year as the drug-store chain moves to fend off rising competition in its home territory of Quebec.

The Montreal-based chain, which reported a wider fourth-quarter loss on its investment in U.S. drug store chain Rite Aid (RAD.N), said it plans to increase the total square footage of its stores by 8.5 percent to 9 percent.

It also said it has earmarked about C$80 million ($66 million) in capital expenditures for this year.

This was seen as a defensive move by some as Shoppers Drug Mart, Canada's biggest pharmacy chain, eyes the lucrative Quebec market and its growing prescription sales.

The largely French-speaking province is a highly coveted market because of the high number of prescriptions dispensed there -- an average 90,000 per drug store annually versus 40,000 elsewhere in Canada. ...more

Monday, April 27, 2009

Woman given 30 months in jail for drug scam

From Toronto Sun:
An Etobicoke pharmacist and her son exploited homeless men to bilk the province out of at least $500,000 in bogus prescription claims.

Abimbola "Bola" Kabiawu, a pharmacist-owner of Kipling Guardian Pharmacy, was sentenced to 30 months imprisonment, and she and her son, Oluwarotimi "Tim" Kabiawu, were ordered to repay more than $200,000, a judgment released yesterday stated.

The two took part in a scheme in which residents of Seaton House shelter obtained pricey prescriptions from doctors, Madam Justice Alison Harvison Young wrote.

The prescriptions were never filled and the pharmacist submitted the claims and gave some cash to the customers.

Both Kabiawu and her son were ordered to repay $204,000, the amount of the fraud they had personally pocketed, minus the $41,000 they'd already repaid. ...more

Health-care workers to get broader powers

From the Toronto Star:
Ontario is about to move ahead with plans to allow pharmacists, nurse practitioners and other health-care professionals to provide some services now performed by doctors, Premier Dalton McGuinty says.

Pharmacists would, for instance, be able to extend prescription refills, one of a series of moves aimed at easing long waits for health care, said McGuinty.

The necessary legislative changes will be made "very soon," he said.

"Our government plans to better utilize your skills and maximize your contributions," McGuinty told the annual general meeting of the Registered Nurses' Association of Ontario in Markham. "Families seeking health care will experience the difference."

The premier went on to give examples of how the changes should help shorten wait times and enhance access to care.

"Instead of waiting in the emergency room to see a physician, you would have your fracture set by a nurse practitioner, who is qualified to do it ... and you'll be on your way home," he said. "People needing a prescription refill would be able to make one trip to a pharmacist instead of two trips: one to the doctor and then one to the pharmacist." ...more

Automated delivery of prescriptions moves a step closer in Ontario

From CBC News:
The pharmaceutical version of the automated banking machine could be coming to Ontario, as the province's pharmacy college took a step toward allowing drug dispensing machines in places where a pharmacist is not present.

On Tuesday, the Ontario College of Pharmacists voted in favour of opening door to the new technology. ...more

Drug info service launched in Moncton

From the Moncton (NB) Times and Transcript:
A Moncton company has come up with a service it believes will greatly assist Canadian health care professionals and ultimately the people they serve with its 24-hour access to product information from Canadian pharmaceutical companies.

The free, web-enabled mobile and personal computer service being developed by PPS Pharma will mean quick access at any time to reliable, up-to-date information on drugs and services offered by pharmaceutical companies that join the service.

The service will help physicians, pharmacists, nurses and industry stakeholders use their cell phones and personal computers to stay up to date on "Canadian" drugs and medical devices, explained company president Tony Hebert. The same system will allow the pharmaceutical companies to update their information, announce new products or send out alerts.

The service will also contain contact numbers and sales policies for the more than 50 companies that are customers of the printed PPS Buyers Guide and Pharmacy Lighthouse Newsletter.

PPS Mobile will be made available to industry stakeholders in early June and the site publicly launched by the fall. ...more

Sunday, April 26, 2009

Pandemic in the making

From the Globe and Mail:
Canada's chief public health officer expressed deep concern about a swine influenza outbreak gripping Mexico and the southwestern United States as health officials around the world went on high alert for a potential global flu pandemic.

"This is very concerning, clearly. That's why we're all paying attention," David Butler-Jones said yesterday. "What it will lead to is impossible to predict."

Mexico shut down schools, museums and libraries in its capital yesterday in the hope of containing a never-before-seen virus that authorities say has killed 20 people - and perhaps dozens more. Hundreds in the country are suffering from a severe respiratory illness.

The virus has not landed in Canada yet, but health officials are awaiting lab results from a Crown attorney in Cornwall, Ont., who returned from Mexico last month with a mysterious illness. ...more

Depression drug doubles in price for P.E.I. man

From CBC News:
A P.E.I. man has raised the alarm about the rising cost of prescription drugs after the drug he uses to treat depression more than doubled in price this month.

Tom Clark of Murray Harbour, in eastern P.E.I., has been taking trimipramine for 19 years, but he got a shock Thursday when he tried to refill the prescription.

"It went from $45 to $105 in less than a month," said Clark.

