Wednesday, December 22, 2010

I'm a believer: drug-supply startup proves its mettle

From the Edmonton Journal:
Chalk up another one for Sine Chadi.

When I first interviewed the CEO and majority shareholder of Edmonton-based Imperial Equities in 2007, he had big dreams for a tiny drug-distribution firm his company had just acquired.

I listened politely to Chadi's upbeat talk, but in truth, I didn't take it too seriously. After all, entrepreneurs are born dreamers and most of their schemes go nowhere.

Besides, I figured, what could a smallish local real estate operator with a market cap of just $30 million and a clutch of second-tier industrial and commercial properties know about delivering drugs to pharmacies?

That's strictly a game for the big guys, I reasoned -- namely corporate giants like McKesson Corp., whose annual revenues ($100 billion-plus US) dwarf the very largest companies in Canada, let alone a minnow like Imperial.

Well, it turns out I was wrong to dismiss Chadi's effusive outpourings. When I checked in with him a year ago, his drug-delivery service had grown to nearly $13 million in annual sales, up from just $1.2 million in 2006. ...more

Pfizer, Health Canada pull Thelin from shelves

From the Globe and Mail:
Health Canada and drug giant Pfizer formally announced Monday the company is taking a drug used to treat a rare, but serious, lung disease off the market due to risks of potentially fatal liver damage.

Pfizer Canada also said the company is abandoning all clinical trials of sitaxsentan sodium, better known by the brand name Thelin, and removing the drug from every country where it is sold.

The decision is raising questions about why the drug, used to treat pulmonary hypertension, was approved in Canada in the first place.

Parent company Pfizer Inc. announced more than a week ago its intentions to pull the drug off the market in Canada, Australia and Europe, as well as halt clinical trials. The decision was prompted by the deaths of three patients involved in clinical trials of the drug.

The company was conducting the trials in a bid to get the U.S. Food and Drug Administration to approve the drug in that country. ...more

Certain heart burn medications linked to increased risk of pneumonia

From the Montreal Gazette:
People on two types of widely prescribed heartburn medications may have a higher-than-average risk of developing pneumonia, a new research review finds.

The drugs in question belong to two classes frequently used to treat heartburn or stomach ulcers: proton pump inhibitors, which include drugs like Nexium, Prevacid and Prilosec; and H2-receptor blockers, such as Pepcid and Zantac.

In the U.S. alone, people spent $27 billion on these medications in 2005.

Some studies have found a connection between the heartburn drugs and a heightened risk of pneumonia. One theory is that by curbing stomach acid, the medications allow ingested bacteria that would otherwise be killed to instead survive and thrive -- and potentially get into the lungs. ...more

Windsor pharmacies running out of commonly-used drugs

From the Windsor Star:

Some commonly used drugs, including antibiotics and sedatives, "can't be found anywhere" in Windsor due to a national prescription drug shortage, a local pharmacist says.

The shortage, highlighted in a national survey, is creating problems across the region, says Peter Dumo, owner of Novacare Pharmacy in Windsor.

"There are some drugs that you can't get anywhere right now," Dumo said, listing among them Triazolan, a sedative, and Cephalexin, typically used to treat skin infections.

Dumo said he's experienced drug shortages before, but "I've never seen anything like this in Ontario."...more

Monday, December 20, 2010

updates

Updates resume Tuesday - sorry for the delay. I will end a message on Twitter when the site is updated. To sign up for our Twitter account, go to:

http://twitter.com/canadapharmnews

Sunday, November 28, 2010

Critics decry change in drug-approval process

From the Globe and Mail:
British Columbia’s widely applauded independent drug-approval process is being dramatically altered to make room for more input by pharmaceutical companies, a change decried by critics as potentially harmful to consumers, a conflict of interest and likely to increase spending on drugs.

An internal health ministry document says there will now be four separate opportunities for drug marketers to make their case while new products are being considered for coverage by B.C.’s PharmaCare plan.

At the same time, the government’s long-standing drug review body with an arms-length distance from the industry is being abolished. The Therapeutics Initiative’s cautious approach to drug approvals has been credited with saving lives and helping B.C. maintain the lowest per capita spending on prescription drugs in the country.

Michael McBane of the Canada Health Coalition said no other provincial drug plan allows as much industry involvement as B.C. is proposing. ...more

Cautionary note sounded on HIV-protection drug

From the Globe and Mail:
AIDS-prevention advocates are hailing a pill newly shown to protect against HIV as a great tool for disease prevention. But they caution that no drug alone can address social factors blamed for the persistence of the epidemic. And they say concerns remain about who will pay for the costly treatment.

A study released on Tuesday showed that daily doses of a drug called Truvada, already used to treat HIV infection, cut the risk of new infections among healthy gay men.

The overall study, published online by the New England Journal of Medicine, involved about 2,500 men at high risk of HIV infection in Peru, Ecuador, Brazil, South Africa, Thailand and the United States.

Susan Buchbinder, director of the San Francisco health department’s HIV-research section, called the findings on the drug a “tremendous step forward.” But she took pains to point out that among the several HIV-prevention studies she has overseen, this latest had especially strict requirements for making sure participants stayed on track. ..more

Monday, November 22, 2010

Twitter

CanadaPharmacyNews.com is now on Twitter. Follow us at #canadapharmnews where we will give you a head's up when the blog is updated and also provide you with links to stories of interest.

www.twitter.com/canadapharmnews

Dying patients ask: Where are the $1 billion in drug savings?

From the Toronto Star:
Deborah Warkus spent the last moments of her life fighting the Ontario health ministry to gain access to a $4,000-a-month drug to treat her invasive breast cancer.

By the time the province agreed, it was too late and the 50-year-old Brampton mother died.

Lucas Maciesza, 26, is lying in a Guelph-area hospital, bleeding to death, because his parents can't afford to pay the $500,000-a-year cost for his medication.

In the last four years, a bold drug reform scheme — which includes bulk purchasing and eliminating professional allowances to pharmacists — has saved the province more than $1 billion.

Those savings are supposed to be used to add new, often pricey drugs to the Ontario Drug Benefit Program formulary.

But patients suffering in the final stages of cancer or with rare diseases say their desperate needs are being ignored. ...more

Health Canada announces restrictions on diabetes drug

From CTV News:
Health Canada has announced new restrictions and a consent form for the diabetes medication rosiglitazone, sold under the brand name Avandia, because of an increased risk of heart-related illness.

The national drug regulator said Thursday that it changed the restrictions after reviewing recent data and in conjunction with manufacturer GlaxoSmithKline Inc.

The drug may increase the risk of serious heart problems, including heart failure, angina (chest pain), heart attack or fluid retention (with or without rapid weight gain). It should not be used by patients who have or have had heart problems, the agency said in a release Thursday.

Health Canada says the medication should be used only in patients with Type 2 diabetes when all other diabetes medicines taken orally have not lowered blood sugar enough, or are not appropriate. ...more

Advances made in developing hepatitis C vaccine

From the Vancouver Sun:
Scientists are zeroing in on a promising vaccine to treat hepatitis C, an international symposium was told Friday in Montreal.

Three preliminary clinical trials in England are showing that a so-called therapeutic vaccine can boost the immune response in those infected with the hepatitis C virus.

Still, a viable vaccine is a decade away, said Paul Klenerman, a University of Oxford physician researcher who is conducting the trials.

"Other vaccine trials have been done already, but ours is the first where we're treating people (with drugs) and giving them the vaccine at the same time," he said.

"What's possible is that you can have a good drug that can get most of the virus, but you might still need a bit more immune response to tidy it all up, because what you don't want to do is have all these drugs suppress it and then it comes back again, which is typically what happens." ...more

Friday, November 19, 2010

Not many pharmacists prescribing medication

As one of those 107 prescribing pharmacists, I thought this was interesting but missed the point a bit. Compensation is part of the reason that pharmacists haven't embraced prescribing. But I don't think pharmacists expect the government or third parties to pay a fee based on number of Rx's written for example. Pharmacists want a clear method to be able to charge government for clinical services like a physician can. Prescribing might be an action done during these clinical services, but not always just as a physician gets paid for a visit and associated clinical services, not an amount based on the number of prescriptions they wrote during a visit.

And when I mention pharmacists want a way to bill the government, I mean the actual pharmacists - not the drugstore they work for. A recent attempt to reimburse pharmacists in Alberta for clinical services called PPMI never made it past the pilot project stage. One aspect of that pilot I didn't like was that a pharmacist could not bill the government directly like a physician could but all reimbursement had to go through a pharmacy. I would think that the majority of the 107 prescribing pharmacists in Alberta do not own their own drugstore and therefore would have to cut a deal with a drugstore so that they could submit their billing to the government. This definitely limits an individual pharmacist's options as far as how they can set up their practice.

From CTV News:
Pharmacists were given the ability to prescribe medication under a new plan introduced a few years ago to take some pressure off family doctors.

