Friday, November 27, 2009

Pharmacy privatization will cost 20 hospital jobs in Calgary

From the Calgary Herald:
About 20 pharmacy positions at three Calgary hospitals will be cut when the province's medical superboard privatizes outpatient pharmacies at the facilities next year.

Alberta Health Services confirmed Thursday it will ask an independent provider to take over most of its outpatient pharmacy services at Peter Lougheed Centre, Foothills and Alberta Children's Hospital-- services that are currently provided by superboard staff. The organization will introduce a similar system at the new south hospital when it opens in 2011. A new provider will be selected through a request for proposals process.

The decision is expected to reduce about 20 full-time pharmacy positions, although it is not yet clear how many layoffs will occur as some staff may find other jobs at the superboard or a position at the new stores.

But the move is meeting with criticism from the Health Sciences Association of Alberta, the union that represents pharmacists and other staff at the hospital drug stores. ...more

Seniors most likely hospitalized for adverse drug reactions: StatsCan

From the Edmonton Journal:
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

Boots 'labels homeopathy as effective despite lack of evidence'

From the Times Online (UK):
The chief pharmacist at Boots today admitted the company markets homeopathic remedies as effective cures despite there being no medical evidence that they work.

Addressing the House of Commons parliamentary science watchdog, Paul Bennett said: “I have seen no evidence that these products are efficacious. It’s about consumer choice and a large number of our customers think they work.”

High street chemists were criticised by scientists and MPs at the meeting for putting business interests above patient care and the reputation of the medical profession.

However, Mr Bennett said that the responsibility to properly regulate the marketing of homeopathic products lay with the UK drug regulator, the Medicine and Healthcare products Regulatory Agency (MHRA).

The comments were made at an evidence session of the House of Commons Science and Technology Committee, part of an ongoing inquiry into the regulation of homeopathic medicine. ...more

Tuesday, November 24, 2009

Critics attack B.C. eye drug policy

From CBC News:
People in B.C. suffering from a degenerative eye condition are in a quandary over a provincial policy that allows doctors to profit by using a medication that's much cheaper than the approved drug.

In June, B.C. started to pay for treatments with Lucentis, a drug that can halt macular degeneration, a retinal condition affecting hundreds of thousands of Canadians over 45 years of age.

Lucentis — the only medication approved by Health Canada for treatment of macular degeneration — costs $1,575 for a vial that provides three doses.

Leanne Bernaerdt of Richmond said the doctor treating her 83-year-old mother decided to switch to another drug, Avastin, a drug that costs about $20 a dose but is intended for colon cancer patients. ...more

Pharmacists protest on a two-day Japanese strike

Pharmacists in Romania will go on a two-day Japanese strike, namely on Tuesday and Wednesday, to draw attention on the "dying state of the pharmaceutical system" and to appeal to the Government to find urgent solutions to stops pharmacies from going bankrupt.

During November 24-25, pharmacists will wear black arm-bands, Romanian College of Pharmacists announced. Pharmacies stopped receiving money for drugs five months ago. ...more

Monday, November 23, 2009

Doctors issue caution in using antivirals for H1N1

As public health officials urge more rapid use of antivirals for H1N1, some experts worry the drugs could become over-prescribed for what is a relatively mild illness in most people.

More than one million antiviral doses have been drawn from the federal stockpile in recent months, and the number of prescriptions filled by Canadian retail drugstores for Tamiflu and Relenza, the frontline drugs being used in the pandemic, nearly doubled between September and October.

As of Oct. 30, 151,688 prescriptions had been dispensed by retail pharmacists nationwide so far this year -- an increase of 73,291 prescriptions over September, according to prescription-drug-tracking firm IMS Health Canada.

Nationally, the number of visits to doctors for flu-like symptoms are at levels not seen in 12 years.

The World Health Organization is recommending that people in at-risk groups, including pregnant women, children under two and those with underlying conditions such as asthma, be treated with antivirals as soon as possible when they have flu symptoms, and that people without risk factors should also be treated if their symptoms worsen or persist. ...more

Shoppers targets growth in pharmacy-friendly provinces

From the Globe and Mail:
Children and youth on certain antipsychotic medications are more prone to getting diabetes and becoming fat, according to a new study published in the Canadian Journal of Psychiatry.

