ADHD drug makers in U.S. told to warn patients of heart, mental risks

From CBC News:
Drugs prescribed to treat attention deficit hyperactivity disorder will include guides in the United States to alert patients and parents to the risks of mental and heart problems, including sudden death.

The U.S. Food and Drug Administration said Wednesday that it directed the manufacturers of Ritalin, Adderall, Strattera and all other ADHD drugs to develop the guides. ...more

Will Canada click its way to better health?

From the Globe and Mail:
After more than 20 years as a family physician, Michelle Greiver questions why Canadians can access their bank accounts 24 hours a day, seven days a week, but when they go to the hospital after hours, their medical records are unavailable.

She is among the minority of the nation's doctors who are trying to do something about the health care system's archaic processes, which by one estimate are causing as many as 24,000 unnecessary deaths each year. ...more

Hepatitis drug may be linked with resistant strain of HIV: Health Canada

From CBC News:
Health Canada has received new information about an antiviral hepatitis medication suggesting the drug may have been tied to the onset of a treatment-resistant strain of HIV in one patient with the disease.

Entecavir, which is sold under the brand name Baraclude, was authorized for use in Canada in June 2006 to treat hepatitis B in adults. ...more

The Return

New posts will resume tomorrow -- Thursday, February 22.

Limited posts this week

There won't be any new postings for a couple days, and further updates later this week will be occasional at best. Hopefully posting will be back to its typical frequency next week.

W-B pharmacy to offer flu shots

From The Citizens Voice:
A Wilkes-Barre pharmacy will soon be offering a service that can save a lot of its customers a trip to the doctor.

Beginning this summer, pharmacists at Harrold’s Pharmacy, Old River Road, will start administering common immunizations, like the ones that can help prevent influenza and pneumonia. ...more

At £50 for four, Viagra goes on sale in the high street

Every now and then, I see a pharmacist prescribing article from elsewhere in the world. Sometimes I post it even though they are not Canadian pharmacy stories. From now on, I intend on posting every one I find. Hopefully Canadian pharmacists can learn from what's happening elsewhere. Perhaps we can copy their successes and avoid their mistakes.

From ThisIsLondon.co.uk:
For the first time, men will be able to buy Viagra from a high street chemist without a prescription.

From Wednesday - Valentine's Day - they will be able to walk into Boots and purchase the anti-impotence drug.

Previously they had to see their GP or a specialist doctor to discuss their problem and get a prescription. ...more

Newer arthritis drug shows fewer side-effects

From CBC News:
A newer arthritis drug leads slightly fewer stomach side-effects than older drugs, according to a new study.

People with arthritis often take non-steroidal anti-inflammatories or NSAIDS over a long term. A newer class of NSAIDS called COX-2 inhibitors cause fewer gastrointestinal side-effects such as ulcers and stomach bleeding than other NSAIDs such as Aspirin and ibuprofen. ...more

Pharmacists demystify cold meds

From Canada.com:
Like many folks stuck in the drugstore cold remedy aisle, Fred Feldman admits he's spent moments that are downright confusing, even Seinfeld-ian.

"You run to the drugstore at 11 p.m. for cough medicine and you're faced with 16,000 different brands," Feldman said. "How do you know, do I have a cough where I want to get rid of the mucus? Do I want the mucus? Who wants mucus?" ...more

Doctors may not present controversial options

I wonder why there is a concern that that the patient may know or have a connection to the pharmacist in a small town. Wouldn't it be equally likely that the physician has a connection to the family?

From CBC News:
..."Women and girls are finding that quite awkward in areas where they might know the pharmacist or the pharmacist might have a connection to their family," said Anne Rochon Ford of Women and Health Protection. "It's not surprising that you're hearing in your region that they're avoiding going altogether." ...more

Group slams inconsistent cancer care

From the National Post:
Cancer patients are increasingly having to pay out-of-pocket for important new drugs administered in public hospitals, the latest symptom of Canada's inconsistent, often inadequate funding of cancer treatment, an advocacy group reported yesterday.

In 2005, only Alberta formally required patients to pay for some drugs they received -- usually by intravenous infusion -- in a public health facility, though taxpayers traditionally pick up the tab for hospital-administered medication. The price for new cancer treatments can run into the tens of thousands of dollars. But last year the "self-pay" trend spread to five other provinces, said the Cancer Advocacy Coalition of Canada. ...more

Newer birth control pills raise clot risk, group warns

I don't think this will probably go anywhere either in the States or Canada, but for your information, desogestrel is an active ingredient in the following Canadian products: Linessa, Orthocept, and Marvelon.

From CBC News:
Some newer, low-dose birth control pills double the risk of potentially dangerous blood clots compared with older contraceptives and should be banned, a U.S. consumer group says.

Public Citizen filed a petition with the U.S. Food and Drug Administration on Tuesday to stop the sale of birth control pills containing a type of progestin called desogestrel. ...more

Seniors, senator fear confiscation of Canadian drugs is new crackdown

From the Orlando Sentinel:
Federal officials confiscated at least 37 packages of medicine from Canada shipped to South Florida consumers in late January, despite an October promise to stop targeting drugs imported for personal use.

A U.S. Food and Drug Administration spokeswoman said in a brief statement last week that Canadian pharmacy shipments were detained at Miami International Airport for strictly routine reasons. ...more

Province not yet funding cancer drug

It's been months since Gardasil was approved for sale in Canada yet not one province has added it to their standard immunization regime. I don't think the moral debate in Canada about Gardasil will be nearly as intense as in the States. The biggest barrier will be the cost as government health care budgets. The dollars are flowing to other areas right now. There is a lot of lip service to health prevention and health promotion amongst various agencies, but when push comes to shove and money is involved, these things tend to get ignored, which is so unfortunate. If I had a daughter, niece, or sister in the target age group, I wouldn't wait and would pay for their immunization as who knows if/when the government will cover it.

From the Edmonton Journal:
The Alberta government won’t be funding a vaccination for young girls that prevents cervical cancer by protecting them against a sexually transmitted virus until it hears from another national committee later this year.

This week, the National Advisory Committee on Immunization said all girls and women aged nine to 26 should be vaccinated against human papillomavirus or HPV. A vaccine like Gardasil — approved by Health Canada last summer — protects girls and women from being infected with four strains of HPV. The vaccination actually prevents cancer since two of those HPV strains cause about 70 per cent of cervical cancer cases. ...more

Drug Ads: Taking Medicine Never Looked So Good - The Checkout

This is an interesting analysis of prescription drug advertising in the United States. The current advertising rules in Canada have been in place for years and probably could stand to be updated. Ultimately, the ads will affect patients and the types of questions they ask their health care practictioner. I find it telling that virtually every commercial suggests regaining control and winning social approval.

From the Washington Post:
Remember all those tricks drugmakers used to get you to take medicine as a kid? They made cough syrup sweet and acetaminophen chewable. They transformed horse pill vitamins into friendly cartoon characters.

Well, perhaps a better approach would've been to inundate you with ads--ones that depict a fearful and alone child who becomes happy, confident and popular after taking a pill.

That formula, it seems, works well on millions of Americans, who watch as many as 16 hours of prescription drug ads every year -- far more than the average time spent with a primary care physician. ...more

House arrest for pharmacist

From the Winnipeg Sun:
A Winnipeg pharmacist who stole $28,000 in "customer refunds" that didn't exist has been sentenced to 18 months house arrest.