But since the plan took off, only 107 of the more than 4,000 pharmacists in Alberta have signed up.

Anjli Acharya was one of the few pharmacists who applied. She said she can now prescribe to her patients at the Bowmont travel clinic.

But she said the application process took four months of work. She also doesn't get paid to prescribe drugs.

Those are some of the reasons many pharmacists haven't applied, says Todd Gehring, who owns and operates his own community pharmacy.

He says prescribing medication takes time and pharmacists need to be paid appropriately. ...more

Thursday, November 18, 2010

Health council calls for better testing of drugs

From the Toronto Star:
Some prescription drugs the federal government approves for the market may not be as safe as people think they are, says a new report from the Health Council of Canada.

“Pharmaceuticals offer significant health benefits, but the risks associated with their use in the real world remain largely unknown when they enter the market and large numbers of people start taking them,” says the report released Wednesday. “This can leave users of medicines exposed to unanticipated drug effects.”

The report noted that some drug safety issues, such as the 2004 recall of the anti-inflammatory painkiller known as Vioxx, gain a lot of media attention, but the problems are not limited to such high-profile cases.

“Most Canadians are not aware of the limitations inherent in pre-market testing of prescription drugs, nor do they realize that there is no systematic scrutiny of people’s experiences with drugs after they have been approved and are available for sale,” says the report. ...more

Drug reforms bring profits down, Shoppers says

From the Toronto Star:
Profit at Canada’s largest drug store chain fell less than expected last quarter as Shoppers Drug Mart made gains in private label generic drug sales, cosmetics, healthy living products and non-prescription drugs.

Still, the retailer said Ontario’s drug reforms cut into its operating and profit margins during the first full quarter since the new rules came into effect.

The reforms saw the Ontario government cut the amount it pays for generic drugs in half and end professional allowance payments to pharmacists by drug manufacturers.

Shoppers Drug Mart, which fought the changes, said it expects to benefit in the long term from increasing consolidation in the pharmacy business.

The provincial drug reforms, which analysts estimate will cut $750 million from pharmacists’ budgets over three years, were expected to hit smaller independent stores hardest.

Shoppers has made few acquisitions so far because “we feel the price per square foot did not come down to the right level to justify the investment to buy and integrate small stores,” president and chief executive officer Jurgen Schreiber told analysts on a conference call Wednesday afternoon. “We are confident this will happen as the reforms kick in year after year.” ...more

Painkiller sting hurts druggist

From the Toronto Sun:
There wasn't a prescription Gregory Melville wouldn't fill.

And when the London pharmacist couldn't help with a doctor's script, he had other ways to help fill a customer's need.

Now, in a twist more like the fate of a street drug dealer than a pharmacist who had his own store, Melville will pay -- his licence will be yanked, he no longer has his pharmacy and he's working in a call centre.

That's on top of the court penalties dished out to the 46-year-old Tuesday -- a two-year conditional sentence that includes nine months of house arrest, two years' probation and 75 hours of community service.

The rare tale of how the druggist went down was the fallout of a London police sting.

Tuesday, Melville pleaded guilty to four charges -- possession of crime proceeds valued under $5,000, possession of oxycodone and two counts of drug trafficking -- stemming from a police investigation two years ago.

Oxycodone, a powerful painkiller known as "hillybilly heroin" on the street, is widely trafficked to addicts, some of whom get hooked after legitimately using it to relieve chronic pain. ...more

Breast-cancer risk of hormone therapy overblown: Gynaecologists

From the Montreal Gazette:
Women arrive at Dr. Wendy Wolfman's menopause clinic carrying shopping bags filled with herbal remedies. Most of it, she said, "is just completely a waste of money."

Some women are willing to try anything to deal with debilitating hot flashes, mood swings and other menopausal symptoms, Wolfman said.

Anything but hormones.

"They're afraid to take hormones because the publicity is they're going to get (breast) cancer," said the director of the menopause unit at Mount Sinai Hospital in Toronto.

Now, the Society of Obstetricians and Gynaecologists of Canada is urging Canadian women to rethink their aversion to hormone therapy. The doctors' group says that women have been needlessly frightened off a "safe and effective therapy" by reports implicating hormones in breast cancer.

In an article titled "Misinformation. Misinterpretation. Missed opportunity." posted on the gynecologists' group's website, executive vice-president Dr. Andre Lalonde says the organization has supported the breast-cancer cause "for years." ...more

Sunday, November 14, 2010

Drug shortages trouble pharmacists

From the Toronto Star:
There are shortages of some prescription drugs — including tetracycline and some anti-nausea medications for heart and cancer patients — forcing pharmacists to scramble to meet patients’ needs, industry sources say.

The trouble lies with supply shortages, such as difficulties for some manufacturers in getting the active ingredients to make the medicines, creating a domino effect in which demand for similar drugs is going up and leading to sellouts.

“It’s a real problem,” said Dennis Darby of the Ontario Pharmacists Association, adding it was not caused by the provincial government’s reforms forcing a 50 per cent cut in the price of generic drugs last spring.

The shortages are being reported across Canada and beyond.

“There’s lot of things the drug reforms are causing but this isn’t one of them,” added Darby, alluding to complaints from pharmacies that the reforms eroded their profitability and would lead to staff and service cuts. /...more

Generic drugs not the same: experts

From the National Post:
As Canadian governments turn increasingly to generic drugs to try to rein in health-care costs, some researchers suggest duplicates can sometimes differ significantly from the brand-name original, potentially causing serious trouble for patients.

One Montreal psychiatrist recently documented adverse effects in patients who were switched to generic medications, and alleged that the cost savings of generics are outweighed in certain cases by the dangerous impact on users.

"I've seen it enough times to know it's a real phenomenon," said Dr. Howard Margolese. "It's sort of another element a physician has to consider if he has a patient who does well, and starts to relapse. ... There needs to be a little more caution and there needs to be a whole lot more study done before a generic is deemed to be equivalent."

Other experts, Health Canada and the generic industry, however, say there is no reliable evidence that the copies are problematic, with some arguing that the skepticism is being fuelled by a brandname sector worried about its bottom line. /...more

Home breast cancer screening device recalled, Health Canada says ineffective

From the Winnipeg Free Press:
Breastlight, a product being sold as a home screening device for the early detection of breast cancer, is being pulled from the market because there is no evidence it works, Health Canada says.

PWB Health Ltd. is recalling Breastlight and asking pharmacies and other distributors to immediately stop selling the product, following Health Canada's evaluation of information about the safety and effectiveness of the technology.

The company has marketed the device as an aid to help women notice changes in their breasts over time and as a component of "breast awareness."

But there is no clinical evidence that the Breastlight can be used effectively as a screening device for the early detection of breast cancer, Health Canada said in an advisory Friday. "As such, it may present a potential risk to women relying on it for early detection of breast cancer." ...more

Monday, November 08, 2010

Websites selling counterfeit drugs, Health Canada warns

From CBC News:
Health Canada has identified three websites that are selling prescription drugs not authorized for sale in Canada, the agency said Wednesday.

The websites — www.northdrugmart.com, www.northdrugstore.com and www.pharmacyrxworld.com — sell products containing references to brand names and resemble drugs that are approved for sale in Canada.

Health Canada said it suspects the products are counterfeit.

"This may lead consumers to believe they are purchasing drugs that have been reviewed for safety, efficacy and quality by Health Canada," the department said in a news release.

"It is important to note that counterfeit drugs may contain no active or unsuitable ingredients, or dangerous additives. To this end, counterfeit drugs may pose a higher risk than other forms of unauthorized drugs." ...more:

Fort Street pharmacy 100 years old thanks to focus on patient care

From the Victoria Times Colonist:
It has survived world wars, the Great Depression and numerous recessions that followed.

And it has flourished as the era of big-box retail turned pharmacies into sidelines.

Victoria Compounding Pharmacy -- formerly Aaronson's -- turns 100 today with a fourth-generation owner committed to keeping the drug store firmly rooted in what it does best and leading the curve on a new spectrum of treatments and patient care.

John Forster-Coull doesn't sell barbecues or computers or cosmetics.

"We sell drugs and provide patient care, and we've always done it very well," Forster-Coull said in an interview at his busy Fort Street pharmacy and lab. ...more

Wednesday, November 03, 2010

Shoppers pulls support from pharmacists’ group

From the Globe and Mail:
Jurgen Schreiber’s latest assault – this time on a former ally – is rattling an industry already grappling with unwanted drug reforms.

In the spring, the chief executive officer of Shoppers Drug Mart (SC-T38.870.120.31%) the country’s largest drug-store chain, waged an unsuccessful war over Ontario’s generic drug proposals and their big hit to pharmacies’ bottom lines. The changes are expected to be adopted to various degrees across the country.

