Ottawa urged to provide low-cost drugs for developing world

From the National Post:
Front-line international health workers appealed to MPs Wednesday to fix the fact that not a single pill has left Canada under a three-year-old regime to provide cheap generic drugs to needy countries in Africa and elsewhere.

They said the plan is unnecessarily complex and cumbersome, and does nothing to quell the intimidation of potential importing countries by brand name pharmaceutical companies and the U.S. government. ...more

More adverse drug reactions being reported

From Canada.com:
A growing number of Canadians are reporting adverse reactions to the drugs they’re taking, a troubling trend that Health Canada says has been on the rise for the last several years.

More than 10,500 new cases of adverse drug reactions were reported to Health Canada in 2006, mainly by health professionals, an increase of 108 cases compared to the previous year. Health Canada also received more than 250,000 reports last year of adverse reactions originating in other countries from drugs that are marketed in Canada, a jump of 43 per cent from 2005. ...more

Cancer patients at risk for dangerous drug interactions: study

This article has a few good points, including some good advice for patients:

Ms. Kwong advises patients to:

—Always carry an up-to-date list of medications and their dosages, including over-the-counter and alternative therapies.

—Try to have prescriptions filled by the same pharmacy: electronic software will alert the druggist of potential drug interactions.

—Make sure to keep different doctors or pharmacists apprised of any changes in prescriptions.

Because of drug interactions, cancer patients can be challenging from a pharmacist perspective. However, solving these types of clinical puzzles can really show that the pharmacist is a drug information specialist.

From the Globe and Mail:
Many cancer patients are at risk for potentially dangerous drug interactions because of the number of different medications they take for multiple conditions, say Canadian researchers, who caution that steps must be taken to avoid these dicey combinations.

In a study appearing Wednesday in the Journal of the National Cancer Institute, researchers at Princess Margaret Hospital in Toronto found that almost 30 per cent of 405 cancer patients studied were taking drugs that put them at risk for at least one adverse drug interaction.

At least 9 per cent of the interactions could have had severe effects — including being potentially fatal — and 77 per cent were of moderate severity and could have resulted in serious health problems, the study showed. About 8 per cent of patients received duplicate medications. ...more

Study in new medical journal compares health outcomes in Canada and U.S.

The website for the new Canadian medical journal is openmedicine.ca. An article discussing its inception is located here. I wanted to add that I have no particular affinity for CBC News, but I find that their links typically stay active longer and remain free after the seven day cutoff that other publishers use. As a result, I tend to link to their stories a bit more.

From CBC News:
Health outcomes for patients in Canada are as good as or better than in the United States, even though per capita spending is higher south of the border, suggest Canadian and U.S. researchers who crunched data from 38 studies.

The findings were published in the inaugural edition of Open Medicine, a new online medical journal launching Wednesday in the aftermath of a rift last year between some editors and the publisher of the Canadian Medical Association Journal. ...more

Jean Coutu's profits surge

I'm going to try to post more Canadian pharmacy business stories when they come up. Does this interest you or should I keep the articles more clinical in nature?

From CBC News:
Quebec-based pharmacy chain Jean Coutu Group reported its best quarterly profit in nine years on Tuesday.

For the third quarter, it earned $184 million US, up almost six-fold from $31.6 million US in the same quarter a year ago.

Jean Coutu three-month trading
The bulk of the gain stems from a rise in shares that Jean Coutu received for selling its 1,850 drugstores in the Brooks and Eckerd chains in the U.S. to Rite Aid. ...more

New clot drugs beckon as replacements for warfarin

From Reuters:
A new crop of medicines to prevent stroke and blood clots could emerge within several years, easing dangers and hardships for patients and creating blockbuster sales for drugmakers.

The oral drugs could prove better and safer than injectable medicines such as heparin now widely used to cut the risk of dangerous blood clots in the legs and lungs after major surgery.

