Wednesday, March 31, 2010

Proposed N.S. legislation will see pharmacists administer vaccines

From the Winnipeg Free Press:
In a move aimed at relieving some of the stress in Nova Scotia's health-care system, pharmacists will be able to administer vaccines by injection and monitor drug therapy under proposed amendments to the province's Pharmacy Act.

Health Minister Maureen MacDonald said Monday the goal is to take advantage of a pool of qualified professionals in order to free up doctors to concentrate on other areas of health care.

"We in the health-care system, like many other professions, are facing a demographic crunch," said MacDonald. "This is part of expanding the health-care team ... and giving them (pharmacists) a greater scope of practice in order to help patients."

Although MacDonald said the move will create efficiencies in the health system, she said she was unable to put a dollar figure on any potential savings. ...more

Health ministry mulls law to allow female pharmacists, opticians to work in public

From the Los Angeles Times:
Saudi Arabia has been inching forward in its efforts to bring a measure of gender equality to the kingdom, starting by removing some professional barriers to women.

Last month the justice minister announced his intention to back a law that would allow female lawyers to argue in court, and now the Saudi newspaper Al Riyadh is reporting that the Ministry of Health is considering a similar law for women in certain fields of healthcare.

The proposed law would lift a ban on female pharmacists and opticians working in pharmacies, community clinics and optical shops. Currently women in these fields are not allowed to work outside hospitals. ...more

Doctors strongly against prescription of medicines by pharmacists

This sounds remarkably similar to what we have heard in Canada...

From the Times of Malta:
The Medical Association has strongly criticised a declaration by the Minister of Health than pharmacists could soon be given the power to prescribe certain medicines.

Speaking during the opening of a symposium, Dr Cassar said prescribing pharmacists existed in other countries. In fact, in May 2006 British nurses and pharmacists who had undergone the appropriate training were able to prescribe medicines.

The doctors' union said however that the Medicines Act prevents medical practitioners from dispensing medicine, thus protecting patients from a potential conflict of interest between the prescriber and the dispenser who profits from the sale of medicines.

"The Medical Association of Malta is surprised and disappointed that the Health Ministry is considering abandoning the ethical principles in the prescription of medicines. Patients have the right to be diagnosed by a registered medical practitioner before a medicine can be prescribed. This is a basic tenet of patient safety," the MAM said. ...more

Pharmacy grads for shortage still 2 years off

From CBC News:
Administrators at the Maritimes' only pharmacy school have no plans to increase enrollment but are expecting the first graduates from the University of Waterloo can help address a national shortage of pharmacists.

With hundreds of pharmacist jobs vacant across the country, Neil MacKinnon, associate director with Dalhousie University's pharmacy program, said his school has already moved to address the shortage.

"About five or six years ago we increased our class size from 65 students per year to 90," said MacKinnon.

"There's one new pharmacy school that opened up in Canada two years ago at the University of Waterloo."

That new school will release its first graduates into the job market in two years.

The P.E.I. Pharmacists Association told CBC News this week the national shortage means there is constant strain on the 180 pharmacists in the province. ...more

Uzbekistan limits foreign travel for doctors

This isn't really a pharmacy story, but I thought it was a pretty interesting international medical story:

From the Washington Post:
Authorities in Uzbekistan have restricted the country's doctors from freely traveling abroad to international medical conferences, a think tank in the Central Asian nation said Friday.

Limiting Uzbek doctors' exposure to foreign expertise is likely to further hinder the authoritarian ex-Soviet nation's troubled health care system, which has struggled to deal with outbreaks of HIV and tuberculosis.

The Expert Working Group, an independent think-tank in the Uzbek capital of Tashkent, said a recently approved government decree has created strict requirements for medical personnel wishing to leave the country, even if only for personal reasons.

Sukhrobjon Ismoilov of the think tank said the order to limit the movement of medical personnel was in flagrant violation of the country's constitution, which grants Uzbek citizens the right to freely leave the country.

Health workers traveling to medical conferences abroad must provide copies of their speeches to the Health Ministry in advance of departure. The group also said physicians will have to submit a report on their activities overseas to government officials within three days of their return, or risk punitive measures and a travel ban. ...more

Oncology pharmacists find their role rewarding

From the Montreal Gazette:
There are few things as devastating as being diagnosed with a critical illness such as cancer.

