U.S. bureau looking into unapproved cancer drug

From the National Post:
The fraud division of the U.S. Food and Drug Administration is looking into concerns that an American entrepreneur and chemist are selling an unapproved compound to people fighting cancer.

The FDA wouldn't say if there is an actual investigation into the buydca.com Web site, but in general, if the agency learns about something unsafe or illegal, it moves swiftly to take action and protect the public. ...more

Extra $1.4 billion earmarked for health care

Today's federal budget featured many spending initiatives, and pharmacy-related items were included. Most notable was a promise to provide $300 million to provinces to immunize women against the HPV virus. There was also a mention of $400 million to help support provincial development of electronic health records. A national pharmacare strategy was not proposed.

Both of these measures are welcomed. I am especially heartened to see the HPV vaccination cash. This should help speed up the process of having the provinces add Gardasil (and future HPV vaccines) to their immunization programs. The details are unclear at this point, but if you use $500 as a rough estimate of the cost of the three necessary Gardasil injections per patient, the $300 million should immunize 60,000 women.

From the Vancouver Sun:
The federal government announced an extra $1.4 billion for health care Monday to make progress on a patient wait times guarantee, establish a national mental health commission and launch a vaccination program to prevent cancer of the cervix.

The largest portion of the extra health money in the minority Conservative government's budget is in a three-year, $612-million fund for provincial and territorial governments that make "public commitments to implement a wait times guarantee" by the end of this month. ...more

Patients 'desperate' for drugs

From the Edmonton Sun:
Desperate cancer patients are using the Internet to buy an experimental anti-cancer medicine intended for animals and self-medicating - despite stern warnings from medical professionals.

"It's a fool's game, but terminal cancer patients can be desperate, grasping at whatever straws are there," said Dr. Louis Francescutti, a local emergency room physician and injury prevention expert. ...more

Health Canada Endorsed Important Safety Information on Exjade* (deferasirox)

From Health Canada:
For health care professionals
For the public

Pharmacy ordered to stop selling compound

This is a fascinating ethical and practice debate question. How inappropriate is it to fill this prescription? How much latitude should be given when a dying patient makes a very unusual request? While the registrar of the Alberta College of Pharmacists said they would be looking into this case, I have a hard time believing this pharmacist will be seriously punished for his actions. He was trying to do the right thing for his patients, and he has now stopped filling these prescriptions.

From the Edmonton Journal:
An Edmonton pharmacist who previously filled doctor-written prescriptions for dichloroacetate (DCA) said he disagrees with the medical researcher who warned him this week to stop selling the compound to cancer patients.

Ron Marcinkoski, a pharmacist at Market Drugs Medical at 97th Street and 102nd Avenue, said he was doing what he could to help cancer patients when University of Alberta professor Dr. Evangelos Michelakis phoned the pharmacy to say DCA, which shrank tumours in rats but hasn't been tested in humans, could be lethal or cause horrible side-effects. ...more

Pharmacists to prescribe drugs April 1

We're only a matter of days away from the beginning of the pharmacist prescribing era in Alberta. How is it really going to affect practice? We'll see. The only sure thing right now is that pharmacists won't be able to initiate therapy yet as those guidelines are not ready.

I hope I will have a better idea of how this works later this week. By then I will have completed the Alberta College of Pharmacists course on how to adapt and extend a prescription.

Keep your eyes on this space as I'm planning to make some predictions about pharmacist prescribing. My attempt to foresee the future will be posted here prior to the April 1 date.

From the Edmonton Journal:
Starting April 1st, some people heading into their pharmacies will be able to get their prescriptions refilled without heading to their doctors first.

The Alberta Pharmacists’ Association is launching a public campaign to let people know of changes to the Pharmacists Act that will allow pharmacists to prescribe drugs and refill prescriptions, with some limitations, as of next month. ...more

Pharmacist consults for team

From the Waterloo (Ont.) Record:
With her son's wedding approaching, Dianne McDonald, was planning to take an herbal product to help her slim down.