Mr. Schreiber is now turning his guns on the Ontario Pharmacists’ Association, one of the key groups that joined him in opposing the government reforms. About two weeks ago, Shoppers notified the association that the retailer would no longer cover the $500 annual membership fee for its 1,300 or so pharmacists who are members of the OPA. The Shoppers pharmacists are free to maintain their memberships, but they will have to pay the fees themselves.

“We have too many pharmacy associations – too many lobbying groups,” Mr. Schreiber said in a brief interview after addressing students at the University of Toronto’s Rotman School of Management this week. “We have to have a very strong lobbying group. You have to pick and choose.”

At stake for the OPA is roughly $650,000 of annual membership fees that Shoppers pays on behalf of its pharmacists. The company’s pharmacists make up about 18 per cent of OPA’s membership. ...more

Drug shortages must be addressed: pharmacists

From CBC News:
Pharmacists say a national drug shortage is increasingly hampering their ability to help patients.

Calgary pharmacist Dan Curle, who owns Market Mall Medicine Centre, said the shortage of some prescription drugs has been going on for the last year, and is only getting worse.

Antibiotics, anti-depressants, anti-nausea medications and other commonly used drugs are increasingly difficult to come by, said Curle.

As a result, he's having to substitute or ration medications.

"It may mean that a patient may only get a small portion of a drug, so we're trying to spread the drug between a number of patients so nobody goes without," said Curle. CBC News - Calgary - Drug shortages must be addressed: pharmacists: "- Sent using Google Toolbar"

Improving patient care and safety

From the Montreal Gazette:
Being admitted to the hospital for any reason can be scary. Amid the stress of the situation, it can be difficult to be your own advocate in terms of giving an accurate history and a list of current and past medications.

Having this information is hugely important for medical professionals in order to deliver the highest quality of care.

That's why the pharmacy department at the Jewish General Hospital (JGH) uses a medication reconciliation process to identify the pharmacological profile of each patient on admission, to help educate the patient about their meds, and provide the documentation necessary for treatment continuity during and after their hospital stay.

"It's very common that patients come in and they don't know the names or the doses of their medication" said Eva Cohen, Chief of Pharmacy at the JGH. "So we've implemented a process to harvest as much information as possible about their medications."

There are many things to consider when it comes to patients' past and present medications, so the pharmacy department uses a form called the Medication Reconciliation Form, on which the health care worker documents the Best Possible Medication History (BPMH). ...more

Teething tablets recalled due to health risk

From the Guelph (ON) Mercury:
A brand of teething tablets is being recalled in Canada and the United States because they may pose a risk to children, Health Canada announced Tuesday.

Hyland’s Homeopathic Canada, a division of Standard Homeopathic Company, is voluntarily recalling Hyland’s Teething Tablets because they could harm infants and toddlers, according to tests done by the U.S. Food and Drug Administration.

The tablets contain a small amount of belladonna, which can cause serious harm in larger doses, Health Canada said in a release. ...more

Tuesday, November 02, 2010

Local pharmacies to provide flu vaccines this season

From the Fredericton (NB) Daily Gleaner:
More than 60 New Brunswick pharmacies will be offering the seasonal influenza vaccine over the winter months, including many across the capital region.

That means residents looking to roll up their sleeves for the protective shot will have more opportunities to access the vaccine than in previous years.

The shot, which is designed to give recipients increased protection from two strains of the seasonal flu and from the H1N1 virus, will still be available at public clinics offered by the Victorian Order of Nurses and through family physicians across the province.

But Lisa Zwicker, president of the New Brunswick Pharmacists' Association, said using pharmacists to administer the shot will make it easier for many residents to get the protection they desire.

She said this is another example of how pharmacists are helping to reduce the strain on provincial medical professionals and make care more accessible and convenient. ...more

Saturday, October 30, 2010

Manufacturer recalls lot of cortisone skin treatment due to mould contamination

From the Winnipeg Free Press:
GlaxoSmithKline is voluntarily recalling one lot of its product Emo-Cort 2.5 per cent Lotion, a product used to treat eczema, dermatitis and other skin irritations, due to contamination.

GSK is asking wholesalers, pharmacies and hospitals to immediately stop selling Lot No. 5R6 of the hydrocortisone lotion.

Health Canada said in a release Friday that the recall follows a consumer complaint to the company regarding a brown substance in the product. Testing of samples of the lot showed the product has been contaminated with mould.

Because of the potential risk of local or more widespread infection from the mould to consumers with weakened immune systems, GSK has put all Emo-Cort products at its manufacturing facility on hold pending an investigation. ...more

Grapevine doctor defends using bargain IUDs

From WFAA (TX):
Commercials tout the Mirena-brand intrauterine device as one of the easiest long-term birth control devices on the market.

That's how one North Texas woman felt about her IUD — until the day she heard from her doctor's office, Women's Integrated Healthcare in Grapevine.

"The first thing she said to me was, 'The Mirena that I had inserted a year-and-a-half previous was purchased in Canada,'" said the patient, who prefers to remain anonymous. "When she told me that, I thought, 'That's wrong; that's really wrong to do that and potentially cause harm.'"

An FDA-approved Mirena IUD in the United States costs about $700 wholesale to physicians. But on the Internet, IUDs imported from Canada can be purchased for as little as $200.

Women's Integrated Healthcare charged the patient News 8 spoke to more than $1,800 for inserting the bargain-priced Canadian product. ...more

Approval of new drug heralds 'momentous' advance in stroke prevention

From the Montreal Gazette:
In what Canadian doctors are calling a "momentous" advance, Health Canada has approved the first anti-clotting drug for stroke prevention since the introduction of warfarin more than half a century ago.

Pradax, or dabigatran, is expected to change practice for the treatment of atrial fibrillation, or AF, a potentially life-threatening heart rhythm disorder that causes the heart to quiver and beat chaotically. About a quarter-million Canadians suffer from AF, and the absolute numbers will grow as the population ages. One in four people over age 40 will develop AF, according to the Heart and Stroke Foundation.

A Canadian-led international trial published this summer involving more than 18,000 patients from 44 countries found that dabigatran was superior to warfarin for reducing the risk of stroke, and also for reducing bleeding complications.

For the study, patients randomly received either dabigatran or warfarin. Two doses of dabigatran — 100 mg twice daily, or 150 mg twice daily — were tested. The higher dose of dabigatran reduced the risk of stroke by 34 per cent compared to warfarin. There was also a significant drop in the risk of bleeding into the brain, the most feared complication of warfarin. ...more

Natural product companies targeting kids’ market

From the Globe and Mail:
When Health Canada ruled in 2008 that children under age 6 should not be given over-the-counter cough and cold remedies, it probably didn’t realize it was creating a whole new market for medications aimed at kids.

Companies that use certain active ingredients in over-the-counter medications, such as dextromethorphan (used in cough remedies) and brompheniramine maleate (used in cold meds), now must carry labels indicating they are not to be given to children under age 6.

But the recent ruling, made because there is little proof that these products work in children and evidence they can cause rare side effects or lead to overdose, doesn’t apply to makers of natural or homeopathic medicine.

Now, many of those companies are rushing to fill the void and attract a following from confused parents looking for ways to help their sick children in the wake of Health Canada’s restrictions on traditional remedies.

The makers of COLD-FX, a Canadian natural health product designed to help boost the immune system to prevent or reduce cold and flu symptoms, are launching a clinical trial in hopes of potentially marketing their product to children. ...more

Friday, October 29, 2010

Nasal mist flu vaccine launched in Canada

From CTV News:
A nasal mist flu vaccine was launched in Canada on Thursday, giving an alternative to those who get squeamish by the very idea of a needle.

The nasal mist has been available in the United States for seven years, and now will be available without a prescription in pharmacies.

Dr. Earl Rubin, director of McGill Pediatric Infectious Diseases Residency Program, has been going to the U.S. for the last five years to get the vaccines for his children, who are deathly afraid of needles.

But he says the less intrusive nasal vaccine has other benefits as well.

"Studies have shown that the intra nasal live attenuated vaccine is more effective in children than the traditional intramuscular or killed vaccine," Rubin told CTV Montreal's Cindy Sherwin. ...more

Thursday, October 28, 2010

Is there such a thing as a safe diet drug?

From the Globe and Mail:
A few years after it hit the market, the diet drug Meridia was being investigated by health authorities globally for links to more than two dozen deaths and hundreds of adverse reactions. But those authorities, including Health Canada, concluded that Meridia, the brand name of the drug sibutramine, was safe enough to remain on the market and be prescribed to treat obesity.

Seven years later, Abbott Laboratories, the company that sells Meridia, has voluntarily pulled it off the market in Canada and the U.S. after a major study published last month, funded by the company, found that it raises a patient’s risk of stroke, heart attack and cardiovascular death.

Two generic versions, called Apo-sibutramine and Nova-sibutramine, have also been pulled off Canadian shelves.

The study, which last more than three years, also found that patients lost, on average, less than 10 pounds on sibutramine, which acts on the serotonin system to make an individual feel full.