But the British Columbia doctors involved in the two-year study say parents shouldn't rush to take their children off the drugs and instead should consult their physicians on ways to monitor and beat the metabolic side-effects.

"On the one hand, the medication has significant and worrying side-effects," said study co-author Dr. Jana Davidson, medical director of child and adolescent mental health and addiction programs at BC Children's Hospital.

"On the other hand, in some of these cases the kids being on medication is what allows them to function in their lives and allows them to stay in their families."

About 6,000 youth in B.C. are on antipsychotic medications and prescription rates have been soaring in the past five years, according to the study.

Between 2002 and 2006, prescriptions of atypical or second-generation antipsychotics for B.C. youth rose by about 22 per cent, from one in 200 youth to one in 154. ...more

Children on antipsychotic drugs more prone to diabetes: Canadian study

From the Vancouver Sun:
Children and youth on certain antipsychotic medications are more prone to getting diabetes and becoming fat, according to a new study published in the Canadian Journal of Psychiatry.

But the British Columbia doctors involved in the two-year study say parents shouldn't rush to take their children off the drugs and instead should consult their physicians on ways to monitor and beat the metabolic side-effects.

"On the one hand, the medication has significant and worrying side-effects," said study co-author Dr. Jana Davidson, medical director of child and adolescent mental health and addiction programs at BC Children's Hospital.

"On the other hand, in some of these cases the kids being on medication is what allows them to function in their lives and allows them to stay in their families."

About 6,000 youth in B.C. are on antipsychotic medications and prescription rates have been soaring in the past five years, according to the study.

Between 2002 and 2006, prescriptions of atypical or second-generation antipsychotics for B.C. youth rose by about 22 per cent, from one in 200 youth to one in 154. ...more

Canada needs two vaccine suppliers, Ottawa admits

From the Globe and Mail:
Canada needs more than one vaccine manufacturer to deal with future flu pandemics and to avoid production delays that have affected the fight against the H1N1 virus, federal officials say.

"There is no debate. We all feel that when the time will come to renegotiate, we will go to tenders on a two-part contract to ensure maximum flexibility," said a senior official who has been working directly on the file.

While the Harper government has applauded GlaxoSmithKline Inc. for making more than 6 million doses so far at its facility in Ste-Foy, Que., a number of officials involved in the crisis said Canada deserves a second producer in the future.

Had that been the case this time, one manufacturer could have worked on the production of vaccines with the adjuvant additive, while the other one could have produced non-adjuvanted vaccines for pregnant women.

GSK was forced to make changes to its production line in mid-course, which caused delays in the delivery of vaccines to the provinces. ...more

Sunday, November 22, 2009

Studies mixed on value of 'immune boosters'

From CBC News:
The evidence is mixed on herbal products that claim to boost immunity this flu season, medical experts say.

Dozens of products are sold in stores and online, claiming to prevent flu by boosting the immune system. Some of the claims have sparked investigations by Canada's Competition Bureau.

Herbs such as ginseng and echinacea make the body produce more immune cells and enhance the way some cells work. But no one has been able to show conclusively whether that translates into stronger overall immunity to ward off infections.

"I think when someone says 'immune booster' you have this idea that you are going to get this dramatic effect," said Heather Boon, a pharmacy professor at the University of Toronto. ...more

Spray-on anesthetic prevents premature ejaculation in U.S. trials

From the Los Angeles Times:
The first U.S. trials of a spray-on anesthetic for the penis showed that it increased the time to ejaculation nearly five-fold, providing the first good solution for premature ejaculation, researchers reported today. The findings are very similar to those obtained in a European study released in April.

Premature ejaculation is generally defined as ejaculation that occurs within a minute after insertion of the penis into the vagina, causing distress to both parties. The condition is thought to affect as many as one in three U.S. men ages 18 to 59, about twice as many as those who suffer from erectile dysfunction. Some antidepressant-like drugs, such as dapoxetine, have been approved in a few countries to treat the condition, but the Food and Drug Administration rejected it because of long-term side effects. Some physicians prescribe anesthetic creams like EMLA cream for off-label use to delay ejaculation, but such creams require 45 minutes to work and the man must use a condom to prevent the anesthetic from numbing the woman.

