When drug-resistant tuberculosis goes extreme

From the Globe and Mail:
Until recently, researchers thought that multidrug-resistant tuberculosis, or MDR TB, was as bad as the disease got.

They were wrong.

In 2005, doctors in South Africa discovered a new strain of the disease. Extremely drug-resistant tuberculosis - or XDR TB - was found to withstand all of the front-line drugs in the tuberculosis treatment arsenal.

Officials in Canada and the United States are searching for passengers who may have travelled with a U.S. man infected with XDR TB on two transatlantic flights this month. ...more

No prescription needed for contraceptive pill

From the Vancouver Sun:
The B.C. College of pharmacists is now offering women the emergency contraceptive pill Plan B as a non-prescription product.

The move comes two years after Health Canada approved the sale of the pill without a prescription. ...more

Authorities hunt 70-80 passengers who sat near TB patient on flights

This is a rather disturbing story. While it seems unlikely anyone was infected, I know I wouldn't want to have been sitting next to this person on a flight.

From the Globe and Mail:
Public health officials in the United States and Canada revealed Wednesday they are looking for roughly 70 to 80 people on two recent transatlantic flights who were seated in close proximity to a man infected with a rare and potentially deadly form of tuberculosis.

In Canada, officials are seeking anyone who sat in Row 12 — plus the two rows ahead and behind — of Czech Airline flight 0104 to Montreal from Prague on May 24.

Officials of the Public Health Agency of Canada have obtained the passenger manifest — the airline's official list of passengers — and are using it to try to trace the passengers to urge them to undergo testing for TB. ...more

Pharmaceutical companies behind push for Ottawa to pay for HIV drugs

It's about time that someone revealed that these patient advocacy groups are totally funded and supported by the pharmaceutical companies. While I think patient groups should be allowed to be formed and pharmaceutical companies should be allowed to sponsor them, there needs to be some transparency.

If any other lobbying group in Canada was 100% funded by one sponsor, they probably wouldn't have a lot of legitimacy. But the Best Medicines Coalition has testified in front of the House of Commons, with a supposed role of being a solely a patient advocacy group. The chairwoman of this group was very ambigious and misleading in describing their funding sources.

During her visit to Parliament earlier this month, Fletcher asked Binder some pointed questions about her group's funding and potential conflict of interest. She told the committee her group receives half its funding from the drug industry and half from Health Canada. Binder said she couldn't name which companies provided money, and said some of it comes from Canada's Research-Based Pharmaceutical Companies, an industry association

But during an interview, Binder said the group actually receives 100 per cent of its $250,000 operating budget from the pharmaceutical industry. Although it received half its funding from Health Canada last year, it was an anomaly, in the form of a grant for a research project.

But the articles ends with this:

The Best Medicines Coalition has nothing to hide, Binder said. She said she doesn't conceal where the group gets its money and would even post that information on the group's website if she thought it were "relevant."

But for now, she said, "I don't think it is."

Excuse me, Louise, but you hid the truth in front of a Parliament committee hearing. If you mean what you say, let's see a complete list of donors over the last several years.

From Canada.com:
Louise Binder is HIV-positive and chairwoman of a coalition that fights for drug-policy reform in Canada. During a recent visit to the nation's capital she urged members of Parliament to rewrite the rules governing prescription drugs that would increase the access patients have to new, expensive medications and require the government to foot the bill.

One thing she didn't mention during that visit is the fact her association, the Best Medicines Coalition, receives 100 per cent of its funding from Canada's pharmaceutical companies - the very industry that stands to profit most from a governmental decision to approve new and expensive drugs for use and coverage in Canada. ...more

Pricing pinches drugstores

From the Globe and Mail:
Uncertainty lingers about whether generic drug pricing changes in Ontario will hurt Shoppers Drug Mart Corp., but already some rivals are feeling the pain.

Loblaw Cos. Ltd., which has a wide network of pharmacies in its supermarkets, has reported a $10-million hit to its first-quarter operating profit because of the legislative reforms, which lower the price the province pays for generic drugs. Other pharmacies in Ontario are being pinched.

"It has hurt pharmacy tremendously," says Neil Bornstein, owner of a drugstore in Toronto that is part of Langley, B.C.-based Pharmasave Drugs (National) Ltd. "The waters are more muddied than ever ... I can't understand how Loblaw can identify it as a significant hurt and Shoppers not." ...more

Cardiac Safety of Avandia® (rosiglitazone maleate)

From Health Canada:
GlaxoSmithKline Inc (GSK), in conjunction with Health Canada, would like to address public concerns about the safety of Avandia®.