Lorraine Anne Hilderman, 53, was also ordered to pay back the stolen money within the next 45 days or face serving her sentence in a real jail. ...more

Medical record system cited for needless deaths

The lack of easily accessible electronic medical records should be a bigger issue than it currently is. The focus by patients and the media are ER lineups and surgical waiting lists more than anything else, and this is somewhat reasonable as they are big issues. Even though the lack of e-records is not that sexy a topic, it should still be addressed. Some provinces have made steps in the right direction, but our health remains one of the least "connected" part of our lives.

I'd prefer that control of a personal health record is given to a patient themselves. Why can't a patient carry their medical records on a flash drive that gets inserted into a computer at each health care provider? This would require an easy to use program that could be used as an industry standard and this currently doesn't exist.

From the Globe and Mail:
After more than 20 years as a family physician, Michelle Greiver questions why Canadians can access bank accounts 24/7 but when they go to the hospital after hours, their medical records are unavailable.

She's among a minority of Canada's doctors trying to update the health care system's archaic processes, which by one estimate costs up to 24,000 lives each year. ...more

Pfizer to Appeal Canadian Decision

It will be interesting to see where this legal battle goes. I think we'll be hearing about this for most of 2007.

From Forbes:
Drug developer Pfizer Inc. said Friday it will appeal a Canadian federal court decision denying its application to block approval of a generic version of the cholesterol-lowering drug Lipitor.

Indian generic drug maker Ranbaxy Pharmaceuticals Inc. is asking for approval of its version of Lipitor. The ruling deals with a patent that Pfizer (nyse: PFE - news - people ) said holds market exclusivity until July 2010. ...more

Justice dispensed to pharmacist fraudster

From the Winnipeg Free Press:
A well-respected Winnipeg pharmacist has flushed her 33-year career down the drain after being caught stealing more than $28,000 from her employer, a Winnipeg court heard Friday.

Lorraine Hilderman, 52, broke down in tears as she apologized for a crime that shocked her friends, family and co-workers.

"I am so sorry for the embarrassment, pain and shame they have endured," said Hilderman. ...more

Antidepressants may raise fracture risk for those over 50

From CNN.com:
The most popular pills for depression might substantially raise the risk for bone breaks in older people, a drawback that should be considered when the drugs are prescribed, Canadian researchers say.

People aged 50 and older who took antidepressants, including Zoloft, Prozac and other top-sellers, faced double the risk of broken bones during five years of follow-up, compared with those who didn't use the drugs, the study found. ...more

Folic acid pills 'can slow mental decline'

From the Times Online (UK):
Taking folic acid supplements can slow the mental decline in older people, a study suggests.

A Dutch team studied 400 people aged between 50 and 70 who were split into two groups. Those in one group were given 800 micrograms of folic acid a day; the others were given a placebo. ...more

Top Ont. pharmacist warns of national security threat posed by U.S. drug bill

I don't agree with Marc Kealey's assertions in his latest speech.

"Who can say with absolute certainty that the next $19 million worth of phoney drugs could be sent to America not by criminals in Belize, but by terrorists determined to kill American citizens? That the fake pills from a purported Canadian Internet pharmacy will contain not talcum powder or baking soda, but cyanide or anthrax?"

Kealey suggests that terrorists purporting to be Canadian pharmacies could attack the United States. This is of course possible, just as some shadowy organizations in obscure countries are selling Viagra through websites with maple leaves on them. But is this reason enough to ban legitimate Canadian online pharmacies? If all cross-border pharmacy was closed tomorrow, the criminal organizations claiming to be Canadian would still exist.

"Picture an open floodgate. Picture a medicine cabinet with the door ripped off the hinges. Picture a made-in-America problem being solved on the backs of Canadians."

Kealey isn't afraid to try to make Canadians afraid. I can't see his gloomy scenario ever happening. I don't agree with bulk exports and I'd be okay with laws to that effect. However, even if no laws are changed, I would think that the Canadian pharmaceutical companies wouldn't allow sales to American bulk buyers just as they choose to not sell to known Canadian internet pharmacies. Even a change in American law will not be able to compel the Canadian branch of Pfizer or Merck for example to sell millions of Canadian Lipitor or Fosamax tablets to the American branch of Safeway or Wal-Mart Pharmacy (all examples).

As for individual purchases, the current market conditions simply don't allow for the grim predictions. Has the sky fallen in the last several months now that U.S. Customs isn't seizing packages from Canadian pharmacies? I am not aware of any substantial changes to the available medication supply in Canada since then, and my understanding is that Canadian internet pharmacies have not seen any signficant surge in business as a result either. As long as the dollar stays above 80 cents U.S. (which is somewhat likely) and the drug companies maintain their existing controls on supply (which will absolutely continue), cross border pharmacy will be a niche market only.

From the Canadian Press:
A U.S. bill that would legalize bulk imports of Canadian prescription drugs should be nixed because it poses a health threat to Canadians and a security risk to Americans, Ontario's top pharmacist said Wednesday.

The legislation, introduced in the Senate and House of Representatives earlier this month, will encourage the proliferation of mail-order and Internet drug sales, which could open the door to drug counterfeiting and drug terrorism, said Ontario Pharmacists' Association CEO Marc Kealey. ...more

Forces' drug needs different, MD says

From the Globe and Mail:
The Canadian Forces say their members don't need access to the full range of medication offered through the drug plans provided to politicians and bureaucrats.

Physician Ken Scott, the colonel who is director of medical policy for the military's health services, said yesterday that members of the Forces have different physical characteristics than the average Canadian and don't suffer from the same types of disease. ...more

'Credibility' at issue

Final arguments were made today at the Norvascgate trial. Look for a verdict by the end of February. Personally, I can't see how pharmacist Abadir Nasr can be found anything but guilty. Even if you buy his defense that he was ignorant and didn't intentionally do anything wrong, what he did was criminally reckless. And this is the most positive scenario for Nasr. The other possibilities are much worse.

From the Hamilton Spectator:
The lawyer representing accused Hamilton pharmacist Abadir Nasr argues the Crown's attack on his client's credibility has become a futile exercise in pill counting.

Dean Paquette told Ontario Court Justice Richard Jennis no one will ever know precisely how many counterfeit and grey market cardiac pills were dispensed at the King West Pharmacy in spring 2005. That's because much of the Norvasc dispensed there, including vials with authentic pills mixed in with fake and foreign-market tablets, had been consumed by Nasr's customers in the months before the RCMP raided his drugstore June 15. ...more

Johnson & Johnson Customers in Canada Can Sue Over Prepulsid

From Bloomberg:
Johnson & Johnson customers in every Canadian province except Quebec can sue the drug company as a group over injuries linked to the drug Prepulsid, an Ontario judge ruled.

Justice Ellen Macdonald of the Ontario Superior Court certified a class-action lawsuit Jan. 18 against Johnson & Johnson, Toronto-based law firm Rochon Genova LLP said today in a Canada NewsWire release. Rochon Genova represents one of the plaintiffs in the case. ...more

Cholesterol drugs don't help 'bulk' of takers

From the National Post:
Healthy women should not be put on a cholesterol-lowering drug to prevent heart disease, suggests a new analysis that raises questions about widespread over-prescription of the fastest growing drug class in Canada.

Millions of Canadians take cholesterol reducers, called statins, to lower their risk of heart attacks and cardiovascular disease. For people who already have artery disease, statins save lives. ...more

Red flags raised over anti-smoking guide

Over the last while, we've seen the mainstream press corps write stories about topics that are mostly common knowledge in the pharmacy/medical community but unknown to the public at large. Here is another one that questions the relationships between charities and their donors.

