Misadventures in medicating

I suppose there is two ways to look at these numbers:
1) pharmacists are needed to help prevent these types of reactions
2) why aren't pharmacists catching more drug-related problems

From the National Post:
Many of the patients filling Canada's crowded hospitals are there because of side effects and other problems with their medication -- and most of those drug "misadventures" could be prevented, a new study suggests.

Almost one in four admissions to the internal-medicine ward of British Columbia's largest hospital was the result of adverse drug reactions, doctors prescribing the wrong medicine or similar glitches, the study found. ...more

Tablets found in Halloween bags were vitamin samples Store owner was promoting business; says children were not at risk

This isn't a pharmacy or pharmacist story, but since it's related to vitamins (and it's unusual) so I thought I'd include it. I don't have much experience in marketing, but I don't think trick-or-treating kids are the primary target market for a vitamin store.

From the Richmond (BC) Review:
Trick-or-treaters in Seafair found a healthy surprise among the candy they collected on Halloween, alarming some parents.

Karen and Ed Robinson found sample packages of children’s multivitamins and vitamin C, each containing two or three tablets, in their children’s treat bags.

...The vitamins were inside sealed manufacturer’s packages and tucked in a larger plastic bag that contained chocolate, chips and a business card for local vitamins and sports nutrition business......more

Alesse birth control pills back in stock soon

It sounds like there is some progress in the efforts to end the Alesse shortage. Has anyone received a new shipment recently?

From CBC News:
Pharmaceutical giant Wyeth says it's making progress in ending a shortage of two popular birth control pills in Canada.

Drug stores across the country are running low on Triphasil and Alesse, and some pharmacies have run out. The company blames a problem at its manufacturing plant. ...more

Codeine more lethal than OxyContin: N.L. data

From CBC News:
Codeine, a common ingredient in over-the-counter cold medicines, has been more lethal than OxyContin in Newfoundland and Labrador, according to provincial government data.

The office of Newfoundland and Labrador's chief medical examiner listed codeine as the cause or a contributing factor in the deaths of 16 people between 2000 and 2005. ...more

Osborne 'surprised' by codeine-related deaths

From CBC News:
Newfoundland and Labrador's health minister said he was caught off guard by revelations that codeine may be related to twice as many deaths as OxyContin.

"This information is a surprise to me," said Tom Osborne, reacting to data obtained by CBC News through a provincial Access to Information Act request. ...more

Needle bungle prompts call for diabetes test changes

I'm not sure how this could happen. Who was conducting the tests? I don't buy that the directions with the machine were unclear. Surely if a typical patient can figure it out a pharmacy staff member should be able to as well.

From CBC News:
The public health authority in Quebec's Chaudière-Appalaches region wants changes made to the province's diabetes detection program after 150 people were tested with shared needles at a grocery store in Thetford Mines.

Public health officials are tracking down people who took the test to administer HIV and hepatitis B and C tests as a precaution after they discovered the device used wasn't working as expected. ...more

Obesity drug may help Type 2 diabetes

I'm not sure if I've mentioned it here before, but I am predicting that Acomplia/rimonabant will be the biggest pharmaceutical phenomenon since Viagra.

From CBC News:
An experimental obesity drug also appears to help reduce the health risks from Type 2 diabetes, researchers say.

The Sanofi-Aventis drug rimonabant, also called Acomplia, reduced risk factors for heart disease in people with Type 2 diabetes compared with those taking a placebo, European researchers report in Friday's online issue of the medical journal The Lancet. ...more

Medicare Part D having big impact on pharmacies

It appears that Medicare Plan D may be drawing customers away from Canadian pharmacies, but the plan also has brought negative effects to American pharmacies as well.

From the Pierre (SD) Capital Journal:
The South Dakota Health Care Commission recently took a look at the impact of Medicare Part D on pharmacies in South Dakota.

"What it all means is that independent pharmacies will be out of business," said Dana Darger, director of pharmacy at Rapid City Regional Hospital, and presenter at the commission meeting. ...more

Many ginseng-based cold remedy claims unproven, expert says

From CBC News:
The success of a natural cold remedy has spawned a number of knock-offs based on ginseng, but in most cases, the science behind the products is lacking.

Cold-fX was developed at the University of Alberta and has quickly become the biggest selling cold medicine in Canada.

"I think it's a big market," said Pam Lavold, a pharmacist in Edmonton. "I think everybody is jumping on the bandwagon and putting out their own product." ...more

Ontario battling drug firms

From the Globe and Mail:
Generic drug manufacturers have threatened to cut the supply of up to 150 medications to Ontario's drug benefit plan -- including antidepressants and a drug to control heart arrhythmia -- in an escalating price dispute with the provincial government.

Legislation designed to curb drug costs, which came into effect Oct. 1, has reduced the prices that the Ministry of Health pays pharmacies for generic drugs by more than 20 per cent in some cases. ...more

Methadone clinic nurse did not know overdose procedure, inquest told

From CBC News:
An Ottawa clinic nurse who first noticed a man had received a fatal methadone overdose during treatment told a coroner's inquest that she did not know of any procedure at the facility to deal with such a mistake.

Sandra Nault testified Monday into the death a year ago of 41-year-old Wade Hatt, who was sent home from the government-sanctioned clinic on Somerset Street after the accidental overdose. He later died. ...more/

Liberal MP tables bill to ban bulk drug exports

Private members bills don't rarely make it all the way to becoming law. I'd say it's even more unlikely in this session of Parliament, but it's an interesting statement.

From the Canadian Press:
The federal government says it has no immediate plans to ban the bulk export of prescription drugs because there’s no evidence the cross-border trade is putting Canadians at risk.

Liberal MP Carolyn Bennett tabled a private member’s bill Tuesday that would prevent U.S. state and city governments from buying cheaper drugs from Canada to help subsidize their health plans. ...more

Reimportation Looms

Typically the refrain as to why pharmaceuticals are cheaper in Canada is "government price controls." Well, it's never been as simple as that. This article breaks down some of the other lesser known reasons.

From the American Spectator:
As of last month, Americans can now purchase Canadian drugs through the mail without fear of U.S. Customs officers seizing the packages. Meanwhile Congress reached agreement on a bill that would allow Americans to buy prescription drugs at Canadian pharmacies and transport them home. ...more

Birth control pills out of stock, women out of luck

At any given time there are several medications that Canadian pharmacies cannot purchase. Reasons can be varied, but typically the reasons behind the shortage is not revealed by the manufacturer. I can understand why these shortages made the news as both Alesse and Triphasil are among the most prescribed drugs in Canada. Fortunately there are potential alternatives available if the supply is totally drained.

How bad is the shortage thoughout Canada? Leave a message in the comments section and let us know.

From CBC News:
Two popular brands of birth control pills are in short supply across Canada, leaving many women scrambling to fill their prescriptions.

The pills — under the Alesse and Triphasil names — are made by the U.S. company Wyeth Pharmaceuticals. The company temporarily stopped production of the two brands in August, which means some pharmacies have run out, making refills almost impossible to get. ...more

Supreme court says pharmacist kickback probe must go on

Here is a bit more info regarding the Supreme Court decision relating to a Quebec Order of Pharmacists' investigation.

From CBC News:
The Supreme Court of Canada has ruled the Quebec Order of Pharmacists can pursue its investigation into allegations that some of its members received kickbacks from pharmaceutical companies.

The SCOC ruled Thursday that four pharmaceutical companies must comply with the order's investigation, and hand over relevant records. ...more

Association of Avastin (bevacizumab) with hypertensive encephalopathy and reversible posterior leukoencephalopathy syndrome (RPLS)

From Health Canada:
Hoffmann-La Roche Limited, in consultation with Health Canada, has informed Canadian healthcare professionals of important new safety information concerning AVASTIN (bevacizumab).
For Health Professionals...
For the Public...

