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

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

Children’s drug recall raises concerns over manufacturing practices

From the Globe and Mail:
A major recall of children’s medications in Canada, the United States and several other countries is raising concerns over manufacturing processes used by the company at the centre of the recall. It also highlights significant differences in how the recall is being handled by authorities in the United States and Canada.

McNeil Consumer Healthcare issued a recall over the weekend of more than 40 types of infants’ and children’s over-the-counter liquid medication sold in more than 10 countries. The Canadian branch of the company posted a recall alert marked “urgent” on its website telling consumers to discontinue use of 11 children’s and infants’ products. There are 10 Motrin brand liquid products involved in the recall as well as one Tylenol product.

McNeil Consumer Healthcare Canada said the recall is being done because the products may not meet “required manufacturing specifications.”

Specifically, the products may contain particulate matter, spokeswoman Tina Peyregatt said. In some instances, the particulate matter may be some of the product itself that has solidified. ...more

Pharmacists not qualified to prescribe: AMA

From Pharmacy News (Australia):
Doctors are warning patient safety will be put at risk by pharmacy’s plans to introduce medication continuance.

Responding to the announcement of the Fifth Community Pharmacy Agreement, AMA president Dr Andrew Pesce criticised the Federal Government’s decision to give pharmacists prescribing rights.

“There should never be a situation where a pharmacist continues a patient’s medication without a current doctor’s prescription and without contacting the doctor to ensure appropriate continuity of care.

“Every prescription medication requires a medical diagnosis of the patient. This is the only way to ensure patient safety. ...more

Pharmacies step up fight with McGuinty by targeting Liberal MPPs

From the Globe and Mail:
Ontario’s pharmacies are escalating their fight against the Liberal government by aggressively targeting the ridings of 25 MPPs.

For the most part, they are MPPs who are expected to face tight contests in the next provincial election – including several ministers. The aim, according to a source close to the pharmacies’ campaign, is to sow dissent among Dalton McGuinty’s caucus members.

If they’re successful, the pharmacies hope the government will feel compelled to soften its plan to reduce prescription costs by eliminating “professional allowances” – the large sums paid by generic manufacturers to stores in return for selling their products.

The drugstores are clearly sparing no expense.

On Friday, a busload of about 50 pharmacy students departed Queen’s Park, aiming to make two stops in each of the 25 ridings.

Three separate flyers are being sent to every household in each of the constituencies – a total of about three million mailings. Each mentions the local MPP by name, charging that his or her “prescription for your family” is “$750-million in cuts to frontline health care.” ...more

Saturday, May 01, 2010

Ontarians won't swallow druggists' pill: Poll

From the Toronto Sun:
The majority of Ontarians who are aware of the province’s plan to reform generic drugs — and the subsequent backlash from pharmacists — believe drug stores are motivated by bottom-line profits, a new government-commissioned poll says.

Only 17% of those polled thought pharmacists were concerned about the impact on access to drugs and health care, while 83% believed revenue was the motive for the opposition.

However, that same Ipsos poll also revealed that more than half of Ontarians are unaware of the pharmacy position on the proposed changes in compensation.

The poll of 1,162 Ontarians, conducted April 16-21, also found support for the government’s planned changes.

Only 6% were strongly opposed and 15% somewhat opposed, compared with 44% somewhat supportive and 19% strongly supportive. ...more