From the Ottawa Citizen:
The Canadian Cancer Society is about to publish an update to its guide that helps smokers who want to quit.

It cost $75,000 to redevelop the popular book, One Step at a Time, but the national charity didn't have to worry about the price. That's because it asked Pfizer Canada, the country's largest maker of nicotine replacement therapy products, to pay the cost.

Pharmaceutical giants are some of the top financial contributors to groups such as the Canadian Lung Association, the Canadian Cancer Society, the Toronto-based Centre for Addiction and Mental Health, and others. ...more

Islanders going on their own with Gardasil

Look for the Gardasil debate to heat up this year. While the medical benefits of this product seem very clear, the questions of who is going to cover it and if it should be a required vaccination remain largely unanswered.

From CBC News:
Many Prince Edward Islanders aren't waiting for the provincial government to start paying for Gardasil, a vaccine approved by Health Canada last year to help in the fight against cervical cancer.

The Department of Health would like Gardasil added to the vaccines covered by the province, but it has been waiting for recommendations from two national committees on who should get it and at what age, and whether governments should cover the cost. ...more

Edmonton aims to screen all for diabetes

I don't know if making diabetes a reportable disease is of any real benefit. It's not like it's a communicable disease and others are at risk. The whole concept seems like to evoke shades of Big Brother. Why stop at diabetes? Maybe the next step is to start a database on every disease group. If you see your doctor and have a high blood pressure reading, are they going to have to report you? What about starting a list of obese people? They are at future health risk just like diabetics. I think that one would be challenged in court about five minutes after it was instituted.

From CBC News:
A new diabetes screening program in Edmonton goes further than any other in North America, effectively making diabetes a reportable disease.

Under the program, whenever someone in the city visits a doctor, hospital or walk-in clinic, their blood-sugar information is recorded in a central database. Edmonton's Capital Health Region plans to use the information to identify and treat anyone with diabetes or at risk for the disease. ...more

Be cautious when taking St. John's wort with other drugs

This is more of a patient-specific article, but it's a good reminder that St. John's Wort interacts with many different drugs.

From the Fort Wayne (Ind.) News Sentinel:
Q: Can St. John's wort cause the birth control pill to fail, as I've heard?

A: St. John's wort, an over-the-counter herbal supplement, can be effective for milder forms of depression. Case reports do suggest that St. John's wort could lead to unwanted pregnancies in women using oral contraceptives. ...more

Shoppers Drug Mart's new CEO will help push cosmetics

Typically I avoid the business part of pharmacy in this blog. If you want to read about Jean Coutu's earnings this quarter or projections for Shoppers Drug Mart stock, there are probably some great business blogs out there that will provide more info and better analysis.

I'm making an exception this time. The article below talks about Shoppers Durg Mart hiring a new CEO with a background in cosmetics. The report mostly talks about the plans to focus primarily on cosmetics as well as food items. There is not one word about pharmaceuticals, pharmacists, or anything relating to medicine. There is absolutely nothing wrong with this from a business standpoint. Anyone who holds stock in Shoppers Drug Mart would probably agree with their plans. However, as a pharmacist I find it disappointing that the biggest "pharmacy" chain in Canada these days really doesn't seem to be even thinking about pharmacy.

From the Calgary Sun:
Jurgen Schreiber's international experience and his work at the helm of a beauty company make him the perfect choice to lead Shoppers Drug Mart Corp. (TSX:SC) as the retailer seeks more global suppliers and higher profits from cosmetics, the company said Thursday.

The firm was looking to focus more on its cosmetics section and "you will find that already in Q1, where we bring in new brands, we enhance around 700 stores," the new CEO said during a call with analysts. ...more

Testing Of Bioidentical Hormones Urged, North American Menopause Society Says They Might Not Be Safe

I have never heard of the North American Menopause Society before, but their comments against bioidentical hormones (and natural remedies like soy and black cohosh) would likely be rejected by some of the compounding pharmacists that make these products.

From CBS News:
The North American Menopause Society says bioidentical hormone treatments might not be the best way to combat the symptoms of menopause.

In an editorial in the journal Menopause Management, the society's executive director says the recent hype surrounding bioidenticals masks the fact that the ingredients are basically no different from those in FDA approved hormone treatments whose use has fallen since a study in 2002 found women using hormones faced a higher risk of breast cancer. ...more

Canada's pharmacists seek ban on exports to U.S.

There's nothing much new here. A few of the tradtional enemies of internet pharmacy are calling for the federal government to put in new rules regarding drug importation. The new push is based on concerns regarding new legislation in the States.

From Reuters:
Canada's pharmacists said on Monday they are banding together to fight a U.S. bill that could see a flood of brand-name prescription drugs diverted south of the border.

The group, which includes the Canadian Pharmacists Association, the Ontario Pharmacists Association, the Best Medicines Coalition and the Canadian Association for Pharmacy Distribution, warns the bill could deplete the supply of prescription drugs in Canada. ...more

Pharmacists help provide patient care

From the Halifax Chronicle Herald:
Truro pharmacist Wanda Woolaver says her work is very satisfying as rarely a week goes by without a patient coming by and thanking her for her help. She said the profession has moved away from simply dispensing drugs to patient care.

When Ms. Woolaver first went to work in a pharmacy, she spent a lot of time with a mortar and pestle mixing and mashing various ingredients together to make medications prescribed by doctors. ...more

Halting heart drugs a big risk, study finds

From the Globe and Mail:
About a third of heart attack survivors stop taking prescribed medications within a couple of years and, as a result, their risk of dying shoots up, new Canadian research shows.

Those who take drugs such as statins and beta blockers routinely, on the other hand, see their risk of dying fall by about 25 per cent, according to the study. ...more

Pharmacy Students Do First-Time Flu Vaccinations

This isn't a Canadian pharmacy story, but I thought that it was worth mentioning that some American states are also attempting to expand the scope of pharmacists' practice. Alberta and other provinces are also looking at allowing pharmacists to administer injections. In fact, there are plans to set up teaching programs to show Alberta pharmacists how to do this. There is no official word as to when the classes will be, but I expect they will happen this spring.

From the University of Maryland Baltimore News:
Sana Majid leaned over David Roesner's right arm and quickly injected a dose of influenza vaccine. It was an utterly ordinary moment of health-care delivery, yet a significant step for Maryland pharmacists and University of Maryland School of Pharmacy students.

Before this flu season, Maryland pharmacists were not permitted to administer flu shots. But a change in state law, and new industry regulations, now allow specially certified pharmacists-and supervised pharmacy students-to give the shots. A collaboration between the School of Pharmacy and Shoppers Pharmacy, spurred by the efforts of J. Bradley Thomas, RPh, Shoppers Pharmacy district manager and a member of the School's class of 1982, led to a series of flu shot clinics at the pharmacies this month. ...more

Cold medicine warning for toddlers

From Canada.com:
More than 1,500 toddlers and babies wound up in emergency rooms over a two-year period and three died because of bad reactions to cold or cough medicine, federal health officials reported Thursday.

The U.S. Centers for Disease Control and Prevention warned parents not to give common over-the-counter cold remedies to children under two years old without consulting a doctor. ...more

Drugstore Owner Sues Michael Jackson

It's not often that I include celebrity news on this site, but I thought it was worth mentioning that Michael Jackson owes an independent pharmacy over $100,000. I've heard of running a tab but this is ridiculous. One can only imagine what meds were filled at the pharmacy.