It never occurred to the Waterloo woman it might aggravate her potentially life-threatening clotting disorder, or leave her dehydrated because she has no colon. ...more

U.S., Canada explore flu vaccine supplies

From CBC News:
By mixing flu pandemic vaccine with proprietary boosters, researchers with the U.S. government hope to have enough vaccine to protect people in case of a flu pandemic.

The plan is to mix vaccine from some companies with the booster adjuvants — chemicals that enhance the effect of a vaccine's active ingredient — of competitors to increase the global supply of influenza vaccine. ...more

Cancer patient wary of new drug

From the Edmonton Journal:
A 70-year-old B.C. woman with advanced lung cancer has waited months to get her own supply of an unapproved drug that a University of Alberta study found shrank tumors in lab rats.

Now that the controversial compound has arrived at her daughter’s house by mail, Janet has changed her mind about taking dichloroacetate (DCA). ...more

Beware of pills, doctors caution

From Canada.com:
On mornings after a particularly brutal night, L. puts in a call to her supplier - another pillar of her community, a responsible grandmother with a stash of sleeping pills in her purse.

L. doesn't have insomnia, but sleep apnea. She seems to sleep well, but wakes feeling drowsy. The idea of having to wear a mask to bed freaks her out. Instead, she sneaks the occasional "dollie" to ease her toward oblivion, although her apnea will persist despite the drug-induced haze. ...more

Provinces take a pass on cancer vaccine

Here's another article about Gardasil. It's similar to the article from a couple of days ago but this one has more details in it. However, I think the prices quoted in the article are a bit low. How about some verification? Pharmacists out there -- check your current retail price of Gardasil and post it in the comments section if you have a chance.

From the National Post:
It has been hailed as one of the greatest advances in immunization in recent years, with the potential to prevent a common form of cancer, but no provincial government has yet chosen to fund the new human papillomavirus (HPV) vaccine.

At $400 per patient, the cost is likely out of reach for many Canadian families, say advocates. Meanwhile, Australia, Texas and some other U.S. states have already decided to offer the vaccine for free, though it has triggered considerable debate in America. ...more

Quebec's public pharmacists demand salary parity

From CTV.ca:
Quebec's association of public pharmacists called on the province's three major parties Sunday to grant its members salary parity with their private-sector counterparts.

Association des pharmaciens des etablissements de sante du Quebec president Francine Lussier-Labelle said public pharmacists earn 25 to 40 per cent less than their colleagues in the private sector despite higher education requirements. ...more

Changes mulled in licensing medicines

From the Globe and Mail:
Health Canada is considering changing its system of licensing prescription drugs, moving to one where the safety and effectiveness of medicines would be more closely monitored after products are approved for sale.

A discussion paper proposes progressive licensing for drugs to follow up on them once large numbers of people are taking them. Clinical trials used to bring drugs to market are typically small; rare side effects generally come to light only when medications are taken by many thousands of people.

The aim is to improve the capacity of the regulatory system to monitor the safety of medication during the life cycle of a drug. The importance of this has been underscored in recent years by the revelation that popular painkillers from the cox-2 inhibitor family raised risks of heart attack and stroke. ...more

HPV vaccine may be offered free in year or two, health unit say

Here's another story that discusses Gardasil not being covered by a provincial government yet. There's not much doubt about the reasons -- it's about the cost. I suspect that it will eventually be covered. Hopefully it happens sooner as opposed to later.

From the Brockton (Ont.) Recorder and Times:
Although residents here are aware of a new vaccine that protects young women from a sexually transmitted disease that causes cervical cancer, there aren't many who are shelling out for it.

Still, Jane Futcher believes it's a matter of time until girls will be eligible to receive Gardasil - a vaccine against human papillomavirus (HPV) currently sold for around $450 - free of charge.

"I expect it will be a publicly funded vaccine in the next few years," said Futcher, the director of clinical services at the Leeds, Grenville and Lanark District Health Unit. "It's good public health and I can expect that the ministry (of health) will fund it at some point," Futcher said. ...more

B.C. pays pharmacists to save lives by not dispensing

I'm glad that I can follow that negative pharmacist story out of British Columbia with a positive one from that same province. This program is a really innovative idea and it would be great if other provinces adopted a similar plan.