Canada - Internet Pharmacies - New U.S. Legislation Puts The Issue Back Into The Spotlight (27/10/2006 17:27:36) from Mondaq

From Fasken Martineau:
Over the last four years the issue of "internet pharmacy" and the import of pharmaceutical drugs into the United States from Canada has become a very contentious political and legal subject. According to IMS Health Incorporated data, the annual total value of sales to the United States through the 278 confirmed or suspected Canadian based Internet pharmacies, identified as of June 2005, was estimated at (CDN) $507 million.1 Early in 2005, a Health Canada official testifying before a committee of the House of Commons stated that there were, at that time, about (CDN) $1.35 billion worth of cross-border retail sales into the United States. Of these sales, approximately $840 million were via Internet pharmacies, with the rest coming from so-called foot traffic. Trans-border drug sales represent eight percent of a $16 billion prescription market in Canada, but less than 0.5 per cent of the U.S. market of some $300 billion.2 ...more

Eyes wide open

It's suprised me that modafanil hasn't been discussed as a "lifestyle drug" more often. Alertec has been sold in Canada for years. It not hard to believe that attempts would be made to determine if modafanil can be the ultimate wake up pill.

Interestingly, when Alertec was initially released in Canada, it was considered a controlled drug. Shortly after its release it was changed to regular prescription drug status. I believe that it is still considered a controlled drug in United States, albeit at their lowest schedule of control.

From the Toronto Star:
"Could I have a non-fat cappuccino with modafinil to go?"

It's quite possible that a few years from now, that will be the wake-up mantra for millions of people around the world. Modafinil, distributed in Canada as Alertec, is a chemical first made in France in the 1970s for treating narcolepsy. But in the past few years, it has been used more and more to combat daytime sleepiness among shift workers. Doctors say it is safe, and that it can "turn off" the urge to sleep. ...more

Net pharmacy closing amid conflict questions

I wasn't aware of this website until I read this article. Based on the info from the article, it's probably best that this site has shut down. Drug manufacturers selling their product directly under the umbrella of a typical pharmacy (which they own) doesn't sound like a great precedent.

From the Toronto Star:
An online drugstore owned by a major U.S. drug maker and run by a prominent Waterloo pharmacist is suddenly shutting down Monday amid questions about a possible conflict of interest.

The move comes after the Toronto Star started asking questions about the unusual arrangement that had industry observers worried. ...more

Weekend YouTube fun

Corey Nahman of coreynahman.com posted a list of YouTube videos relating to pharmacy on his site. They are not to be taken seriously, but are good for a laugh. Below is the link to a clip from the Simpsons episode "Midnight Rx." The plot revolves around the issue of buying prescriptions from Canada.

Supreme Court orders Quebec drug maker to co-operate with inquiry

This article doesn't provide many details, but I suspect we'll hear more about this story in the near future.

From CBC News:
The Supreme Court of Canada has ordered a generic drug manufacturer to co-operate with the Quebec Order of Pharmacists in a rebate investigation.

The Order has demanded since 2003 that drug manufacturer Pharmascience provide details of rebates or other advantages it has offered to pharmacists. The company refused. ...more

Studies challenge drugmakers' claims

This story really shouldn't be that surprising. These medications have been primarily touted as a modest first step to treat Alzheimer's. I suppose the bigger question is whether they are worth the expense. There are a lot of drugs on the market that are worthy of coverage, and budgets are limited. Sometimes tough decisions have to be made by the drug benefit managers.

From the Ottawa Citizen:
Canadians spent $143 million last year on three major drugs to treat Alzheimer's disease, but a national study suggests that investment produces few meaningful results for patients or their caregivers.

The Canadian Agency for Drugs and Technologies in Health last year completed a thorough review of drug trials related to the Alzheimer's drugs Aricept, Exelon and Reminyl. ...more

Flu shots rolling out for Canadians

From CBC News:
The bulk of seasonal flu vaccine is ready to go to the provinces and territories, says the Public Health Agency of Canada, which performs quality checks on all batches before releasing them for use.

In Ontario, people at highest risk, such as residents of long-term health-care facilities or those with chronic medical conditions such as heart or lung disease, have already received their vaccines. ...more

GlaxoSmithKline CEO says drug law will 'restructure' Ontario drug market

From CBC News:
New legislation in Ontario designed to curb the price of prescription drugs through bulk discounts will scare away investors by creating a "transactional relationship" between government and drug developers, the head of GlaxoSmithKline Inc.'s (NYSE:GSK) Canadian operations said Tuesday.

The Transparent Drug System for Patients Act will have a ripple effect across the country by encouraging the use of copy-cat medication and cutting into drug company revenues, Paul Lucas said in a speech to pharmaceutical investors in Toronto. ...more

Be your own advocate to increase safety, doctor suggests

This isn't a pharmacy-specific article, but it has a good message for patients and health care professionals.

From CBC News:
Patients put too much trust in doctors and should take a more active approach to their medical well-being, a health-care safety conference heard Friday.

Health experts from across Canada and around the world are meeting in Vancouver this weekend to attend the Canadian Healthcare Safety Symposium. ...more

Opening doors to unproven treatments

From the National Post:
One expert calls 714X simply a "bad joke." Health Canada says there is no scientific evidence the cancer drug does any good.

But the regulator has just re-opened access to the controversial and unlicensed medication in the wake of a Federal Court ruling that analysts say could boost the availability of a host of other unproven, alternative treatments. ...more

Technical help may be of little value: pharmacy board

This could be a first: a pharmacist organization publicly questioning the role and usefulness of pharmacy technicians. They actually even went further by suggesting that technicians result in pharmacists having to do more work.

From CBC News:
...Newfoundland and Labrador Pharmacy Board registrar Don Rowe said: "It may help and assist in taking care of some of the technical functions, but it's an added task then that the pharmacist will have in terms of supervision and oversight of those technicians."
...more

I think the pharmacy board is missing the point. The effective use of technicians has been shown to help pharmacists focus on professional tasks. Rowe says that technicians may help with technical functions. No kidding...that's what they are there for.

All of this seems to be as a result of a labour dispute occurring in Newfoundland hospitals. There is more info in this CBC News report.

From what I've seen over the years, pharmacy technicians do a pretty good job and fill an important role in any type of pharmacy practice. I would hate to see relations between pharmacists and techs damaged because of this, especially since the pharmacists' dispute is with the government, not their co-workers.

By the way, why are Newfoundland hospital pharmacists preparing chemo anyway? I know that many hospitals rely on qualified pharmacy techs to do the manual tasks of making the product and the pharmacist checks their work. This is done without incident all over the continent and is not considered bad practice as long as policies and procedures are in place.

New regulations give additional dose of protection to drug companies

I haven't read any of the actual legislation yet, but it sounds like these new regulations will protect the brand name pharmaceutical companies and their patents for an extended period of time. However, there is an interesting line in the article stating that these companies will not be able to throw up certain legal roadblocks when a generic company makes application for a new product. As I understand it, brand name companies have the ability to delay new generic approvals even if their patent has expired. These legal tactics effectively delay a generic coming to market and results in a practical extension of a patent.

I'm looking forward to reading more about this and what it will actually mean down the road.

From the Canwest News Service:
Prime Minister Stephen Harper's government quietly unveiled controversial new regulations Wednesday that will extend market protection for some drugs produced by brand name firms in a move critics predict will lead to higher costs for consumers and provinces already facing skyrocketing medicare bills.

The new rules, which took effect earlier this month, increase exclusive selling rights for all brand name drugs to eight years from five, with an additional six months of protection granted to drugs involved in pediatric studies. ...more

Health Canada warns consumers about counterfeit Lifescan blood glucose test strips

From Health Canada:
Health Canada is warning Canadians that certain Lifescan, Inc., One Touch Brand Test Strips, Basic/Profile and Ultra, sold in the United States are counterfeit. The counterfeit blood glucose test strips could potentially give incorrect blood glucose values, either too high or too low, which could result in a patient taking too much or too little insulin, leading to serious injury or death. ...more

Island doctors want province to cover cost of HPV vaccine

For years, vaccines seemed to be somewhat of an afterthought in the pharmaceutical business. Recently they have become one of the hottest areas of research and development. But now that some innovative products have either been released or soon will be approved, drug benefit plans are going to have to decide what will be covered or not.