Abbott Laboratories stands by Meridia, maintaining that the benefits outweigh the risks as long as the appetite suppressant is given to people without pre-existing cardiovascular disease and patients are monitored closely for increased blood pressure or pulse rate.

However, some medical experts and advocates see Meridia as an example of deep-rooted problems in the drug-safety system that urgently need to be fixed. There is concern that such health issues could arise again, as other companies look to create new appetite-suppressing prescription drugs. ...more

Wednesday, October 27, 2010

Trade deal would include increased protection for brand-name drugs

From the National Post:
Canada’s pharmaceutical industry and the European Union have been quietly lobbying for changes that could give brand-name drugs several years more patent protection here — and potentially add hundreds of millions of dollars to Canadian medication costs annually.

The EU has reportedly proposed the measures be included in a landmark free-trade agreement now being negotiated between the jurisdictions, with the fifth round starting last week in Ottawa.

The changes would delay the entry of cheaper, generic copies of medication onto the market, but brand-name companies and some provinces say the measures are needed to restore fairness to the complex patent system, and generate more drug research in Canada. ...more

Pharmacy tobacco sales snuffed

From the Saskatoon Star Phoenix:
Saskatchewan pharmacies will stop selling tobacco products as of April 1, 2011, Health Minister Don McMorris said Monday.

McMorris released the province's tobacco reduction strategy as he opened a two-day symposium that brings together health officials from across Saskatchewan.

He later told reporters the government is delaying the ban on pharmacy tobacco sales by several months.

"A lot of pharmacies have to change the design of the store and we're giving them time to do that," McMorris told reporters Monday. "We had thought that we would be able to implement this by the first of January. That was tight for them. Not that (pharmacies) are opposed to the legislation, they just need time to make structural changes." ...more

Tuesday, October 26, 2010

Mention in Drugstore Canada

Canada Pharmacy News has been featured in the latest edition of Drugstore Canada. I will like to the online version shortly. To those of you who have found this site from the article - welcome! There has been a lack of posts lately but this will change this week. Look for daily updates starting this evening.

Monday, October 11, 2010

Weight loss drug pulled from Canadian shelves

From the Montreal Gazette:
The prescription diet pill market in Canada just got slimmer.

The manufacturer of the weight-loss drug Meridia announced yesterday it is voluntarily pulling its product off the Canadian market, the same day the company withdrew its diet pill in the U.S. at the request of American drug regulators over an increased risk of heart attack and stroke in some people.

The move leaves Canadians looking for prescription weight loss drugs with just one possible option -orlistat, sold under the brand name Xenical, which prevents dietary fat from being absorbed by the intestines.

Meridia's removal comes seven years after Health Canada concluded in 2003, after a yearlong safety review, that the drug's benefits outweighed the risks.

The drug (sibutramine), which works on the brain to make people feel fuller, has already been pulled from markets in Europe and has faced questions in the U.S. since the consumer group Public Citizen petitioned the FDA unsuccessfully to have the drug banned in 2002. The group charged health regulators knew of the potential for heart problems before Meridia was introduced to the U.S. market in 1998. ...more

Monday, September 27, 2010

Doctors over-prescribe, test: report

From the National Post:
Swayed by pharmaceutical sales reps and less than fully versed on new technology, family doctors may be prescribing drugs improperly and ordering too many expensive diagnostic tests, warns a new federal-provincial report.

Governments must give such primary-care physicians the tools to make better decisions if they want to corral spiralling health-care costs, says the Health Council of Canada in a report to be released on Monday.

"Our research points to inappropriate prescribing of drugs and over-use of diagnostic imaging," says the report, Decisions Decisions. "If there is no change in how family physicians are supported in their role as gatekeeper, we can expect a surge in health service use."

The council's head stressed the group is not attacking the competency of the doctors Canadians visit most often, but issuing a "call for action" to help them better assess a barrage of new medications and technologies. ...more

Canada weighs tighter rules on Avandia diabetes drug

From the Globe and Mail:
Popular diabetes drug Avandia is being pulled off the market in Europe and will face tighter restrictions in the U.S. because of fears patients who take it face an increased risk of heart attacks, stroke and other cardiovascular problems.

The decision is a blow to GlaxoSmithKline Inc., the company that sells Avandia, the brand name of the diabetes drug rosiglitazone.

It also raises questions about further regulatory restrictions in Canada. Health Canada said in 2007 that, because of the potential for cardiovascular problems, Avandia shouldn’t be taken on its own unless patients can’t tolerate other diabetes drugs. Similar restrictions were announced Thursday by the U.S. Food and Drug Administration.

But the European Medicines Agency, which evaluates drugs in the European Union, recommended suspending Avandia’s market authorizations and said it would no longer be available there in the next few months.

In July, Health Canada said it was continuing to review the safety of Avandia and that it was closely monitoring developments in the U.S. The department issued a public advisory in July saying it would take “the appropriate regulatory action necessary” pending the outcome of safety investigations in other countries. ...more

Stricter controls on the way for methadone in B.C.

From CTV News:
.C.'s pharmacists will face stricter controls on their methadone supplies, and the province's pharmacy watchdog says even more rules could be on the way to stop kickback schemes and scams.

Starting in October, pharmacists will have to keep records of all narcotics in their possession to better report theft of the drugs and keep track of methadone use, according to B.C.'s College of Pharmacists.

"This policy change adds more rigour and structure to what many pharmacists were doing in the first place," said the college's deputy registrar Suzanne Solven.

She said the policy came into being as a result of increased concerns about thefts from pharmacies, but that the rules would work in tandem with anti-kickback regulations that have been announced already.

Other rules could be on their way after the college completes a review of methadone practices by the end of the year, she added.

Methadone is a daily medication that satisfies cravings for addicts and keeps them away from hard drugs. ...more

Bismarck Pharmacist Creates Gel to Help Chemo Patients

From KFVR-TV (ND):
A Bismarck pharmacist has been receiving phone calls from physicians all over the world after he created a special gel to relieve pain some patients experience after undergoing chemotherapy.

Mike Riepl is a personalized medication specialist. He created the gel for one patient of his and couldn`t have guessed it would help people across the globe.

Riepl has spent many hours in his pharmacy lab. Mixing chemicals to help people feel better is nothing new to him.

"I was talking to a patient who had gone through chemotherapy, and sometimes chemo will damage the nerve endings or the nerves in the hands and the feet," explained Riepl. "She was complaining she was having a burning sensation, pins and needles. She asked if there was anything that would help."

Riepl talked to the woman`s physician, and then decided to come up with a new solution to help the patient. He created BAK gel, which stands for its three main ingredients, baclofen, amitriptyline and ketamine. ...more

Feeling the effects of a drug shortage

From the Ottawa Citizen:
Claudia McKeen's pharmacy fills 200 to 300 prescriptions a day, but she has to scramble for a couple of dozen of those because her suppliers keep running out of stock.

"There's no penicillin right now in Canada," she said Wednesday -- at least, none of the 300-milligram tablets, a standard size, which stopped coming a few weeks ago. That means a call to each doctor who prescribes it. Would amoxicillin be OK instead? The same goes for a host of drugs. Warfarin, a blood thinner, is now in short supply. So is hepatitis B vaccine; adults have to get two pediatric doses instead of a single shot.

"It's just craziness." Next week, who knows what will run out? There's seldom any warning.

McKeen owns the Glebe Apothecary on Bank Street. There have always been occasional drug shortages, but for the past year it has become much worse, she says.

"We're dispensing things in quarter-tablets because we can't get the right strength. It's a nuisance and a massive headache. It's a big, big concern and a time-waster. I think it's a very bad situation." McKeen warns shortages will likely cause more drug errors. Some of her older customers have trouble keeping track of their drugs already. If she substitutes three small blue pills for one big red pill, they'll have more trouble, she says. ...more

OxyContin cure often worse than ailment

From the Calgary Herald:
Sometimes armed, and always desperate, Cory Alan Sharlow terrorized pharmacists across the city during a series of brazen robberies last fall.

His pattern was wellplanned and predictable: Steal a car. Rob a pharmacist. Make his getaway.

His motive was less complex, but always the same: to get the OxyContin his body craved.

The plan worked so well he robbed 10 pharmacies in a month, until he was caught and later jailed.

Police and addictions experts say Sharlow's case typifies the danger and desperation of addicts driven to get their fix of OxyContin, the brand name given an opioid painkiller that dispenses the drug, oxycodone, through time release. When crushed, the high dosage is released at once, producing a euphoric feeling.