From the Vancouver Sun:
Last year in British Columbia, thousands of people were saved from harm or even death because pharmacists refused to fill their prescriptions.

Sometimes they prevented a dangerous drug interaction; sometimes they prevented fraud or fixed a doctor's mistake.

The provincial government paid nearly $700,000 to pharmacists last year for not filling prescriptions the health professionals believed might endanger the health of patients.

The unique and increasingly popular, yet low-profile, B.C. program gives a "professional intervention fee" to pharmacists that amounts to twice the normal dispensing fee. ...more

When things go wrong at the pharmacy

From the Vancouver Sun:
A pharmacist who admitted he routinely processed a dog's insulin through its owner's Pharmacare medication record so the owner could receive Pharmacare benefits may or may not be disciplined, says the College of Pharmacists of B.C.

Same with the pharmacist who violated a customer's privacy by talking about her methadone replacement therapy in front of others waiting for prescriptions. ...more

Prescription imports could lower drug prices by 12-20%

From the Lexington (Ky.) Herald Leader:
The prices Americans pay for prescription drugs would fall — though not to the levels of Canada or Europe — if the government let consumers buy medications abroad, lawmakers were told yesterday.

For a decade, a bipartisan cadre of lawmakers has tried to give U.S. consumers legal access to drugs imported from Canada, Australia, New Zealand, Japan and Europe. They say foreign prices can be half or a quarter what Americans pay for the same drugs.

But permitting those drugs to be imported would cut U.S. prices by only 12 percent to 20 percent, Stephen Schondelmeyer, a University of Minnesota pharmaceutical economist, told a Senate subcommittee yesterday. ...more

Reluctant uptake of pharmacists’ medicine use reviews

This isn't a Canadian pharmacy story, but I thought it was worth mentioning that physicians in the United Kingdom aren't exactly thrilled about pharmacist medication reviews. It's also interesting to see that it hasn't exactly been embraced by pharmacists yet.

From Healthcare Republic:
Pharmacists’ medicines use reviews (MURs) are slowly catching on despite widespread unpopularity with GPs, a study of the service has found.

Accredited pharmacists have been paid to review the way patients take their medicines since the new pharmacy contract came in in 2005.

Pharmacies can now claim for 400 MURs a year. But the GPC has condemned the reviews as a 'duplication' of effort. ...more

Canadian groups protest U.S. bid to legalize bulk drug imports

From 570 News (Ont.):
Legalizing bulk imports of Canadian prescription drugs will deplete supplies, raise prices and strain relations, pharmacists and a patients' group told the U.S. Congress on Wednesday.

The Canadian groups submitted a brief to a U.S. Senate subcommittee that held a hearing on two bills that would allow cheaper drugs from north of the border. ...more

Health Canada proposes better drug monitoring

From the Toronto Star:
Health Canada is considering a new system of licensing prescription drugs that would more closely monitor the safety and effectiveness of medications after they are approved for sale.

A discussion paper posted on the department's website proposes progressive licensing for drugs to follow up on them once they are being taken by large numbers of people. Clinical trials used to bring drugs to market are typically small; rare side-effects only generally come to light when medications are taken by many thousands of people. ...more

Drug Imports Battle Heats Up Again

From WTOP-FM (DC):
The pharmaceutical lobby pushed back Wednesday against a renewed effort in Congress to pass a law enabling U.S. consumers to buy cheaper prescription drugs from Canada and other countries.

The legislation, supported by Democrats and Republicans, would allow individuals and pharmacies to order drugs from 19 countries. Supporters of the bills point out that Canadians pay about 60 percent less for their medication than Americans, according to a study by the Canadian government. ...more

Mi’kmaq drug abuse rampant

This article discusses an important topic -- prescription drug abuse among First Nations peoples. It's too bad that the author felt the need to use quotes containing incorrect information to try to drive the point home.

"We can get all the free (prescription painkiller) OxyContin we want, all the hard drugs for free, but we have to pay for a leg brace or an asthma puffer and you have to ask why that is."