Trimipramine is made by Canadian drug maker Apotex. The company notified retailers April 1 that it was raising the price of the drug and several others. Pharmacists on the Island say the increase in the price of trimipramine is just one of several hefty increases this month from drug companies. They advise people with concerns to contact their local pharmacist.

"Will their drug prices go up because of this? That would be the question I'd ask," said Paul Jenkins, a pharmacist with the Friendly Pharmacy in Charlottetown. ...more

Second-class citizens

From the Fredericton (NB) Telegraph Journal:
David Lyon is painfully aware of one of the cruelest facts of life in New Brunswick - you do not want to be seriously ill in this place.

It's a wry twist on New Brunswick's much-ballyhooed tourism slogan, "Be ... in this place."

Lyon is dying of incurable brain cancer and like many other seriously ill people in New Brunswick, he feels trapped in a province bewilderingly out of step with the rest of the country.

Just out of reach in other parts of Canada are life-lengthening drugs people can afford and compassionate services designed to ease the economic and emotional burden of catastrophic illness.

But not here. In this place, the road to better health, to the sweet promise of longer life, is paved with catch-22s. ...more

Abuse of prescribed opiate painkillers on rise, research shows

From CBC News:
A growing number of Canadians are becoming addicted to prescription painkillers such as Tylenol 3 and OxyContin, say researchers who fear the problem could lead to more deaths.

In many Canadian cities, more people are addicted to prescription opiates than street drugs such as heroin or cocaine, according to study published in the April issue of the Canadian Journal of Public Health.

In 2005, the majority of street drug users in main Canadian cities were non-medical users of prescription opioids, with the exception of Vancouver and Montreal, researchers found.

The study's authors estimated that there are between 321,000 and 914,000 people in Canada who are abusing prescription opioids — between one per cent and three per cent of the country's population. ...more

Condom controversy hits NT teens

From the Australian Broadcasting Corporation:
Pharmacists in the Northern Territory would have to report any 15-year-old buying condoms under new underage sex laws, the Territory's Minister for Child Protection has confirmed.

The Australian Medical Association has described the legislation as unworkable because it makes it illegal not to report teenagers under 16 years of age who are sexually active.

The AMA warns the laws could increase teenage pregnancies and sexually transmitted infections because young people would be afraid of seeking sexual health advice and contraception.

Malarndirri McCarthy has told Triple J's Hack program that under the new laws, pharmacists would be obliged to inform authorities about teenagers under 16 years of age buying condoms. ...more

Drug Sales To Shrink

From Forbes:
The global pharmaceutical market, measured in dollars, will shrink in 2009 for the first time in 25 years, according to a new report.

Sales of medicines will generate between $750 billion and $760 billion this year, according to a revised forecast from research firm IMS Health ( RX - news - people ), down from $773 billion in 2008. A big part of that decrease is the relative strength in the dollar. But even when exchange rates are held constant, IMS now forecasts sales growth of only 3%, 40% less than IMS was predicting as recently as October.

"We were already predicting the lowest growth rate ever, and we decided to take that down further," says Murray Aitken, a senior vice president at IMS. He said that the overall economic climate was the main reason for the new cut in expectations. ...more

Saturday, April 25, 2009

Study links morning sickness to brighter kids

From CTV News:
Moms who spend part of their pregnancies vomiting and nauseated can take heart: Canadian research suggests they might actually have a smarter baby.

Researchers at Toronto's Hospital for Sick Children's Motherisk Program have discovered that morning sickness appears to be linked to enhanced neurodevelopment of the fetus.

Morning sickness, which affects as many as 80 per cent of pregnancies, is often one of the first signs of pregnancy, typically beginning around the second week of pregnancy. The name is a bit of a misnomer, since the nausea and vomiting that result can come on at any time of the day.

Morning sickness is little understood, but many doctors speculate it is the result of altered levels of hormones, such as estrogen, HCG (human chorionic gonadotropin), and thyroxine. ...more

Tuesday, April 21, 2009

Canada planning to change breakdown of flu drugs in pandemic stockpile

From the Canadian Press:
Canada will adjust the mix of antiviral drugs in an emergency pandemic stockpile this year, a response to concerns over the vulnerability of the main drug in the arsenal, Tamiflu, to the development of viral resistance.

Supplies of the drug zanamivir - sold as Relenza by GlaxoSmithKline - will be beefed up in the national emergency stockpile, says Dr. Arlene King, the senior official responsible for pandemic influenza planning at the Public Health Agency of Canada.

As well, some stocks of an older flu drug, amantadine, will be added to the mix as an inexpensive extra. Scientists are studying whether using Tamiflu in combination with amantadine or a sister drug, rimantadine, will lower the likelihood flu strains will develop resistance to the few drugs currently marketed to treat influenza.

"I think the general view is that from a scientific perspective, greater diversification (of stockpiles) would be desirable," says King, director general of the public health agency's centre for immunization and respiratory infectious diseases. ...more

Hormone therapy still viable treatment: Report

From Canada.com:
With unprecedented numbers of Canadian women about to enter menopause, Canadian doctors are telling women it's safe to go back on hormones.

An expert panel convened by the Society of Obstetricians and Gynaecologists of Canada has concluded that no treatment is as effective as hormone therapy for hot flushes and other symptoms of menopause.