But makers of the new drugs say their biggest use would be as an alternative to warfarin, a pill used for decades by people with atrial fibrillation -- or irregular heartbeat -- to prevent strokes. An estimated two million Americans have been diagnosed with the heartbeat problem and the number is expected to double in the next 20 years. ...more

Death rate from breast cancer falling, more women living longer: Cancer Society

From CBC News:
More women with breast cancer are surviving longer than in the past and a significantly smaller proportion are dying from the disease, says the Canadian Cancer Society, which released its latest statistics Wednesday.

A special report in Canadian Cancer Statistics 2007 shows the breast cancer death rate among Canadian women has dropped by 25 per cent in the last two decades and that 86 per cent of women diagnosed with the disease are surviving at least five years. The survival stat excludes Quebec, which collects data differently than other provinces. ...more

At the drugstore, the nurse will see you now

While Bill 102 has typically been looked at with a mixture of concern and fear from the pharmacy community, there might be a bright side. There may be potential for new services and revenue streams as a result of the new cognitive services fees.

From the Globe and Mail:
The latest generation of the Rexall drugstore has a nurse on duty six days a week, podiatrists, chiropractors and other health professionals on hand regularly, and a four-seat classroom for health-related seminars.

Call it the new competitive front in drugstore retailing wars.

Pharmacies have been battling each other for years by flogging more shampoos, cosmetics, food and even electronic gadgets.

Now, with new drug legislation in Ontario that is expected to eventually spread across the country, the outlets are looking to transform themselves into patient counselling centres too. ...more

Health Canada charging huge markup on pot

From the Toronto Star:
The federal government charges patients 15 times more for certified medical marijuana than it pays to buy the weed in bulk from its official supplier, newly released documents show.

Critics say it's unconscionable to charge that high a markup to some of the country's sickest citizens, who have little income and are often cut off from their medical marijuana supply when they can't pay their government dope bills.

Records obtained under the Access to Information Act show that Health Canada pays $328.75 for each kilogram of bulk medical marijuana produced by Prairie Plant Systems Inc. ...more

Only one class of antibiotics remains effective against gonorrhea: U.S. CDC

From CBC News:
The wily gonorrhea bacterium appears to be en route to vanquishing yet another class of antibiotics, leaving just one last weapon in the arsenal to fight this very common sexually transmitted disease.

The U.S. Centers for Disease Control on Thursday urged American doctors to stop using all antibiotics in the fluoroquinolone class to treat gonorrhea, a decision prompted by rising rates of resistance among gonorrhea strains isolated in the United States and beyond.

Doctors should instead use antibiotics from the cephalosporin class, said Dr. John Douglas, who noted this is the only remaining class of drugs effective against the infection. He also warned there are no new antibiotics in the pharmaceutical pipeline to fight gonorrhea. ...more

Magazine mentions Canada Pharmacy News

I received a copy of the Winter 2007 edition of newpharmacist magazine today. On page 44, CanadaPharmacyNews.com is mentioned in the feature "10 Sites to Bookmark." Thanks to Kristan Wolfe and newpharmacist for the mention.

If the article in the magazine brought you here -- welcome to Canada Pharmacy News! If you have any questions about the blog, feel free to contact me at info@canadapharmacynews.com.

Jason

Druggist will fight to keep his licence

It looks like Abadir Nasr wants to get his side of the story in the press. The Hamilton pharmacist, who sold fake Norvasc tablets but was acquitted of criminal charges, answered questions for the Hamilton Spectator today. I find it odd that he answered the questions in writing. Nasr claims he is not fluent in English. I thought pharmacists are required to be able to speak at least one of Canada's official languages. I believe most provinces have language tests that are requirements for licensure. However, I'm not sure specifically about Ontario.

There is no mention of a date for his disciplinary hearing with the Ontario College of Pharmacists. I suspect it will still be a while as the regulatory body will likely need time to gather all of the relevant information.

