Sunday, February 28, 2010

For-profit medical centre set to open

This has been "Where are they now?" week when it comes to some of the Canadian internet pharmacy pioneers. It's been interesting to see where they're at these days.

From the Winnipeg Free Press:
Charleswood is set to become a new front in the battle for private for-profit medical care.

The Four Rivers Medical Clinic will open a new centre at 5905 Roblin Blvd. this spring that will charge patients who are treated by nurse practitioners, registered nurses who have advanced medical training.

Internet pharmacy pioneer, downtown property developer and medical clinic operator Daren Jorgenson said he believes the time is right to charge patients a nominal fee for basic health care in place of them not being able to find a family physician.

"I think everyone understands our current health-care system is broke," Jorgenson said. "Is there any family medicine physician in Charleswood accepting new patients? No. Can I recruit 10 doctors for Charleswood? No, I can't. But what I can do is recruit some nurse practitioners and, partnered with some doctors, deliver a mixed model of fee-for-service."

The clinic is already renovated to begin operation and all Jorgenson is waiting to do is recruit some nurse practitioners. Still, it hasn't been an easy sell.

"There's some that believe that anytime you charge a patient money that somehow you're against Tommy Douglas and our universal health-care system," he said. "But then you remind them that dental care is health care and you pay for that and a pharmacist is health care and you pay for that." ...more

Online pharmacist eludes ban

From the Winnipeg Free Press:
An Internet pharmacist who recently lost his credentials to practise in Manitoba is distributing generic drugs from an online pharmaceutical business based on an island off the coast of Venezuela.

The Free Press confirmed online pharmacy pioneer Andrew Strempler's business, PharmaCheck, started operating in a free-trade zone in Curacao in August 2006 -- the same month the U.S. Food and Drug Administration first warned consumers prescription drugs from Strempler's Manitoba-based online pharmacy, RxNorth, were unsafe.

Strempler did not respond to interview requests from the Free Press, and an employee at his Curacao office said he is currently in Panama. His company's website says PharmaCheck Canada has expanded beyond the North American market and now ships generic pharmaceutical products to Europe, Central and South America and the Caribbean.

The news that Strempler is still in business outside Manitoba comes as a shock to local regulators, who recently wrapped up a three-year probe into allegations his Minnedosa-based Internet pharmacy sold counterfeit prescription drugs to Americans. Strempler agreed to strike his name from the provincial pharmacist registry and pay $7,500 as part of a deal to stay the charges against him at a discipline hearing last October. Experts say it's the most severe penalty that can be handed to a pharmacist and prevents Strempler from renewing his licence to practise in Manitoba. ...more

Generation B - Independent Drugstores Seek Own Rx for Survival

From the New York Times:
Drugstore chains measure success in market share — Walgreens, CVS and Rite Aid, the three largest, fill one-third of all prescriptions in the United States. But small family-owned stores, like Tepper Pharmacy on East Lancaster Avenue here, build a business a customer at a time, sometimes at the darkest hour.

Barbara Renninger, 52, became a Tepper customer for life during a 1996 snowstorm. Her son had pneumonia, roads were impassable, stores in this Philadelphia suburb were closing early, and she needed a prescription filled. “Tepper said, ‘We’ll stay open until you can get here,’ ” she recalled. “I walked. The pharmacist was standing at the door waiting for me to lock up. You never forget something like that.”

Last Dec. 24, as the store was closing for the holiday, Naomi Bolts’s family called. Ms. Bolts, 79, was being discharged from the hospital at 4:30 Christmas Eve after open-heart surgery and needed 15 prescriptions filled. “I don’t know who did it, but I’m sure that nice young Joe Niagara was involved,” Ms. Bolts said last week. Mr. Niagara, 47, the manager, who started working 30 years ago as a delivery boy for the current owner’s father, stayed two extra hours, helping the pharmacist fill the order.