From Starpulse:
Michael Jackson is being sued by the bosses of a Los Angeles pharmacy, who claim the pop superstar is behind on his pill bills. The owners of famous Beverly Hills drugstore Mickey Fine Pharmacy claim they had an oral bill-paying agreement with Jackson, but the King of Pop still owes them over $100,000. ...more

U.S. bill aims to import cheaper medications from Canada

From CBC News:
The solution to high medication costs in the U.S. is importing cheaper drugs from Canada, a group of U.S. politicians said Wednesday.

Members of both the Democratic and Republic parties announced plans for legislation to allow imports of prescription medicine from other countries....more

Brain Bleeds From Blood Thinner on the Rise

The knee-jerk response to this article by some would be that "Coumadin is dangerous." However, I think this has a lot more to do with poor monitoring. During my time in a hospital-based pharmacist-run anticoagulation clinic, I am regularly amazed by the casual approach of many family physicians when it comes to warfarin monitoring. This attitude results in some of the problematic cases that I see.

Physicians have a lot on their plate. It seems to make a lot of sense to offload this task to pharmacists who have studied and specialized in this area. I don't think a physician who glances at a lab report in the middle of a busy day seeing patients provides more value when compared to a specially trained pharmacist who devotes their entire day to the subject. The Alberta College of Pharmacists seems to agree as they have indicated that this could be one of the first clinical areas noticably impacted by pharmacist prescribing. I'm planning on applying for my clinical prescribing rights for warfarin and other anticoagulants when the opportunity arises later this year. It should be an interesting experience.

From Forbes:
The rate of bleeding in the brain associated with use of the anticoagulant drug warfarin quintupled during the 1990s, University of Cincinnati researchers reported Monday.

Moreover, in people over 80, the rate of brain hemorrhages associated with warfarin, best known as Coumadin and used to thin the blood and prevent strokes, increased more than tenfold, according to the study, published in the Jan. 9 issue of Neurology. ...more

Pharmacy pamphlets omitting key information

It's good to see someone drawing attention to these handouts, which are often out-of-date or have American-specific information on them.

Why can drug info sheets look so similar whether they are picked up at a chain pharmacy, independent, or grocery store pharmacy? It's likely because First Data Bank has secured the contracts to provide drug information sheets to most Canadian pharmacy software makers.

The worst mistake I can remember on these sheets was on the patient counselling for Lopressor SR (metoprolol extended release) tablets. Lopresor SR is made by Novartis and is available in Canada and not in the United States. The Americans have their own version of metoprolol sustained release tablets called Toprol XL (not available in Canada), which is made by Astra Zeneca. The Lopresor SR patient info sheets said that tablet could be split in half. While the American Toprol XL is designed to be split in half, Lopresor SR must not be cut or else it destroys the sustained release effect. I remember getting phone calls from patients who would listen to me counsel them to not cut the tab, then they'd go home and read the sheet. Fortunately, I think most them believed me and not the printout.

From the National Post:
Information sheets that pharmacies hand out to educate customers about the drugs they are taking actually leave out key safety information in some cases, omissions that are prompting concern from federal regulators.

Pamphlets distributed by two major retailers on attention-deficit medicines, for instance, fail to mention the government directive that patients with certain heart conditions avoid such drugs. ...more

Clinical trial company calls for 'bill of rights'

From CTV News:
A Montreal company that conducts clinical trials is calling on the federal government for an official bill of rights to protect those who take part in human drug trials.

Janice E. Parente, founder and president of Ethica Clinical Research Inc., said Monday there are too many shortfalls in Canadian industry regulations. ...more

Clinical trial company calls for 'bill of rights'

From CTV News:
A Montreal company that conducts clinical trials is calling on the federal government for an official bill of rights to protect those who take part in human drug trials.

Janice E. Parente, founder and president of Ethica Clinical Research Inc., said Monday there are too many shortfalls in Canadian industry regulations. No comments:

Internet Pharmacy in Germany

This article has nothing to do with Canada, but I thought it was interesting to provide some perspective regarding how the internet is changing the way pharmacy operates around the world.

There are definite parallels. A pharmacy in a smaller, more liberal country is trying to sell inexpensive product in a larger neighbouring nation with higher drug prices, but are encountering heavy resistance from a powerful lobby group within the larger country. However, the independent pharmacist plays vastly different roles. Canadian pharmacists have tried to use internet pharmacy to change the business of pharmacy but in Germany they are the powerful establishment trying to maintain the status quo.

From Deutsche Welle:
In Germany, where drug prices are higher than the rest of Europe, certified pharmacists have a virtual monopoly on the sale of over-the-counter and prescription drugs. So when DocMorris, Europe's first mail order pharmacy opened its first affiliate in the western city of Saarbrücken last July and sold non-prescription medication at discount prices, competitors forced the state courts to shut it down in September.

Now, nearly four months later, the Dutch Internet retailer and pharmacy chain wants to get around the German Pharmacy Act, which does not permit corporate entities to sell drugs and limits ownership to three branches that must be in close proximity to each other, by paying pharmacy owners licensing fees to sell its products. ...more

January a great time to clean medicine cabinet

From CTV News:
January has long been the month of resolutions and renewal. And if Dr. Marla Shapiro had her way, it would also be the month of medicine cabinet cleanup.

Shapiro says the beginning of the year is a great time to go through your cache of medicines, lotions and potions -- and dump the ones that have grown old and could do more harm than good. ...more

Local Rx import programs find fewer takers

From Benefitnews.com:
Although rolled out with great fanfare a few years ago, state and local programs allowing residents to purchase prescription drugs from Internet pharmacies based in Canada apparently have not been popular with the public.

In September, a state audit of the Illinois importation program revealed that in 19 months, importation outlet I-SaveRx had served fewer than 4,000 residents yet cost the state nearly $1 million. Auditors found I-SaveRx had reached an even fewer 1,265 people in other states. ...more

Flu drug Relenza gets approval from Health Canada

The headline sounds bigger than the actual news. Relenza now has the official indication for prevention of influenza.

From the Halifax Chronicle Herald:
Health Canada has given pharmaceutical giant GlaxoSmithKline permission to market its flu drug Relenza for the prevention of influenza, not merely the treatment of the illness.

The Canadian approval, announced by GSK on Thursday, follows in the footsteps of similar approvals by regulators in the United States and 15 European Union countries.

Other flu drugs on the market here — Tamiflu and the generic drug amantadine — were already approved for prevention of influenza. ...more

Antibiotic suspected as factor in deaths

From what I've seen, the risk/benefit ratio for Levaquin still looks pretty good...

From the National Post:
A powerful antibiotic used to treat pneumonia, urinary tract infections and other ailments is suspected of causing diabetes like and liver problems in dozens of Canadians, five of whom died, a new Health Canada report reveals.

As the department tries to gauge the extent of the problem, doctors are being urged to report any cases of blood-sugar level upset or liver damage that may be linked to levofloxacin. ...more

MD urges universal testing for HIV

From the Toronto Star:
Making HIV testing a routine part of any doctor's visit is at the heart of a debate in Canada's medical community, which is desperate to reduce the number of people who are infected with the virus but don't know it.