The group says an "extensive" review of new data — along with a re-analysis of a massive study that led women to abandon their hormones in droves seven years ago — shows hormones are a safe option for moderate to severe symptoms, if started early and used over the short term.

The group is recommending using the lowest effective dose. And while there is no fixed timeline, "we suggest that taking it for four to five years is a good starting point," says Dr. Robert Reid, lead author of the updated guidelines and chair of the division of reproductive endocrinology and infertility at Queen's University in Kingston. ...more

Sunday, April 19, 2009

Pharmacy school opens its doors

From the Waterloo (Ont.) Record:
Celebration was in the air as University of Waterloo officially opened its new school of pharmacy, the first to open in Canada in 20 years.

Hundreds of students, professors, politicians and donors crowded the bright, airy building, widely noted as an architectural gem, to mark what university president David Johnston called a "barn-raising at its best."

"Ontario has a shortage of pharmacists, and this school is going to go a long way in ensuring we meet that need," said John Milloy, Ontario's minister of colleges and universities as well as MPP for Kitchener Centre.

He was joined by Health Minister David Caplan, plus a Who's Who of politicians from Kitchener and Waterloo, including mayors, MPs, MPPs and municipal councillors. ...more

Low-cost medicine for developing world lost in red tape

From the Ottawa Citizen:
This week, Senator Yoine Goldstein will rise in the upper chamber and ask his fellow senators to fix Canada’s Access to Medicines Regime.

Passed in 2004, CAMR was hailed as a world-leading initiative that would help millions in developing countries get life-saving medicine to treat HIV, tuberculosis, malaria and other diseases. CAMR was supposed to make it easier for Canadian companies to produce cheap, generic medicine for export.

But five years after CAMR became law, just one shipment of medication has been exported.

The Harper government and brand-name pharmaceutical companies say the law is fine just the way it is, but legal experts and access-to-medicine campaigners say CAMR created a process so laden with red tape and time-wasting regulatory steps that it was doomed from the start. ...more

Study shows seniors not always aware of drug risks

From the Naniamo (BC) Daily News:
Although past studies have shown drug side-effects to be the No. 1 reason seniors are hospitalized, most don't understand the risks associated with adverse drug reactions or how to avoid them, according to research by the University of Victoria's Centre on Aging.

Anthropology professor Peter Stephenson and a team of researchers conducted in-depth interviews with 20 seniors in Parksville and Qualicum Beach in the fall to gauge their attitudes toward medication. Preliminary results show elderly people also often don't have someone they can rely on who could look at all of their health products and possible interactions.

Earlier this week, a Statistics Canada report showed that Canadians 80 and older fill five times as many drug prescriptions a year as the average person, while a study published last year by the Canadian Medical Association Journal said that adverse drug reactions accounted for 12% of all emergency-room visits.

Stephenson said more education is needed on the issue, not only for seniors but also medical professionals who are tasked with writing and handling prescriptions.

"The pharmacist usually gives them a fairly minimal accounting of things. They're often rushed (because) they have many people coming in," he said. ...more

High-tech pharmacist of the future based in Lindley

I thought this was an interesting approach to pharmaceutical manufacturing that isn't occurring in Canada, at least not yet.

From the Huddersfield (UK) Examiner:
Medicines used in Huddersfield Royal Infirmary now come from ... Lindley!

The new £8m pharmacy at Acre Mill is now producing almost half a million tablets each year.

And it is capable of manufacturing medicines for individual patients or in large-scale batches.

The pharmacy is now making all the medicines needed in both Calderdale Royal Hospital and HRI.

They are also supplying medicines to hospitals, pharmacists and chemists throughout Yorkshire.

Saturday, April 18, 2009

Ill Patients Forced to Pay for Cancer Pills

I think this story perhaps explains in part why drug costs are outpacing other aspects of medical care.

From the New York Times:
Chuck Stauffer’s insurance covered the surgery to remove his brain tumor. It covered his brain scans. And it would have paid fully for tens of thousands of dollars of intravenous chemotherapy at a doctor’s office or hospital.

But his insurance covered hardly any of the cost of the cancer pills the doctor prescribed for him to take at home. Mr. Stauffer, a 62-year-old Oregon farmer, had to pay $5,500 for the first 42-day supply of the drug, Temodar, and $1,700 a month after that.

“Because it was a pill,” he said, “I had to pay — not the insurance.”

Pills and capsules are the new wave in cancer treatment, expected to account for 25 percent of all cancer medicines in a few years, up from less than 10 percent now.

The oral drugs can free patients from frequent trips to a clinic to be hooked to an intravenous line for hours. Fewer visits might save the health system money as well as time. And the pills are a step toward making cancer a manageable chronic condition, like diabetes.

But for many patients, exchanging an I.V. bag for a pill is a lopsided trade because the economics and practice of cancer medicine have not caught up with the convenience of oral drugs. ...more

HIV deal shows need for new pharmaceutical models

From Reuters:
The pharmaceutical industry is going back to the lab for its business models as it faces historic challenges.