Plethora Solutions of London and Sciele Pharma Inc. of Atlanta have developed a spray anesthetic, called PSD502 or Tempe, that contains lidocaine and prilocaine dispensed by a metered aerosol. It is applied five minutes before intercourse, and it selectively numbs the head of the penis. ...more

Friday, November 20, 2009

Canadians shouldn't buy drugs on the Internet: RCMP

From the Vancouver Sun:
Canadians ordering prescription medication online are being warned that they may be illegally receiving counterfeit products manufactured overseas by criminal organizations.

And the products claiming health benefits are full of other chemicals that could make them sick, the RCMP and Canada Border Service Agency said at a joint news conference, part of an INTERPOL and World Health Organization initiative in 26 countries called Operation Pangea II.

"The people selling these products are often organized crime groups operating internationally," RCMP Sgt. Duncan Pound said, adding it is better for people to steer clear altogether from Internet purchases of prescription drugs even when websites claim to be Canadian.

He said the RCMP is working with its international policing partners to catch those responsible at the source. ...more

Wednesday, November 18, 2009

New drug boosts women's sex drive

From CBC News:
Researchers are hailing a new drug called flibanserin as a possible remedy for sexual dysfunction in women.

Originally created to treat women suffering from depression, the pill was later found to increase the number of sexual encounters and overall sexual satisfaction among women who have hypoactive sexual desire disorder.

HSDD is a controversial dysfunction that not everyone in the medical field agrees exists. Those diagnosed with it, however, are said to experience "diminished feelings of sexual interest or desire that causes marked distress."

Over 1,000 pre-menopausal women from across the U.S., Canada and parts of Europe were included in the clinical trial funded by German pharmaceutical company Boehringer Ingelheim.

The study found women who took 100 milligrams of flibanserin each day experienced an increased libido after four weeks. ...more

Hooked: Canada's painkiller problem

From the Globe and Mail:
Janey Nagle wasn't looking for kicks when she began courting a drug habit. The Percocets her doctor prescribed were the only thing that could take away the excruciating pain that lingered a decade after a car accident threw her into a windshield with such force that her face left an imprint in the glass.

For the first two years, the painkillers did the trick. The Perth, Ont., mother of four was able to work and look after her family. But after a while she couldn't get through the day without the pills' euphoric effect, and that demanded higher and higher doses.

Fearful her doctor would cut her off, Ms. Nagle looked elsewhere. She spent hundreds of dollars a day on prescription drugs bought off the street, primarily from friends and acquaintances. She photocopied her prescriptions and filled each one repeatedly at pharmacies around Perth, Kingston and Smiths Falls.

“It was a horrible, panicked feeling every morning when I woke up,” says Ms. Nagle, now 43. She remembers the daily dilemma: “How am I going to get them? Where am I going to get the money?”

This went on for years before she was caught at a drugstore and charged with forgery.

Like Ms. Nagle, Canada has fallen quietly into the grip of a pill problem in the past decade. Medications designed to treat pain and anxiety are creating legions of accidental addicts from coast to coast. In Regina, it's morphine; in Toronto, OxyContin and Percocet; in Edmonton, OxyContin, various benzodiazepines and the whole Tylenol gamut. ...more

Pharmacists remixing adult doses so kids can receive Tamiflu

From the Globe and Mail:
A worldwide shortage of children's Tamiflu to treat H1N1 infections has the federal government dipping into its national emergency stockpile and pharmacists preparing doses the old-fashioned way – with a mortar and pestle.

Meanwhile, the Canadian spokeswoman for Hoffman-La Roche, the Swiss maker of the antiviral drug, said the order for more of the children's liquid doses won't be ready for another month or so – likely after the pandemic virus has passed its peak.

“We're actively working to bring more product into the country,” Laura Pagnotta said yesterday. “We can't provide a specific date but we are definitely in the queue. And we do anticipate having additional [supplies] available in the next month or so.”