From the Hamilton Spectator:
The Hamilton pharmacist who was found not guilty of criminal fraud after selling counterfeit heart pills to the public says he never doubted his acquittal on all charges.

Abadir Nasr, 29, said he intends to fight for his licence and his right to own another drugstore when he goes before a future disciplinary hearing of the Ontario College of Pharmacists.

"As God knows, I never had the intent to harm anybody so I was completely sure that not guilty would be the (outcome) of this case," said Nasr. ...more

Will generic drug policy hit Shoppers?

Here's a timely article regarding the new generic rebate restrictions (Bill 102) in Ontario. I think these changes will hurt the bottom line in all types of pharacies in Ontario, from the small independent to the biggest chain. There is no doubt that it could affect Shoppers stock price. However, I'm pretty sure that they will ultimately land on their feet as a business since they have a lot of non-prescription items to profit from.

My biggest concern about Bill 102 is that it's going to devastate smaller, service-oriented, clinical pharmacies that heavily rely on prescription sales. They can't run the pharmacy department at a break-even or loss leader pass and reap their profits selling cosmetics or groceries. We've seen the independent pharmacy pretty much disappear in the United States. Bill 102 could make the Ontario pharmacy scene very American-looking: nothing but big chains and grocery stores with almost no independents. If these boutique pharmacies disappear, so will some of the unique professional services they offer. That lack of choice won't be good for either the average Ontarian or the pharmacists that serve them.

From the Globe and Mail:
There is mounting concern that Shoppers Drug Mart Corp. will be hurt by generic drug pricing changes in Ontario, home to more than half of the retailer's stores.

Analyst Keith Howlett at Desjardins Securities said Monday he can't see how the legislative reforms, which reduce the price the province will pay for generic drugs, “cannot have an impact on the largest retail pharmacy chain in the province.”

The drug policy could slice as much as $38.3-million a year off of Shoppers' profit in Ontario, or $75,000 a store, he estimated in a report. (That is earnings before interest, taxes, depreciation and amortization.) Shoppers has 511 pharmacies in Ontario and almost 1,000 across the country.

Mr. Howlett's concerns add to earlier ones raised by at least one other retail analyst, as well as pharmacists and other groups, about the impact of the new law. It came into force in October although parts of it have been phased in over the past few months — and some provisions took effect as recently as April 1. ...more

Pharmacist restores piece of the past - nasty drugs and all

From the Kitchener-Waterloo (Ont.) Record:
There's enough strychnine in the handful of vials to send most of the town into convulsions.

Then again, many of the drugs in Mike Bain's basement are cringe-inducing by modern medical standards.

Besides the strychnine, a lethal poison once used as a stimulant, the Castor, Alta., pharmacist is fond of Stillman's Freckle Cream and Codol, a cough syrup. ...more

Pharmacists await training in new role

This isn't really a surprise. A lot of people are going to expect that the pharmacist can help them circumvent seeing a physician, and this really isn't the case. Extending prescriptions can be done, but it's still not going to be really straightforward.

Considering the current views of most physicians, I'd be hesitant to extend a prescription for any patient who I didn't know their physician well. While you might be within your scope to make that extension, is it worth it if their physician reacts badly and you've make an enemy? Don't forget that a pharmacist is mandated to inform the prescribing physician that they've extended the order. I can imagine that some physicians will be protesting every extension on principle alone.

Also, I have yet to hear much talk about fees relating to prescribing. If it was appropriate and a pharmacist extended a prescription, would a patient pay a separate cognitive fee? The Alberta Pharmacists Association has recommended a cognitive fee of $16-$17, which isn't covered by Alberta Health. Are patients willing to pay that, or are they just going to go to their physician where there are no fees involved?

By the way, I was asked why narcotics and controlled drugs are excluded from the legislation. This was not a choice by the Alberta College of Pharmacists. Controlled prescription drugs are federally regulated, so if the federal government doesn't recognize a type of prescriber in the controlled drugs laws, they can't prescribe these drugs. This is why podiatrists in Alberta can prescribe everything except controlled drugs.