Large drugmakers are experimenting with various collaborations as their major products face revenue declines, research productivity stalls, and governments and health insurers crack down on drug prices and healthcare costs.

The new ventures -- from deals on products to mega mergers -- seek to meet these challenges by cutting costs and mitigating the risks of research into new treatments.

Look no further than Thursday's deal between GlaxoSmithKline Plc and Pfizer Inc. The world's two biggest drug companies announced plans to merge their HIV operations into a new company.

"Pharma is feeling its way," said Erik Gordon, a professor at the Ross School of Business at the University of Michigan. "They know that the present business model isn't going to work in the future ... What they're not sure of is what will work." ...more

Drug costs smother health care in Quebec

From the Montreal Gazette:
Quebec spends far more on prescription drugs than any other province or territory in Canada – a factor that’s to blame for spiralling health-care costs, a new study reveals.

More disturbing, Quebec has gone from spending the least of any province on medications in 1985 – as a percentage of its total health-care expenditures – to the most last year, according to the Canadian Institute for Health Information.

“This surprises me a lot, because Quebec had stayed within the Canadian average until 2005-2006,” said André Côté, a drug-policy expert at Université Laval.

“The spending is very high and hasn’t stopped going up.”

The study found that Quebec spent almost $963 per capita on medications last year, an increase of 8.1 per cent since 2007. By comparison, Ontario spent $924 per capita last year, up by 5.9 per cent.

The Canadian average was $897 per person. ...more

Canadians spend almost $30 billion a year on medications, study finds

From the Canadian Press:
Canadians are forking out close to $30 billion a year to stock their medicine cabinets with prescription and over-the-counter medications, says an annual report on drug spending released Thursday.

That works out to an average of almost $900 per person across the country, concluded the Canadian Institute for Health Information report on estimated 2008 drug costs outside hospitals.

The report shows last year's drug expenditures accounted for 17.4 per cent of total health costs - nearly double the proportion that drug spending claimed in 1985 when the institute began compiling and publishing such data.

"Typically, and this has been a pattern really for the last 10 years, drugs are certainly the fastest-growing component of health expenditure," said Michael Hunt, CIHI manager of pharmaceutical programs.

Drug spending grew by an estimated eight per cent in 2008 over the previous year, outstripping the six per cent rate of growth in what is paid out for hospitals and doctors.

"So it's really not in line with what we see for physician spending, hospital spending and actually the overall increase in health expenditure," Hunt said from Ottawa. ...more

Vitamin therapy is healthy alternative

From Canada.com
Mike Eams didn't eat very well and drank a lot of coffee and energy drinks to get him through the day.

Then he made a New Year's resolution to get healthier.

He talked to his doctor about other ways to boost his energy without caffeine and was told to eat well and take a multivitamin and B vitamins, which are good for stress relief.

"I'm not sure if it works as a placebo, but I feel a lot better," says Eams, who followed the doctor's advice and added ginseng, too. "I feel I have more energy and I don't have to drink caffeine or coffee all day."

Eams is one of millions of Canadians who take vitamins to improve their health. In fact, so many people are using so-called alternative therapies that medical students now learn about them in school. ...more

The hardest working pill on the market

From Canada.com:
For the past decade, erectile dysfunction drugs such as Viagra and Cialis have sent men marching into bedrooms all over the world with renewed confidence and vigour.

Now, there seems to be another good reason to appreciate them -- they may help to save some of the planet's endangered animal species.

Evidence is mounting that men who used to rely on concoctions such as tiger penis soup and powdered rhinoceros horn are finding the convenient and fast-acting pills a good alternative.

One landmark study, done in 2004 by Australian researchers led by William von Hippel, involved 256 Chinese men, aged 50 to 76 years. All were receiving treatment at a traditional Chinese medicine clinic in Hong Kong.

The scientists found these consumers reported selectively switching to Western medicines to treat erectile dysfunction or ED, but not to treat other health ailments, such as gout and arthritis. ...more

Robber gets surprise when pharmacist opens fire

From WRDW (GA):
It was a robbery with a big surprise for the robber. A gunman walked into a CVS drugstore expecting to hold up the place. What he didn't expect was to find a pharmacist who had a gun and was not afraid to use it.

The shooting happened just after midnight at the CVS on Walton Way and 15th Street.

Investigators say this isn't the first time CVS has been robbed, but this time was different. A pharmacist fired at the suspect, protecting himself and the store.

The surveillance pictures tell the story. In a matter of seconds a masked robber wearing black enters this CVS Pharmacy and starts demanding money. Clenching a pistol, the robber gives the cashier a bag to fill and then heads towards the back.

"The suspect then asked about the register in the pharmacy and began heading back to the pharmacy," says Richmond County Sheriff's Sergeant Ken Rogers.

But Investigators say the overnight pharmacist, Michael Swindle, heard the commotion, grabbed his gun and made his way out into the store. ...more

Lack of sleep could be driving us mad

From the Calgary Herald:
With reports that “economic insomnia” is robbing people of sleep, researchers are warning poor sleep can unhinge the mind and increase the risk for depression and other full-blown psychiatric conditions.