The drug formulary commitees have always seemed to be more focused on treatment with prevention not viewed as being all that much of a priority. It will be interesting to see how they handle some of these products such as Gardasil, which appears to be a truly innovative breakthrough product.

From the Victoria Times Colonist:
Island doctors want the province to pay for a new vaccine to protect girls from genital warts and cervical cancer, a disease which kills 400 Canadian women each year.

But the human papilloma virus or HPV vaccine, approved by Health Canada for females aged nine to 26 years, costs about $400 for three doses. ...more

A short break

There will probably not be any new posts until Tuesday or Wednesday as my access to a computer will be relatively limited until that time.

Canada shouldn't be 'medicine cabinet' for U.S., pharmacists warn

Cross border pharmacy has hit the headlines again. Now that the American government is stopping their crackdown on medications from Canadian pharmacies, there is considerable concern about the States using up the existing drug supply.

The Canadian Pharmacists Association and the Ontario Pharmacists’ Association are leading the charge. The OPA has issued this press release stating they are “deeply disturbed” about the situation. Jeff Poston of the CPhA has similar thoughts. "We can't afford to be the medicine cabinet for the U.S.," said Poston.

While I understand their concerns, I think their fears are largely unfounded. First of all, there is no sign that the doors have been flung open in the States without restriction. The FDA will still be seizing packages from Canadian pharmacies according to this article. Bulk imports of drugs still aren't allowed and there is no plan to change that.

Changing these rules don't alter the fact that prices of medications from Canada just aren't as appealing as they were two or three years ago. The increased exchange rate, pharmaceutical company restictions on the online pharmacies, and the option of Medicare Plan D will keep many Americans dealing with pharmacies in their own country regardless of any policy change. I don't see a return to the booming days of a couple years ago for internet pharmacies unless some of these factors also change.

Besides, many people look at these decisions to simply be a method to gain votes in the upcoming American midterm elections. I don't think too many people would be shocked to see a return to the previous policies in the new year once the votes have been counted.

From CBC News:
An American decision to stop seizing U.S.-bound prescription drugs at the border could jeopardize the Canadian drug supply and access to care, a pharmacy association warned Thursday. ...more

Updated Safety Information on Ketek (telithromycin) and hepatic events, aggravation of myasthenia gravis and syncope

From Health Canada:
Sanofi-aventis Canada Inc. in consultation with Health Canada would like to inform you of important updated safety information regarding KETEK (telithromycin) tablets. Based on information in published case reports* and post-market adverse event reports, the Canadian Product Monograph has been revised to include information on severe and sometimes fatal hepatotoxicity in patients taking KETEK. The Product Monograph also includes updated information regarding syncope (loss of consciousness) and the use of KETEK in patients with myasthenia gravis.

For Health Professionals
For the Public

Health Canada approves promising new drug to treat multiple sclerosis

This sounds like a rather promising new drug approval. Hopefully it can provide some benefit to MS patients, despite a rare but potentially deadly adverse reaction. The risk to benefit ratio always has to be considered, but I fully expect that many MS patients with limited treatment options will appreciate a new possibility.

From CBC News:
Canadians with multiple sclerosis will soon have access to a highly touted new drug for the treatment of the relapsing-remitting form of the progressive neurodegenerative disease, following approval of the medication by Health Canada.

The new drug, to be sold under the brand name Tysabri, is the first in a new therapeutic class of MS treatments called selective adhesion molecule inhibitors and the first pharmaceutical advance for treating MS in 10 years, manufacturers Biogen Idec Canada and Elan Corp. said Wednesday. ...more

Pharmacists on front line of drug rehab

From CBC News:
Hundreds of people trying to kick a drug addiction have been lining up at pharmacies in Cape Breton every day under an expanded methadone program.

Methadone is used to wean people off heroin, OxyContin and other highly addictive drugs, and used to be only offered at clinics. ...more

FDA role restored over mail-order drug imports

From Reuters:
U.S. customs officials will still seize prescription drugs imported from Canada through the mail but will hand over enforcement to federal health officials in a policy reversal that one lawmaker said would benefit consumers seeking cheaper medicines.

Since November 2005, customs officials have confiscated medicines ordered through Canadian pharmacies, sent letters to customers notifying them of the violation, and in many cases destroyed the drugs.

But the U.S. Customs and Border Protection agency said on Wednesday it will revert to its earlier policy of sending the confiscated orders to the U.S. Food and Drug Administration where enforcement is expected to be more relaxed. ...more

Katz Group commits $14M to U of A

From the Edmonton Journal:
The Edmonton-based Katz Group pharmacy chain has committed $14 million to the University of Alberta’s faculty of pharmacy, the largest ever one-time gift to a Canadian pharmacy school.

The money will be matched by the provincial government for a total of $25 million. ...more

Cancer drug may decrease heart function, company advises

Health Canada has recently issued advisories regarding the anticancer drug (imatinib mesylate (brand name Gleevec). Separate advisories are published for health professionals and the public.

From CBC News:
The cancer drug Gleevec may carry a risk for decreased heart function, drug maker Novartis Pharmaceuticals warned Monday.

Gleevec or imatinib mesylate is used to treat adults with a type of blood cancer called chronic myeloid leukemia and a type of cancer of the stomach and bowels known as gastrointestinal stromal tumour. ...more

U.S. to Allow Canadian Drug Imports

Here are a couple of articles from the Los Angeles Times and the Charlotte NC Observer about the apparent easing of U.S. Customs' ongoing campaign to restrict Canadian drug imports by mail.

From the Los Angeles Times:
The federal government plans to halt a controversial crackdown on discount
drugs mailed from Canadian pharmacies to U.S. customers, removing a significant
hurdle to Americans buying cheaper medications from abroad.

The Department of Homeland Security, which operates the Customs and Border
Protection agency, disclosed this week that it would halt confiscation of
Canadian drugs Monday and instead conduct random sampling to identify
counterfeit and unsafe drugs. ...more.

Drug imports from Canada set to be eased

I am rather behind on news, but I thought this was worth mentioning even though it's a few days old. Is it political posturing prior to an election or potential for actual imporation? We'll see, but as long as the exchange rate is at its current level there will probably not be a big push for Canadian drugs regardless.

From the Fort Worth Star Telegram:
House and Senate Republicans reached an agreement that would allow Americans to bring a 90-day supply of prescription medications back across the border from Canada.

Shopping for drugs in Canada has become popular with U.S. consumers. The cost of many popular brand-name prescription drugs can be 30 percent to 80 percent lower in Canada than in the U.S. because of government price controls, surveys by The Associated Press and others have shown. ...more

McGill researchers say reanalysis confirms antacids raise risk of C. difficile

If I was a researcher, I'd really like to set up a study to determine the difference in effectiveness between H2 blockers and proton pump inhibitors. This article is an arguement to avoid the PPI's when possible.

From CBC News:
Widely prescribed antacid drugs appear to be linked to a higher rate of C. difficile cases in people who have acquired the nasty bacterium outside of hospitals, a team of Montreal researchers reported Monday in the Canadian Medical Association Journal.

Using data collected on the patients of family doctors in Britain, the researchers showed that non-hospitalized people who took drugs known as proton pump inhibitors were three and a half times more likely to develop Clostridium difficile than people who didn't take the popular drugs. ...more

Report reveals flawed drug system

These recommendations from the Institute of Medicine make quite a bit of sense. I like the idea of a mandatory re-evaluation of a new product within five years.

I suppose these concepts are being brought forward with the goal of preventing another Vioxx or Baycol incident. My concern is that these measures won't prevent the inevitable questionable prescribing of the latest new drugs over tried-and-true therapies that are lacking some tiny advantage that was pointed out by a drug rep.