From the Edmonton Journal:
People who tried to obtain new prescriptions directly from pharmacists left empty-handed Sunday, the day new provincial rules kicked in to give the pharmacists broader powers.

By early afternoon, about five people had asked the staff at Rexall Drugs in Clareview to dole out medications without a doctor's visit.

"They were upset that they didn't get what they wanted," said Peter Nguyen, the pharmacy technician who referred patients back to their physicians. ...more

Addiction’s heavy toll

From the Halifax Chronicle Herald:
Using pliers to rip out healthy teeth just to get a narcotics prescription. Twelve-year-olds having sex with men in exchange for narcotics.

"It’s the worst kind of nightmare," said Mike McDonald, who just completed a four-week internship with Indian Brook’s outreach worker. "Our people are in real trouble and the worst part is, the kids are being hit bad." ...more

Complacency about disease is dangerous

From the Ottawa Citizen:
Paul Thorn has seen the monster that's coming for us. He's been in a hospital bed with it. It attacked his body and nearly drove him out of his mind.

Ten years later, he's cured of the multi-drug-resistant tuberculosis that attacked him in a hospital in London. Seven people died in that outbreak. He's the only survivor. What makes his survival more impressive is that he was already infected with HIV....more

Health Canada reviewing link between Parkinson's drug Permax and heart valve conditions

From Health Canada:
Health Canada is informing Canadians that Permax, a drug used for the treatment of Parkinson's disease, has been withdrawn from the U.S. market amidst concerns about an association with cardiac valvulopathy, a condition involving inflammation or stiffening of the heart valves.

Permax (a brand name of the drug pergolide) has been marketed in Canada since 1991 for the treatment of Parkinson's disease. The risk of heart valve problems has been known with this drug and is in the current labelling. Health Canada communicated information regarding this risk to Canadian healthcare providers and patients in 2003 and again in 2004.
For the public

Voluntary suspension of sales of Zelnorm due to cardiovascular ischemic events

From Health Canada:
At Health Canada’s request, Novartis Pharmaceuticals Canada Inc. is suspending marketing and sales of Zelnorm* (tegaserod hydrogen maleate) tablets in Canada to permit further evaluation of important safety information.
For health care professionals
For the public

Pharmacies offer smokers chance to butt out

From the Mississauga News:
Two Shoppers Drug Marts in Mississauga are among 55 pharmacies across Ontario that have signed on to help smokers kick the habit.

The stores will supply five weeks' worth of free nicotine replacement therapy (NRT) to selected smokers who want to quit.

In a promotion announced yesterday, the Ontario Pharmacists' Association (OPA), the Centre for Addiction and Mental Health (CAMH) and the Ministry of Health said as many as 5,000 Ontarians will receive the free therapy. The effort is part of a Smoking Treatment for Ontario Patients (STOP) study. ...more

Study probes genetic link to drug reactions

From the Vancouver Sun:
A B.C.-led study into tailoring drug therapy for individual patients based on their genetic makeup is the only research of its kind in the world.

The study will identify the genetic makeup and variations in children who suffer adverse reactions to medications.

Researchers will then turn their attention to developing tests, called predictive biomarkers, that would be given to pediatric and adult patients before they take drugs so that those susceptible to such reactions would either be given different agents or the indicated drugs, in smaller or larger doses. ...more

Updates over long weekend

Look for a bunch of posts over the long weekend as I catch up on the news over the last week or so.

New laws give Alberta pharmacists prescribing power

From the Canadian Press:
Pharmacists in Alberta now have the precedent-setting power to prescribe medications, but grave concerns remain over their ability to make the right diagnoses.

Laws that took effect Sunday morning make Alberta pharmacists the first in North America to be legally and independently allowed to prescribe drugs for minor conditions or in urgent situations.