“When you are tired, when you’re worn out, then everything becomes more of a challenge for you,” says Dr. Adam Moscovitch, medical director of the Canadian Sleep Institute in Toronto and Calgary. “Your confidence is affected, your ability to trust yourself. So there is a higher likelihood you’ll be ruminating about, are you doing things right? It significantly affects, from the psychological standpoint, the (risk) of mental illness developing.”

According to prescription drug tracking firm, IMS_Health Canada, about 17.8 million prescriptions for sleep aids were dispensed by Canadian retail drug stores last year.

There’s speculation that, with the economic crisis, the population may be using more sleep aids, and there was a slight increase in prescriptions from June to December, 2008. However, IMS_says at least three to four months of solid data into 2009 are needed to know for certain. ...more

Pharmacists get paid more for consultations

From the (Nashville) Tennessean:
A push by Medicare and other insurers to control patients' misuse of medications as a way to cut unnecessary drug costs has given many pharmacists a chance to make additional money by getting paid for in-depth consultations or other extra services.

Kroger, for instance, is training more pharmacists to handle up to one-hour consultations with patients that it began offering members of sponsoring health plans two years ago. As profit margins shrink, the new fees could help pharmacists develop another stable source of revenue.

Already, health plans are required to offer such pharmacist-patient chats to members enrolled in private Medicare plans known as Medicare Advantage. Those conversations can produce fees of $160 for up to one-hour conversations covering a patient's medical background and other services.

Other pharmacists perform extras for patients, including packaging patients' drugs in ready-to-use individual dosages to reduce the chances of a patient's taking too many pills or the wrong ones.

"You've got to find creative niches to stay alive," said W. Shane Reeves, co-owner of Reeves-Sain Drug Store, a small Murfreesboro pharmacy chain with two stores. ...more

Tuesday, April 14, 2009

Big-profile Schering arthritis drug wins Canada nod

From Reuters:
Johnson & Johnson and Schering-Plough Corp said on Monday that Canadian regulators had approved use of their experimental once-monthly drug Simponi to treat moderate to severe rheumatoid arthritis.

The potential blockbuster medicine, awaiting approval in the United States and Europe, is a follow-up to the widely used Remicade treatment sold by the two drugmakers.

Simponi could turn out to be a high-stakes bone of contention in Merck & Co's planned $41 billion purchase of Schering-Plough because Merck has said it will inherit overseas rights to Simponi and Remicade. Under an earlier marketing deal with J&J, Schering-Plough is obliged to return overseas rights to J&J if control of Schering-Plough changes.

J&J has exclusive rights to sell the new injectable treatment in the United States. Schering-Plough, which has rights in most other markets, said it hopes to introduce Simponi in Canada during the second half of the year.

Canadian authorities also approved Simponi for active psoriatic arthritis, an inflammatory condition of the skin and joints, and ankylosing spondylitis, a chronic inflammatory arthritis of the spine. ...more

Battle erupts over B.C. funding for eye treatment

From the Globe and Mail:
British Columbia has become the first province in Canada to pay for a relatively inexpensive drug that can help stop the progression and even reverse the effects of wet macular degeneration.

But not everybody is happy about it. A drug company that sells a similar treatment at a much higher cost said the decision could put the health of patients at risk - the latest chapter in a long-brewing battle over the two treatments.

The issue began to unfold Wednesday, when the B.C. government announced it will provide funding for Lucentis, an expensive breakthrough drug that has proven effective in fighting the progressive eye disease. At the same time, the government said it will become the first province in Canada to fund Avastin as a macular degeneration treatment.

Avastin was originally developed to treat colorectal cancer and isn't approved by Health Canada for use as an eye treatment. But significant anecdotal research indicates the drug has similar effects to Lucentis, and many ophthalmologists in Canada, the United States and Britain have been using it to treat macular degeneration. ...more

MP calls for independent drug agency following daughter's death

From the Vancouver Sun:
Nine years after vowing to find out why his healthy teenage daughter died while taking a popular prescription drug, a rookie MP is launching a campaign to persuade the Harper government to establish an independent drug safety agency in Canada.

Terence Young, Conservative MP for Oakville, Ont., is making his pitch for the agency in a new book that details his battle with "Big Pharma" and the health agencies and professionals that are charged with protecting patients like his daughter Vanessa.

Next week, he will introduce a motion in the House of Commons, where he hopes MPs from all parties will support his push for drug safety reform.

"This is a non-partisan issue. I will be appealing to all my colleagues in Parliament to create an independent drug agency to deal with these issues and make Canadians safer," Young said in an interview. "It's my goal, my dream, to have a consensus in Parliament to move forward on this."

The MP says his book, Death by Prescription: A Father Takes on his Daughter's Killer - The Multi-Billion-Dollar Pharmaceutical Industry, officially released Tuesday, is the culmination of his efforts to "uncover the truth" about why his 15-year-old daughter's heart stopped and she collapsed before his eyes on March 19, 2000. ...more

Seniors most likely hospitalized for adverse drug reactions: StatsCan

From the Calgary Herald:
Canadians aged 80 and older fill five times as many drug prescriptions a year as the average person, according to new data from Statistics Canada, helping explain why drug side effects are the No. 1 reason they visit emergency rooms.