"They find themselves cheating, lying, exaggerating (and) violating their own sense of ethics with the end of satisfying the habit," says Dr. David Hodgins of the University of Calgary's addictive behaviours lab. ...more

Sunday, September 12, 2010

Insomnia and anxiety medications increase mortality risk by 36%: Canadian study

This is a decent enough article except when it comes to listing the drugs in the table. Ambien - not available in Canada. Lunesta - not available in Canada. Rozerem - not available in Canada. Sonata - was called Starnoc in Canada but has been discontinued. Silenor - not available under this name. No mention of Imovane at all, which is easily the most prescribed sleeping pill in this country. Memo to the reporter: check more than one source and make sure one of them is Canadian.

From the National Post:
A new comprehensive Canadian study that looks at 12 years’ worth of Statistics Canada data has concluded that taking medications to treat insomnia and anxiety increases mortality risk by 36%.

Genevieve Belleville, a professor at Université Laval‘s School of Psychology, published her finding in the September edition of the Canadian Journal of Psychiatry.

Belleville arrived at these results through analysis of over 14,000 Canadians in Statistics Canada’s National Population Health Survey. The data includes information on the social demographics, lifestyle and health of Canadians age 18 to 102, surveyed every two years between 1994 and 2007. She also considered the possibility that depression, alcohol and tobacco consumption, physical health and physical activity level could contribute to mortality rates and controlled for these factors.

Respondents who reported having used medication to treat insomnia or anxiety at least once in the month preceding the survey had a mortality rate of 15.7%. Respondents who reported not having used such medications had a rate of 10.5%. ...more

Lack of training for Canadian doctors contributing to narcotics crisis: report

From the Toronto Star:
Canadian doctors are woefully undertrained in pain management and addiction, a shortfall that is contributing to Ontario’s prescription narcotics crisis, says the body that regulates the province’s doctors.

Medical schools in this country devote a meagre 16 hours on average to proper pain education, half of the training nurses receive and less than one fifth the time that veterinary schools devote to the subject.

In a sweeping set of recommendations aimed at stemming epidemic abuse of narcotics like OxyContin, the College of Physicians and Surgeons of Ontario is urging beefed-up academic training in pain relief and addiction.

“Pain management training in its present format in undergraduate education, particularly for physicians, is insufficient,” said Dr. Stephen Wetmore, who headed the report’s education working group.

“Physicians receive less pain management training than virtually any other health care provider,” he said. ...more

Diabetes could cost Ontario $7B a year by 2020: report

From the National Post:
More than one in 10 Ontarians could be living with diabetes by 2020, costing the province $7-billion a year in health care and lost productivity, a new report reveals.

The study, released on Wednesday morning by the Canadian Diabetes Association, urges the Ontario government to rethink how it fights the epidemic.

According to the report, the number of Ontarians with diabetes has nearly doubled since 2000, from 546,000 to more than 1.1 million, and is on track to grow over the next decade to 1.9 million.

That means 12% of all Ontarians could be diagnosed with the disease by 2020.

Diabetes already costs Ontario $4.9-billion annually, mostly in lost productivity ($2.8-billion) and long-term disability claims ($998-million). Another $1-billion is spent on hospital visits, doctors’ fees and medications. ...more

Wednesday, September 01, 2010

Next Front In Border Debate: IUDs

From the National Post:
In an unusual twist on the cross-border trade in medical products, doctors in the United States are coming under fire for ordering much cheaper, but apparently identical, versions of IUD birth-control devices from Canada.

The U.S. Food and Drug Administration says it has not approved the Canadian products, so cannot guarantee their safety. Critics argue the agency is only propping up inflated, U.S. prices, underscoring the high cost of health products generally in the U.S. system.

Meanwhile, one practitioner faces fraud and other criminal charges for importing Canadian IUDs, and some state governments have mounted high-profile crackdowns, ordering doctors to stop using the devices.

"Anybody who takes a look at this scenario can see the problem," said Erin Cassinelli Couch, an Arkansas lawyer who represents the specialist awaiting trial on federal charges.

"You have a private corporation that sets the price quite a bit higher than they set for the same product in other countries, and they've gotten the U.S. government to limit purchases to that company and at that price." ...more

New Pharmacy building slated for 2012 opening

From the Ubyssey (BC):
The latest gaping hole of construction at UBC is an indication of good things to come, as the Faculty of Pharmaceutical Science finds a new home on campus.

Expected to open in September of 2012, the faculty’s new home will cost $133.3 million. Around 900 pharmacy students will make use of the building by 2015, a 50 per cent increase. It will also include the Canadian Drug Research and Development (CDRD).

Dr. Helen Burt, the faculty’s acting dean, is excited for the structure and design of the new building.

“We’re going to have some of the best infrastructure for teaching and learning anywhere on campus—state of the art teaching facilities for small group learning and for larger groups we’re going to have a real pharmacy clinic located in the building,” said Burt. ...more

Alberta rejects therapy to quit smoking

From the Calgary Herald:
The Canadian Medical Association Journal is calling on provincial governments to publicly fund medications designed to help Canadians quit smoking, but Alberta is closing the door on the idea for now.

In an editorial published Monday, the authors suggest tax revenues collected on the sale of tobacco products could fund reimbursement for smoking cessation therapies.

Last year, 5.7 million Canadians -- or 20 per cent of those who are 12 and older -- smoked either daily or occasionally, according to Statistics Canada.

Among provinces, Alberta and Nova Scotia had the highest smoking rate, at 23.3 per cent.

The medical association editorial notes the number of smokers has remained relatively stagnant in recent years despite provincial and federal programs geared to help Canadians quash their nicotine addition. ...more

Angina medication could save patients with heart failure

From the Toronto Star:
A $16.50-a-week drug used to treat angina has been shown in a European trial to be an effective treatment for heart failure and could save the lives of thousands of Canadians who suffer from the disease.

Researchers, who presented their findings Sunday at the European Society of Cardiology congress in Stockholm, estimate the drug, ivabradine, could save 5,000 to 8,000 lives annually in the U.K. About 700,000 people, or one per cent of the population there, have the disease. About 400,000 Canadians suffer from heart failure.

The study was also published in the respected British medical journal the Lancet.

“It’s a very large trial, which is hugely positive and will make a big difference to the way people with heart failure are treated,” said Martin Cowie, a cardiologist at London’s Royal Brompton Hospital who led the U.K. arm of the study.

Ivabradine is already licensed in Europe to treat angina and can now be prescribed off-label to treat heart failure. In the U.K., the cost of treatment with ivabradine is the equivalent of about $16.50 per patient per week. ...more

Ontario to track overuse of OxyContin and other prescriptions drugs

From the Western Star:
Ontario plans to launch a new tracking system to curb the abuse of the highly addictive painkiller OxyContin and other prescription drugs, a growing problem that's sparked crackdowns in other provinces.

The system would monitor prescription narcotics and other controlled substances, from painkillers such as oxycodone, morphine and codeine, to stimulants and sedatives like Ritalin, Valium and phenobarbital.

The misuse of prescription narcotics isn't just a problem in Ontario, said Health Minister Deb Matthews.

"Canada does have one of the highest per capita usages of anywhere in the world, and Ontario is more than double the rate of the rest of Canada," she said in an interview Friday. ...more

Liberating the pill

From the Montreal Gazette:
t's not addictive, it's easy to take and 50 years of use shows it's safe.

So why do women still need a prescription for the birth-control pill?

A move to make oral contraceptives available over the counter is gaining momentum in the United States - and any regulatory changes there would have significant ramifications for Canada.

Proponents for taking the pill off prescription-only status say the benefits outweigh the risks, the potential for misuse is minimal and easier access could help lower rates of unintended pregnancies and abortions.

But the prospect of women gaining unfettered access to the pill has some doctors and sexual health counsellors uneasy. Would women still see their doctor for Pap smears? Could they safely screen themselves for contraindications - conditions under which the pill should not be used? Would it unleash a marketing bonanza for drug-makers and a huge increase in users?

Nevertheless, a Canadian leader in reproductive medicine and editor of the Journal of Obstetrics and Gynaecology Canada says it seems wrong and paternalistic that, half a century after the pill's debut in the U.S. and 41 years after coming to Canada, women still cannot get access to the most effective, self-administered birth control on the market without a doctor's blessing. ...more

Wednesday, August 25, 2010

Reforms not to blame for drug shortages: group

From CBC News:
Recent changes to provincial drug plans are not to blame for significant medication shortages, the Canadian generic drug industry says.

Pharmacists in New Brunswick say they have been struggling to find alternatives to fill prescriptions, substituting products when items are not available.

"Certain manufacturers don't seem to be able to supply the product right now," said Donna Chauvin, a Fredericton pharmacist. "We're noticing we have to switch strengths of one drug for another."

The head of the provincial pharmacists' association said pharmacists have speculated that reforms in other provinces are to blame for the shortages.

"It's not out of the question for a manufacturer to decide, 'You know what, we're going to sell every molecule we make this year. Maybe we make sure those products make their way into more profitable markets,'" said Paul Blanchard, executive director for the New Brunswick Pharmacists' Association.