In 2009, roughly 171,000 people embarked on that journey nationwide. The fortunate have a support system rich with loved ones and a highly specialized medical team.

Gabriel Gazzé has been a member of one such team at the Royal Victoria Hospital for 16 years. He's not a doctor or a nurse. He's a pharmacist. And although you might not realize it, he and other pharmacists in his position are often a crucial source of information and support for people undergoing cancer treatments.

"A big misconception about the profession is that pharmacists have a low profile in hospital settings," Gazzé said. "We actually play a big role in patient care, more than ever before."

In health care institutions, pharmacists work as part of a collaborative medical team alongside doctors and other medical specialists in many departments, and a field as multifaceted as oncology is no exception. ...more

Codeine ban will induce headaches: pharmacists

From the Sydney (Australia) Morning Herald:
Big changes to the way codeine tablets such as Nurofen Plus and Panadeine are sold are expected to cause a headache for pharmacists and customers.

From May 1, all combination medications containing codeine, which are used by 4 million Australians each year, will be rescheduled.

Packs containing up to 12 milligrams of codeine will be kept behind the counter and dispensed only by a pharmacist who will record the customer's details. This includes 12-tablet and 24-tablet packs of Nurofen Plus and Panadeine.

Customers will have to obtain a prescription for a 48-tablet pack or larger, leading many to stock up before so-called Codeine May Day.

The National Drugs and Poisons Schedule Committee ordered the changes over concerns that 1 in 20,000 people abused combination analgesics containing codeine and ibuprofen, which can cause perforated gastric ulcers and kidney failure. ...more

Sunday, March 28, 2010

Short counselling session with pharmacist improves smoker's odds of quitting

From the Regina Leader Post:
A few minutes of counselling from a pharmacist can dramatically improve the odds of a smoker butting out for good.

"Research shows that even brief counselling will improve a smoker's ability to quit," said Janice Burgess, director of Professional Practice for the Pharmacists' Association of Saskatchewan. "A brief intervention can be just three to five minutes where the pharmacist might ask you some questions to help determine how ready you may be to actually quit."

Through the Partnership to Assist With the Cessation of Tobacco (PACT) program, more than 300 Saskatchewan pharmacists in 60 communities are trained to help residents quit smoking.

PACT pharmacists can advise residents about medications to help them quit, strategies to help them reduce the amount they smoke and assess why they smoke.

The success rate for smokers who quit "cold turkey" and receive no medical treatment or counselling is five per cent. Success rises to 10 per cent with brief advice and jumps to 30 per cent if behavioural therapy is combined with medication, Burgess said. ...more

New pharmacy code continues opt-outs over beliefs

From BBC News:
Pharmacists across the UK have been told they can continue to refuse to prescribe items that might clash with their personal religious beliefs.

A revised code of conduct from the new industry regulator will allow staff to opt out of providing items such as the morning-after pill and contraception.

But they may in future have to give customers details of alternative shops.

The National Secular Society wanted the General Pharmaceutical Council to scrap the so-called conscience clause.

The General Pharmaceutical Council (GPhC) is to take over the regulation of pharmacists, pharmacy technicians and the registration of pharmacy premises from the Royal Pharmaceutical Society later this year. ...more

Monday, March 22, 2010

Antibiotic may be linked to liver problems

From the Globe and Mail:
Health Canada is warning that the antibiotic Avelox may be linked to rare but dangerous liver problems.

The drug regulator says Bayer Inc., which makes the drug, is updating the product label to draw attention to this potential side-effect.

Avelox is used to treat a broad spectrum of bacterial infections, including respiratory illnesses.

But concerns raised in recent years in a variety of jurisdictions led Health Canada to investigate whether people taking the drug are at increased risk of liver injury.

Health Canada says anyone who develops certain symptoms while on Avelox should stop taking the drug and contact their health care professional immediately. ...more

Sunday, March 21, 2010

Clinical pharmacists key part of medical team

From the Montreal Gazette:
From psychiatry and intensive care to oncology and transplant teams, hospitals are a melting pot of diverse talent and specially trained medical experts.

But unless you spend a lot of time hanging around medical centres, you might not know that pharmacists are among the white coats in nearly all departments.

