Monday, August 31, 2009

New drug 'spectacular' at preventing strokes: study

From the Montreal Gazette:
For the first time since the blood thinner warfarin was introduced more than half a century ago, Canadian researchers are reporting that a new drug is safer and more effective at reducing the risk of stroke in high-risk patients.

An estimated 250,000 Canadians suffer from atrial fibrillation, or AF, a potentially life-threatening heart rhythm disorder that causes the heart to quiver and beat chaotically. Blood can pool in the upper chambers of the heart, allowing clots to form and travel up to the arteries that feed the brain, creating a stroke. AF patients are at five times greater risk of developing stroke, and twice as likely to die from one, than patients without the condition.

The disorder affects about three per cent of the population over age 45, and about six per cent over age 65, according to the Heart and Stroke Foundation.

Warfarin has been the drug of choice for reducing stroke risk in atrial fibrillation for more than 20 years. But it increases the risk of major bleeding, sometimes into the brain. About half the patients who might benefit can't take it, "and when they do try and take it, they often end up having to stop it for a variety of reasons," says Dr. Stuart Connolly, a professor of medicine at McMaster University in Hamilton. ...more

500 pharmacists training to give jabs for swine flu

From the Herald (Ireland):
Around 500 pharmacists have now signed up to a training programme which would enable them to administer the swine flu vaccine.

The Health Service Executive has not yet indicated whether pharmacists will be involved in the planned flu vaccination programme.

However, the Irish Pharmaceutical Union (IPU) said it believed that "it would be prudent to allow as wide a range of health professionals as possible to address the challenges that face us this winter."

A spokesperson said that the IPU would hope that pharmacists would be included in the plan for administration of the swine flu vaccine to the public in the coming months.

"In Portugal, 40pc of all seasonal flu vaccines are administered by pharmacists. In the US, pharmacists have been involved in vaccinations since the mid-1990s," she said. ...more

Tuesday, August 25, 2009

Pharmacists tapped for injections

From the Edmonton Journal:
Pharmacists and paramedics could be called on to help inject the H1N1 vaccine this fall alongside nurses and doctors as part of a provincial plan to protect as many Albertans as possible from the new flu strain.

"This is one potential," said John Tuckwell, spokesman for Alberta Health and Wellness. "The immunization is the best defence against the virus and so our goal is to get as many Albertans vaccinated as quickly as possible."

Pharmacists were given additional responsibilities in April 2007, allowing them to refill prescriptions, change drug therapies or administer injections without direct physician instruction as long as they take training courses and successfully apply for certification. About 300 pharmacists out of a total of just under 4,000 in Alberta are authorized to give injection drugs, the Alberta College of Pharmacists says. ...more

Steady Drop in Hip Fractures

From the New York Times:
Rates of hip fractures, an often devastating consequence of osteoporosis, have been steadily falling for two decades in Canada, a new study finds. And a similar trend occurred in the United States, researchers found. But it is not clear why.
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Drugs that slow the rate of bone loss may be part of the reason, but they cannot be the entire explanation, osteoporosis researchers say. And although experts can point to other possible factors — like fall prevention efforts and a heavier population — the declining rates remain a medical mystery.

The new study, published Wednesday in The Journal of the American Medical Association, analyzed Canadian hospitalization data. From 1985 through 2005, the researchers report, hip fracture rates, adjusted for the age of the population, fell by 32 percent in women and by 25 percent in men. ...more

Tuesday, August 11, 2009

Manitoba's aboriginals, pregnant women and homeless get priority for flu drug

From the Canadian Press:
The province that experienced an acute outbreak of swine flu on its northern reserves is making it easier for aboriginals and other vulnerable patients to get free antiviral drugs in a bid to lessen the impact of the virus come fall.

Manitoba has set out who can get Tamiflu more quickly under its pharmacare program. The groups include aboriginals, those with underlying medical conditions, pregnant women, smokers and the obese. The homeless and those with immune deficiencies, including cancer patients, will also get priority.

The changes, which will make it easier for doctors to prescribe Tamiflu quickly, were set out in a regulation that takes effect Aug. 18. People who don't meet the medical criteria can still buy a prescription for Tamiflu but it may not be covered by the province.

Under the old system, doctors had to justify each prescription which involved phone calls, faxes and paperwork.

Provincial Health Minister Theresa Oswald said her government wants to make sure that those who need the antivirals get them quickly. ...more

Pharmacists urged back to work

From the Irish Times:
The Irish Pharmacy Union this evening urged pharmacists to resume normal services immediately “in the interests of patient safety.”

In a statement this evening, the IPU said they were urging members to return to work “in order to prevent a recurrence of the chaotic scenes of yesterday and last week, and in light of commitments made by the Minister in recent statements.”