With "universal testing" patients would have to opt out of being screened for HIV during a physical or regular blood work. Taking a detailed sexual history, doing a risk assessment and conducting pre and post-test counselling would no longer be mandatory. a href="http://www.thestar.com/News/article/168453" target="_blank">...more

Pharmacists seek power to prescribe in some cases

Here's a pretty good article that provides an update regarding pharmacist prescribing. It primarily talks about Alberta, but it also gives some noteworthy updates from other provinces.

Pharmacist prescribing in Alberta is slated to start on April 1, but it's still unclear exactly how everything will play out. It should be an interesting few months.

From the Toronto Star:
Pharmacists in several provinces, wanting to do more than just count out pills, are pushing for the power to prescribe medications and play a more meaningful role in their patients' health care.

But some physicians' groups caution that allowing pharmacists to write prescriptions without consulting a doctor could harm those very patients. ...more

Superbug to 'emerge in force' across Canada

From CTV News:
Doctors warn that a superbug causing infections in pro baseball and football players, as well as toddlers in day care centres in the U.S., is making inroads in Canada and is about to "emerge in force" across the country.

Clones of community-associated Methicillin-Resistant Staphylococcus Aureus, or MRSA, are "spreading with alarming rapidity," according to infectious disease experts in a commentary published Tuesday in the Canadian Medical Association Journal. ...more

Anti-obesity drug no magic bullet

Here's an update regarding Acomplia from CBC. They may state it's not a magic bullet, but if it brings in $5 billion per year in the U.S. alone, it would make it one of the biggest selling drugs in the world.

From CBC News:
Some doctors in Canada are worried about the side-effects of an anti-obesity drug that is expected to hit the market in the U.S. by spring 2008.

Known in Europe as Acomplia and generically as rimonabant, the drug helps people to lose weight, controls Type 2 diabetes, raises high-density lipoprotein or HDL "good" cholesterol and tells the brain to stop craving food and cigarettes. ...more

Too Little Bang for the Buck in Drug Research?

I think the idea of longer patents for breakthrough drugs and shorter patents for "me-too" drugs makes a lot of sense.

From Time.com:
Whenever critics complain about the high cost of prescription drugs, the pharmaceutical industry's standard defense is that companies have to plow so much money into researching innovative new medicines. But a recently released report from the Government Accountability Office casts doubt on that rationale. Yes the industry is spending heavily on R&D, the GAO found, but it turns out big pharma isn't actually generating such a good return on their investments. ...more

Druggist motivated by greed: Crown

Final statements were made by the lawyers in the Norvascgate trial today. The trial is slated to continue on January 22. I suspect we are getting close to a verdict.

From the Hamilton Spectator:
The Crown says a Hamilton pharmacist was driven by pure greed when he sold bogus heart medication to unsuspecting patients suffering from serious medical conditions.

In her closing submission, assistant Crown attorney Cheryl Gzik also suggested Abadir Nasr, 29, was willing to jeopardize the welfare of clients for the sake of money. ...more

Popular heartburn drugs linked to hip fractures in people over 50

From the Canadian Press:
Taking such popular heartburn drugs as Nexium, Prevacid or Prilosec for a year or more can raise the risk of a broken hip markedly in people over 50, a large study in Britain found.

The study raises questions about the safety of some of the most widely used and heavily promoted prescription drugs on the market, taken by millions of people.

The researchers speculated that when the drugs reduce acid in the stomach, they also make it more difficult for the body to absorb bone-building calcium. That can lead to weaker bones and fractures. ...more

Pharmacist fights back, thieves flee

This pharmacist was willing to put his life on the line when he fought off some robbers. I'm not sure what was in the safe, but it seems like a risky move to challenge a couple of armed bandits.

From the Hamilton Spectator:
Two drug hunting robbers fled a Mountain drugstore empty-handed after a feisty pharmacist fought back.

Police said the men entered Henderson Pharmacy on Concession Street around 5:10 p.m. Wednesday wearing disguises and demanded the pharmacist open the safe. ...more

Health Canada Endorsed Important Safety Information on Xigris [drotrecogin alfa (activated)]

From Health Canada:
Association of increased mortality and risk of serious adverse events when prophylactic low-dose heparin is abruptly discontinued in patients to be started on Xigris® [drotrecogin alfa (activated)] therapy for severe sepsis. ...more

Powerful U.S. Democrat puts drug imports at top of January's agenda

Could Canadian internet pharmacy make a comeback with changes to American laws? I suppose it's possible, but I still don't think we'll see a revival of the heyday for the online drug firms. However, the issue will be alive in the American political system in 2007.

From 680 News Toronto:
A top U.S. Democrat says his first order of business in January will be a new push to legalize prescription drug imports from Canada.

Illinois Congressman Rahm Emanuel, the House Democratic caucus chairman and a key architect of the party's election sweep of Congress, said this week his top priority is introducing another bill allowing Americans to buy cheaper Canadian medicines. ...more

Common chemo regimen inferior, Canadian-led study suggests

From CBC News:
Many Canadian women with breast cancer are already getting the best chemotherapy treatment available, according to an international study that compared three different drug combinations.

AC/T, a chemotherapy regimen commonly used in breast cancer patients, is significantly less successful at preventing cancer from recurring than another Canadian-developed combination, the study suggests. ...more

Drugstores still dealing with birth control pill shortage

Are Triphasil and Alesse available in your pharmacy? Leave a message in the comments section.

From the Halifax Chronicle Herald:
Popular birth control pills Alesse and Triphasil are in short supply again.

Pharmacists at several Halifax drug dispensaries confirmed Friday that they are experiencing difficulties obtaining the oral contraceptives.

Wyeth Pharmaceuticals, the American firm that manufactures the pills, said last month that it had been experiencing problems at its production plants since the summer. ...more

Makers of controversial MS drug seek its use for Crohn's disease

From the Canadian Press:
The makers of a multiple sclerosis drug that U.S. regulators recently allowed back on the market despite a rare but life-threatening side effect are seeking approval to also market the drug for Crohn's disease.

Biogen Idec Inc. and Elan Corp. PLC said on Friday they applied to the Food and Drug Administration to expand Tysabri's use in the U.S. to cover moderate to severe cases of Crohn's disease, an intestinal disorder, along with its existing approval for MS, a disease of the central nervous system. ...more

Add antidepressant warning labels for young adults: U.S. panel

From CBC News:
Antidepressant drugs should be labelled to warn that their use may increase the risk of suicidal thoughts and behaviour in people up to age 24, a U.S. government advisory panel said Wednesday.

The information should be added to current "black box" warnings that say taking the drugs may increase risks in children and teens, said the panel of outside experts, which the U.S. Food and Drug Administration called on for advice on the issue. ...more

Health Canada Endorsed Important Safety Information on Iressa (gefitinib)

From Health Canada:
Lack of Survival Benefit and Increased Incidence of Tumour Haemorrhage in Association with IRESSA® in Patients with Squamous Cell Carcinoma of the Head and Neck (SCCHN ...more

Drug-name confusion can be deadly

Similar drug names leading to confusion is a long standing pet peeve of mine. Unfortunately, another bad example recently hit the Canadian market. Trosec (trospium chloride) is a newly approved antispasmodic medication. It sounds eerily similar to the hugely popular Losec (omeprazole), which is a proton pump inhibitor. Both products are typically dosed at 20mg once daily. Why didn't the pharmaceutical manufacturer call this product Sanctura, which is the brand name used in the United States?