When Pauline Hirsch’s grandson became sick in the middle of the night, she reached the owner, Steven Tepper — who has a 24-hour answering service — and he came in to fill the prescription. “I shop here five days a week,” said Ms. Hirsch, 74. “I want them to stay in business.” ...more

Lawsuit launched over common Parkinson’s drug

From the National Post:
An Ontario judge has approved to a class-action lawsuit by Parkinson’s patients who say a commonly used drug turned them into “relentless” gambling addicts, causing some to lose hundreds of thousands of dollars.

The decision to certify the unusual class action is the first such ruling in Canada among several cases that have been launched over “dopamine-agonist” drugs, designed to counter stiffness, shaking and other symptoms of the nervous-system disease.

A growing number of studies have linked the medicine to excessive gambling, sex addiction and other compulsive behaviour in a minority of Parkinson’s sufferers.

The certification judgement by Justice George Strathy of the Ontario Superior Court deals with Permax, which was taken off the market in 2007 because of other, heart-related side effects. About three dozen Parkinson’s patients have already signed up with the class-action, said Darcy Merkur, one of the lawyers handling the lawsuit. ...more

E-prescriptions more reliable than handwritten ones

From CNET News:
Here's one for the important-but-obvious files.

New research at Weill Cornell Medical College in New York finds that medical professionals writing prescriptions by hand are seven times more likely to make errors than those using electronic systems.

Researchers looked at prescriptions written by health care providers at 12 community practices in the Hudson Valley region of New York. They compared the number and severity of the found errors between 15 providers who wrote prescriptions by hand and 15 who used a commercial system that provides dosing recommendations and checks for drug allergies, duplicates, and combination effects.

The researchers inspected 3,684 paper-based prescriptions at the start of the study and 3,848 paper-based and electronic prescriptions written one year later. After one year, the percentage of errors for providers using the electronic system dropped from 42.5 to 6.6. For those writing prescriptions by hand, the percentage of errors held almost steady, increasing slightly from 37.3 percent to 38.4 percent. ...more

Hilo pharmacist’s life or death struggle with armed robber

From Big Island Video News (Hawaii):
It was a day like any other at Tom Moyer’s Windward Pharmacy at the Puainako Town Center in Hilo on Tuesday, until he found himself in a life or death struggle with an armed robber who was demanding drugs and wielding a loaded 30.06 bolt-action rifle.

As Moyer recounts in this video, the lengthy (and terrifying) grapple over the rifle led to suspect Paul Santoro - a 28 year old Puna man - being disarmed, and later arrested at the pharmacy for his actions.

Pharmacist Tom Moyer's life or death struggleThe 57 year old Moyer had some help from his pharmacy employees. Hawaii County Police say two of the pharmacy employees were injured during the incident. A female employee sustained an injury to the back of her head when she was allegedly struck by the suspect. The male pharmacist sustained lacerations to his hands. Both refused treatment. ...more

Anti-seizure drug promotion faces legal fire

I can't recall ever seeing Neurontin being used for a seizure disorder. It's one of the few drugs I can think of that is almost exclusively used off-label.

From CBC News:
A lawsuit over the anti-seizure drug Neurontin began in the United States on Monday, with patients, insurance companies and unions accusing the drug manufacturer of aggressively marketing it as pain medication, an unapproved use.

Neurontin, also known by its generic name gabapentin, is approved for use in Canada and the United States to help control epileptic seizures.

Doctors in both countries prescribe gabapentin to control pain. Canadian doctors wrote two million prescriptions for the drug or its generic versions in 2009.

In 2004, Pfizer subsidiary Warner-Lambert settled a lawsuit filed by federal and state drug programs over the marketing of gabapentin, admitting it fraudulently promoted the drug. Pfizer paid $430 million US in penalties and fines, including $152 million to reimburse the drug programs, which had covered the drugs. ...more

AMA backs pharmacist/doctors shops

From the Gladstone (Australia) Observer:
The Australian Medical Association (AMA) believes a one-stop pharmacist/doctors shop would allow each health professional to work to their full potential in a well-supported environment.