The union’s executive is holding an emergency meeting in Dublin this evening to discuss the ongoing dispute.

IPU president Liz Hoctor said some of the issues at stake had not been resolved and warned that further disruption to services was almost inevitable if they were not. ...more

Monday, August 10, 2009

New online drug listing service may eliminate print catalogues

From the New Brunswick Business Journal:
Tired of receiving a plethora of different drug catalogues at his Saint John pharmacies, Peter Hebert knew there was a more organized and innovative way to get drug information out to pharmacists.

So in 1991, the now-retired pharmacist approached his salesman brother Tony for help and together they created Moncton-based drug catalogue company, Total Pricing Systems Inc.

This fall the Heberts will launch the mobile version of their online catalogue, PPS Pharma, which healthcare workers can access using any smart phone in any wireless network.

The first cellphone-friendly drug listing service in Canada, it will further eliminate the unwanted stacks of print catalogues Peter grew so tired of nearly 20 years ago.

"We believe what we've developed is very innovative," says Tony, the company's president. "We're trying to be the electronic connection to the drug industry." ...more

Chinese dispensaries puzzled by legal revision

Purveyors of Chinese herbal medicines--and their long-time mail-order customers-- are up in arms over a revised law that took effect June 1 banning sale of such medicines through the mail or online.

Advocates say the revised Pharmaceutical Affairs Law must be amended to allow the continued mail-order sales of Chinese herbal medicines.

Classified in the same category as drugs that carry a medium risk of side effects, medicines such as Chinese remedies, common cold medicines and analgesic fever reducers must now be sold over the counter by pharmacists or other specialists.

Like before the revision, buyers don't need a prescription.

In general, the only mail order or online sales of OTC drugs now permitted are items that have few side effects, such as vitamins and elixirs for stomach upsets. ...more

Many U.S. teens share medications

From CBC News:
Many U.S. teens have lent or borrowed prescription medications such as antibiotics and acne medication, a survey suggests.

When researchers interviewed 529 people aged 12 to 17 in 11 U.S cities or suburbs, they found one in five reported they had borrowed or lent a prescription.

A third of the teens who took a borrowed prescription did not tell their doctor, the team said in this week's online issue of the Journal of Adolescent Health.

"Other researchers have studied people selling prescription drugs, but we looked at people with good intentions, trying, for instance, to help a friend who lacked money or transportation for a doctor's visit," co-author Chris Mayhorn, a professor of psychology at North Carolina State University, said in a release from the Center for the Advancement of Health.

Increased antibiotic resistance is also possible, since neither the lender nor the borrower was likely to take the full course of the drugs, the researchers noted. ...more

Canada dismisses warning about flu drug

From the Globe and Mail:
Canadian health authorities will not change their practice of prescribing the anti-viral drug Tamiflu to treat cases of pandemic H1N1 flu in children, despite a new study that raises questions about the drug’s effectiveness.

Researchers at the University of Oxford cautioned about the broad use of anti-viral drugs to treat children 12 years of age and younger suffering from seasonal flu. They found anti-viral drugs have little or no effect on asthma flare-ups, ear infections or bacterial infections in children. Tamiflu was also linked to increased vomiting.

The authors questioned whether children would face the same risks when being treated with anti-virals for the pandemic H1N1 flu virus.

But the Public Health Agency of Canada assured parents Monday that Tamiflu has a strong safety profile, and has recommended doctors prescribe it for infection prevention and to treat cases of H1N1 in infants under one year. ...more

Dispensing with the niceties

From the Irish Times:
The pharmacy dispute over the State drugs scheme is already leaving many people with chronic conditions stranded, but its potential impact could yet be greater

This day last week, the ongoing pharmacy dispute began, with the withdrawal of several hundred pharmacies from the State drugs scheme, the system that issues prescriptions to medical card holders and those on the drugs payment scheme. Prior to the dispute, 1,521 pharmacies had a contract with the Health Service Executive (HSE) to dispense these prescriptions.

At its core, the dispute is about money. Last year, participating pharmacists were paid a total of €540 million to dispense drugs under the community drugs scheme. As part of an ongoing series of cutbacks, the Government decided to reduce the payments it made to pharmacies to carry out this service.

Towards the end of last month, Minister for Health Mary Harney declared that even with the new cuts in payments from the Government, participating pharmacies would still keep a margin of 25 per cent on the drugs they dispensed.

“I believe that pharmacists will still continue to be adequately rewarded for the huge skill that they bring in dispensing medicines to our patients,” she said. ...more

Pope tells pharmacists avoid filling prescriptions for 'immoral purposes'

From the Lewiston (ME) Sun Journal:
Pope Benedict XVI urged Catholic pharmacists on Monday to use conscientious objection to avoid dispensing drugs with "immoral purposes such as, for example, abortion or euthanasia."