In 2005, pharmacists filled an average of 74 prescriptions for each person over the age of 80, compared with an average of 14 prescriptions per Canadian, said the Statistics Canada study.

Typically, seniors on multiple drugs see numerous specialists who prescribe various medications to treat a range of chronic ailments: high blood pressure, hypertension, diabetes, Alzheimer's, arthritis, heart disease and stroke.

Experts have long known that seniors are the major consumers of drugs, but the Statistics Canada study is the first to quantify it nationally.

A study published last year by the Canadian Medical Association Journal revealed that adverse drug reactions accounted for 12 per cent, or more than one in nine, of all emergency-room visits. ...more

Saturday, April 11, 2009

Pharmacist wins kudos for his compounding skills

From the Waterloo (Ont.) Record:
When pharmacist Phil Hudson came to Canada from England in 1986, the idea of a pharmacist customizing medications was a novel idea. Twenty years later, not only is his field fully accepted, but the British-trained Hudson was named compounding pharmacist of the year for 2008 by a company called Professional Compounding Centers of America, Canada.

The profession has come full circle. Early apothecaries mixed their own medications to suit a patient's malady. Over time, factory-produced pharmaceuticals became the norm. Today's compounding pharmacists can take basic medications and customize them to better suit a patient's needs and tastes.

"I had a situation (with a patient) I couldn't deal with," Hudson explained. "I came across a compounding pharmacist and called her, in the U.S. She started talking about how to overcome the problem." ...more

Quebec men arrested for Windsor card skimming scam

Good job by this alert pharmacy employee...

From the Windsor (Ont.) Star:
Windsor Police arrested two Quebec men Monday after they allegedly tried to pull a skimming scam at a west side pharmacy.

Police went to the pharmacy in the 1700 block of Huron Church Road at 11 a.m. Monday after receiving information that two suspects had stolen the point of sale PIN pad from a store counter.

Police said skimming involves taking a valid PIN Pad from a business and replacing it with a decoy. The scammers then put a card reader into the valid PIN and return it to the store. They wait while the card reader obtains information from peoples’ credit and debit cards, then return and take it back.

Once they have the information, police said the criminals begin cloning credit and debit cards and start running up charges on the unsuspecting victims.

Police said the suspects had been in the store on April 5. They removed a PIN Pad and one of them replaced it with a decoy. The pair were captured on surveillance video.

The next day, an alert store employee noticed the decoy PIN pad and informed her manager. Soon after the decoy discovery, the two suspects were back in the store. Police were called. They arrested the two suspects in the parking lot. ...more

C.B. doctor wants way to recycle used drugs

From the Halifax Chronicle Herald:
Ron MacCormick has attracted national attention by pitching the idea of recycling prescription drugs, which isn’t done in Canada.

The 56-year-old Cape Breton oncologist got the idea from the families of cancer patients who wanted their leftover or unused medication put to good use.

Dr. MacCormick says that a lot of expensive drugs, especially those used to treat illnesses such as cancer, are being wasted. In Canada, about $200 billion is spent on oral medication every year. If one per cent of that amount was recycled it would save $2 billion, he says. Flushing leftover drugs down the toilet has also resulted in traces of the medication turning up in drinking water throughout North America. ...more

Community pharmacist admits fatal medicine mistake

From Management in Practice:
A pharmacist who had worked a 10-hour shift without a break wept in court when it heard an elderly woman collapsed and later died after she gave her the wrong drugs.

The daughter of 72-year-old cancer sufferer Carmel Sheller was given a heart rate reducing drug by Elizabeth Lee, 30, who was working on the busy Tesco counter in Dedworth Road, Windsor.

She was in fact supposed to be collecting the steroid prednisolone for her mother who had been prescribed the drug to treat her wheezing and lung inflammation, the Old Bailey heard.

Ms Lee was working as a locum and was in sole charge of the counter when she made the mistake "under pressure" as two other pharmacists were both on maternity leave. The court heard the mother of two had been working from 9am to 7pm.

After pleading guilty to supplying medicine with a misleading label on the package Ms Lee was given a suspended sentence of three months under a breach of the Medicines Act 1968 - an offence carrying a maximum two-year jail sentence. ...more

Sunday, April 05, 2009

Study on cholesterol drugs raises ethical questions

From the Calgary Herald:
Quebec doctors are being offered $100 for every new patient they put on cholesterol-lowering statin drugs as part of a major, federally subsidized study that's raising questions about the influence of the pharmaceutical industry on health research.

Critics say the OBSTAT trial seems more about drug marketing than science, getting thousands more people to take an already popular medicine.

Statins are among the most successful medications in history, with Lipitor — Canada's top-selling prescription drug — racking up almost $1.4 billion in national sales in 2008. There is ample evidence that, by cutting levels of blood cholesterol, they lower the risk of heart attacks and strokes in people already diagnosed with cardiovascular disease.

Whether they work well as primary prevention — for people who have high levels of cholesterol but don't have heart disease yet — is more debatable, though millions of such patients are taking them.