From the Saskatoon Star Phoenix:
As Bill Emrich left a Red Deer, Alta., hospital in 2004, emergency room staff thought they had given him a dose of morphine to deaden the pain of a riding accident.

In fact, a nurse had mistakenly administered hydromorphone, a similarly named narcotic that is seven times more potent. Less than an hour later, the 69-year-old was back in emergency, this time with doctors furiously trying to revive his stalled heart. "All resuscitation attempts failed," a report on the case said later, "and the patient expired." It was a dramatic example of a problem that has become almost routine in health care: the mixing up of drug names that sound or look alike, sometimes with deadly results. ...more

Health spending continues to rise

From the Globe and Mail:
Drugs cost more than the doctors who dish them out in Canada.

According to figures released Tuesday by the Canadian Institute for Health Information (CIHI) in its annual report on health care, health care spending in Canada is expected to reach $148-billion in 2006, an increase of $8-billion over last year but lower than the average increases of the last six years.

Medication is expected to be the second largest expense in Canadian health this year — second only to the cost of running hospitals. ...more

Pharmacists get power to prescribe

This article is from a week or so ago and doesn't exactly cover any new ground, but I thought it is a decent summary of the Alberta pharmacist prescribing situation.

From the (University of Alberta) Gateway:
As of 1 April, 2007, pharmacists in Edmonton will be able to prescribe drugs and administer injections, under the recently sanctioned Health Professions Act (HPA) and the Pharmacy and Drug Act (PDA), approved by the provincial Cabinet on 8 November 2006.

While some believe this will make pharmacists more effective, some members of Alberta’s medical profession are skeptical—with one concern stemming from the conflict of interest inherent in the possibility of pharmacists prescribing drugs for financial gain. ...more

Birth control now comes in spearmint

This sounds like an interesting idea, but it has not yet been approved by the Canadian government yet. It's unfortunate that a Canadian news website didn't add that important bit of info.

From Canada.com:
Looking for a contraceptive that's convenient -- and tasty? The first chewable birth-control method, a tiny, spearmint-flavoured tablet that also can be swallowed without chewing, has hit U.S. pharmacy shelves. ...more

‘Canadians should sleep better tonight’

Thelink for the complete pandemic guidelines are here.

From the Halifax Chronicle Herald:
The federal government released the latest version of Canada’s national pandemic influenza plan Saturday, the first official update of the plan in nearly two years.

It revises the document to reflect the real strides Canadian pandemic planning has made, suggested Federal Health Minister Tony Clement, who tabled the plan at a federal, provincial and territorial health ministers’s meeting in Moncton, N.B. ...more

Pfizer wins Canadian ruling on Lipitor

It looks like Pfizer has blocked an attempt by Novopharm to sell a generic Lipitor. There is one mistake in this article -- Novopharm is not "closely held" as stated but in fact is owned by Israel-based Teva, which is a publicly traded company.

From Crain's New York Business:
Pfizer Inc. said Friday that a Canadian federal court has blocked Novopharm Ltd. from launching a generic version of its blockbuster cholesterol drug Lipitor until the patent expires.

The ruling, by the Canadian Federal Court in Toronto, prevents closely held Novopharm from selling a generic form of Lipitor until its Canadian patent ends in July 2010. The ruling is subject to appeal, said Pfizer, which sued to block Toronto-based Novopharm from moving forward with its generic plans. ...more

Internet drug firms' merger now permanent

Here's the official verification regarding the closing of Minnedosa's best known business. I don't really know how this is considered a merger. It sounds more like a takeover.

From the Winnipeg Sun:
Winnipeg-based Canada Drugs is absorbing the operations and patient files of rival Internet pharmacy RxNorth.com, a company spokesman said yesterday.

The Manitoba companies explored the possibility of merging during a recent test run that saw Canada Drugs take over RxNorth's distribution of prescription drugs.

"After the last couple of months it looks like this is going to work so the parties have decided ... to have RxNorth continue to operate but as part of the CanadaDrugs.com group of companies," Canada Drugs spokesman and lawyer Troy Harwood-Jones said. ...more

Health Canada advises consumers of the lack of a child-resistant cap on certain Robaxacet Caplets bottles

From Health Canada:
Health Canada is advising consumers that certain bottles of Robaxacet Caplets 40s do not have a child-resistant cap, despite the outer package indicating the bottle has a ‘child-lok' cap. This poses a risk that children could accidentally ingest the product. ...more

Xylocaine (lidocaine HCI) - Advisories, Warnings & Recalls (for hospitals)

From Health Canada:
On September 22, 2006 AstraZeneca recalled Xylocaine® (lidocaine HCl) Jelly 2% Single Use Plastic Syringe (10 mL) because of an issue related to the break seal construction of this syringe product and how it was being opened. ...more

Drug-ad ban past expiry date

The linked article below is an opinion piece that argues in favour of changing the current advertising rules in Canada regarding prescription drugs. For those of you not familiar with these rules, it can be effectively summed up as following: A drug manufacturer can mention the name of their product in an ad, but can't mention its indicated use. Alternatively, they can place an ad promoting awareness of a medical condition as long as no drug product is mentioned.

These rules have forced advertisers to come up with commericals that bear little resemblance to those shown on American television. A prime example of mentioning a drug name but not the condition would be this Viagra commercial:



This ad works because everyone knows what Viagra is used for. Pfizer and their ad agency came up with a different approach when they wanted to promote Lipitor in Canada. In this case, they created the Making the Connection cholesterol awareness promotion. They were able to connect with their target audience with events like the Canadian Football League's Greatest QB/Receiver Connection while making no mention of a product.

While I admire the ingenuity of these ads, I think it's time to revisit the rules. The ads that mention the name only take advantage of the rules by not having to mention anything about the product, either good or bad. As a result, selling brand attitude without regard to any risks occurs. The worst example of this for me were the Alesse birth control pill ads. They simply sold a brand name in spots that resembled music videos with cool music and appealing actresses having fun then simply saying, "I'm on Alesse" with a big smile. There is no mention of what Alesse is, but the commercial ends showing a package of what is unmistakably birth control pills. The spots were clearly created with teenage girls in mind. There has to be a more upfront yet responsible way to allow drug companies to promote their products than this.

From the National Post:
Warning: Defective government policies can cause high blood pressure, nausea, dizziness, confusion, and loss of both freedom and income. Nowhere is this more true than in Canadian socialized health care, and nowhere more bizarre than in regulations on prescription-drug advertising.

Let me explain. ...more

U.S. stores change privacy rules after patient info found in trash

I found this pretty interesting. From what I've seen, most pharmacies have come a long way when it comes to proper disposal of patient information. I remember walking through a pharmacy parking lot perhaps 7 or 8 years ago and found extra patient labels that had blown out of the overfilled dumpster. I'm sure there are a few stores out there that still put this type of info in the regular garbage, but I think it's a lot less common now.

From CBC News:
The largest drugstore chains in the United States say they are working to better protect patient privacy after an investigative TV report checked city trash bins and found information on hundreds of store customers.

Indianapolis TV station WTHR inspected nearly 300 trash bins and found nearly 2,400 patient records, including pill bottles, customer refill lists and prescription labels. ...more

Pfizer stops Canadian trials

This is the first article I've seen mentioning a Canadian connection to torcetrapib. It shouldn't be a surprise that trials were being done here. There are many studies going on that are North America wide and essentially disregard the border.