They said the arrangement fits within the GP Primary Care Centres proposal that is outlined in the AMA’s Priority Investment Plan for Australia’s Health System.

AMA Capricorn Area Representative Dr Kim Bulwinkel said the provision of health care wasn’t really a one-person patch.

“The right thing to do is to provide the right care for the patient, and there are significant concerns with pharmacists dealing with medications as they are not trained as doctors,” he said.

U.N. narcotics board warns of prescription drug abuse

From Reuters:
Abuse of prescription drugs is growing rapidly around the world, with more people abusing legal narcotics than heroin, cocaine and ecstasy combined, the United Nations global drugs watchdog said on Wednesday.

The International Narcotics Control Board (INCB) also pointed to a rise in the use of so-called "date rape drugs," as sexual abusers try to get around more rigorous controls with substances not banned by international drugs laws.

The INCB said several high-profile celebrity deaths, such as pop star Michael Jackson last year, had focused attention on prescription drug abuse.

In the United States, abuse of prescription drugs "is now the second most important drug abuse issue after cannabis," it said, with 6.2 million people hooked on them in 2008. ...more.

Thursday, February 25, 2010

HIV drug combination carries heart risk

From CBC News:
People taking a combination of two anti-HIV drugs may face potential heart risks, U.S. regulators say.

Invirase and Norvir are antiviral medications given together to treat HIV infection. Norvir is given at a low dose to boost the level of Invirase in the body.

The U.S. Food and Drug Administration said Tuesday that preliminary data suggests taking Invirase and Norvir together may affect electrical activity in the heart.

Both drugs are approved for use in Canada.

The FDA advised patients currently taking Invirase that they should not stop taking the drug, but to discuss any questions or concerns they have about Invirase with their doctors. CBC News - Health - HIV drug combination carries heart risk

Internet pharmacist accused of selling phoney drugs loses credentials

From the Calgary Herald:
One of Canada's Internet pharmacy pioneers has lost his credentials to practise in Manitoba after a three-year probe into allegations he sold counterfeit prescription drugs to Americans.

Andrew Strempler, founder of the Minnedosa, Man.-based Mediplan Prescription Plus Pharmacy, agreed to strike his name from the provincial pharmacist registry at a discipline hearing last October. The outcome of the fall hearing has only recently been posted on their website.

Experts say it's the most severe penalty that can be handed to a pharmacist, and prevents Strempler from renewing his licence to practise in Manitoba.

The fallout comes nearly four years after the U.S. Food and Drug Administration first warned consumers that drugs from Strempler's Manitoba-based firm were unsafe.

In August 2006, the FDA said preliminary lab tests of intercepted shipments found counterfeits of widely prescribed drugs such as Lipitor and Celebrex. ...more

Saturday, February 13, 2010

Natural Remedy Makers In 'Crisis'

From the National Post:
Makers of natural-health products say they are bracing for widespread layoffs and millions of dollars in losses after Canada's pharmacy regulators issued a surprise directive recently urging druggists to stop selling unlicensed natural remedies.

The order affects thousands of herbal treatments, multi-vitamins and other products, most of them waiting for approval from Health Canada under a backlogged, five-year-old program to regulate natural-health goods.

The National Association of Pharmacy Regulatory Authorities (NAPRA) says pharmacists cannot be assured the products are safe until they are granted a government licence, and should not sell them in those circumstances.

"Pharmacists are obliged to hold the health and safety of the public or patient as their first and foremost consideration," said the association's recently issued position statement.

Representatives of the natural health industry, however, have reacted angrily to the directive issued last month, predicting it will have little impact on patient safety, while triggering an economic "crisis" for their members. ...more

Antidepressant reduces effectiveness of cancer drug

From the Vancouver Sun:
Paxil, an antidepressant commonly prescribed to women with breast cancer, can reduce or even abolish the effects of the breast-cancer drug tamoxifen, increasing a woman's risk of death, Canadian researchers are warning.

