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 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.

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 —, and — 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