From the Globe and Mail:
Canadian patients who were trying Pfizer Inc.'s new cholesterol treatment, torcetrapib, are being asked to stop immediately, the drug maker's Canadian arm told the Globe and Mail Monday.

The news comes after Pfizer said Saturday it had halted development of its key new cholesterol treatment. An independent board monitoring a study for torcetrapib recommended that the work end because of an unexpected number of deaths. ...more

Internet pharmacy to pull out of Minnedosa?

Minnedosa was once the poster child for international pharmacy in Canada, and now it's closing up shop. Now it's a symbol of how the business has fallen on tough times.

From the Winnipeg Sun:
A Minnedosa Internet pharmacy that helped shape a multi-million dollar industry appears to be on the verge of shuttering its call centre in the western Manitoba town.

A source said RxNorth is closing the centre this month, a move that would essentially put a halt to the mail-order pharmacy's operations in Minnedosa. ...more

New information regarding Tamiflu

From Health Canada:
Health Canada is informing Canadians of international reports of hallucinations and abnormal behaviour, including self harm, in patients taking the antiviral drug Tamiflu. These reports include children and teenagers, primarily from Japan. While the connection with the drug in these cases has not yet been proven, high fever or other complications of influenza can affect mental state, which in turn can lead to abnormal behaviour. Health Canada has not received any such reports in Canada and is continuing to actively monitor adverse events reported for Tamiflu. ...more

Eastern Health package could hurt other regions: pharmacists

From CBC News:
One health board's attempts to ease a shortage in pharmacists could wind up creating new problems in Newfoundland and Labrador's health care system, according to the group that bargains on behalf of pharmacists.

The Eastern Health regional authority announced Friday it would pay an extra $12,000 to pharmacists who in return agree to not leave their jobs. ...more

Congress expected to renew push for drug imports

From the Boston Globe:
Efforts to allow Americans access to cheaper prescription drugs from abroad should blossom once Democrats assume control in Congress, but the issue won't be a top priority, lawmakers and healthcare experts said.

Members of the House and Senate are readying for for a renewed push to permit broader imports of prescription drugs from Canada and elsewhere, where certain medicines can cost less than two-thirds what they do in the United States. Their hope is the imports will drive down prices at home. ...more

Hospital nurses doing pharmacists' work: union

From CBC News:
The Newfoundland and Labrador Nurses' Union says its members at an eastern Newfoundland hospital are being asked to do after-hours work that ought to be done by pharmacists.

Nurses at the hospital in Clarenville are left a supply of drugs in a secure cabinet on weekends, when no pharmacist is on duty. ...more

Health Canada advises Canadians of health risks involved with using benzocaine

From Health Canada:
Health Canada is advising Canadians who will be undergoing surgical, dental and other medical procedures about a link between the local anesthetic benzocaine and a potentially serious blood condition known as methemoglobinemia (MHb).
For the Public
For Hospitals

New safety information about Evra (norelgestromin and ethinyl estradiol) Transdermal System

From Health Canada:
Following discussions with Health Canada, Janssen-Ortho Inc. would like to update you on important new safety information pertaining to EVRA*. The EVRA* transdermal system marketed in Canada contains 6.0 mg norelgestromin (NGMN) and 0.60 mg ethinyl estradiol (EE) and is indicated for contraception.
For Health Professionals
For the Public

Groups ask Ottawa to ban drug exports before U.S. Congress legalizes trade

With the American election over and the possibility of legislative changes in the U.S., I suppose it was simply a matter of time for these groups to announce they sent another letter to the government. There isn't anything here we haven't heard many times before. It sounds scary, but isn't very specific.

From CBC News:
A coalition of pharmacists and patient advocates wants the federal government to ban prescription drug exports to the United States in a bid to get ahead of any renewed efforts by the new U.S. Congress to legalize the trade.

In a letter to Health Minister Tony Clement, the group says the issue is urgent because some senior U.S. Democrats have said legalizing imports from Canada will be a priority when the next congressional session begins in February. ...more

Industry approves proposed legislation

I don't know all of the details of this legislation, but it does sound concerning that Manitoba pharmacists have given up the power of voting on pharmacy practice issues and have left it up to the executive only. Hopefully the pharmacists that voted for this weren't blinded by the negative effect that this legislation will have on internet pharmacy. No matter how badly some pharmacists want the online businesses gone, is the price worth it?

From the Winnipeg Free Press:
About 400 Manitoba pharmacists attended a special meeting of the industry association on Wednesday night for last-minute discussions on proposed legislation that will change the practice of pharmacy in the province.

After more than an hour of debate and procedural wrangling, pharmacists voted 221 to 151 in favour of the bill, effectively ending a debate that has been going on for more than four years. ...more

N.B. to monitor sales of prescription drugs

From CBC News:
The government of New Brunswick has announced it will set up a system to track prescription drugs in the province after a new study showed prescription-drug abuse to be a bigger problem than the use of heroin.

The study, published in Tuesday's issue of the Canadian Medical Association Journal, showed that heroin in 2005 wasn't even a factor among injection drug abusers in Fredericton, and it was barely noticeable in Edmonton and Quebec City. ...more

MD, pharmacist win national award

From the Hamilton Spectator:
Protecting yourself from medication errors is as simple as carrying around a list of the drugs you take.

It sounds like common sense, but is so rarely done that a Hamilton doctor and pharmacist have won a national award for making it easy for patients to do. Dr. Richard Tytus and pharmacist Iris Kravchenko teamed up to provide patients with a one-page summary of their medical record and prescribed drugs. ...more

Dr. Tytus' website is www.drtytus.com

Creation of drug program imperative: Romanow

From the Globe and Mail:
The federal government must create a national catastrophic drug program to ensure that cancer patients don't have to worry about financial ruin while fighting for their health, says Roy Romanow, who headed a royal commission that called for such a plan years ago.

The strong warning follows a Globe and Mail story that showed how cancer patients in Atlantic Canada are taking out loans, racking up credit-card debt and rationing pills in an effort to afford crucial, costly prescriptions. ...more

Prescription opioids replace heroin as drug of choice on street: study

Finally there is some data that backs up what many of us have suspected. The growth in prescription drug abuse shouldn't be a surprise. I see two reasons for this: access and price.

If you live in Vancouver, heroin is probably a lot easier to find and with that higher level of supply brings a relatively lower price. I would suspect that an addict in smaller centres such as Saint John or Edmonton (for example) would have trouble getting heroin as easily or cheaply than prescription narcotics. Heroin needs to be shipped in from around the world and goes through a long and twisted supply chain. Meanwhile, there are pharmacies that dispense narcotics (which can be diverted to the street) in even the smallest towns and cities.

While this is concerning, I will mention that I feel for those in legitimate pain and need opoids for chronic pain relief. Many of these individuals are already viewed with a level of suspicion unseen in other medical conditions. Reports like this will not make it easier for these patients to convince everyone that they aren't addicts or traffickers.

From CBC News:
Heroin is no longer the drug of choice among many substance abusers in Canada, with prescription narcotics such as morphine and OxyContin now taking its place, says a study of street users in seven cities across the country.

Researchers found that heroin remains the No. 1 illicit drug only in Vancouver and Montreal. In the five other cities - Edmonton, Toronto, Quebec City, Fredericton and Saint John, N.B. - more often than not, getting high means grinding up and injecting prescription opioids. ...more

Fake drugs bought from 'walk-in'

The Norvascgate trial is adjourned until December 22 when closing arguments will be made. The defense will not call any witnesses.