A quick check for the First Nations and Inuit Health drug benefit listing for Oxycontin shows that:

OXYCODONE HCL -- Limited use benefit. Prior approval required for controlled release tablets (editor note: this refers to Oxycontin) only. Regular release dosage forms are full benefits and do not require prior approval.

This means that for any Oxycontin prescription to be covered, special authorization would need to be applied for by the pharmacist with information supplied by the prescribing physician. The application would then need to be approved by First Nations and Inuit Health.

Meanwhile, asthma inhalers like Ventolin (salbutamol) are full benefits with no special authorization requirements. I'm also quite sure that leg braces are eligible for coverage, but I can't find that documentation online.

It's a quote like this that makes up for these errors:

"Health Canada knows exactly who’s getting quadruple prescriptions and they know the names of the doctors who are over-prescribing; it’s all on their computers," he said.

Why isn't the government checking on the physicians and pharmacists? It's a good question that deserves follow up with both the government and the health professionals involved. Perhaps a follow up article will make this query.

From the Halifax Chronicle-Herald:
The 18 names on a piece of paper on Doreen Bernard’s kitchen table are people from this First Nations community whose deaths have been related to prescription drug use over the past few years.

Ms. Bernard lives in constant fear the list will grow longer. ...more

Health Canada red flags natural bipolar remedy

From the National Post:
An extended battle between Health Canada and the makers of a controversial natural remedy for bipolar disorder has been stoked again with the regulator issuing new warnings about potential serious side effects from taking the product.

The latest salvo in the struggle comes less than a year after Truehope Nutritional Support Ltd. was acquitted at an unusual criminal trial of selling Empower Plus as a drug without a licence. ...more

Firms step up battle over drug commercials

From the Toronto Star:
If the makers of Viagra advertise the little blue pill on a U.S. television station, they're allowed to mention both the name of the drug and the fact that it's used to treat erectile dysfunction.

But, if a drug company advertises the same product on a Canadian TV channel, it can mention either the brand name or the condition for which it's prescribed – but not both in the same ad. ...more

'What a waste of time'

As of today, Abadir Nasr is a free man with no criminal charges pending. An appeal by the Crown is possible. He still holds his pharmacist license and can work at a pharamcy but does not have authority to sign for narcotics. Also, he cannot own a pharmacy. No date has been set for his hearing with the Ontario College of Pharmacists.

The judge in the criminal case agreed that Nasr was "negligent and incompetent" but didn't knowingly sell fake drugs to patients so no fraud occurred. Nasr was smart enough to go through university, get a pharmacist license, and run his own business, but he was convinced that a travelling saleman selling discount pharmaceuticals was legitimate? I don't think a reasonable pharmacist would've come to the same conclusion.

The eventual College of Pharmacy hearings will likely be more difficult for him. The College will only need to prove that there was a public safety risk. Intent will not be relevant.

From the Hamilton Spectator:
Frances LaForme was the first customer to raise the alarm over the funny looking pills dispensed to her at King West Pharmacy.

LaForme was in court yesterday when Ontario Court Justice Richard Jennis dismissed all 12 fraud-related charges against her former pharmacist, Abadir Nasr, 29. The decision left the Hagersville woman wondering if all her work with police and drug company investigators was worth it. ...more

New approach to reviewing cancer drugs starts March

From CBC News:
A new cancer drug review process begins its pilot project in Canada on Thursday in all provinces and territories except Quebec.

The provinces pay for most cancer drugs, with each one doing its own review and deciding on when and if to pay for a medication.

Given the high price of some new drugs, many provinces will only pay under special circumstances or not at all, resulting in a patchwork of coverage, said Dr. Tony Fields, vice-president of medical affairs for the Alberta Cancer Board in Edmonton. ...more

Bill 102 causing stress for Emo pharmacist

From the Fort Frances (Ont.) Times:
Mike McKinnon is stressed. And it’s because of Bill 102.

The Emo pharmacist has been making plans to buy the pharmacy portion of Emo Drugs, but now he’s starting to think twice.

“I’m just stressed out about it, basically,” he remarked Friday morning. “I have no idea what’s going to happen. . . .