An article recently published in the New England Journal of Medicine (NEJM) has raised concern about an increased risk of myocardial infarction (heart attack) and cardiovascular death in patients with type 2 diabetes treated with Avandia®. This article was based on a review of 42 clinical studies. The conclusions reached require confirmation. Further investigation of these results is underway and more information will be communicated when available.
For the public

Sickest patients less likely to get full care

From CTV News:
Two new studies by Canadian researchers suggest that patients in greatest need of heart medications and treatments are often less likely than moderately ill patients to be offered them, and it may because of what's known as the "treatment-risk paradox."

One of the studies, by researchers at universities in Edmonton and Calgary, showed that only 56 per cent of higher risk patients were taking statin drugs a month after being diagnosed with heart disease. In contrast, 63.5 per cent of lower risk patients were taking the drugs a month later.

After analyzing differences between the groups, the researchers found that patients who were depressed or whose lives were most restricted by their heart disease accounted for the difference. ...more

Drug use climbing

From the Sarnia (Ont.) Observer:
Prescription drug addiction can happen to anybody.

Without the proper information and monitoring, it is very easy for someone to become dependent on medications such as opiates, benzodiazepines and stimulants, Luis Viana said.

The pharmacist consultant told those gathered for the annual Chatham-Kent Crime Stoppers appreciation luncheon that addiction to prescription medication is a growing problem. ...more

Canadian drug imports shrink in half from 2004

From the Detroit News:
The once-booming business of selling Canadian prescription drugs to Americans has shrunk in half since 2004-05 as the surging Canadian dollar and better U.S. government health insurance erode the price gap.

Annual sales have slipped below $500 million Canadian, down from nearly $1 billion Canadian in 2004, according to figures supplied by the Canadian International Pharmacy Association, which represents Internet and mail-order drugstores.

The figures include sales of drugs to Americans from third countries, mainly in Europe, but brokered by Canadian pharmacies. ...more

Cancer drug Avastin battleground in debate over fairness versus costs

I suspect that someone is eventually going to take this type of inequality to court as a Charter of Rights challenge. I'd suspect that the court would rule it's a breach of Charter rights, and would that result in a chaotic aftermath in the health care system.

While a ruling like that would appear to be a victory for patients, I think it would financially break the provincial systems, and that would bring in more of a private element into the system. Ironically, this would the opposite result that the plantiff would be looking for.

From the Canadian Press:
Two middle-aged women living on opposite sides of the country, both battling the spread of colorectal cancer, believe a medicine called Avastin separates their fates.

Ruth Tremblay of Vancouver says she's now "cancer free" because the drug is part of her treatment.

Halifax resident Judee Young wonders if her life will be cut short because her provincial government has declared the same medicine, at roughly $35,000 a year, too expensive to provide.

Young, 47, the married mother of an eight-year-old, calls the contrasts "crazy."

"It's a question of whether my health is not as important as someone else's health. I've been a taxpayer for 25 years and the time comes I need help from my government, and I can't get it."

Tremblay, 48, married and living on a yacht with four step children, said she always thought there was an equality of health care in Canada.

"What I've discovered is it's divided down by province on who gets what." ...more

Doctors too slow to embrace electronic health records

I'm glad to see this issue getting attention. I think it's embarrassing that Canada is so far behind when it comes to using electronic record keeping when it comes to medical records.

From CBC News:
Patients would be better cared for if Canadian hospitals and doctors' offices would stop relying on paper charts and begin using electronic health records, health policy experts say.

Computers can improve patient care, for example, by helping to prevent drug interactions, said Charlyn Black, head of the Centre for Health Services and Policy Research at the University of British Columbia.

It can "make sure patients are receiving refills, that they don't forget to take medications, that they get reminders for important preventive care," said Black. ...more

Shoppers has competitive advantage in Ontario: Analyst

From the Financial Post:
Analyst Keith Howlett of Desjardins Securities has reconsidered his position on Shoppers Drug Mart Corp., (SC/TSX) saying the retailer might have a competitive advantage over others despite recent changes to drug policy in Ontario.

The analyst has upgraded his rating on the stock to "hold" from "sell" with an unchanged target of $50.