From the Globe and Mail:
A new report that calls for a major overhaul of the way prescription drugs are regulated and monitored by the U.S. Food and Drug Administration also has applicability to Health Canada, medical experts say.

The report, released Friday by the Institute of Medicine, part of the National Academy of Sciences in the United States, recommends that consumer alerts be put on the labels of all new drugs for a two-year period. Other recommendations include a mandatory re-evaluation of the safety and efficacy of new drugs within five years of their approval for use. ...more

Canada to Let Biolyse Make Generic Version of Roche's Tamiflu

From Bloomberg:
Biolyse Pharma Corp., a closely held Canadian firm, may soon become the first company to use a World Trade Organization treaty to make a low-cost generic copy of Roche Holding AG's Tamiflu and help developing countries fight a potential avian-flu pandemic.

The Canadian government on Sept. 21 added the drug, also known as oseltamivir, to a list of patented medicines that can be produced and exported to developing countries even as the patent remains active, a process called compulsory licensing, Doug Clark, Industry Canada's director of patent policy, said in an interview today. The list, which was established in compliance with the 2003 WTO treaty and contains 58 drugs, hasn't yet been used. ...more

Co-founder of online drug industry scales back after counterfeit allegations

Here's another RxNorth article, quoting the owner Andrew Strempler. It's difficult to say from the article how involved he will be in the new arrangement. It has been my understanding that he hasn't been too involved in day-to-day operations in Minnedosa for some time.

It appears that the pharmacy staff in Minnedosa will be let go. I have not seen any mention of the Barbados operation run by RxNorth, but I would expect that it will be closed up as well.

From CBC News:
A Manitoba co-founder of the multimillion-dollar online pharmacy industry is scaling back his business after allegations that his websites sold counterfeit drugs.

RxNorth.com, owned by Andrew Strempler, has contracted its dispensing operation to CanadaDrugs.com, the largest player in the industry.

"This decision was made in the interest of continuity of patient care, medication supply and to maintain the same high standards of customer service and safety that RxNorth.com has always provided," the company said in new release Wednesday. ...more

Internet pharmacy moves part of operation out of Minnedosa

It was bound to happen eventually. One of the first and largest Canadian online pharmacies is transferring its operations to a competitor. The fact that it's RxNorth shouldn't be a big shock. After the FDA warnings in the summer, the company was looking at a difficult road to recovery, especially in a trying online pharmacy market.

From CBC News:
Minnedosa, Man.-based internet pharmacy RxNorth.com is shutting down its distribution operation there and moving it to a Winnipeg company, due to American concerns over drug safety.

RxNorth.com, which is operated by Mediplan Global Health Inc., will transfer its operation to another company, CanadaDrugs.com, which is based in Winnipeg. ...more

U.S. TV ad campaign backs purchase of Canadian drugs

The American midterm elections will be happening soon. I don't expect importation of pharmaceuticals from Canada to be remotely as important as it is was in the 2004 elections. However, I'm sure some politicians will try to get some attention by bringing up the topic. The AARP has decided to run a series of TV ads in the districts of "importation friendly" Senators.

From the Globe and Mail:
An advocacy group for the elderly is launching a $500,000 (U.S.) ad campaign Sunday in 14 states pushing for Senate action on legislation that would let consumers buy U.S.-made prescription drugs from Canada and other countries.

The ads will appear in newspapers and on radio David Certner, legislative policy director for the advocacy group, said the campaign focuses on the home states of senators who have shown some openness to letting people buy U.S.-made medicine shipped abroad.

Drug used to treat Type 2 diabetes also seems to prevent it in high risk cases

I wonder if the results of this study will result in high risk patients starting Avandia. I seem to remember a similar study regarding metformin, but I don't think it ever gained any traction.

From CBC News:
A drug used to treat Type 2 diabetes appears to prevent onset of the disease in some people who at high risk of developing it, authors of a large international study reported Friday.

The Canadian-led trial found people who took the drug rosiglitazone (sold as Avandia) and who were given advice about lowering their risk through diet and exercise were substantially less likely to develop diabetes in the three years of followup than people who received lifestyle advice and took a placebo. ...more

Pharmacist had 'friend'

The fake Norvasc in Hamilton trial is adjorned for a month or so, but here is a rather interesting article about the testimony of one of the drugstore's pharmacy assistants. She claims she found nothing unusual about the directive to not order Norvasc from traditional sources, even after the tablets looked different. I'm not sure if she came off as loyal to her employer or simply oblivious, but I can't imagine she looked that great on the stand.

From the Hamilton Spectator:
When RCMP entered the King West Pharmacy in June 2005 looking for counterfeit drugs, their attention was caught by a note on the wall where the fast-selling medications were kept.

The handwritten poster said: "Don't order any Norvasc. Ask Abs."

Pharmacist Abadir Nasr, who bought the Hamilton business in August 2004, had told staff not to order the cardiovascular medication from their regular wholesaler because he had a friend who would be supplying the store. ...more

Governor Blagojevich to expand prescription drug plan

Some harsh words for the I-Save-Rx program...

From WLS-TV (Ill.):
The Illinois auditor general says importing prescription drugs from Canada is not only illegal -- it doesn't help many seniors. But Governor Rod Blagojevich announced plans Tuesday to expand the state's prescription drug program.

The governor launched the program nearly two years ago to help Illinois seniors cut the cost of their medications. But Illinois Auditor General William Holland says the program not only violates federal law -- it's a failure. ...more

Naperville woman's medicine cut off

From the Joliet (Ill.) Herald News:
Grace Wojtowicz of Naperville has fallen into the doughnut hole and it isn't sweet.

Last February, Wojtowicz, 71, signed up for Medicare Part D, joining the 22.5 million Medicare beneficiaries who now obtain their prescription drugs under the program. At first, her $49 premiums under Part D were less than what she had been paying to order her drugs from Minitdrug, a Canadian pharmacy based in Calgary. ...more

2nd heist rattles pharmacist

Another crime story relating to Canadian pharmacy. This one involves a pharmacist as a crime victim instead of being the perpetrator.

From the Ottawa Sun:
A pharmacist who's been robbed at gunpoint twice in the past month says police need to step up patrols to protect small retailers from armed robbers.

"We need more protection. There are certain pockets of the city that need more surveillance and more patrolling," said the owner of the Montreal Rd. Pharmacy.

"If the police know that there is a pharmacy that's been hit a couple of times, they should have a constant surveillance, whether it be undercover or whatever, to keep a watchful eye on us," said the pharmacist who didn't want his name published out of fear for his safety. ...more

Sight blurred after dizziness

I get the impression that updates from the courtroom are going to be a reasonably regular feature at Canada Pharmacy News over the next while. This post has two links: the first one was published yesterday and can be seen here.

I don't see much new in either report compared to the first one. More patients testified about problems associated with taking fake Norvasc. I find it reprehensible that the pharmacist dismissed their claims. Maybe he (misguidedly) thought that he could make more money by using cheap foreign Norvasc but once the problems started to reveal themselves, he should've put a stop to the whole thing and tried to make things right.

From the Hamilton Spectator:
John Dindial awoke the morning of April 24 last year feeling extremely dizzy, then his sight went blurry and the room began to go black.

The 69-year-old Hamilton man was visiting a friend in Scarborough who took him to the Rouge Valley Centenary Hospital. The patient, who had diabetes and high blood pressure, had been controlling his hypertension for about 12 years with a cardiovascular drug known as Norvasc.
...more

Problems with the blog

There have been some technical difficulties with the blog. Hopefully they are fixed shortly.

New pharmacy 16 years in works

I love hearing a success story like this. After many years of hard work, an couple opens an independent pharmacy. I really hope they can make the business work.

From the London (Ont.) Free Press:
Andrew and Bonnie Gurgul realized one dream 16 years ago when they came to Canada and a second dream five months ago when Andrew opened an independent pharmacy.