"Clinical pharmacists are specialists," said Linda Vaillant, director of l'Association des pharmaciens des établissements de santé du Québec (APES). "Their roles are very different than what you see in commercial pharmacies; they work almost exclusively with IV or injection medications."

APES is the association that represents the 1,300 hospital pharmacists who work in the public health care system.

"People tend to think we're just pill counters who dispense medication," said Hala Yazbeck, a pharmacist working in the Montreal General Hospital Intensive Care Unit. "They really have misconceptions about what we do and the extent of our role." ...more

B.C. residents sue maker of quit-smoking drug

From CBC News:
Three British Columbia residents are suing Pfizer, alleging the drug company's quit-smoking product Champix can cause serious psychiatric reactions.

Plaintiff Alicia Pickering, 34, said she was a normal, healthy woman until she started taking Champix to kick her smoking habit. Within days of starting the drug, the married mother of two experienced a dramatic change in personality and was consumed with thoughts of dying, she said.

"It literally felt like something had broken in my head," Pickering, of Sechelt, B.C., northwest of Vancouver, told CBC News. "Intense, severe depression overtook me. I would sit on the couch sobbing, not knowing why."

In a writ filed in B.C. Supreme Court, Pickering and two other B.C. residents claim Pfizer "negligently designed, tested, labelled, manufactured and marketed the drug to Canadians." According to the document, Pickering developed bipolar disorder after taking Champix. ...more

Seniors take 5 drugs or more: study

From CBC News:
Almost two-thirds of Canadian seniors in six provinces are taking five or more types of prescription drugs, according to a new report.

The Canadian Institute for Health Information's study, covering the years 2002 to 2008, looked at public drug claims for more than one million people aged 65 or older in Alberta, Saskatchewan, Manitoba, New Brunswick, Nova Scotia and Prince Edward Island.

In 2008, 21 per cent of the seniors were using 10 or more types of prescription drugs and six per cent took 15 or more different classes of drugs. ...more

Teva to acquire Ratiopharm for $5B U.S.

From the Montreal Gazette:
Israel's Teva Pharmaceutical Industries Ltd., the world's leading generic drug producer, is buying German-based Ratiopharm for $5 billion U.S., beating out Pfizer Inc. and Actavis Group.

Privately held Ratiopharm was put up for sale by the Merkle family of Germany last June and the nine-month auction process was finally completed Friday. Ratiopharm is a major German generic drug producer with subsidiaries in Canada and the U.S. The combined company will have annual sales of more than $16 billion U.S. Teva to acquire Ratiopharm for $5B U.S.

Thursday, March 18, 2010

$75 million drug heist is bitter pill for Lilly

From the Indianapolis Star:
It was a brazen, well-planned break-in, straight out of "Mission: Impossible" -- but the loot wasn't gold bars or bundles of cash.

Thieves made off with $75 million worth of pharmaceutical drugs from an Eli Lilly and Co. warehouse in Enfield, Conn., the latest and perhaps largest in a rising string of industry thefts, raising questions about drug security and where the products will wind up.

Early Sunday, under cover of darkness, bandits scaled the side of the building and cut a hole in the roof, rappelled inside on ropes, disabled the alarm and spent more than an hour loading pallets of drugs into a waiting vehicle at the loading dock.

"It wasn't a random, impulsive act," said Carl Sferrazza, police chief of Enfield.

Increasingly, pharmaceutical drugs are becoming a lucrative target of thieves, who are using more aggressive and sophisticated methods to break into warehouses, hijack trucks and make off with millions of dollars worth of painkillers, antidepressants and other popular drugs. ...more

Canadians slow to get approved medications

From the Vancouver Sun:
Canadians are not able to quickly access newly developed prescription medicines because of the slow drug approval process and delays by provincial drug plans in approving the medicines for reimbursement, according to a new study released Wednesday by a leading Canadian think-tank.

Mark Rovere, a policy analyst with the Fraser Institute, said it takes Health Canada about 13 months to approve new drugs as safe, but it takes another year for the provinces to make a decision on whether they will cover the drug.

Once drugs are approved by the federal authorities, most private insurers will cover them immediately, he said, but this leaves people that rely on provincial plans out in the cold.

"In the end, the provinces usually choose not to cover these drugs, leaving the one-third of Canadians who rely on provincial drug plans without access to most new medicines," he said. ...more

Woman forced to choose between cancer drug and bankruptcy

From the Hamilton Spectator:
Her kidneys ravaged by chronic disease and advanced cancer, Judy Pope had been doing remarkably well with a new drug.