Ontario decided in June that generic drug prices will be cut to 25 per cent of the price of patented drugs, down from 50 per cent. In July, British Columbia decided to drop the cost of generic drugs from 65 per cent of the brand name cost to 35 per cent. Alberta and Quebec reached similar cost-cutting deals with the drug industry recently. ...more

Moroccan pharmacies threatened over cross symbols

From Magharebia:
A self-proclaimed "lover of al-Qaeda and Jihad" has given Moroccan pharmacy owners one month to remove cross symbols from storefronts or else face beheading.

"In 2009, crusade France lured owners of pharmacies with financial benefits and discounts in medications in return for placing the green cross along the green crescent," said a letter published in late July by several online forums. "We demand you remove the crosses off the façades of your pharmacies and to respect our religion," the web threat continued.

"Forewarned is forearmed," the unnamed writer said. "We give you and those who work with you an interval of one month to return to your true nature and nation."

The deadline expires August 28th.

Morocco has not issued an official response to the online ultimatum. Communication Minister Khalid Naciri on August 17th told Magharebia that "the government can't issue reactions to each and every threat posted on the internet". ...more

Drugs protect monkeys from Ebola, US study finds

From Reuters:
U.S. government researchers working to find ways to treat the highly deadly Ebola virus said on Sunday a new approach from AVI BioPharma Inc (AVII.O) saved monkeys after they were infected.

Two experimental treatments protected more than 60 percent of monkeys infected with Ebola and all the monkeys infected with a related virus called Marburg, the team at the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) in Fort Detrick, Maryland reported. ...more

Many drugs for U.S. kids tested in poor countries

From Reuters:
A law intended to speed up development of new drugs for U.S. kids has ended up financing clinical trials in poor countries, where the medicines might never become available.

That's the conclusion of a new report whose authors say the situation raises ethical concerns.

More than a third of the published trials performed under 1997 legislation called the Pediatric Exclusivity Provision were carried out at least partly in developing or transitioning nations, such as Uganda and India, researchers found.

"The trend that we describe brings up some scientific and ethical problems," said Dr. Sara K. Pasquali, a pediatrician at Duke University Medical Center in Durham, North Carolina, whose findings appear in the journal Pediatrics.

"Oftentimes, access to a study may be the only access to medical care a family has," she said of trial participants in developing countries. Once the testing is done, however, it's unclear if effective drugs will be marketed in the country in question, and whether they will be affordable. ...more

Fasting women risking health by taking tablets to delay periods

From the Arab News:
There is a growing tendency among young women, especially unmarried ones, to take drugs to delay menstrual cycle in the holy month of Ramadan.

“Out of their eagerness to observe fasting throughout the month of Ramadan without missing any days, many young women customers, including unmarried, are coming to buy Primolut N tablet. The sale of the tablet is on the rise with the advent of the fasting month of Ramadan,” Al-Watan daily reported, quoting a pharmacist in Taif.

According to the pharmacist, most of the customers of this tablet are unmarried girls. “They are not at all bothered about the side effects after using these tablets. They approach familiar pharmacists to buy it without a prescription,” he said.

Primolut N tablet contains the active ingredient norethisterone, which is a synthetic hormonal product similar to the natural female hormone progesterone. It is used in a wide range of menstrual disorders. ...more

'Magic drug' gives hope to bipolar patients

From the Vancouver Sun:
A new antidepressant being tested in Canada appears to do what no other drug can -- increase connections between brain cells within hours to swiftly improve symptoms.

The finding by Yale University researchers may explain how one dose of ketamine can reduce symptoms of depression within 40 minutes among the hardest-to-treat cases, and could help spur development of quick-acting antidepressants.

About 17 per cent of the Canadian population will experience major depression at some point in their lives.

Prozac-like drugs and other antidepressants take at least two weeks to produce an effect, and sometimes months for a full effect.

Even then, they work well in only about a third of patients.

The risk of suicide increases during those dangerous weeks or months of lag time. ...more

Monday, August 09, 2010

New cancer drugs used less often in Canada

From the Halifax Chronicle Herald:
Groups that advocate for cancer patients are using a new report from the United Kingdom to bolster their call for greater access to cancer drugs in Canada.

The report said that of 14 countries studied, Canada ranked 13th in usage of cancer drugs launched in the last five years.

On Thursday, the Cancer Advocacy Coalition of Canada renewed its request that the federal, provincial and territorial ministers of health create a national catastrophic drug plan for cancer patients.

"I think this means that many cancer patients, many Canadians, aren’t getting the treatments that might help them for their cancer," Dr. Kong Khoo, vice-chairman of the coalition, said from Kelowna, B.C. ...more

Controversial drug proves highly effective in treating depression

From the Globe and Mail:
Medications used to treat depression may have powerful side effects, take weeks or longer to work, or have limited effectiveness in some individuals.

But there is growing excitement – and even surprise – about a new treatment that relieves symptoms of depression in some patients in a matter of minutes, a discovery that could chart a new path in research of the disease.

The medication that is gaining more attention, and respect, in the mental health field is ketamine.

A small study of 18 patients with bipolar disorder resistant to treatment published this week in the Archives of General Psychiatry found depressive symptoms improved significantly in 71 per cent of those treated with ketamine, compared with a six-per-cent improvement in the group that was given a placebo. Among those given ketamine, depressive symptoms began to improve in as little as 40 minutes. ...more

Monday, July 19, 2010

Flu vaccine nasal spray coming to Canada

From CTV News:
or Canadians who don't get the flu shot because of the whole "shot" part, a new option is now available. A nasal spray flu vaccine has just received Health Canada's approval.

The product is called FluMist and will be sold in Canada by AstraZeneca.

FluMist has been on the U.S. market since 2003 and is the only non-injectable flu vaccine in North America. It's now approved in Canada for the prevention of seasonal influenza in Canadians two to 59 years of age.

FluMist is a mist that is sprayed into the nose, allowing the vaccine to enter the nose to deliver an active, attenuated (weakened) form of three flu viruses into the body.

It should be administered by a health care professional, although in Alberta, pharmacists will be able to administer the vaccine themselves. The cost of a dose hasn't yet been decided. ...more

Diabetics shouldn't stop drug without doctor OK

From CBC News:
Medical experts are warning people taking a controversial diabetes drug not to change their medication without consulting their doctor.

The warning comes after an American advisory panel voiced major concerns over the drug Avandia (Rosiglitazone), but eventually voted to recommend it be allowed to stay on the U.S. market.

Studies have suggested the GlaxoSmithKline drug raises the risk of heart attacks, strokes and death in some users.

In 2007, Health Canada issued usage restrictions on Avandia due to cardiovascular risks. At that time, the health agency said that Avandia was no longer approved for use alone to treat Type 2 diabetes, nor approved for use with a sulfonylurea drug except when the drug metformin is contraindicated or not tolerated. ...more

Pharmacists run doctor show

From the Calcutta (India) Telegraph:
Pharmacists in the state capital are prescribing medicines in the absence of doctors at some unit hospitals or zonal dispensaries.

Shortage of doctors has become so acute that they are now being rotated to attend services at Capital Hospital, the nearest referral facility, to manage the patient inflow.

Hence, in their absence at some unit hospitals, pharmacists and even paramedics are issuing prescriptions for patients.

Asked about the new role of some pharmacists at zonal dispensaries, chief medical officer of Capital Hospital Dr Gangadhar Rath said: “Pharmacists cannot write prescriptions. They should only distribute medicines.” ...more

Pharmacist gets 'sweet' revenge on pill-snatching thief

From WOAI (TX):
The front doors of the building were broken by burglars, and small pieces of glass litter the floor. And, it's not for the first time.

“You know, this pharmacist has been burglarized several times. This pharmacist has just had enough,” explained Glynda Chu of the Edmond Police Department.

Like so many pharmacies, the workers at Clinic Pharmarcy have been victimized over and over again by pill-seeking thieves.

“You know, they steal money from banks because that's where the money is," Chu said. "The same with pharmacies, cause that's where the drugs are kept.”

As a non-violent way to spoil the thefts, the pharmacist recently emptied several bottles of hydrocodone pills, filling the bottles, instead, with M&Ms. As a result, when burglars stole the prescription bottles, only M&Ms poured out. ...more

Vitamin D levels linked to Parkinson's disease risk

From AFP:
Greater levels of vitamin D have been linked to a lower risk of Parkinson's disease in a study in Finland where low sunlight leads to a chronic lack of the nutrient, researchers said Monday.

Scientists from the National Institute for Health and Welfare, Helsinki, Finland, first hypothesized that Parkinson's "may be caused by a continuously inadequate vitamin D status leading to a chronic loss of dopaminergic neurons in the brain."

Vitamin D, supplied chiefly by the sun's ultraviolet rays and a small range of foods, is known to play a role in bone health and may also be linked to cancer, heart disease and type 2 diabetes, the researchers said.