“Now I want to see how this Bill 102 pans out—to wait and see what happens after the smoke clears.” ...more

Nasr could still lose his licence

From the Hamilton Spectator:
The Ontario College of Pharmacists has no plans to change its rules in the wake of a fake heart medication scandal in Hamilton.

The college says it believes the dispensing of counterfeit heart medication from Abadir Nasr's King West Pharmacy is an isolated incident. ...more

Druggist cleared of fake pill charges

From the Hamilton Spectator:
The Hamilton pharmacist who sold fake drugs to heart patients walked out of court a free man yesterday.

Ontario court Justice Richard Jennis said Abadir Nasr may be negligent and incompetent, but he said there is no evidence the Egyptian-born druggist knowingly sold counterfeit and out-of-country medication. ...more

Pharmacist cleared

I will post more info once it's available...

From CHML-AM:
The Pharmacist who was charged with selling fake heart drugs has been cleared of criminal charges.

Abadir Nasr, had a dozen fraud charges dismissed today as the crown couldn't prove that he intended to sell the counterfeit drugs. ...more

Pharmacist defaulted on $1m loan

It looks like the counterfeit Norvasc case in Hamilton will have a verdict announced today. Meanwhile, Mr. Nasr appears to be in further legal trouble as a civil suit is now being filed regarding some shady financial dealings.

From the Hamilton Spectator:
CIT Financial Ltd. of Burlington is seeking a civil judgment against a former Hamilton pharmacist who defaulted on a $1 million loan.

Abadir Nasr, 29, of Mississauga, also faces a criminal court judgment today in a separate proceeding in which he is charged with defrauding the public, pharmaceutical manufacturer Pfizer Canada and various public and private health insurers through the sale of a counterfeit heart drug and pills not authorized for sale in Canada. ...more

Slight OD of popular antidepressant could cause death

The details of the venlafaxine toxicity report is located at the British Columbia Medical Journal website.

From the Vancouver Sun:
B.C. doctors are being put on alert that the most commonly prescribed antidepressant in B.C. is increasingly being observed to have toxic overdose consequences such as seizures and even deaths.

"We are alerting doctors about our concerns to give them a heads-up that it is a potential concern because it appears it is more toxic than it was originally hoped it would be," Derek Daws, managing director of the B.C. Drug and Poison Information Centre said in an interview Monday, referring to the medication called venlafaxine whose brand name is Effexor. ...more

Sask. pharmacy owners sell UPE

I suppose it's a sign of the times: a pharmacist-owned wholesale company sells out to one the big players in the wholesale business. Hopefully the pharmacists/shareholders get a good return on their investment, but it's unfortunate that Saskatchewan pharmacists have one less option to buy their pharmaceuticals.

From the Saskatoon Star Phoenix:
A group of Saskatchewan pharmacy owners have decided it's time to wind down their Saskatoon-based pharmaceutical distribution company and tap into a much larger supply chain.

The pharmacist-shareholders of United Pharmacists Enterprises Ltd. (UPE) announced Monday that the company is being sold to McKesson Canada. The sale will mean the loss of about 50 full-time and 15 part-time jobs at the UPE distribution centre on 45th Street East in Saskatoon's north end. ...more

Deal reached in methadone case

From the Toronto Star:
A deal has been reached between a pharmacist accused of professional misconduct and prosecutors with the Ontario College of Pharmacists.

Susan Wong, the pharmacist, is alleged to have behaved in a "disgraceful" and "unprofessional" manner in her involvement in a methadone pipeline that supplied a large chain of drug-addiction clinics. ...more

Eligible kids missing out on Pharmacare

It sounds like this drug plan for low-income families is relatively new. Hopefully Nova Scotia pharmacists can help spread the word about the program. A link to the plan is at http://www.gov.ns.ca/coms/LIPC.html

From the Halifax Chronicle Herald:
Less than a third of children in low-income families eligible for $5 prescriptions are in the program, according to the Community Services Department.