For the Gurguls, it hasn't always been easy. The Polish immigrants first left their native land for Germany in the late 1980s, when communism was falling and tough living conditions got tougher. ...more

Rx for excellence

Here's an article about the new pharmacy school at the University of Toronto. It seems to be a definite improvement over the old facilities. There's no shortage of corporate names attached to it, but I suppose that's the way things are these days. The "hanging classrooms" and bookless library sound pretty cool.

From the Toronto Star:
Suddenly this fall, pharmacy student Jason Lam feels like he's on Star Trek.

To enter his weekly fall seminar about the drug industry, the fourth-year student must cross a catwalk into a sleek silver classroom that hangs like a spaceship in mid-air over the student lounge.

It's one of two egg-shaped lecture "pods" suspended in the glassy five-storey atrium in the University of Toronto's dramatic new pharmacy digs at the corner of College St. and University Ave. As undergraduates arrived this week for their first classes in the new $75 million building, the airy design by British architect Norman Foster won top marks from many. ...more

Pharmacist's trial told of numb face

The trial of the Hamilton pharmacist who allegedly was selling fake Norvasc started this week. The article below provides some compelling information. It sounds like an inquistive patient and pharmacist got the investigation rolling. This whole episode is a black mark on the profession, but thankfully is not representative of pharmacy in general.

From the Hamilton Spectator:
Beryl Preston was flying home to Canada from a winter holiday in Cuba when one side of her face went suddenly numb.

The retired Dofasco employee, who was taking six different medications for high blood pressure and other ailments, got the attention of a flight attendant, explaining the numbness was spreading across her face toward one eye....more

Pharmacists' touch brings patients relief

Here's an article discussing compounding pharmacists in Toronto. It's worth a read...

From the Toronto Star:
Pharmacist Richard Stein has a special way of getting personal with his patients.

Not only does he have intimate knowledge of which medicinal ingredients they can or can't tolerate, he often even knows what flavours they prefer.

He is a compounding pharmacist, which means he customizes doctor-prescribed medicines for patients with special, individualized needs — people and animals....more

Rae pledges catastrophic drug plan if elected federal Liberal leader

It was bound to come up at some point...proposing a national pharmacare program has been brought up by a Liberal leadership candidate. This article suggests that Bob Rae is more interested in developing a plan that can only be accessed under catastrophic circumstances as opposed to a universal plan that all Canadians would be obligated to be part of. However, the article then quotes him talking about replacing existing provincial plans so I'm really not sure what he wants.

I don't know the mechanisms of some of the other provincial drug plans, but I don't think a federal plan would be any better than what is already here in Alberta for example where there are mechanisms that generally prevent huge out of pocket expenses for drugs. Provinical programs completely cover transplant medications and antiretrovirals for HIV patients, and any Alberta citizen with a provincial health card can apply (and cannot be refused) to get a plan similar to what all seniors over 65 get autotmatically. The deductible for this coverage is based on income and even at the full rate it is quite affordable.

Also, isn't health care a provincial responsibility? The feds handle drug coverage for refugees, First Nations peoples, and veterans but these are exceptions.

From the Canadian Press:
Canada needs a national catastrophic drug program to help patients who face bankruptcy when their health demands that they pay for a costly, life-saving drug, federal Liberal leadership hopeful Bob Rae said Thursday.

The so-called Maple Leaf Drug Plan comprises the centrepiece of a six-point health-care campaign platform Rae unveiled Thursday as part of his effort to succeed Paul Martin as leader of the federal Liberal party. ...more

'Expert pharmacists' get go-ahead in UK

It's not really Canadian pharmacy news, but I thought there are some interesting parallels between the expansion of pharmacists' roles in Britain and in Alberta.

From BBC News:
Patients will soon be able to consult "expert pharmacists" under plans revealed by the government.
They will be able to offer advice and support for people with conditions such as diabetes, heart disease and sexually transmitted infections.

The first specialists are set to be in place across England from next summer, the government said. ...more

Delayed availability of Influenza Vaccine for the 2006-07 Season - Statement - Public Health Agency of Canada

I have not heard any of the major media sources (newspapers, television news) report this information yet. I think that's a bit unusual as this can be played up as a huge story even though it's probably not that big a deal. When they eventually notice, I'm sure we will see the usual inferences to a potential pandemic, which always seems to catch attention.

From Health Canada:
Flu vaccine manufacturers have reported problems growing one of the strains recommended for this season’s flu shot. As a result, the vaccine should be available to the provinces and territories at the end of October or beginning of November.

This is about a month later than usual in some jurisdictions and means that the timeframe for the delivery of public programs will be compressed. People, however, should be able to receive the vaccine before the peak of the flu season, which typically does not occur until mid-December or later. ...more

Antiretroviral drugs keep HIV-positive triathlete on track for world event

Here's a good little article talking about how antiretroviral therapy can change patients' lives.

From the Halifax Chronicle Herald:
As a triathlete with HIV, Scott Simpson says the reason he can race in the world triathlon championship Saturday is because he’s part of the lucky minority to be on antiretroviral drugs.

The 40-year-old from Toronto will race in the men’s 40-44 age group at the world championships in Lausanne, Switzerland.

Canada’s elite triathletes, led by Olympic gold medallist Simon Whitfield, will race Sunday in the 1.5-kilometre swim, 40-kilometre bike and 10-kilometre run. ...more

CIPA responds

Here is the press release put out by the Canadian International Pharmacy Association responding to the claims that MediPlan has shipped counterfeit products. I don't think it says anything too different from what would be expected.

I have put links to two other articles regarding the ongoing story. The CTV News article does a pretty good recap.

From CTV News:
The U.S. Food and Drug Administration rattled Canada's online pharmacists Wednesday with a report that found fake versions of Lipitor and other widely used prescription drugs were sold by websites linked to a co-founder of the industry.

But the past president of Canada's largest industry lobby group is urging people not to jump to conclusions until key questions are answered about the drugs and whether they truly are counterfeit. ...more

From USA Today:
One of Canada's largest Internet pharmacies — the one credited as the birthplace of the cross-border drug industry — is selling counterfeit drugs to U.S. consumers, the FDA said Wednesday.

The Food and Drug Administration warned consumers that sub-par versions of Lipitor, Crestor, Celebrex and seven other drugs shipped by Mediplan Prescription Plus Pharmacy were seized en route to Americans during the past few weeks. ...more

OPINION: The world is not an ice cream cone

In the effort to expand this blog's range of content, I'm attaching a link to an opinion from commonground.ca which I thought was interesting. From time to time when I see something of note, I will pass it on and let you judge for yourself. I'll attempt to give different viewpoints if possible. My main criteria will be

1) Is there a logical thought process to the commentary?
2) Does the commentary inspire thought and/or discussion?

Regarding this article, I think it raises some good points. Drug companies in Canada have to market to consumers in a much more indirect fashion than we see in the U.S.A. Sometimes I think we would be better off with the direct (yet sometimes squirm-inducing) ads as opposed to the Canadian nudge-nudge wink-wink approach.

FYI, television ads for prescription medications in Canada may contain the name of the product but not discuss what it treats OR it can discuss the illness being treated but not mention the name of the drug. That's why the Canadian Viagra ads are, in my opinion, not in the public's better interest compared to the U.S. ones that have to list warnings and side effects.

FDA stands by warning against Canadian web pharmacy

There is no shortage of articles about the FDA allegations that MediPlan is shipping counterfeit drugs. Their statements don't provide any definitive evidence and considering their past comments regarding Canadian pharmacies, I'd like to see more information. However, the FDA warnings in the past have tended to be more vague and has never been this specific naming a specific location.

MediPlan's president doesn't help his public relations cause when he refuses to mention the location of his non-Canadian pharmacy. He said in the Globe and Mail article below, "I hesitate to put that information out there, because it's another way they target us," when it is public knowledge that the pharmacy ships out of the Bahamas. It's even mentioned in this CTV report.