The Finnish study, published in the July issue of Archives of Neurology, followed 3,173 Parkinson's-free Finnish men and women aged 50-79 over a 29-year period from 1978-2007. ...more

New system urged to treat rare-disease patients: analysis

From the Globe and Mail:
Government decisions to fund expensive treatments for rare diseases shouldn’t be made on an ad hoc basis that leaves countless patients out in the cold, says a new analysis published Monday by the Canadian Medical Association Journal.

Canada needs a new system that would allow policy makers to measure the effectiveness of treatments while connecting rare-disease patients with much-needed drugs, wrote Chaim Bell, co-author of the analysis and associate professor of medicine and health policy management at the University of Toronto.

The issue of rare diseases and access to treatment has been brewing for years. Canada has long been criticized by rare-disease patients and health experts for not having a formal policy that allows access to “orphan drugs,” or those that are used to treat rare diseases. It’s one of the few developed countries that doesn’t have one.

Without a formal policy, there is too much red tape and not enough financial incentives for drug companies to obtain approval for these products in Canada because the market is relatively small. As a result, patients may have no way of getting certain drugs or have to pay exorbitant amounts for them. ...more

Monday, May 24, 2010

If pot must be sold, it should be at pharmacies

I don't often post opinion pieces but I thought I'd make an exception here. If/when medical marijuana becomes a bigger deal in Canada, maybe pharmacies should push to have some involvement. It might be a better alternative than marijuana only dispensaries. It also could help replace some income being lost by generic rebate cutbacks.

From the Vancouver Province:
Why am I not surprised that a medical marijuana dispensary has now opened, without a business licence, in downtown Maple Ridge?

Well, such cannabis dispensaries are growing like weeds in Western U.S. states such as California where, in a November referendum, citizens will vote on whether to legalize recreational use of the drug and tax sales of it.

In B.C., of course, smoking marijuana has become effectively legal for years -- for all except those who actually blow the smoke in a cop's face. What we Canadians don't seem to approve of is growing pot for profit. A recent poll shows that, while most support legalizing marijuana, a hefty majority want stiff penalties for grow operators.

We're a bit conflicted about the issue, in other words. So are Lower Mainland politicians and police -- especially about the dispensing of medical marijuana, currently governed by somewhat Byzantine Health Canada rules. ...more

Seniors most likely hospitalized for adverse drug reactions: StatsCan

From the Ottawa Citizen:
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. ...more

Take your meds—if you can get them

From Macleans:
With dozens of prescription drugs unavailable and hundreds more on back order, pharmacists in Saskatchewan are scrambling to find alternative medications for patients. “It’s worsening and there seems to be no end in sight,” says Ray Joubert, registrar with the Saskatchewan College of Pharmacists. “We need to solve it before something disastrous happens.”

While the rest of Canada is suffering a moderate drug shortage, experts say it doesn’t compare to what’s going on in Saskatchewan. For almost a year, pharmacists there have been cutting pills in half, contacting multiple manufacturers and, when necessary, calling doctors to temporarily switch a patient’s medication because the supply of many prescriptions—including tetracycline and certain strengths of vitamin B9—have dried up. It’s especially hard for patients on complicated drug regimens, since alternatives can’t always be found. “Some patients,” says Joubert, “have gone without their meds.” ...more

McGuinty pushes pharmacare again

From the Toronto Star:
Ontario’s controversial reforms cutting the price of generic drugs in half could help point the way to a national pharmacare program, Premier Dalton McGuinty said Wednesday.

“I think that will very likely be a natural evolution from this debate. I think you’re going to see many other provinces adopt the funding approach we are bringing when it comes to paying for our generic drugs.”

The idea of a national pharmacare program was quashed by the former Liberal federal government six years ago as too expensive, but increased pressures on health care budgets since then show the idea is worth reconsidering, McGuinty told reporters.

“We’re going to have to find a way as we work together to ensure that our health-care system becomes sustainable, because, at present, it is not,” added the premier, who championed a national pharmacare program along with B.C. counterpart Gordon Campbell in 2004. ...more

10,000 natural products still unlicensed

From the Toronto Sun:
More than six years after Health Canada started regulating natural health products for safety and effectiveness, it still hasn’t processed licence applications for about 10,000 non-traditional, homeopathic, food or personal care remedies now sold in Canada.

The backlog has prompted drug stores to pull some natural products from their shelves after their umbrella regulatory body reminded pharmacies they should not sell unlicensed products.

Now the federal department is scrambling to find a fix that will exempt natural products from current rules until it can process them fully.

The department recently unveiled temporary licensing proposals meant to “make the sale of these products legal” for the time being if they file safety information on request, show “good manufacturing practices,” report any adverse reactions and work from a licensed site.

The products include traditional Chinese and herbal medicines; non-traditional medicines such as herbs, vitamins and minerals; homeopathic medicines; or personal care products such as shampoos that make health claims. ...more

Pharmacists take drug company to cour

From Stuff.co.nz:
Pharmacists are taking drug manufacturer GlaxoSmithKline (GSK) to court over the recall of a blood thinning drug, saying they are bearing the company's expenses in carrying out the work.

Pharmacist Ian Johnson, who owns Johnson's Pharmacy in Otara, south Auckland, and is president of the Pharmacy Guild, served a civil notice of claim on GSK in Manukau District court last week.

The claim is a test case after GSK earlier this year recalled of the blood thinner Marevan. A manufacturing error meant some 3mg tablets had higher doses.

"I accepted that I had a professional duty to safeguard my patients. But I also saw this as GSK, whose medicine this was, asking me in my professional and business capacity to do work for them - necessary and urgent work. I expected that I would be paid reasonable compensation for my work," Mr Johnson said.

He said he invoiced GSK $395.10. The money covered contacting seven patients for an average of 15 minutes each time, the dispensing fee for replacing four patients' Marevan tablets, administration costs, briefing staff, liaising with GPs, internal stock management and GSK paperwork. ...more

Monday, May 10, 2010

Ont. pharmacists want $260M/year to stop protest

From CTV News:
Ontario pharmacists asked the government Friday for at least $260 million a year in direct funding to drop their opposition to a provincial plan to eliminate $750 million a year in professional allowance fees paid to them by generic drug companies.

About 100 pharmacists wearing white lab coats rallied at the legislature Friday and delivered a petition with 500,000 signatures decrying what they said are the government's cuts to health care.

The pharmacists agree with the goal to lower the costs of generic drugs, and are willing to live without professional allowances if they get funding to compensate them, said Ben Shenouda of the Independent Pharmacists Association of Ontario.

"The submission we are putting to the government is talking about $260 million reinvested from the government in the pharmacies, and provides hundreds of millions in net savings to the government every year," said Shenouda. ...more

Government preparing to cushion the blow of pharmacy closings

From the Globe and Mail:
From the outset of Ontario’s drug wars, Dalton McGuinty’s government has been unapologetic about the fact that some pharmacies will be forced to close as a result of its reforms.

There’s little to suggest that a month-long public relations fight with pharmacists has done much to alter the Liberals’ thinking. But as the battle enters its final stages, the government seems to be preparing a concession – probably part of the game plan all along – aimed at limiting just how many of the stores will be forced under.

Government and industry sources suggest that the likeliest “give” will be some form of transitional fund, along the lines of what Alberta provided when it undertook more modest pharmacy changes.

The idea would be to provide short-term funding to give drugstores a chance to shift their model toward one in which more of their revenue comes from providing additional publicly funded health-care services, such as extensive consultations. (At present, their profits come largely from “professional allowances” – the payments from generic drug manufacturers in return for stocking their products, which the government plans to eliminate in order to achieve lower prices.)

What shape that funding will take, exactly, will likely be announced before this month is out. The obvious challenge for Health Minister Deb Matthews between now and then is to figure out how best to show she’s listened to complaints about her reforms, without cutting too deep into the province’s savings from lower prices. ...more

Pharmacy technical assistants do more than assist

From the Montreal Gazette:
Batman had Robin, the Lone Ranger had Tonto and pharmacists have technicians.

"They're our right arm," said Martine Dubois, a pharmacist at Pharmaprix on Cote-des-Neiges. "They play the key role in what we do."

Pharmacy technical assistants are specially trained workers who perform a large variety of day-to-day tasks in a multitude of pharmacy settings.

In case you're wondering, yes, they're definitely more than assistants.

"They do everything from customer service in community pharmacies to preparing cutting edge research medications in health care institutions," said Dubois, who is also a teacher and coordinator of the Pharmacy Technical Assistance program at Pearson Adult and Career Centre in LaSalle.

In hospital settings, technicians perform a wide range of tasks including medication preparation, inventory maintenance in the main pharmacy and in satellites, and management of automated medication machines. ...more

Advocates want life-saving drugs made available to all residents

From the Daily Gleaner (NB):
Advocates calling for a universal catastrophic drug plan in New Brunswick say the province has to find a way to make access to these life-saving medications available to every citizen.