The MacDonald government launched the children’s Pharmacare program in October, after promising it during last year’s election campaign. As of mid-February, 10,600 children from 8,500 families were enrolled. That’s only 30 per cent of the 35,000 children eligible. ...more

A chance to jump wait list

This isn't a specifically a Canadian pharmacy story, but it's about a Canadian pharmacist who was one the internet pharmacy pioneers. Now that the online pharmacy business has cooled, it can be expected that some of those original entrepreneurs will use their experience and resources to branch out into different projects.

From the Winnipeg Free Press:
Manitobans will have the chance to jump the wait list and pay for their own surgeries in India and Cuba thanks to a new medical tourist program starting this spring.

Choice Medical Services is set to launch in less than three months, and is intended to be a middle-class alternative to pricey procedures at the U.S. Mayo Clinic. For about $6,000, patients can pay out-of-pocket for a total hip replacement in Delhi, India, instead of waiting an average of 25 weeks in Manitoba or forking over upwards of $20,000 to have the surgery done in the U.S.

Local businessman and Internet pharmacy pioneer Daren Jorgenson has already inked agreements with Apollo Hospitals Group in India and the Cuban Ministry of Health in Havana to start sending patients through the program, which he said is a safe alternative for Manitobans frustrated with lengthy wait times in the health care system. ...more

Important safety information on rosiglitazone-containing products: Avandia, Avandamet and Avandaryl

From Health Canada:
GlaxoSmithKline Inc. (GSK), in consultation with Health Canada, would like to inform you of recent safety data concerning rosiglitazone-containing products, i.e., AVANDIA® (rosiglitazone maleate) tablets, AVANDAMET® (rosiglitazone maleate/metformin hydrochloride) tablets and AVANDARYLTM (rosiglitazone maleate/glimepiride) tablets. These products are used in treating type 2 diabetes mellitus.
For Health Professionals

Health Canada examining information linking antiviral drug to development of treatment-resistant HIV

From Health Canada:
Health Canada is informing Canadians of new information submitted by the manufacturer of the antiviral drug Baraclude that suggests the drug may be linked to the development of a treatment-resistant strain of HIV in one patient with HIV.
For the Public
For Health Professionals

Saccharin ban under review

From Canada.com:
Health Canada is considering lifting the country's 30-year-old ban on saccharin, the infamous artificial sweetener that was forbidden for use in food here after it was linked to cancer in lab animals, and is still classified by the department as a suspected carcinogen.

New studies and information about the health and safety of saccharin, perhaps best known as the sweetening agent in Sweet 'N Low, prompted the decision to review its regulatory status in Canada, Health Canada spokesman Paul Duchesne said. ...more

For cures to colds, it's buyer beware

Cold fX really scored big points last week when it received new approvals by Health Canada. It sure helped their stock price a lot, but will it really change the opinions of pharmacists who don't recommend it? As the article below mentions, it's still buyer beware.

From the Ottawa Citizen:
When Canadians walk into drugstores, they are greeted with more cold remedies than ever before. But just because the aisles are filled with natural health products and drugs that promise to combat the sniffles doesn't mean we're any healthier, pharmacists say.

While Health Canada gave its official seal of approval to the immune-boosting product COLD-fX yesterday, medical experts say consumers still need to take a cautious, "buyer beware" approach when examining solutions to runny noses and coughs. ...more

NDP calls for recognition of foreign credentials

Instead of rehashing yet another story about foreign professionals not being recognized in Canada, let's go over the NDP proposal in regards to pharmacists.

1) Creating an agency for the recognition of foreign credentials.

The Pharmacy Examining Board of Canada is an organization all pharmacists must go through before they are able to get a license, whether they are Canadian or foreign trained. This includes writing the PEBC exam.

2) The establishment of uniform recognition practices across the country.

Pharmacy and the approval of pharmacy licenses has always been under provincial jurisdication, which is the same for physicians, nurses, dentists, veterinarians, and pretty much any other health care profession I can think of. There is a lot more uniformity between provinces now then there was a decade ago when I got my pharmacy license. Back then, it was difficult for even a Canadian pharmacist to move between provinces. I can't see the provincial colleges giving up their current level of authority.

3) Websites to publicize accreditation processes.

The PEBC site has pretty much everything a foreign grad needs to know. It's in both official languages as well. PEBC website

4) More mentorship and training programs for newcomers.