Published this week in the British Medical Journal, the study exposes an "extremely common" and potentially life-threatening drug interaction that is "widely underappreciated," yet entirely avoidable, the researchers say.

"For women taking these two drugs together, I think there are better options for the treatment of depression," Dr. David Juurlink, a senior scientist at the Institute for Clinical Evaluative Sciences in Toronto and one of the study's authors said in a statement.

Breast cancer is the most commonly diagnosed cancer in women worldwide; an estimated 1.5 million new cases will be diagnosed globally this year, including about 22,700 in Canada.

Tamoxifen has been used for the treatment of breast cancer for more than three decades. For women with early stage estrogen receptor-positive breast cancer, the drug reduces the risk of recurrence by about half, and the risk of cancer death by about one-third, according to the study. ...more

Don't come to us for sickies, say pharmacists

From the Sydney (Australia) Morning Herald:
Pharmacists are reluctant to use powers authorising them to issue medical certificates, citing a lack of diagnostic skills and a fear of being sued.

Two years after the Federal Government changed the rules for pharmacists in an attempt to ease the burden on GPs, the system seems to have failed.

The scheme allows pharmacists to charge a fee, usually up to $30, to assess a customer and provide a medical certificate for minor ailments, such as influenza or headache. It was introduced after Work Choices legislation put a greater requirement on employers to demand medical certificates from staff.

It was also designed to ease the crippling lack of GPs. Most pharmacists contacted by the Herald yesterday said they had not promoted the service because they did not feel comfortable issuing certificates.

''We are not trained diagnosticians and it just doesn't seem the right thing to do,'' a pharmacist, Chadi Tahan, said. ...more

Thursday, February 11, 2010

Changes to provincial drug plan will affect foothills

From the Western Wheel (AB):
As more foothills residents creep towards retirement age and beyond the strain on Alberta’s health infrastructure will increase said one of the province’s top health officials.

As a result, the Province has been looking at ways of expanding care options to ease the strain on local hospitals such as Oilfields General Hospital in Black Diamond and High River Hospital.

“We need to provide the choices and the options out there for people that allow them to live in the least restrictive setting that meets their needs that they can have some choice over,” said Silvius.

Some of the changes include grant funding to increase home care with the stipulation it be spent by March 2011 and funds may be allocated in areas such as home care or self-managed care to lighten the load on hospitals but no final decisions have been made. ...more

Medicines shortage prompts Government summit

From the Telegraph (UK):
Patients and pharmacists have struggled with medicines shortages for months as low prices in Britain spur dealers to buy them cheap here to sell abroad where prices are higher.

A wide range of drugs have been affected including cancer medicines, treatments for high blood pressure, lung disease, depression, schizophrenia, epilepsy, Parkinson's and asthma.

The weak pound and the movement of drugs around Europe has made the trade more lucrative.

Pharmacists and chemists in Britain have warned they are spending a large amount of their time trying to source medicines for their patients.

Mike O'Brien, Health minster will host a summit next month to address the problem.

Minister for Health, Mike O'Brien said: "For months I have been concerned about the potential impact on patients’ health of a small number of medicines being sold abroad by speculators. It is unacceptable that people have had to wait longer than they should have to get their medication. ...more

Wednesday, February 03, 2010

Planning a winter getaway? How to avoid malaria

From CTV News:
Pop quiz: if you're planning a vacation to a Caribbean hotspot this winter -- say, some place like Jamaica -- do you need to worry about malaria? How about if you're going to the Bahamas? The Dominican Republic?

The fact is if you're going to parts of any of those countries, malaria could be a threat. Yet few Canadian travellers think about the potentially fatal infection when planning getaways, and that can be a dangerous oversight, say doctors.

A recent poll conducted by Leger Marketing found that less than a third of Canadians planning vacations said it was a top priority for them to talk with a doctor about travel-related illnesses. Most were more likely to be concerned with planning sightseeing, accommodations and worrying about currency.