In a speech to participants at the 25th International Congress of Catholic Pharmacists, Benedict said that conscientious objection was a right that must be recognized by the pharmaceutical profession.

Such objector status, he said, would "enable them not to collaborate directly or indirectly in supplying products that have clearly immoral purposes such as, for example, abortion or euthanasia."

In his speech, the pope also said that pharmacists have an educational role toward patients so that drugs are used in a morally and ethically correct way. ...more

Saturday, August 08, 2009

Flu vaccine may be more dangerous than virus: ethicist

From the Winnipeg Free Press:
The race to create a vaccine for the H1N1 flu virus could place the public at a greater risk than the illness the vaccine is designed to prevent, says a University of Manitoba ethicist.

Arthur Schafer, director of the U of M's Centre for Professional and Applied Ethics, said it appears a vaccine will be rushed to the public before it can be determined properly that it's safe - or if it even works.

Schafer said the scientific research shows the effectiveness of seasonal flu vaccines in the past has been marginal. The effectiveness of antiviral drugs, designed to mitigate the effects of flu, is equally unimpressive, and research shows the drugs can have dangerous side effects, he added.

"Good ethics requires good facts, and the ethical debate so far has been who should be the first (to get the vaccine) and there has been virtually no discussion of the safety and effectiveness of the drug," he said. ...more

Pharmacist at a loss

From the Sudbury Star:
Pharmacist Jason Keeping is planning on having a minimal supply of OxyContin at his pharmacies after being hit twice by robbers in the last few months.

Keeping's staff at Hanmer Medical Pharmacy was still reeling Thursday from being held up at gunpoint the day before. Keeping's other operation, Lalonde Pharmacy in Capreol, was robbed May 5.

"It's just terrible," Keeping said. "I'm sure it's going to get worse. Every pharmacy seems to be at risk right now, especially smaller pharmacies."

Five pharmacies have been held up for OxyContin since early July in Greater Sudbury.

Aside from being a safety risk for Keeping and his staff, being robbed takes a financial toll. The pills are expensive and insurance doesn't cover everything. It also creates a mountain of work. ...more

Nurses and pharmacists to be given off-label prescribing rights

From Pulse (UK):
Exclusive: The Medicines and Healthcare products Regulatory Agency is planning a controversial change in the law to allow nurses and pharmacists to prescribe off-label treatments, in a move that has split prescribing experts.

The UK drug regulator says it expects regulations to change by the end of the year, but critics say the move could expose patients to potentially dangerous treatments.

It is the latest in a series of developments to loosen the rules surrounding non-medical prescribing, coming just weeks after Pulse revealed proposals to extend prescribing rights to physiotherapists, dieticians and chiropodists.

The MHRA now says it wants to ‘regularise’ restrictions on prescribers and allow prescribing nurses and pharmacists the same freedoms as doctors.

Such a change will require the Home Office and the Advisory Council for the Misuse of Drugs to alter Misuse of Drugs Regulations - but the Government has already accepted the recommendations, made by the MHRA’s Commission on Human Medicines. ...more

Thursday, August 06, 2009

H1N1 drugs available to First Nations, official says

From the Winnipeg Free Press:
A senior Manitoba Health official said its stockpile of H1N1 antiviral drugs was made available to Health Canada for distribution among the province's First Nation communities.

Terry Goertzen, an assistant deputy minister of health, said Ottawa did not request from Manitoba more than the 45 courses, or 450 doses, of Tamiflu it was given in mid-May to deal with an H1N1 outbreak on reserves.

"When it comes to health care on First Nation communities, (Ottawa) takes the lead," Goertzen said, adding no special requests for additional antiviral drugs were made to deal with the outbreak in the Island Lake communities.

Chiefs from Garden Hill and St. Theresa Point are demanding to know why their communities received next to no antiviral drugs when the northwestern Ontario First Nation of Sandy Lake was given 1,800 doses to control an H1N1 outbreak there. ...more

Ontario’s law curbing the cost of generic drugs sparks changes

From CMAJ:
Ontario shook up the world of generic drug pricing across the country 3 years ago when it passed Bill 102, the Transparent Drug System for Patients Act.

In turn, the executive officer of Ontario’s $4-billion-a-year drug benefit plan saw her own life disrupted.

In late April, Helen Stevenson was flanked by plainclothes Ontario Provincial Police bodyguards when she delivered a speech to IMS Health Canada. It was the day after the province announced a series of legal actions and imposed penalties totaling $33.8 million in a crackdown on violations of the Act.

Stevenson confirms that her need for security continues because of threats made in connection with her job.