I wonder if there is any connection between the FDA warning and the release of a poll that says 80% of Americans would be okay with the importation of medications from Canada and other countries.

From the Globe and Mail:
The U.S. Food and Drug Administration blindsided Canada's on-line pharmacists Wednesday with a report that found fake versions of Lipitor and other widely used prescription drugs were sold by websites linked to a co-founder of the industry.

But the past president of Canada's largest industry lobby group is urging people not to jump to conclusions until key questions are answered about the drugs and whether they truly are counterfeit. ...more

From CBC News:
The U.S. Food and Drug Administration said Thursday it stands by its warning to Americans not to buy drugs from a Manitoba-based internet pharmacy, claiming the drugs are counterfeit.

The FDA issued a news release on Wednesday warning against ordering 10 specific prescription drugs from 10 websites, including rxnorth.com, canadiandrugstore.com and canadian-safe.com. ...more

FDA Warns Consumers About Mediplan

I am quite sure we will be hearing a lot more about this soon. I'll have more info posted later today.

From the Food and Drug Administration:
The U.S. Food and Drug Administration (FDA) is advising consumers not to purchase prescription drugs from websites that have orders filled by Mediplan Prescription Plus Pharmacy or Mediplan Global Health in Manitoba, Canada following reports of counterfeit versions of prescription drug products being sold by these companies to U.S. consumers. FDA is investigating these reports and is coordinating with international law enforcement authorities on this matter. ...more

Health Canada cuts off sick man’s pot supply

I'm not certain if having medical marijuana available through a local pharmacy would help this patient or not, but it seems to me that it would be a lot more practical for pharmacies to distribute the product as opposed to a federal agency.

From the Halifax Chronicle Herald:
Tom McMullen ran out of the medication that gave him his life back about two weeks ago, and he can’t get more.

The Prospect Bay man is an authorized medical marijuana user and buys his drugs directly from Health Canada.

But the bill for the 90 grams he’s allowed each month is 80 per cent of his monthly Canada Pension, his only source of income. ...more

Mass. city ends drug plan that defied US

The Springfield, Mass. Canadian pharmacy plan is dead. This well-publicized and controversial plan was the brainchild of former mayor Michael Albano. Albano started the program in 2003 and both he and the plan were often the focus of the cross border pharmacy debate.

I suppose this could be viewed as another sign of the decline of the Canadian internet pharmacy industry. I'm sure somewhere a drug company executive is smiling...

From the Boston Globe:
The Massachusetts city that stood up to federal regulators and inspired a national movement to import less expensive prescription drugs from Canada is calling it quits.

Three years after Springfield became the first city in the United States to buy drugs from Canada for about 1,500 municipal employees and retirees, the city has decided to stop offering its own health insurance coverage, including the Canadian drug importation plan. ...more

Customs seizes Canadian meds

It's time for a bit of an internet pharmacy update. There isn't anything in this article we haven't seen before, but here it is anyway.

From the Mankato (Minn.) Free Press:
Maurice Hardie isn’t a criminal.

He lives a quiet, retired life in Madison Lake, with his wife, Dorit, taking care of a lush back yard. Doing a little grilling. Visiting with friends.

So when he got an ominous letter from Homeland Security and the U.S. Customs and Border Protection, he was surprised and a little worried. ...more

U.S. allows some nonprescription sales of morning-after pill

It looks like the FDA was able to push Plan B to OTC status after a long road despite political objections. However, it's not as simple as it ordinarily would be. Plan B will be kept behind the pharmacy counter and only those over 18 can purchase it without a Rx. Youths will still require a prescription.

Beyond the obvious political and moral debate, this is pretty interesting from a pharmacy point of view. While Canadian pharmacies have established "no public access" areas that contain items like Gravol, Tylenol #1's and other items that a pharamcist must give out, such a category has not existed in the States. A drug there is either Rx or can be sold anywhere, even gas stations, etc. This ruling essentially creates a "no public access" category in the States. Will pharmacy regulators take advantage of this new category and attempt to add other items, or will the opportunity be missed?

From the Canadian Press:
Women in the United States can buy the morning-after pill without a prescription, the government declared Thursday, a major step that nevertheless failed to quell a politically charged debate over access to emergency contraception.

The manufacturer, lawmakers and other advocates said they will press the U.S. government to allow minors to purchase the pills over the counter. ...more

Oral rotavirus vaccine okayed for infants

There have been a few new product announcements over the last while. One that I don't have a link for yet is for rasagaline, which is a new med to treat Parkinson's. Meanwhile, here's a note about a new vaccine. It seems that some vaccines have been making news. It's nice to see new products coming out that aren't "me too" drugs. After all, do we really need another statin or ARB?

From the Toronto Star:
An oral vaccine that protects babies against a nasty bug that causes fever, vomiting and diarrhea — and sends thousands of kids to hospital each year — will be available this fall in Canada.

Merck Frosst Canada Ltd. announced last week that Health Canada has approved its vaccine RotaTeq, which protects against rotavirus gastroenteritis. Distribution to doctors and pharmacists is expected to begin next month. ...more

Canada's pioneering law to get cheap AIDS drugs to poor nations falls on face

Since the big HIV/AIDS conference is in Toronto, there may be a lot of related posts this week. It's probably an area that a lot of pharmacists are not too familiar with since in most provinces the antiretrovirals are dispensed through special clinics and programs.

From the Ottawa Citizen:
For Ibrahim Umoru, it was a stark but simple decision: He sold his car and his small apartment so he could buy HIV/AIDS drugs.

"I wanted to live," said the Nigerian father of two.

Then, in 2004, he was able to get drugs and related health care at no cost through a Medecins Sans Frontieres (MSF) project in Lagos....more

Many HIV Canadians not following drug plan: study

From CTV News:
Canadians infected with HIV are less likely to follow instructions when taking anti-HIV medications than those in sub-Saharan Africa, a new Canadian-led study suggests.

In an analysis of almost 60 studies on medication compliance during the past decade, researchers found that just 55 per cent of North Americans HIV patients followed their anti-retroviral medication (ART) regimens to the letter, compared with 77 per cent of their counterparts in sub-Saharan Africa. ...more

The link to the JAMA abstract is here.

How to wipe out AIDS in 45 years

This is a fascinating theory which questions current methods used to prevent the spread of HIV. Can the widespread use of antivirals work better than behavior changes? It would cost a fortune but it's an interesting idea.

From Macleans:
Dr. Julio Montaner, the Argentinian-born director of the internationally acclaimed B.C. Centre for Excellence in HIV/AIDS and president-elect of the International AIDS Society, doesn't exactly think small. On Aug. 4, The Lancet published a paper in which Montaner and his colleagues outline a theory to eradicate the global spread of HIV within 4 1/2 decades. And it has nothing to do with condoms, abstinence or free needle exchanges. ...more

Drug insurers dispense warning

Dispensing fees are making the news again. It's disheartening but not unexpected that the fee is not judged on value of service received, just on the dollar figure. I love the line in there from CUPE stating to use mail order pharmacy but not at the expense of closing down local pharmacies. Nice try to cover all the bases, but I don't see how what they suggest is possible. Any Rx filled via mail order would potentially hurt a local pharmacy or am I missing something?

From the Halifax Chronicle Herald:
Drug-dispensing fees are one of the latest targets in the battle to reduce health insurance costs.

Some insurance providers are now advising employers to alert staff to the widely varying fees charged by drugstores to fill prescriptions.

For example, in 2005, Nova Scotia pharmacies charged between $4.42 and $11.74 to fill a prescription, a Manulife Financial survey found. The fees also varied within chains such as Shoppers Drug Mart and Sobeys. ...more

Pharmacists Rap New Version of Decongestants

I've never heard this before. Pseudoephedrine, despite it's potential for diversion, is a quality decongestant. If the article is accurate the new phenylephrine versions may be rather useless.