Considered relatively safe, the drugs can nevertheless cause muscle pain — sometimes severe — and other side effects. ...more

Secrecy slowing drug research

From the Toronto Star:
It takes a big brain and a big-time swagger to transform the drug industry. And Aled Edwards – a renowned University of Toronto biochemist and respected laboratory leader – employs both to change the way drugs get into your medicine cabinet.

The 47-year-old researcher says the current method of creating drugs – one shrouded in secrecy and driven by patents and money-making – has failed. Too few medicines have come to market in the past 30 years, which means too many people still get sick and die from disease.

Edwards believes the only way to get more medicines to patients is for industry and academia to work together – and to post all their findings free on the Internet.

It is a groundbreaking idea – one many said would be anathema to the billion-dollar drug industry, which for decades has thrived on the spoils of patented blockbuster drugs. ...more

Grapefruit, birth control pill interaction may have caused weird blood clot case

From the Canadian Press:
Chalk another one up to the bizarre power grapefruit and grapefruit juice have to mess around with medications.

An American woman in her 40s nearly lost a leg to gangrene because of a confluence of health factors exacerbated by a diet that included daily doses of grapefruit, the doctors who treated her reported in a medical journal on Friday.

"The way I think of it actually is like she's a setup for the perfect storm. And I believe it was the grapefruit that tipped the balance," Dr. Lucinda Grande, a medical resident at Providence St. Peter Hospital in Olympia, Wa., explained in an interview.

Grande is the first author on the case report, which appears in this week's issue of The Lancet.

The woman, then 42, arrived at the hospital's emergency room last November with a badly swollen and discoloured left leg. She was experiencing shortness of breath and light-headedness.

Doctors diagnosed a large deep vein thrombosis - a dangerous blood clot - in her left leg, running all the way from her hip to her calf. Because of the condition of the leg, the doctors treating her were worried she might be developing irreversible gangrene that would force amputation of the limb. ...more

New law to force pharmacies to close for lunch?

From Stuff.co.nz:
A new law about rest breaks may force some pharmacies to close for lunch, the Pharmacy Guild of New Zealand says.

Changes to the Employment Relations Act come into force tomorrow, meaning a person working more than four hours is entitled to an unpaid half-hour meal break.

Pharmacy Guild chief executive Annabel Young said under the Medicines Act a pharmacy must be operated with the "immediate supervision and control of a pharmacist".

This meant small pharmacies where only one pharmacist worked would have to close when that person took a lunch break, she said.

However, a spokesman for Labour Minister Kate Wilkinson said the Act covered this kind of situation.

"Our advice from the Department of Labour is that the legislation is flexible enough to deal with these concerns in that if breaks can't be scheduled due to certain requirements or commitments then they should be taken 'where reasonable and practicable'." ...more

Fish oil pills don't boost benefit of heart drugs

From the Associated Press:
Heart attack patients who are already taking the right medicines to prevent future problems get no added benefit from taking fish oil capsules, a large study in Germany finds.

The study tested a 1-gram daily dose of a prescription version of highly purified omega-3 fatty acid — the "good fat" contained in certain oily fish that is thought to help the heart.

Researchers led by Dr. Jochen Senges of the University of Heidelberg gave fish oil or dummy capsules to more than 3,800 people who had suffered a heart attack in the previous two weeks. About 90 percent were already receiving all the medicines recommended to prevent a second attack, including aspirin, anti-clotting and cholesterol drugs.

After a year, it made no difference whether these patients took fish oil or dummy capsules. In both groups, fewer than 2 percent had suffered sudden cardiac death, 4 percent had another heart attack, and fewer than 2 percent had suffered a stroke.

If recent heart attack patients are already getting good care, "there is almost nothing you can do better on top of this" to further lower risk, Senges said. He presented the results Monday at an American College of Cardiology conference. ...more

Cleanup Drive to Sweep Pharm Industry

From the Korea Times:
The government will step up its fight against chronic illegal rebate practices whereby doctors and pharmacists receive money from drug makers in return for prescribing or recommending their products.

The wholesalers who receive such de-facto bribes will be sanctioned, the Ministry for Health, Welfare and Family Affairs said Tuesday.

A relevant bill has been submitted to the National Assembly to establish the legal grounds to suspend the licenses of doctors who take the money for up to one year.

Under the new rules to make more transparent the way pharmaceuticals are distributed to consumers, all parties ― doctors, pharmacists, wholesalers and retailers ― who give or take rebates will be subject to sanctions. ...more

Pharmacist warns of 'pharm parties'

From the Madison (IN) Courier:
"Pharm parties" where party-goers ingest random prescription drugs collected from family medicine cabinets without regard for potentially lethal drug interactions are a rapidly increasing trend among teens and young adults, a pharmacist told a town hall audience Monday in Carrollton, Ky.

Pharmacist Dave Sallengs likened the possible deadly consequences of mixing prescription medication to the death Jan. 22, 2008, of Academy Award-winning actor Heath Ledger, who accidentally overdosed on six different painkillers and sedatives.

Sallengs said the number of 12- to 17-year-olds abusing controlled substances in the U.S. grew 212 percent between 1992 and 2003, and the number of prescriptions written for controlled substances in the U.S. grew 150 percent.