For five years, the medicine had kept the Cambridge woman’s cancer under control.

But when her husband’s work insurance was changed to another provider, a cap on coverage put the expensive drug financially out of reach.

Pope and her husband Gary could not afford the monthly $3,200 cost of the medication on his modest income and her disability pension.

As well, the province’s program to help people with prescription drug costs denied applications for help.

Pope had no choice but to stop taking the drug that had kept her alive by slowing the growth of the kidney cancer. ...more

Fight continues between pharmacists' association and Blue Cross

From the Fredericton (NB) Daily Gleaner:
The New Brunswick Pharmacists' Association has taken exception to what it feels is Medavie Blue Cross' advice that consumers should change their pharmacy if it no longer provides pay-direct service with the insurer.

"It's hard to comprehend a private insurer with health care and health care cost expertise advising that route for New Brunswickers," said the association's Executive Director Paul Blanchard, in a press release.

"It's simply inappropriate, unsafe and potentially very costly advice."

Blanchard said the situation arose when the reimbursement scheme under the contract between Medavie Blue Cross and New Brunswick pharmacies expired in January.

He said Medavie Blue Cross granted extensions of the reimbursement scheme to most community pharmacy owners, while staggering the negotiation of a new reimbursement model with selected owners or chains.

Blanchard said pharmacists are trained to provide continuity of care and are most effective in that role when they acquire knowledge of a client over time - something he feels would be jeopardized by patients switching pharmacies. ...more

Friday, March 12, 2010

B.C. pharmacies put cough medicine behind counters following a rash of teen overdoses

From the Vancouver Sun:
Some B.C. pharmacies are moving cough remedies containing Dextromethorphan — known as DM or DXM — behind the counter at the request of the College of Pharmacists of B.C. following a rash of intentional overdoses by teens.

In the last two weeks alone, four teenagers in the Victoria area have landed in treatment after overdosing.

DXM, a cough suppressant and pain reliever, is easily accessible at drugstores. Youth use it to get high by exceeding the recommended dose.

According to the College of Pharmacists, the prime recreational users of DXM are 14 to 15 — although there are reports that children as young as 10 also use the drug.

Signs will be placed on pharmacy shelves where cough remedies are kept directing purchasers to the dispensary for a consultation, college spokesman Marshall Moleschi said Wednesday. ...more

Canadian research links anti-depressants, cataracts

From the Montreal Gazette:
Some depression and anxiety drugs are associated with an increased risk of cataracts, new research shows.

According to the study in the journal Ophthalmology, British Columbia and Quebec researchers found a link between cataracts and some drugs in a class of medications called selective serotonin reuptake inhibitors.

The study used a database of more than 200,000 Quebec residents over the age of 65.

Across Canada, pharmacies last year dispensed about 24 million prescriptions for SSRIs with a dollar value of $1.1 billion.

After adjusting for other risk factors including gender, hypertension, diabetes and heart disease, the relative risk of having cataract surgery was 1.51 times greater for those taking fluvoxamine (Luvox).

For those taking venlafaxine (Effexor), the risk was 1.34 times higher and for those on paroxetine (Paxil) the risk was 1.23 times higher. ...more

Tuesday, March 09, 2010

Prescription for variety

From the Montreal Gazette:
Television viewers of a certain age will remember a Western called Have Gun, Will Travel. Louise Le May is no hired gun: she's a pharmacist. But like Paladin, the star of the long-running series, she does travel for work.

Le May works as a replacement pharmacist: instead of being based in a single pharmacy, she works in pharmacies around the province: she might be in Abitibi one week, in Drummondville and Richmond the next, in a pharmacy near Joliette the week after that.

Replacement pharmacists fill in for absent pharmacists, whether they're vacationing or ill or on maternity leave, or they simply help with the general pharmacist shortage in Quebec. Often they spend just a couple of days at a time at a particular pharmacy - and never longer than a couple of weeks.