For complicated reasons, Canadian prices for generic drugs — copies of brand-name drugs which have lost patent protection — are among the highest in the world (see Patented Medicine Prices Review Board, Non-Patented Prescription Drug Prices Reporting, 2006.) ...more

PU claims 'widespread' problems

From the Irish Times:
Pharmacists have reported “widespread” problems for patients today as they sought to have prescriptions filled under a HSE contingency plan to deal with the withdrawal of hundreds of pharmacists from State schemes.

The Irish Pharmacy Union (IPU) said there were “major problems” today in Mayo, Donegal, Carlow, Waterford, north Dublin, Wexford, Kerry, Offaly, Clare and Galway.

In response, the HSE said its temporary dispensing facilities were “busy but manageable” over the course of the day.

Hundreds of pharmacists have withdrawn from operating the State drug schemes, including the medical card and long-term illness schemes, in protest at the Government's decision to cut fees by €133 million over a full year. Up to a dozen temporary dispensing centres have been established by the HSE to help fill the shortfall in supply caused by the pharmacists’ action.

But the IPU claimed today the contingency measures are inadequate, that many patients are facing delays of up to eight hours to have prescriptions filled and that the HSE pharmacies do not have some medications in stock. ...more

Online pharma spammers capitalize on Canada's health-care reputation

From the Ottawa Citizen:
Cyber-criminals from Russia are taking advantage of Canada's reputation for quality health care, bombarding the Internet with unwanted e-mail advertising counterfeit and potentially lethal male-enhancement drugs and painkillers, according to online security experts.

"Almost every illegal pharmacy that's out there invokes Canada," said John Praed, a Virginia-based lawyer who has filed a lawsuit to investigate the online pharmaceutical market.

"This will taint Canada," Praed said.

The current king of the online pharmaceutical spamming world calls itself "Canadian Pharmacy," which according to Praed is an illegitimate operation based in Russia that distributes more than 75 different counterfeit medications produced in India and China. He said they use Canada as a selling tool because the biggest market for online drugs is the U.S., and Canada has a reputation for providing cheap, safe medications to Americans.

It is estimated that more than 200 legitimate online pharmacies are based in Canada, but they are being undermined by the illegal operations co-opting Canada's reputation, said Tim Smith, general manager of the Canadian International Pharmacy Association. (CIPA is the membership association for online Canadian pharmacies licensed to sell medications internationally.) ...more

Pharmacy condemns codeine decision

From Pharmacy News (AU):
Tighter controls on over-the-counter codeine combinations will not address the problem of misuse of the products and will put significant pressure on pharmacists, say the profession's peak bodies.

Both the Pharmacy Guild of Australia and the Pharmaceutical Society of Australia (PSA) have expressed disappointment with the National Drugs and Poisons Schedule Committee (NDPSC) decision to upschedule OTC combination analgesics containing codeine (CACC) to Schedule 3 in a bid to address concerns of misuse and abuse of the products.

The Guild said the scheduling changes would only mask the problem and were unlikely to influence individual misuse behaviour.

It said it was regrettable that the committee rejected its proposal to adopt real-time monitoring and reporting of these products through its NotifyRx technology, calling it a "missed opportunity". ...more

Human tests of swine flu vaccine start

From CBC News:
Human tests of a potential swine flu vaccine have begun, a spokesperson for Novartis said Wednesday, as other drug companies also prepared to start trials.

Novartis is testing a vaccine in a yearlong trial of 6,000 people of all ages in Britain, Germany and the United States, said Novartis spokesman Eric Althoff.

"We initiated clinical trials about 10 days ago," Althoff told The Associated Press.

A Briton received the first shot of H1N1 pandemic vaccine about 10 days ago, he said.

Novartis expects two doses will be required. The trial will also test this assumption.

Sanofi-Pasteur, which makes about 40 per cent of the world's flu vaccines, expects to start testing its swine flu vaccine within days in the U.S. and Europe, said spokesman Benoit Rungeard. ...more

University of Alberta to offer doctorate of pharmacy degree

From the Edmonton Journal:
The University of Alberta will establish a new doctorate of pharmacy degree, the first of its kind in Western Canada, in part to prepare practitioners for a growing slate of responsibilities in the health-care system.

"Recent legislative changes in Alberta mean that pharmacists can now have the right to prescribe, and as part of a team they can help to manage a patient's drug therapy," said Sharon Mitchell, the U of A's assistant dean of pharmacy and pharmaceutical sciences.

The university currently offers a five-year bachelor's degree program in pharmacy.

The new doctorate, which must still be approved by the province, will be six years long and feature a more intensive curriculum in subjects such as patient assessment and evidence-based medicine, Mitchell said. ...more