Sallengs, the manager of the drug enforcement and professional practices branch office of the Kentucky inspector general, said the number of people abusing prescription drugs exceeded the number of people abusing cocaine, hallucinogens, inhalants and heroin combined during that same period. ..more

Wednesday, April 01, 2009

More than $547M spent on drugs

From the Fredericton (NB) Daily Gleaner:
More than $547.3 million worth of prescribed drugs were sold in 191 New Brunswick pharmacies last year, accounting for more than nine million prescriptions filled provincewide.

According to an IMS Health Canada report, New Brunswick was second, behind Quebec, in spending per capita.

At the same time, New Brunswickers are keen to purchase cheaper prescriptions, leading other provinces in sales of generic brands (purchasing 58.9 per cent of generics versus brand name drugs at 41.1 per cent).

Janet Cooper, senior director of professional affairs at the Canadian Pharmacists Association, said this doesn't necessarily mean New Brunswickers are paying more for prescriptions.

"You have to look at it from a much bigger picture and get into the details," she said, adding that people in the province may be getting different kinds of prescriptions that could in turn be more expensive.

New Brunswick had a prescription per capita rate of 12 for each person in the province last year, below the national average of 14. ...more

P.E.I. retailer upset by pulling of electronic cigarettes

From CBC News:
A Charlottetown store owner is wondering where some of her customers will turn now that Health Canada has ordered her to stop selling electronic cigarettes.

"We see people doing two things," Tracy Dooley of Wild Impulse told CBC News Monday.

"We see people using them who either want to reduce the amount they're smoking. So, they're substituting them — cigarettes and one of these [electronic ones]. And we've seen a lot of people as well completely quit smoking using these."

But they won't be using them for either purpose in the foreseeable future. Health Canada has ordered Canadian retailers to stop selling the e-cigarettes until it has had an opportunity to evaluate their safety.

E-cigarettes look like real cigarettes from a distance, complete with a glowing tip, but they deliver nicotine in a vapour. E-cigarettes are reusable, with a replaceable nicotine cartridge. ...more

Merck Wins Reversal of Vioxx Ruling in Saskatchewan

From Bloomberg:
Merck & Co., after settling most of its Vioxx lawsuits in the U.S., persuaded an appeals court to halt one of two national group lawsuits in Canada claiming the painkiller caused heart attacks and strokes. The drugmaker still faces trial in Ontario, Canada’s most-populous province.

A three-judge panel of the Court of Appeal for Saskatchewan ruled unanimously yesterday there were too many different issues involved to resolve in a class-action lawsuit and a lower court judge erred in allowing the plaintiffs to proceed as a group.

The case “gives the impression of commonality, where commonality in fact does not exist,” Judge Gene Ann Smith wrote on behalf of the panel.

The ruling bodes well for Canadian plaintiffs because pursuing one national lawsuit, rather than two, may be quicker, Michael Peerless, a lawyer representing the Ontario plaintiffs, said in a telephone interview today. ...more

'Polypill' could reduce heart disease, stroke: Researchers

This article mentions the polypill, but doesn't break down the ingredients. Here it is: atenolol 50mg, ramapril 5mg, ASA 100mg, simvastatin 20mg and hydrochlorothiazide 12.5mg.

From the Calgary Herald:
Canadian researchers say a single, daily pill combining five medicines could potentially cut by half the number of heart attacks and strokes in middle-aged people.

The pill — called Polycap — is a cocktail of three blood-pressure lowering drugs, Aspirin to reduce blood clotting and a cholesterol-lowering drug. In tests involving more than 2,000 people in India, each component of the pill did what it was supposed to do.

In addition, the Polycap was generally well tolerated. There was no evidence of increasing side effects with increasing number of active components in one pill.

The 12-week study wasn't designed to see whether the "polypill" actually reduced heart attacks, stroke and death. Larger numbers of people would need to be treated with a longer followup.

But the findings suggest the pill could potentially reduce cardiovascular heart disease by 62 per cent, and stroke by 48 per cent, researchers from McMaster University in Hamilton and St. John's Medical College in Bangalore, India write in the journal, The Lancet. The study is to be presented Tuesday at the American College of Cardiology meeting in Florida. ...more

it's in the blood: the story of vitamin k

From the Montreal Gazette:
The chickens were hemorrhaging but Henrik Dam, a young biochemist at the University of Copenhagen couldn't figure out why.

The year was 1929 and Dam was investigating the metabolism of cholesterol in chickens. Eggs contained cholesterol but where was it coming from? The birds' diet?

To check this out, Dam extracted the cholesterol from the chicken feed and saw they still produced eggs with cholesterol. Obviously the birds were synthesizing the substance from other dietary components. But they were also bleeding in an unusual fashion. Adding cholesterol back to the chicks' diet didn't solve the problem. It therefore seemed that the cholesterol extraction removed some other substance of importance from the feed.

Dam eventually found that a second fat-soluble compound had indeed been extracted and it was its absence from the birds' diet that prevented blood from clotting. He called it the coagulation vitamin, or in German, Koagulationsvitamin. We now know it as vitamin K. ...more