Most of the time, they're hired, through agencies, by the pharmacies or the hospitals that need them. Longueuil-based Elitis Pharma, where Le May works, has a bank of 160 pharmacists who do replacement work. About 20, including Le May, are full-time Elitis employees. The rest work part-time on behalf of the agency. It might mean 25 or 30 hours for some each week and, for others, one weekend a month. Others, in turn, choose to work flat out over several months, then take a few months off to travel. ...more

A Rash Of Robberies

From the Calgary Herald:
After pharmacist Randy Howden was robbed at gunpoint twice last year by the same man, he had to make changes to his business.

First and foremost was a new security camera.

Then he installed signs at the front of his pharmacy and other secret security measures.

Adding security bars to the windows, though, seemed like too much.

"It's hard because you don't want to make your place look like Fort Knox and not welcoming. It's about trying to find that balance," says Howden, owner of The Medicine Shoppe on Crowfoot Crescent N.W. ...more

Sunday, March 07, 2010

Drug deal in place

From the Halifax Chronicle Herald:
Medavie Blue Cross and Shoppers Drug Mart have called a truce in their war over how and how much customers pay for drugs.

The two companies announced Saturday that they had reached a tentative deal that would end the dispute that related to payments for generic drugs.

Talks were continuing, but Medavie said in a news release from Moncton that an agreement was in place that would see their cards accepted by Shoppers Drug Mart.

And Jeff May, senior vice-president of professional affairs for Shoppers Drug Mart, said the deal ensures customers can fill their prescriptions and not have to wait to be reimbursed.

"This tentative agreement will allow these pharmacies to maintain the level of service their patients have come to expect, including the electronic processing of Medavie Blue Cross payments," May said.

Details of the tentative agreement were not released. ...more

Friday, March 05, 2010

Sask. pharmacists to get dose of prescribing power

From CBC News:
Saskatchewan pharmacists will soon be allowed to provide services normally reserved for doctors, the province announced Wednesday.

Proposed changes to the Pharmacy Act, which could be in place by summer, would let pharmacists dispense drug refills when a doctor is on vacation and provide a limited supply of a prescribed medicine in an emergency.

"It'll cover pretty much every regular style prescription drug that, for example, they'll be able to extend if the patient runs out of their medication," Ray Joubert, the registrar of the Saskatchewan College of Pharmacists, explained at a news conference.

Pharmacists have lobbied the government for years for more leeway with prescription medicines.

"We have asthmatics coming in that need their medication," George Furneaux, a Regina pharmacist, told CBC News Wednesday. "They're late at night. They're having an asthma attack and our legal choice is not to be able to fill the prescription." ...more

An indispensable team member

From the Montreal Gazette:
As a pharmacy student interning at the Montreal General Hospital last summer, Alexandre-Jacques Amiel often followed the doctors on their rounds in the intensive-care unit.

He listened carefully as they examined patients and made their diagnoses. One afternoon, Amiel stood at the foot of the bed of a patient suffering from endocarditis, a potentially fatal heart infection.

The doctors weren't sure which medication to prescribe as a course of treatment. The debate went back and forth. So the 22-year-old Amiel screwed up the courage and recommended the ideal antibiotic.

And they listened to him.

"The doctors were having trouble deciding what kind of treatment they were going to give, and I felt like I had a very big impact with that antibiotic," recounted Amiel, who is in his third year at the Université de Montréal's undergraduate pharmacy program. ...more

Dispensing advice

From the Montreal Gazette:
Pharmacists these days are on the front line of health care - often the first health professionals people seek out for guidance.

"They don't want to go and sit for hours in a clinic or emergency room, so they come to us with questions," pharmacist Marc Rabbat said. "We do a sort of triage with them. We're not trained to diagnose diseases, but we're trained to look for certain symptoms."

Rabbat has been a pharmacist for 10 years. He is currently working at the Uniprix Pierre Gravel pharmacy at Plaza Pointe Claire.

Joelle Wizman has been a pharmacist for 25 years. She works at the Jean Coutu pharmacy on Monkland Avenue in Notre Dame de Grace.

"Some people don't have a family doctor, so they come to us for advice," Wizman said. "If they just have a cold, we can give them some guidance before they start to panic and then go clog the emergency rooms." ...more

Medavie, Shoppers Drug Mart can't reach deal; card will no longer be accepted at pharmacy

This could be an interesting situation. If Shoppers is able to win this battle, I would think they would try similar tactics in other provinces.