They will also be entitled to modify or alter the dosages and duration of prescriptions written by doctors. ...more

New HIV Drug May Be More Effective

FYI: Prezista has also been approved for use in Canada.

From CBS News:
A new HIV drug called Prezista helps curb HIV in patients who don't respond to other HIV drugs, a new study shows.

Prezista belongs to a class of drugs called protease inhibitors, which block HIV (the virus that causes AIDS) from multiplying.

The FDA approved Prezista in June 2006 for use with a protease inhibitor called Norvir and other anti-HIV drugs in adults whose HIV infection hasn't responded to other treatments. ...more

Certain lots of Salivart Oral Moisturizer contaminated with mould or yeast

From Health Canada:
Health Canada is advising consumers not to use certain lots of Salivart Oral Moisturizer, because the product may be contaminated with mould or yeast. Using the affected product may cause health problems such as nausea, vomiting, and diarrhea. Consumers with reduced immunity due to illness or immunosuppressant medications may be at increased risk of more severe reactions.

Salivart Oral Moisturizer is promoted as a natural treatment for dry mouth. One lot of the affected product has been distributed in Canada. The lot number is 06BB002, with an expiration date of 06-08. The lot number and expiration date are located at the bottom of the product container. ...more

Brief Hiatus

The next update will be on Wednesday, April 4.

By the way, some new features will be appearing on the blog -- probably around Easter. They will include a RSS feed, new links, and a couple of pages of additional content.

If you have suggestions, questions, or comments about the blog, send them to info@canadapharmacynews.com.

Don't forget to support the ads on the sidebar!

Jason

Procedure treats asthma without drugs

This isn't really a pharmacy story, but I thought it was an interesting new treatment.

From the Globe and Mail:
Asthma can be treated, safely and effectively, with a procedure that uses electromagnetic energy to alter problematic muscles in the airways, according to promising new Canadian research.

The procedure, known as bronchial thermoplasty, does not cure asthma, nor will it eliminate the ubiquitous inhaler, but it reduces symptoms and lessens the need for drugs to treat the condition.

It is the first non-drug treatment for the common breathing disorder, good news for sufferers who have trouble controlling their symptoms with traditional anti-inflammatory drugs such as steroids. ...more

Pharmacists getting power to prescribe

Look for an all out media blitz about pharmacist prescribing in Alberta over the next week or two. Besides trumpeting the news in general, the Alberta College of Pharmacists want to clear up as many misconceptions about prescribing that are currently held by the public.

I'd say this publicity is needed. Last week I got a decent sampling of comments from the public when I did a shift in a community pharmacy. I think the public generally expects that pharmacists will have powers similar to physicians. However, this isn't the case. In fact, some aspects of a pharmacy purchase will become more difficult. A pharmacist is now required to log the sale of all Schedule 2 (behind the counter) OTC products. So anyone picking up some Gravol or acetaminophen with codeine will have to give all of their personal info (including Alberta Health Care number) to the pharmacist.

Overall, pharmacist prescribing should be a positive development, but it's still very much a work in development. For example, the criteria for determining if a pharmacist can initiate drug therapy are still not known. For now, adapting prescriptions and emergency supplies are the only types of pharmacist presribing we'll see.

From the Calgary Herald:
Albertans will soon be able to bypass the doctor's office and head directly to the drugstore to purchase some prescription medications from pharmacists in a first for Canada.

The Alberta government said Wednesday it's moving to allow pharmacists to prescribe some drugs under new regulations that will take effect as early as this fall.

The change will also allow the province's 3,500 pharmacists to extend and modify prescriptions from physicians as well as administer injectable drug treatments like vaccines. ...more

Changes to Canadian labelling of Tamiflu

From Health Canada:
Health Canada wishes to inform Canadians that the Canadian labelling for Tamiflu has recently been updated to include new safety information resulting from adverse reaction reports of abnormal or suicidal behaviour in Japanese children or teenagers taking Tamiflu. As of February 28, 2007, there have been no Canadian reports of deaths or psychiatric adverse events such as abnormal or suicidal behaviour in children or teenagers.