More formal training programs are needed for foreign pharmacists, but I think that as a profession we are doing a lot better than most when it comes to mentorship programs. It's not uncommon to see a foreign pharmacist working in a dispensary assisting a pharmacist, gaining experience that undoubtably helps their chances of passing the PEBC exam. Perhaps some type of tax incentive from the government for hiring these positions could be instituted.

Overall, I think pharmacy is doing better than average compared to other health care professions when it comes to foreign professionals. However, there is room for improvement. I hope Mr. Layton and the public also have to keep in mind that there are some foreign pharmacists that will not meet Canadian standards. We ask a lot of our health care system and it's not unreasonable to expect that all practitioners meet those standards.

From CTV News:
NDP Leader Jack Layton has called on the federal government to do more to recognize the foreign credentials of immigrants to Canada.

"The tragic fact is that we lure people to come here, we give them points for their experience, and their professional credentials," Layton, speaking in front of Toronto's Union Station, said Sunday. ...more

Cherokees look into mail-order-medicine business

It's been a while since a specific American group has made public noise about buying Canadian drugs. This story is a bit different because the Cherokee tribe argues that they are a soverign nation and not subject to regular American laws. I'm hardly an expert when it comes to these type of matters, but I suspect the big problem they would have is that the Cherokee would want to sell to the general public. That would give the state pharmacy board the jurisdiction to do something about it. We'll see if this actually goes anywhere, but keep in mind that a tribe in Maine tried something similar a while back and never went ahead with a Canadian option.

From the Contra Costa (Calif.) Times:
Cherokee leaders are scouting the moneymaking potential of a business venture other tribes have found lucrative: selling discount prescription drugs by mail.

They might also import less expensive pharmaceuticals from Canada for a future business that could fill prescriptions for tribal members and for people who live far beyond the boundaries of Cherokee land in the mountains of western North Carolina.

But that would set up an age-old conflict between a tribe that argues it has the rights of a sovereign nation that exempt it from federal laws and federal health officials who say selling Canadian drugs in the United States is illegal and, perhaps, unsafe.

"We've definitely looked at the Canada option," said Michell Hicks, principal chief of the Eastern Band of Cherokee Indians. "That definitely could go under sovereignty." ...more

Health Canada advises consumers not to use herbal sleep supplement Sleepees which contains a habit-forming drug

From Health Canada:
Health Canada is advising consumers not to use a product called Sleepees, because it was found to contain an undeclared drug estazolam, which can be habit-forming when used for as little as a few months. Consumers who may still have this product in their homes are advised to consult with a health care professional before they stop taking the capsules, because of the risk of withdrawal symptoms. ...more

Concern over Xenical sales

Here's another global story. It seems that Australian pharmacists aren't doing a great job of screening patients wanting to buy Xenical. I'm not familiar with what needs to be done by a pharmacist before being allowed to sell Xenical, but I think it must be relatively similar to what is expected of Canadian pharmacists that sell Schedule 2 or "behind the counter" drugs.

From Sky News Australia:
...When put to the test, 80 per cent of pharmacists sold Xenical inappropriately, when they should not.

The Pharmaceutical Society of Australia says an 80 per cent failure rate is indefensible, and that pharmacists had contravened the Society's strict guidelines. ...more

Pharmacists Freely Dispense Drugs Without Prescription

This story has nothing to do with Canadian pharmacy, but I think it's worthwhile to pass on pharmacy practice issues in other countries that are interesting. I'm not exactly sure how Saudi pharmacists can get away with selling prescription only mediciations without a prescription. Isn't there some sort of government regulatory body that monitors pharmacy practice?

From the Arab News:
If you live in the Kingdom long enough, chances are you’ll eventually go to a pharmacy and pick up prescription-only medication as easily as picking up a package of Panadol, an over-the-counter, non-narcotic painkiller.

The practice of buying drugs illegally conjures up images of drug addicts finding ways to obtain controlled substances in order to abuse them for a cheap high. However the most “under-the-counter” drugs are antibiotics and other powerful medications used for treating diabetes, heart conditions or depression. ...more

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