The second wave of the H1N1 virus has not only led to more hospitalizations and additional deaths, it has resulted in more Canadians walking into pharmacies with prescriptions for antiviral medication. In the last week of October, more than 28,000 prescriptions were written for Tamiflu, the highest number since the virus first appeared in April, according to data from the Public Health Agency of Canada. ...more

90,000 H1N1 inquires daily: OPA

From Metro Toronto:
Ontario residents are flocking to their pharmacists with questions and concerns about the H1N1 flu virus.

The Ontario Pharmacists’ Association said yesterday the 3,000 pharmacies in the province are getting about 90,000 inquiries per day, or about 30 per pharmacy, about swine flu.

“Most of them are related to the vaccine itself, but also I think... people are a little bit unsure about what is true flu and then what is simple influenza and a cold,” said association chairman Dean Miller.

The association conducted a random survey of pharmacists around the province and found over the past several weeks there has been an influx of patients concerned about swine flu as public awareness about the virus has gone up. ...more

Online gangs cashing in on swine flu

Criminal gangs are making millions of dollars out of the H1N1 flu pandemic by selling fake flu drugs over the internet, a web security firm said on Monday.

Sophos, a British security software firm said it had intercepted hundreds of millions of fake pharmaceutical spam adverts and websites this year, many of them trying to sell counterfeit antiviral drugs like Tamiflu to worried customers.

Tamiflu, an antiviral marketed by Switzerland's Roche Holding and known generically as oseltamivir, is the frontline drug recommended by the World Health Organization to treat and slow the progression of flu symptoms. GlaxoSmithKline makes another antiviral for flu, known as Relenza.

Sophos said many of the gangs behind the sites were based in Russia and the top five countries buying fake Tamiflu and other medicines on the internet were the United States, Germany, Britain, Canada and France. ...more

Monday, November 09, 2009

New drug therapies and promising studies offer hope for MS patients

From the Vancouver Sun:
Early diagnosis of multiple sclerosis can change the lives of people living with this chronic disease of the central nervous system.

“Today, there is a huge urgency to make the diagnosis because we know that early and aggressive treatment can alter the course of the disease,” says MS specialist and University of Alberta assistant clinical professor Dr. Brad Stewart. “Back 15 or 20 years, diagnosis was less urgent because we had nothing to offer the patient.”

Then, says Dr. Ruth Ann Marrie, the director of the multiple sclerosis clinic of the University of Manitoba Health Sciences Centre, “treatment largely focused on acute management of relapses — those times when people presented with sudden worsening of symptoms like vision loss, limb weakness or numbness. We tried to help them manage some of the chronic symptoms like fatigue and difficulty in walking.

“We didn’t have medication that we thought could alter the long-term course of the disease.”

In 1995, the first drug treatment that could modify the disease was approved. Shortly afterwards, three more drugs of the Interferon type were added. In 2006, a fifth drug was approved. ...more

Pharmacist performs simple blood test

From the Windsor Star:
AWindsor pharmacist is making it easier for people who take blood thinning medication to have their blood tested and drug dosage adjusted -- all in about 15 minutes.

There are thousands of people in the community who take warfarin, a widely prescribed anticoagulant drug better known under the brand name Coumadin. Warfarin is used to treat patients with various types of blood clots, pulmonary embolisms, some heart conditions and other ailments. Those who take warfarin and other types of anticoagulants must have their blood regularly monitored to avoid serious complications, such as bleeding, because the medications alter the normal function of the body's blood clotting system.

Typically, patients must have their blood drawn in a lab, wait up to several days to get the results and then see their doctor for any necessary medication adjustments.

But Peter Dumo at the Novacare pharmacy on Walker Road can now do all that in just one appointment, thanks to a small device called CoaguChek XS, which looks and works much like a blood glucose meter. ...more

Wednesday, November 04, 2009

One supplier bad planning: critics

From the Winnipeg Sun:
Critics assailed the federal government yesterday for going to only one company for the H1N1 vaccine, saying it should have had a plan to avoid the bottlenecks Canadians are encountering at flu-shot clinics.

"Getting 50 million doses from one company is like trying to fill 50 million cups of water from the same tap," said NDP health critic Judy Wasylycia-Leis.