Even when asked about the travel health treats they worried about, most replied that malaria was well down the list...more

Homeopathy: medicine that's hard to swallow?

From the Telegraph (UK):
At 10.23 on Saturday morning, Simon took a vial out of his pocket. He examined the instructions on the label: two pills to be taken every two hours for the first six doses. The contents should not be touched by hand, but be administered directly into the mouth. The vial should be kept both out of reach and sight of children. The middle-aged man then knocked back all 84 tablets and swallowed.

As Simon Singh stood in a public square in London, and waited for the effects of his overdose to take hold, hundreds of other despairing men and women around him poured scores of pills and medicines down their throats.

What has been called a mass overdose attempt is perhaps better described as a cry for help. By taking remedies in quantities far beyond the dosages recommended by their manufacturers, Singh – a television presenter and author of several books on science – joined campaigners attempting to demonstrate the case against homeopathy, and those who supply it.

Many scientists say theories behind homeopathy – which relies on the extreme dilution of animal, plant, mineral as well as synthetic substances so that remedies do not contain a molecule of the original substance – are a nonsense. ...more

Tuesday, February 02, 2010

Herbal remedies may put heart patients at risk: review

From CTV News:
Herbal remedies, such as St. John's wort, gingko biloba -- even garlic, may be putting patients on heart medications at serious risk, doctors are warning.

"It is potentially deadly and the most important thing is it's avoidable," Dr. Arshad Jahangir, one of the authors of the review and a consultant cardiologist at Mayo Clinic Arizona said.

In a scientific review in the Journal of the American College of Cardiology, doctors warn that while herbal remedies are thought of as safe and natural, they can cause serious interactions with heart drugs. ...more

Pharmacists keep 50pc profits as medicine costs fall

From the Independent (Ireland):
Pharmacists will pass on the cuts in factory drug prices to customers -- but they will still claim a 50pc profit from the sale of the medicines.

The manufacturers' price of 300 popular off-patent drugs fell by 40pc yesterday.

But while the amount patients will pay for the medicines in the pharmacy will be less, it will not be by as much as that quoted on the website, which has been set up as a guide for customers by the Irish Pharmaceutical Healthcare Association (IPHA).

The final prices quoted on the website -- once the wholesaler and pharmacist have been paid -- are based on a profit mark-up of 20pc.

However, the majority of pharmacists are still claiming a 50pc profit mark-up and are also adding a dispensing fee of around €2.50. ...more

Monday, February 01, 2010

More drug-dispensing kiosks on the way

From the Toronto Star:
Drug-dispensing machines tested in Toronto medical centres will be permanent fixtures across the province under a plan approved by the Ontario Hospital Association.

One of the machines linked around the clock to a pharmacist will be installed this week at Toronto’s Holland Orthopaedic & Arthritic Centre.

The hospital association has agreed to roll out the green and white kiosks after trials at three hospitals and a medical clinic over the past 2-1/2 years.

Hundreds more will be installed in far-flung communities across the province only after the Ontario College of Pharmacists approves new regulations, expected later this year, said Peter Suma, chief operating officer and co-founder PharmaTrust, the Oakville company that makes the machines.

Until then, the multilingual kiosks, which look like bank machines and are linked to live pharmacists, can be placed only in hospitals or doctors’ clinics, Suma said. ...more

Treat vitamins as over-the-counter drugs: doctors' group

From the National Post:
With Health Canada poised to let food makers fortify a wide range of new products with vitamins and other nutrients, a group of leading emergency-department doctors is calling for vitamins to be treated like over-the-counter drugs because of their potentially dangerous side effects.

The physicians from children's hospitals in British Columbia, Alberta and Ontario also recommend that vitamin A no longer be allowed as an ingredient in multivitamins, citing evidence that it can cause birth defects in high doses.

The researchers stress that vitamins are generally safe and healthy when consumed appropriately. But with many Canadians convinced that taking large quantities of certain supplements can stave off various medical problems, the doctors caution that the public needs to know more about the downsides of high doses or improper chronic use. ...more