From CBC News:
Starting in late September, Sudafed and similar cold medications will only be available from behind pharmacy counters because their active ingredient can be used to make the street drug methamphetamine.

So, consumers may be tempted to try a new type of drug that will be easier to buy. But two pharmaceutical researchers contend there's a big problem with the new nasal decongestants: They don't work. ...more

Pharmacies chafe at changes to First Nations drug plan

Perhaps the government has pushed the pharmacies up north too far. Apparently one Yukon pharmacy is ready to give up on filling NIHB Rx as the formula has made these scripts not worth it. I wonder if more will follow suit.

Ordinarily this type of boycott would not work as most communities have more than one pharmacy. However, up north the next pharmacy can be too far away to access. It'll be interesting to see how it plays out.

From CBC News:
A dispute between pharmacists and Health Canada may force some First Nations people in the North to pay up-front for their prescription medications.

At least one pharmacy in the Yukon has warned First Nations members in their region that they will have to pay for their medications as of Sept. 1.

Northern pharmacies and Health Canada are at loggerheads over changes to prescription drug service for aboriginal people. ...more

It's been a while

Greetings to everyone out there. I've been wrapped up in various summer activities, but look for some more regular posts here as of August.

Time to get started....

US Senate votes to end seizures of Canadian drugs

I think it's rather unlikely that this will ever pass through all the levels of the American government, but the Senate did approve a bill allowing Americans to buy prescription drugs from Canada. It might simply be a move by some politicians to win points with the electorate in the American mid-term elections. Regardless, I don't think prescription drugs will be the hot button topic it was in the 2004 campaign.

From the Washington Post:
U.S. customs and border security agents would be banned from seizing prescription drugs that Americans import from Canada under a measure passed by the Senate on Tuesday.

The Senate voted 68-32 in favor of the provision, with supporters saying the federal government should stay out of the way of Americans seeking cheaper medicines in Canada for personal use. Many Americans import prescription drugs from abroad even though the practice is illegal. ...more

It looks like the Canadian government is greeting the news with a yawn. There are some Liberals that are talking about it, but their focus seems to be more about trying to pin a conflict of interest charge on the health minister as opposed to the issue itself. Cross border pharmacy has largely dropped off the radar for the Canadian public. Remember the days when it was a staple of the nightly news and in the newspaper regularly? That seems like a long time ago.

From the Globe and Mail:
The federal government is unconcerned about a move by the U.S. Senate to end a ban on the import of cheap Canadian pharmaceuticals, but a former Liberal health minister says the proposal threatens the drug supply in this country.

And another Liberal suggests the reluctance of Health Minister Tony Clement to act on the file may be linked to the fact that his former communications aide is now head of the organization that represents on-line pharmacists who sell much of their product to Americans. ...more

Canadians may soon be able to drink their nicotine

Watch out Nicorete and Nicoderm -- here comes a new nicotine replacement in a bottle of water. I can't figure this one out. The nicotine drink will not be treated as a natural product? Didn't the government stop sales of that pharmacist-invented nicotine stick a couple of years ago claiming it was a drug? Also, I was under the impression that the caffeine-laced water sold in the States was not allowed in Canada.

From Canada.com:
...NIC Lite water contains about two cigarettes worth of nicotine and is being sold as a dietary supplement in the U.S. even though the Food and Drug Administration recently said it's an unapproved drug and its claim to be a supplement violates the Food, Drug, and Cosmetic Act. ...more

Important Safety Information: Intracranial Hemorrhage in Patients Receiving Aptivus® (tipranavir) Capsules

From Health Canada:
...As of June 7, 2006, Boehringer Ingelheim (BI) has received 14 reports of intracranial hemorrhage (ICH), including 8 fatalities, in 6840 HIV-1 infected patients receiving APTIVUS in clinical trials...

for the Public
for Health Professionals

Canadian sale hits record low

With the dollar being what as high as it is and the new Medicare plan, I guess this is no surprise.

From the Duluth (Minn.) News Tribune:
Sales of low-price prescription drugs from Canada, purchased through a state-sponsored program, plunged to their lowest level last month, Minnesota officials reported Wednesday.

The program of phone and Internet links to Canadian pharmacies was started two years ago by Gov. Tim Pawlenty as the first in the nation. Sales fell to $30,417 last month -- down about 30 percent from May and a shadow of the $153,000 during its best month in January 2005. ...more

Drug firms' research spending falls short

Here's an article that's a bit old, but it's interesting. I didn't realize that there are specific amounts that the brand name drug companies are supposed to spend on research in Canada. They seem to be having trouble reaching it over the last five years.

If the drug companies met this pledge, they would have a good statement to make in negotiations with governments when it comes to changes to formularies and patent laws (like the recent Ontario drug bill). They could say that they have held up their end of the negotiated bargain. Instead, I think they've left themselves open to criticism that is hard to deflect.

At least the stats are improving, up from 8.5% in 2004 to 8.8% last year.

From the Ottawa Citizen:
While seeing rising sales, Canada's big drug companies again failed to hit their promised target for spending on research and development of new medicines last year.

Brand-name drugmakers spent $1.2 billion or 8.7 per cent of their sales on research and development, marking the fifth consecutive year that the industry has failed to meet the 10-per-cent-of-sales ratio pledged when patent rules were strengthened in 1987. ...more

Native woman appeals demands to change drugs

From CBC News:
An aboriginal woman living in Winnipeg is appealing a demand that she switch medications for a health problem, saying the federal government's efforts to cut drug costs for First Nations people have gone too far.

Doreen Demas, 50, is blind and has diabetes and rheumatoid arthritis. She takes medications that require an extra drug, a proton pump inhibitor, to protect her stomach. ...more

Pinning hopes on `wonder drug'

Here's another story regarding a really expensive new drug which treats a relatively uncommon but serious ailment. These stories are in the papers more and more these days. The issue here isn't so much about government approval as opposed to coverage of the drug. It's hard to draw the line of what is covered and what isn't, and sometimes it isn't fair. But isn't that essentially what the Canadian health care system is about? We have one dominant payer in the government which holds all the cards in these cases. The government decides what type of surgery, diagnostic test, or drug is covered and we essentially have to live with it. Or else we need to change the system.

From the Toronto Star:
...The Toronto resident is pinning all her hopes on a wonder drug called Avastin, which was approved by Health Canada in September 2005 for patients with metastatic colon cancer. The problem is the Ontario Drug Benefit program, which pays for drugs for seniors, those on disability and the poor, doesn't cover the steep cost of the medication, which is close to $40,000 for a round of treatment. For cancer patients who want to get the drug when they're in hospital, Ontario doesn't provide or cover it.

This month she began yet another round of chemotherapy as well as Avastin, which is delivered intravenously at a private health clinic in Toronto. Family and friends are raising money to pay the hefty bill. ...more

Viagra helps performance in more ways than one

Here's an interesting article about another potential use for Viagra. Pharamcologically, I understand what they are saying and see how it could work. And it's a sure headline grabber for any cagey newspaper editor.

From the Ottawa Citizen:
U.S. scientists, looking for a way to help soldiers perform in Afghanistan's mountains, have found a miracle pill that safely helps the heart and lungs work at high altitudes - Viagra.

In tests on cyclists in the thin air of high altitudes, it helped may men ride taller in the saddle, though it didn't boost the performance of everyone. ...more

Army wants medical recruits

We knew there was a shortage of pharmacists in the civilian world. Now it's spread to the military:

From the Toronto Star:
The Canadian Forces are hunting for nearly 300 medical personnel to serve at home, overseas and to staff the coalition hospital in Kandahar, Afghanistan, and they're hoping lucrative signing bonuses will help bring in some new recruits.



"We are short 50 per cent of the pharmacists we need. The role of pharmacists is not just what you see happening in Shoppers Drug Mart. They manage our equipment. They co-ordinate all our supplies in and out of theatre. They handle some of our other medications and vaccinations we use to protect our soldiers that you might not use in the civilian environment."