From the Fredericton (NB) Daily Gleaner:
Most Atlantic Canadian Shoppers Drug Marts will stop accepting the Medavie Blue Cross card for prescription drug payment next week.

Shoppers and Medavie have been unable to reach an agreement on a new payment schedule. This means people with a Blue Cross drug plan who go to Shoppers for their prescriptions will have to pay the full cost up front and seek reimbursement from Blue Cross later.

Medavie spokesman Mike Randall said there may be an easier way for people who don't want to make the trip to a Blue Cross Quick Pay outlet or send their reimbursement forms through the mail.

"The easiest and simplest way would be to head to another pharmacy close to you, ask the pharmacist to transfer the prescriptions and they'll take care of the rest," Randall said, adding there are still more than 600 pharmacies in Atlantic Canada that accept the card.

"Then there will be no out-of-pocket expenses for you and you'll get seamless continuous coverage."

Medavie Blue Cross has been in discussions with pharmacies in the Atlantic region over the past few months about introducing a new payment schedule "designed to reflect ongoing changes in prescription drug landscape in Atlantic Canada, and Canada, particularly with generic drugs," said Randall. ...more

Online medicine comes with risks

From the Montreal Gazette:
From clothing and books to groceries and dog food, it seems like you can buy just about anything online today.

But people looking to save a buck might get more trouble than they bargained for by purchasing medications and natural products online.

"If it seems too good to be true, it usually is," said Michel Caron, a pharmacist at Ordre des Pharmaciens du Quebec. "The risks of buying medications online are enormous."

Many websites claim to be selling brand name prescription drugs at discounted prices. The main problem, Caron said, is that people don't know what they're actually getting when they order medications from a website.

"There is a huge market for counterfeit drugs online," he explained. "These pills may resemble the genuine ones but many of them don't even contain medication; they're flour or sugar pills."

Some of the most popular counterfeit pills are lifestyle medications such as those for erectile dysfunction. ...more

Pharmacies reporting slow supply of drugs

From the Swindon (UK) Advertiser:
A leading Swindon pharmacist has spoken out at a shortage of drugs which, it has been claimed, is a result of some healthcare organisations who have been selling UK drugs to Europe, where they can get a better price.

As a result, the Royal Pharmaceutical Society says urgent action is needed. They claim that patients’ lives are being put at risk and UK pharmacies are facing increasing shortages of drugs used to treat cancer, high blood pressure and epilepsy.

Richard Thomas, proprietor of a small chain of five pharmacies which include Park Lane Pharmacy, Old Town Pharmacy and Toothill Pharmacy, which are part of the Hatch Ride Holdings, has become increasingly aware of the problems in sourcing some expensive drugs.

He said: “My pharmacists have been experiencing severe difficulties in obtaining certain drugs from the wholesalers. Naturally, we cannot keep each and every medicine in stock, so we rely on express ordering. ...more

Thursday, March 04, 2010

Oxycodone boom hits Manitoba

From CNews:
A few years ago people were worried crystal meth would invade Manitoba the way it did some U.S. states, which became ridden with addicts, fatal overdoses and clandestine labs.

It didn’t happen to that extent, thankfully.

But a different drug has creeped in without the hoopla and warnings, and is quickly becoming an abused drug of choice, especially for middle-class Manitobans.

The oxycodone boom is here.

Law enforcement and support workers say the continuous busts by police and rising number of addicts seeking treatment or overdosing on the highly-addictive prescription painkillers are proof, and they’re worried things will get worse if more isn’t done to educate people about the risks and signs. ...more

Wrong Prescription Filled at Walgreens Pharmacy Costs Company $33 Million Following Death of Woman

From Drugwatch:
In 2002, a Walgreens pharmacy filled a woman’s prescription for warfarin, a medication used to prevent blood clots, at 10 times the recommended dosage, a mistake that eventually caused her death. On February 26, 2010, Walgreens was ordered to pay $33.3 million to the woman’s surviving family.

Beth Hippely took her prescription for 1 milligram tablets of warfarin (sold under brand names such as Coumadin) to a Polk Country, Florida Walgreens pharmacy, where a 19-year-old pharmacy technician filled her prescription with 10 mg tables of the medication.

Hippely took the medication for several weeks before she experienced severe headaches, a brain hemorrhage and paralysis. Prior to her death, Hippely’s only form of communication was blinking her eyes. ...more