“Given recent share price weakness, management’s steadfast confidence in the outlook for the business and our possible identification of the company’s competitive advantage in dealing with drug policy changes in Ontario, we are upgrading our rating,” Mr. Howlett wrote in a note to clients. ...more

Trade gambit doubles cost of cancer medicine

From the Globe and Mail:
A chemotherapy medicine that sells for $500 a vial is about to be marketed for double that amount due to changes in Canada's intellectual property rules that, unwittingly, will leave one pharmaceutical company with a monopoly on a long-established cancer drug.

The regulation changes will give Sanofi-aventis Canada eight years of market exclusivity over the colorectal cancer drug oxaliplatin as soon as the firm receives its licence from Health Canada to sell it - expected as early as next month.

That means that three other companies will have to stop selling versions of oxaliplatin to cancer centres, hospitals and patients at deep discounts. ...more

Pharmacist wins compensation

From the Vancouver Sun:
In a landmark decision, the Interior Health Authority has been ordered to pay compensation to a former pharmacist who alleged he was discriminated against because he was a recovering drug addict.

Mark Brady filed the complaint to the B.C. Human Rights Tribunal in 2003 when he was turned down for a pharmacy job at Kelowna General Hospital after he divulged his painkiller addiction history.

He also told former hospital pharmacy manager Gary Inaba and Interior Health that he was continuing in drug treatment programs. ...more

Vioxx, Avandia, what next?

From the Associated Press:
How does a drug go from blockbuster to bust?

How can big safety issues go undetected in medicines taken by millions of people for many years, as happened this week with the diabetes pill Avandia and a few years ago with the painkiller Vioxx?

Or with devices like drug-coated stents, which came under a cloud last year after six million heart patients had already received them?

All roads - and fingers this week - point to the U.S. Food and Drug Administration. From a company's labs to a consumer's lips, the chronically understaffed federal agency has the power and duty to keep dangerous products from harming the public. ...more

Stronger warnings urged for herbal hot-flash remedy

From Canada.com:
Health Canada is being urged to issue stronger safety warnings about the potentially dangerous side-effects of a popular herbal remedy that’s predominantly marketed to menopausal women after reports that it could be linked to liver damage.

Black cohosh is purported to ease hot flashes and other symptoms associated with menopause, but has also been linked to liver problems in Canada and around the world, including a recent death in the United States.

Health Canada announced last summer it would review the safety of black cohosh after reports of problems associated with it. At the same time, the department issued a public advisory warning about the possible link to liver damage. ...more

Diabetes drug linked to heart attacks

From the Toronto Star:
The widely prescribed diabetes drug Avandia is linked to a greater risk of heart attack and possibly death, a new scientific analysis revealed, prompting the U.S. government to issue a safety alert yesterday.

The U.S. Food and Drug Administration urged diabetics taking the pill to talk to their doctors, but stopped short of forcing a sharper warning label on the drug sold by GlaxoSmithKline PLC of London.

More than six million people worldwide have taken the drug since it came on the market eight years ago. Pooled results of dozens of studies revealed a 43 per cent higher risk of heart attack, according to the review published by the New England Journal of Medicine. ...more

Health Canada faces huge backlog in the licensing of natural health products

From the Toronto Star:
An estimated 20 per cent of Canadians regularly use natural remedies because they believe they are safer than man-made pharmaceuticals, according to David Bailey, a clinical pharmacologist at the University of Western Ontario.

"That is simply not true," he says. "Many of our most potent medications and toxic substances are derived from plants."

Health Canada tries to keep up with new products through its Natural Health Products Directorate. Products that meet the agency's criteria for safety, efficacy and quality get a licence and an eight-digit Natural Product Number. All 50,000 natural health products for sale in Canada must have an NPN by 2010. ...more

Rapid spread of disease alarms experts

From the Globe and Mail:
The public-health world has been alarmed since the early 1990s about what's called multidrug-resistant (MDR) tuberculosis.

Drug resistance emerges when people are prescribed the wrong drugs or do not complete a course of treatment, which allows for the natural selection of bacteria that are resistant to the drugs.

MDR is found all over the world, with the fastest growth in cases in China and Russia. It is curable in about half of cases, but patients must take highly toxic drugs for as long as two years to get rid of it. (The other half of people die of the disease within a few years.) ...more

Experts scorn 'natural' products

From the Toronto Star:
It's a billion-dollar industry that uses photos of svelte bodies and flashy fat-busting claims to peddle its products:

"Lose 30 pounds in 8 weeks!"

"Pound-for-Pound, The Most Powerful Weight-Loss Formula on Earth!"

"Lose 10.65 pounds fast!"

And it works: Thousands of overweight and obese Canadians are lured to store shelves and strip malls by these promises of perfection. ...more