The attacks came as Dr. David Butler-Jones, Canada's chief public health officer, confirmed that drug manufacturer GlaxoSmithKline is shipping extra vaccine antigen out of the country because it cannot fill vials for the Canadian market any faster than its current pace.

The vaccine antigen is stored in bulk, then passed through a "fill line" into vials for quality control and distribution. But the antigen is being produced faster than the vials can be filled at GSK's plant in Ste-Foy, Que. So the excess is being exported. ...more

Unbelievable happens

From the Edmonton Journal:
Something oddly momentous, perhaps even portentous, happened in Alberta politics this week.

Health Minister Ron Liepert held a news conference to make an announcement about health-care reform--and nobody screamed for his head. No protests, no outraged opposition, no angry health care professionals.

In fact, he's being cautiously praised by his usual critics.

It's as if the world has suddenly been turned on its head: rivers are running backward; the sun is rising in the west; the Edmonton Eskimos are in the Grey Cup.

What Liepert did was unveil the second phase of his pharmaceutical strategy--which is being received much more warmly than his first phase last year that forced higher-income seniors to pay more for their drugs.

The second phase will drastically reduce the cost of generic drugs paid by Albertans and will pay pharmacists extra money for additional professional work they do above their usual role of filling prescriptions. ...more

Pharmacist cuts could disadvantage rural Albertans

From the Drumheller (AB) Mail:
The most accessible health care professional, the one that Albertans have said they are most satisfied with, are facing cutbacks that will reduce services to patients.

Paul Ainscough, pharmacist and owner of Riverside Value Drug Mart says heath care cuts will affect Drumheller residents.

“The total reduction in health costs comes directly from the pharmacists," said Ainscough. "In 1992 when Klein had his cutbacks, the pharmacists took a big cut then, and we have never recovered from that. It is going to get to the point that rural pharmacies will not survive."

Alan Hodgins, CEO of Value Drug Mart Associates Ltd., an organization of 57 independently owned and operated community pharmacies, primarily operating in rural Alberta, believes that Phase Two of the Alberta Pharmaceutical Strategy (APS) will cause most community pharmacies to cut services to their patients. ...more

MDs press Ontario to fund rare-disease therapy

From the Globe and Mail:
The specialist physicians who treat patients suffering from a deadly heart and lung disease are pleading with provincial officials to allow them to continue "pushing the envelope" with under-studied treatments that can drastically help their sickest patients.

Some patients diagnosed with fatal pulmonary arterial hypertension (PAH) see their life expectancies more than double - from three years to seven or 10 in some cases - when doctors treat them with drug combinations.

While the often expensive drugs are all approved for use in Canada, the effects of combining them have not been well studied. Because of that, Ontario recently decided to cut off support for PAH patients who require more than one drug - even in cases where patients were not asking for coverage of more than one medication.

The decision remains illogical to most patients and their doctors, who were not given a detailed explanation. The province responded to queries about the criteria used to make the funding decision by repeatedly citing "a lack of evidence with respect to combination therapy." ...more

Pharmacist testifies he refused to fill drug order for Anna Nicole Smith

This is a bit old but I thought it was an interesting pharmacist-related article.

From the Los Angeles Times:
A Valley Village pharmacist testified today that he refused to fill a drug order for Anna Nicole Smith the year before her fatal overdose because the quantities of medication requested by her psychiatrist amounted to “pharmaceutical suicide.”

“If she got ahold of these medications, it could have fatal consequences,” pharmacist Ira Freeman told a Los Angeles County Superior Court judge hearing evidence against the psychiatrist, another doctor and Smith’s boyfriend.

Freeman recounted being stunned by the handwritten list of a half-dozen painkillers, muscle relaxants and sedatives faxed to his store Sept. 15, 2006 – just four days after Smith’s son had died.

Dr. Khristine Eroshevich, a psychiatrist who had flown to the Bahamas to treat the model, signed the list and Smith’s Studio City internist, Dr. Sandeep Kapoor, forwarded it to the pharmacy, he said.