New Brunswick and Prince Edward Island are the only two provinces in Canada without catastrophic drug plans.

Two weeks ago, PEI Finance Minister Wes Sheridan announced the province would commit an additional $1.3 million to cover several new drugs for the provincial formulary.

In New Brunswick, the bi-partisan committee behind the poverty reduction plan has committed to making changes that will first protect low-income residents before exploring ways to introduce an expanded universal plan in the future.

Ellen Snider, manager of public issues for the Canadian Cancer Society of New Brunswick, said those promises should be commended, but she also believes the changes should be implemented more quickly. ...more

Sunday, May 09, 2010

Fear of metal in children’s medication prompted recall: company official

From the Globe and Mail:
Fears that children’s liquid medication could contain small metal particles is what prompted a major recall in Canada last weekend, according to a company official in the U.S. who said while the risk to consumers is remote, it does exist.

This comes after the Canadian branch of McNeil Consumer Healthcare, the company at the centre of the recall, said it didn’t know the identity of the substance, but that it posed no risk to consumers. The products were pulled off of Canadian shelves because they didn’t meet the “manufacturing specification,” similar to what would happen if there was a printing error on product labels, said company spokeswoman Tina Peyregatt.

“I mean, there’s no safety concern, but it’s not to the quality, the level of quality, that we adhere to, so we pull it off the shelf,” Ms. Peyregatt said in an interview Monday.

As information emerges about the serious nature of problems at the plant where the recalled medication was made and U.S. lawmakers prepare to investigate McNeil, the company’s response to the issue in Canada and lack of involvement from this country’s health regulator raises questions about the level of transparency and consumer protection available this side of the border. ...more

P.E.I. pharmacists chafe at computer woes

From CBC News:
Pharmacists in Prince Edward Island are frustrated with continuing glitches in a computerized drug information system that has been in place for two years.

It was set up as part of a government plan to move to a complete system of electronic health records. But some pharmacists say the technology isn't what they hoped it would be.

Pharmacists are required by law to use the drug information system (DIS), sharing data on what drugs patients are using, what allergies they have, and their medical history.

Pharmacists say it's great information to have, but the system crashes at least once a month.

"It could be down for a couple of seconds, it could be down for a couple of hours, it could be down for several hours," said pharmacist Rob MacLellan. ...more

As the Pill turns 50, the little agent of modernity still arouses trouble

From the Globe and Mail:
Momentous change is rarely the thing of a moment. When we celebrate (or denounce) the 50th anniversary of the Pill on Sunday – Mother's Day, for the ironists in the crowd – we're picking out the date in an amazingly far-off calendar when the U.S. Food and Drug Administration voiced its approval for a revolutionary form of birth control.

The little pill was going to transform the entire world, according to its wide-eyed backers, who predicted that dependable family planning would be a source of miracles that went well beyond keeping unwanted babies unborn. As often with utopian believers, they were on the right track for all the wrong reasons. ...more

Misuse of Alzheimer drug patches can lead to OD, death, Health Canada warns

From the Winnipeg Free Press:
Health Canada and Novartis Pharmaceuticals Canada are warning against misuse of a drug patch for an Alzheimer's medication.

They say people have overdosed and even died after using the Exelon Patch in the wrong way.

They are reminding doctors, caregivers and patients that it's important to remove one patch before applying a new one to a different location on the back, upper arm or chest.

And they are stressing that the patches should be used whole, not cut into pieces.

There have been at least 129 reported cases of medication error or misuse worldwide involving the Exelon Patch, including two deaths.

Shoppers Drug wants private label drugs

From the Toronto Star:
Life Brand antibiotics?

Shoppers Drug Mart is planning to extend its private label brand to its generic drug business, a move it says will cut the price paid by consumers.

But Ontario residents won’t see the benefits because the province’s proposed drug reform plans won’t permit store-brand generics, the retailer said.

“We want to have private label generics,” Shoppers Drug Mart’s chief executive officer Jurgen Schreiber told the company’s annual general meeting in Toronto Thursday.

“It will reduce generic costs further.”

Shoppers Drug already carries a variety of in-house products, from multivitamins to dishwasher detergent, under the name Life Brand, in its 1,234 stores across Canada.

A lot of retailers develop store brands to cut costs without hurting profits.

Store brands can be priced below national brands because they have lower marketing costs. They can also help build customer loyalty because they’re exclusive to that retailer. ...more

N.S. health minister says province too broke to fund costly vision-loss drug

From the Winnipeg Free Press:
Nova Scotia's health minister says the province is simply too broke to pay for a costly but effective drug used to treat those suffering from age-related vision loss.

A family delegation came to the legislature Thursday to ask Maureen MacDonald to consider funding for Lucentis, a drug used to combat macular degeneration.

It's estimated funding Lucentis would cost the province $4.5 million in the first year and the cost would rise to $10 million in the third year of its inclusion in the formulary.

Betty Jennings, who came to Province House on behalf of her 73-year-old mother, said her mother faces other health problems, ranging from depression to an increased chance of falls, if she doesn't get the drug.

"If you're asking where the money for this will come from, I think the money will come from all the medical treatments the government is not going to have to pay for if these people can see," she said. ...more

Drug makers seek relief from price cuts

From the Toronto Star:
The manufacturing costs of some generic drugs are too high to slash prices by 50 per cent under Ontario’s controversial reforms, Health Minister Deb Matthews acknowledged Thursday.

Negotiations have been taking place for weeks with generic drug makers to work out exceptions to the rule, Matthews said after generic giant Apotex Inc. sent a letter to pharmacies warning of trouble ahead.

“The extent of the cuts announced by the government of Ontario could undermine our ability to keep some existing products in the market and potentially impact our ability to develop and bring to market new cost-saving drugs,” said the two-page letter signed by Apotex president Jack Kay.

The letter, dated Wednesday, did not specify which drugs could be in jeopardy because that information is viewed as sensitive in the cutthroat generic drug industry, sources said. There are about 10 generic companies in Ontario. ...more

Wednesday, May 05, 2010

Prescription for disappointment: Inside a city pharmacy

From the Toronto Star:
It’s just after 10 in the morning when a couple of regulars drop by the West Hill Pharmasave in Scarborough to pick up their prescriptions.

Owner-pharmacist Neil Bornstein is steering retired nurse Norma Tuttle toward the cheaper private label brand of baby aspirin while summoning a staff member to address a problem with her Glucometer, a device that measures blood sugar levels.

“I come here because he knows me,” Tuttle, 70, says of Bornstein. “I want my pharmacist to know my name.”

Bornstein says a lot of people choose to deal with independents because he may not be able to provide that level of personal service in future under the province’s proposed drug reforms.

The Ontario government plans to slash $750 million in professional allowances pharmacists receive from generic drug makers, part of a plan to cut the price of those drugs in half.

The cuts, which the government says will bring Ontario’s drug prices in line with other jurisdictions, will hit pharmacies across the province, whether they’re independently owned, part of a national chain, or housed in supermarkets or discount department stores.

The industry says independents like Bornstein, who account for 51 per cent of the Ontario market, will be hit hardest. ...more

Loblaw plans drugstore expansion

From the Toronto Star:
Canada’s largest supermarket said it plans to expand more aggressively into the drug store business in the wake of dramatic proposed changes in Ontario’s regulatory environment.

Loblaw Cos. Ltd. said it plans to open more pharmacies in its grocery stores and also have them stay open longer hours.

The grocer’s announcement Tuesday comes in stark contrast to those of the country’s largest specialty drug store chains and small independent pharmacies, which have said they’ll have to cut store hours and service in response to the government’s plans.

The province wants to cut the cost of generic drugs in half and eliminate $750 million in professional allowances drug makers pay to pharmacists.

“We see it as a big opportunity for us to drive our drug store business. There’s a huge amount of consumers out there who are going to be looking for an improving service,” Loblaw president and deputy chairman Allan Leighton told analysts on a conference call. ...more

First Canadian guidelines issued for opioid painkillers

From the Globe and Mail:
The first Canadian guidelines have been created to keep powerful opioid painkillers out of reach of potential abusers and put them into the hands of patients who need them.

The guidelines urge doctors to thoroughly assess patients before prescribing the painkilling drugs and closely monitor them to mitigate risks of abuse, addiction and overdose. Doctors must also stop prescribing opioids if patients don’t respond to treatment or there is a serious risk of addiction, misuse or other problems.

The guidelines, published yesterday in the Canadian Medical Association Journal, are the first comprehensive attempt at helping health professionals navigate the minefield of prescribing opioids to non-cancer patients who experience chronic pain.

Opioids are a class of powerful painkilling drugs used to treat severe pain. There are several different kinds of opioids, but those made with oxycodone, such as Percocet and OxyContin, have become a source of concern in recent years as prescriptions skyrocketed and countless stories of addiction began to emerge. ...more