US women may be part of reason sales of Plan B spiked in Canada

It seems rather unlikely to me, but a newspaper article suggests that American women are buying a lot of Plan B from Canadian online pharmacies.

From the Boston Globe:
Since Canadian regulators waived prescriptions for Plan B last year, sales of the emergency contraceptive have nearly doubled, and some of the additional customers are probably American women. ...more

Canadian researchers cure Huntington's disease in genetically altered mice

Maybe this is not directly pharmacy related, but I thought it was a pretty cool medical story so I thought I'd post it here:

From CBC News:
Canadian researchers have unlocked the molecular secret that eliminates the symptoms of Huntington's disease in mice, a landmark discovery that is offering new hope for preventing the devastating effects of the inherited disorder in humans.

A team of scientists from the University of British Columbia have discovered that by preventing the cutting, or "cleavage," of a protein responsible for Huntington's in genetically altered mice, the symptoms of the disease do not develop and the animals exhibit normal brain function. ...more

Dispute blocks cancer drug

From the Globe and Mail:
One of the world's most costly cancer drugs will not be marketed in Canada because the distributor can't charge the price it wants -- one a federal board has found to be too high.

Bristol-Myers Squibb Canada has taken the unusual move of not launching the colorectal cancer drug Erbitux after it could not agree on a price with the Patented Medicine Prices Review Board. The drug was approved by Health Canada nine months ago. ...more

Minister must go: Liberals

From the Ottawa Sun:
The Liberals are calling for Health Minister Tony Clement's resignation after revelations he hired a campaign aide on a department contract immediately after he was appointed to cabinet. ...more

So does anyone out there know when Gord Haugh was hired by CIPA? Was it before, during, or after his federal contract?

Pharmacist 'scripts safe, group says

It looks like the turf war between pharmacists and physicians could heat up over the next few months. Today the RxA fired a response back to the physician groups in a press release.

“RxA is gravely concerned about how the AMA and CPSA have called into question the professionalism of Alberta pharmacists in comments made to their members and in the media, and the impact that may have on the public trust of pharmacists. The public has every reason to trust that their health and safety will be respected and protected by Alberta pharmacists,” said RxA CEO Barry Cavanaugh.

It's interesting to note that physicians have tried the scattershot approach to attack pharmacist prescribing. First there is mention of competency, then the talk turns to questioning a pharmacist's commercial interests, then the comments about liability concerns. It seems to me that they are throwing a lot against the wall and trying to see what sticks.

Why is it assumed by some that pharmacists are going to prescribe for their personal gain and that it's a conflict of interest? I have never heard anyone question veterinarians about this before. Vets have been prescribing and dispensing most of their own items for years.

I think physicians are raising some points that need to be considered, but I wish they would give pharmacists a bit more credit.

More from the
Calgary Sun

New regulations let pharmicists prescribe drugs

After years of lobbying, pharmacists in Alberta have been granted the ability of prescribe medications. The press release by the Alberta College of Pharmacists is located >here.

Health Minister Iris Evans stated, "Expanding the scope of practice for pharmacists is an example of the innovation possible in the health system to enable competently trained health professionals to use all of their education
and expertise to benefit Albertans."

Individuals with chronic or recurring conditions will be the primary beneficiaries of the new authority, in particular the authority for pharmacists to prescribe. For example, when an individual with asthma runs out of their medication and is unable to see their physician, the pharmacist will be able to provide an inhaler for use until the patient's appointment with their doctor.

It sounds like positive news, but the next question is how will these changes be implemented? What kind of courses will be required? I would suspect that a separate type of "prescribing pharmacist" license will also be required. It sounds like the College will have a lot of details to announce over the next few months.

Here's a link to the Edmonton Journal article regarding the legal changes...New regulations let pharmicists prescribe drugs

Triaminic Vapour Patch warning

From Health Canada:
Health Canada is warning consumers not to use Triaminic Vapour Patch due to the serious adverse health effects that could result if the product is accidentally ingested by children.

Triaminic Vapour Patch contains camphor, eucalyptus oil and menthol. The reported side-effects from swallowing products containing camphor or eucalyptus oils vary from minor symptoms such as burning sensation in the mouth, headache, nausea and vomiting to more severe and life-threatening reactions such as seizures. ...more

Pharmacy rebate program on hot seat

Update: apparently the $25 markup cap has been taken off the table. There is a comment in this article that suggests the government may move their position a bit.

Health Minister George Smitherman offered a reprieve to worried pharmacists by announcing plans to scrap a proposed $25 cap on markups put on special, expensive medications such as HIV drugs — a move that will save pharmacies $13 million.

And he hinted that the controversial rebate ban could use some further definition.

“This continues to be, frankly, a very, very murky area of the Ontario drug system,” he said prior to the start of the hearing.

But he stressed the province’s bottom line was to rein in soaring costs of the drug program, estimated to eat up 10 per cent of overall provincial health-care spending, and get the best possible pricing for medicine.

It looks like the pressure being put on the government is having an effect.

More in this Toronto Star article here

Pharmacy battles for life in Ontario

There is a lot of news regarding the new legislation in Ontario. This article in the London Free Press talks about the beginning of hearings that will give stakeholders such as pharmacists, drug companies, and patients a chance to give their opinions.

There is no word if pharmacy owners will be asked to the table. Their advocacy group, called the Coalition of Ontario Pharmacy has repeatedly asked for a voice. They have even sent a couple of letters to the minister responsible with no response.

Canadian online pharmacies rebound from sales slump caused by U.S. plan

From the Brandon Sun:
As President George W. Bush mounted a final push this week to sign seniors up for a new prescription drug benefit, Canadian online pharmacies said business is already rebounding from an early hit caused by the U.S. plan.

Americans who've enrolled since January are starting to realize there are a lot of gaps and shortfalls in the Medicare benefit, with some drugs not covered at all, industry experts said. ...more

Vioxx's risk high in first two weeks, study finds

From the Globe and Mail:
The blockbuster drug Vioxx was pulled from the market in the fall of 2004 after research showed that the painkiller doubled the risk of heart attack and stroke and that its use may have contributed to thousands of deaths in North America.

Now, a new Canadian study shows that the risk was even more dramatic because one in four of the heart attacks that occurred were within two weeks of the start of treatment. ...more

Druggists fear new bill's rebate ban

From the London Free Press:
Neighbourhood drugstores may have been handed a lethal prescription from the Ontario government, say those who work in the business.

The province is proposing a law that would prohibit pharmacies from receiving rebate payments from generic drug companies -- something that would hit independent pharmacies the hardest.

"It will have a huge influence on the very existence of pharmacies in Ontario," said Hesham Abdelsayed, president of Ontario Medical Group, which operates three pharmacies in London and one in the region. ...more

Smitherman tells drug companies to pipe down

From the Toronto Star:
Canada’s brand-name pharmaceutical companies should “tone down their rhetoric” and work with the Liberal government to help save Ontario’s taxpayers millions of dollars in drug costs, Health Minister George Smitherman said Friday.

Smitherman was reacting to Paul Lucas, the CEO of GlaxoSmithKline, who warned Thursday that the province’s cost-saving plan will do to Ontario’s research-based drug companies what the Diefenbaker government’s cancellation of the Avro Arrow jet fighter did to the aerospace industry. ...more

Smitherman tells drug companies to pipe down

From the Toronto Star:
Canada’s brand-name pharmaceutical companies should “tone down their rhetoric” and work with the Liberal government to help save Ontario’s taxpayers millions of dollars in drug costs, Health Minister George Smitherman said Friday.

Smitherman was reacting to Paul Lucas, the CEO of GlaxoSmithKline, who warned Thursday that the province’s cost-saving plan will do to Ontario’s research-based drug companies what the Diefenbaker government’s cancellation of the Avro Arrow jet fighter did to the aerospace industry. ...more