Based on what has been published, I think the pharmacist is going to be found guilty of some charge. Even if you buy his story, he recklessly put the public in danger when he purchased these fake pharmaceuticals from a random guy who walked in the pharmacy and dispensed them to patients as medicine. That is not acceptable at any level.

From the Hamilton Spectator:
The defence will call no evidence at the trial of Abadir Nasr, the Hamilton pharmacist accused of selling fake and unauthorized heart drugs to the public.

Lawyer Dean Paquette told Ontario Court Justice Richard Jennis the defence will rely upon the evidence provided by the Crown, including approximately 45 witnesses and 200 exhibits. ...more

The killing cost of drug treatment

From the Globe and Mail:
Diagnosed with ovarian cancer in July of 2004, Rhonda Morey knows she will likely not live long enough to see her girls grow up. So she has made them keepsakes: hand-stitched blankets for when they turn 13 -- they are 6 and 4 now -- and embroidered handkerchiefs for their wedding days.

There is something else Ms. Morey may leave behind, something she dreads -- as much as $4,000 of the $10,000 she put on her credit card to pay for cancer treatment. ...more

Officials warn of flu vaccine shortage

From the Globe and Mail:
There's a limited supply of flu vaccine for the healthy B.C. residents who are required to buy it if they want to get a shot.

An increased demand for doses for the public health system, coupled with production problems, meant manufacturers, British-based Glaxo Smith Kline Inc., and France's Sanofi Pasteur, diverted their vaccine supply to fulfill the public health sector's needs, said Patricia Daly of the Vancouver Coastal Health Authority. ...more

Doctors mull adult drugs for obese kids

From the Toronto Star:
Doctors are warning that obese children may have to start taking adult cholesterol-lowering drugs amid evidence that 5-year-olds are developing heart disease.

Canadian researchers believe the explosion in child obesity means that medication may be the only way to help youngsters who already run the risk of premature heart attack. ...more

Didn't know pills were fake, insists pharmacist

Interesting testimony in the Norvascgate trial. I've spent some time in retail pharmacy, and it's always been my experience that the only companies that would ever offer volume price breaks are the generic companies. The brand name companies simply don't do it because they don't have to. There is no competition on a patented drug with no generics available. The only scenario where I can see a brand name company offering a price deal is when they are vying for a place on a hospital formulary. In this situation, they would be competing against other drugs within their class and price may be a consideration for one of those coveted spots.

I think this pharmacist is either incredibly naive or we're not hearing the whole story.

From the Hamilton Spectator:
Accused Hamilton pharmacist Abadir Nasr admits he purchased counterfeit drugs, but says he did not know the cardiovascular medication was fake at the time.

In an affidavit filed in court, Nasr, 29, told the Ontario College of Pharmacists that between January and June 2005 he purchased Norvasc in 5-milligram and 10-milligram strength from a man who identified himself as Ali Hussein, a drug wholesaler from Vancouver. ...more

New rules in Quebec for doctors renting from pharmacists

I'm quite sure that similar arragements happen between landlords and tenants in other types of industries regularly. This is an example of how the business of health care in Canada is not treated just like any other business. Is that good or bad?

From CBC News:
The Quebec government is putting a halt to the controversial practice of doctors getting a break on rent if they locate their clinics in buildings owned by pharmacists.

Jean Charest's government tabled legislation on Wednesday to limits trade-offs between the two groups of professionals.

The bill will force pharmacists to charge market-value rent to physicians who are tenants in their buildings, and will charge fines up to $20,000 for repeat offenders. ...more

'Silent exodus' will greet rejection of pay demands: pharmacists

I hope pharmacists in Newfoundland will be able to earn a higher wage. However, if pharmacists are sufficiently dissatisfied with the pay and there is no hope for improvement, they should vote with their feet and move to a job that pays them the wage they feel they deserve. There is a shortage of pharmacists pretty much everywhere in North America, so they have options. Ultimately, if pharmacists are serious about wanting a pay raise and move away, Newfoundland pharmacies will have to obey the laws of supply and demand and increase pay accordingly.

From CBC News:
The Newfoundland and Labrador government has turned down hospital-based pharmacists' requests for greater pay, even though professionals have been leaving for higher pay elsewhere and competitions for some vacancies have drawn no applicants.

Finance Minister Loyola Sullivan said the government does not currently have the resources to make hospital pharmacists' salaries competitive with rates in other provinces. ...more

Chemist helps court identify fake drugs

From the Hamilton Spectator:
A Pfizer chemist who analysed dozens of Norvasc prescriptions dispensed at King West Pharmacy is helping a Hamilton court to sort out which customers got fake pills and which got the authentic tablets.

Dr. John Thomas said some of the medicine bottles patients handed over to the RCMP after it raided the pharmacy on June 15, 2005, contained no amlodipine besylate, the active ingredient patented by Pfizer Products Inc. to treat high-blood pressure. ...more

Generic drug makers fight brand protection

From CBC News:
The generic pharmaceutical industry went to court Tuesday to challenge new federal regulations, which it says will block its ability to produce cheaper drugs and cost consumers millions of dollars.

The Canadian Generic Pharmaceutical Association said its members began legal action in the Federal Court of Canada because they feel the new drug patent rules give brand-name drug makers an unfair competitive advantage. ...more


From the Toronto Star:
Prescription costs in Canada will soar dramatically if new rules that protect brand-name pharmaceuticals from competition are allowed to stand, manufacturers of generic drugs said today.

The companies that make generic drugs asked Federal Court to quash the regulations, arguing that Ottawa had no right to extend ``data protection" for brand-name drugs to eight years from five. ...more


From Reuters:
Canada's generic drug makers launched legal action in the country's highest court on Tuesday, arguing that a multi-year ban on generic competition favors the big brand-name companies.

The Canadian Generic Pharmaceutical Association said new federal regulations that protect brand-name drug makers with an eight-year ban on generic competition pads the balance sheets of large pharmaceutical companies and vastly exceeds Canada's trade obligations. ...more

Drug Rituxan linked to bowel problems, Health Canada advises

Here is some additional info about the Rituxan advisory...

From CBC News:
Health Canada has revised prescribing information for the medication Rituxan after some people taking the drug for non-Hodgkin's lymphoma developed potentially life-threatening bowel obstruction or bowel perforation.

Rituxan is approved for use in Canada to treat non-Hodgkin's lymphoma (a cancer of the lymph nodes) and rheumatoid arthritis.

The drug's manufacturer, Hoffmann-LaRoche, said there have been two cases of bowel obstruction, including one death, and two cases of bowel perforation related to the use of Rituxan in Canada. ...more

Reports of Bowel Obstruction and Gastrointestinal Perforation with RITUXAN® (rituximab)

Hoffmann-La Roche Limited, in consultation with Health Canada, has informed Canadian health care professionals of important safety information concerning RITUXAN® (rituximab).

From Health Canada:
Hoffmann-La Roche Limited, in consultation with Health Canada, has informed Canadian health care professionals of important safety information concerning RITUXAN® (rituximab).
For Health Professionals...
For the Public...

Acetaminophen Recall in the United States

It's good to see that Health Canada did get an advisory posted early in the week...

From Health Canada:
Health Canada is advising Canadians of the recall of 11 million bottles of store brand pain-relieving pills in the United States due to contamination with metal fragments.

Health Canada has received confirmation from the company that the affected bottles have not been distributed to Canada, but the product may have been purchased by travellers or over the Internet. ...more