“This is crazy. This is pharmaceutical suicide,” he recalled telling Kapoor in a phone conversation. He said he was so concerned that he tracked down Smith’s boyfriend, Howard K. Stern, in the Bahamas and arranged through him for Eroshevich to consult by phone with a respected toxicologist. ...more

Province mulling drug plan changes

From the London (Ont.) Free Press:
Major changes to the Ontario drug benefit system -- based in part on a secret, $750,000 sole-sourced consultant contract -- that the government hopes will increase taxpayers' "value for money" are coming soon.

But the Health Ministry insists the changes are targeting "very unacceptable practices" in the professional allowance system of payments between generic drug companies and pharmacies and not the seniors and welfare recipients who use the plan.

"In Canada, we are paying dramatically higher prices for generic drugs than most other countries," said Helen Stevenson, assistant deputy minister and executive officer of Ontario Public Drug Programs.

She added that legislation passed two years ago that was meant to address the issue is being skirted.

"The decision was taken that we need to do some further reform. We are still paying inflated prices for generics and we understand why -- it's because of these allowances."

Stevenson would not say what the changes being contemplated involve since no final decision on the policy options has been made, nor would she discuss the recommendations made in the McKinsey and Co. report that informed the process. Health officials asked the firm to do the report before Premier Dalton McGuinty banned untendered consulting contracts in June. ...more

Pharmacy team reunited

From the London (Ont.) Free Press:
When Paul Rutherford set out about a year ago to prove that yes, you can come home again (in a business sort of way), the first item on his list was to round up the usual prospects.

Those would be two pharmacists and a pharmacy assistant whom Rutherford knew and had worked with at a long-gone Big V pharmacy, establishing strong community and professional ties in northeast London.

"I'm the guy who pulled them all together," Rutherford says of the team he assembled to crew a new Pharmasave store at Highbury Ave. and Huron St..

"In the research stage, we knew we had a great location, but I made sure I had my people on board before I signed the lease" on 3,000 square feet of space in a plaza on the northwest corner of the intersection, Rutherford says.

At the same time, major changes in Ontario regulations -- partly prompted by a shortage in diabetes specialists -- is thrusting more of the diabetes treatment load onto family doctors working closely with pharmacy technicians. This also played a major role in the decision of Rutherford's old workmates to jump aboard his new pharmacy bandwagon. ...more

Sunday, November 01, 2009

Flu keeps pharmacists hopping

From the Lethbridge (AB) Herald:
Drug stores in the city are having trouble keeping hand sanitizer, masks and other flu-related supplies on the shelves as customers react to the H1N1 outbreak.

What’s more, pharmacists said Wednesday, they’re being flooded with calls from people seeking information on everything from symptoms of the flu to whether or not they should be vaccinated.

“We’ve been open for three hours this morning and we’ve already had at least 10 calls,” said Doug Bennett, pharmacist at Shopper’s Drug Mart in West Lethbridge.

“People want to know if we’re going to be getting the vaccine here. They’re wondering if they have the flu and they’re wondering if they should get vaccinated. They’re asking when they should be going to the doctor, but most of the time I think they’re deciding to go anyway.”
Shopper’s has seen hand sanitizer disappear as soon as it’s stocked, a situation mirrored everywhere.

“It started weeks ago,” said Igor Shaskin, owner of Stafford Pharmacy and Home Health Care on 9 Street North. ...more

Pediatric Tamiflu not easy to come by, parents find

From the Ottawa Citizen:
Some doctors are prescribing a liquid form of Tamiflu, an anti-viral drug, to treat the youngest victims of the H1N1 pandemic. But a shortage of a syrup used to make the children's formula has forced some Ottawa parents to hunt from pharmacy to pharmacy.

The drug can make the flu milder and go away more quickly and may cut the risk of potentially life-threatening complications if taken within 48 hours.

Thomas Hayes, chair of an emergency-planning committee for area hospitals and nursing homes, said Thursday there is no shortage of Tamiflu in capsule form in Ottawa drugstores or hospitals. Capsules are for adults and older children.

"The province has a supply of Tamiflu stockpiled for a pandemic and other anti-virals as well," says Hayes. Supplies are currently on their way to pharmacies.

But the ready-made liquid form of the medicine used for young children has become hard to come by. And now, there is a shortage of a syrup called Ora-Sweet used by pharmacists to mix an alternative formula from adult capsules. ...more