Health Canada has also received preliminary information on eight new cases in Japan of self-harm in patients taking Tamiflu, and is aware that Japan has now restricted use of Tamiflu in patients 10 to 19 years old. Further information is expected from the manufacturer, Hoffman-LaRoche Limited, and appropriate measures will be taken if necessary following analysis. ...more

Senator Fights For Canadian Drug Access

From Newschannel5.com (Tenn.):
Lawmakers battled over prescription drugs on Capitol Hill Tuesday. One state lawmaker was fighting to give seniors a major price break, but drug companies countered with strong opposition.

State lawmakers examined a new way for Tennesseans to legally buy drugs from other countries, mainly Canada. The savings are amazing.

Senator Doug Jackson wants Tennesseans to be able to legally buy discount drugs from other countries, via the I-SAVE RX program. ...more

Company offering cheap prescription drugs faces probe

From the Vancouver Sun:
The College of Pharmacists of B.C. says it has launched an investigation into a Richmond company offering cheap prescription drugs online without being registered with the college.

The investigation will probe regulatory matters. There is no evidence that the Richmond company is in any way linked to the death of a Quadra Island woman who died after ingesting drugs she ordered online.

Under the college's guidelines, a B.C. pharmacy that sells drugs online must publish its name and address on its website -- along with the college's phone number, which people can call to verify the site is legitimate. ...more

MD: Online medical treatment 'frightening'

There are a few more details about the Marcia Bergeron in this article. Most notably, the names of the drugs she bought online were mentioned: alprazolam (brand name Xanax) and zolpidem (brand name Ambien in the U.S)

From the Vancouver Sun:
The Quadra Island woman who died after taking tainted pills she bought on the Internet became very sick in the weeks leading up to her death but never mentioned ordering drugs online, her best friend said yesterday.

"She complained that she felt like she had flu symptoms and diarrhea," said Glenda Billerbeck, who visited Marcia Bergeron at her home in the days before her death. "She said, 'My legs are kind of swollen up,' and she was tired."

Billerbeck said Bergeron, 57, suffered from several health problems, including a bad hip and severe allergies.

But she said her friend, whom she knew for more than 15 years, never mentioned ordering medicine online. ...more

'I want this drug in Alberta'

I feel for this mother, but I think she's asking the wrong question here. Alberta does not have the authority to approve drugs when it comes to safety and efficacy. This is a federal responsibility. To my knowledge, a provincial government won't cover a drug if it hasn't been approved yet. She should be asking for improved access to drugs that are as yet unapproved.

The article makes it sound like the mom has access to the drug but not the funds. As a result they are trying to raise money and get the government on board. My question is, when they raise the money, where are they going to access the drug? It's unapproved in Canada, which means that it can't be sold here, even if you have a prescription for it from your doctor.

Does she intend to buy it off the internet? Is she going to a foreign country where it has been approved? I'd like to know the answer to that.

It's pretty much impossible to get the government to pay for a treatment that isn't approved as being safe in this country yet. And shouldn't it be that way? The line has to be drawn somewhere, and this seems like a reasonable place to do it.

From the Edmonton Sun:
An Edmonton mom fighting for the $1-million-a-year drug therapy that could help prolong the lives of her three terminally ill sons says she’s blown away by a recent outpouring of community support.

That support includes a three-day charity Strip-a-thon – organized by exotic dancers from Showgirls – slated for three cities in mid-May.

But Nicole Miranda is less than impressed with the Alberta government.

“Regular Albertans have stepped up to help and the government, who has the money, is just sitting back,” she said Sunday. ...more

Muslim cashiers won't ring up pork products

I ran into this posting at the Liberty Papers and thought it was worth a link. It's an interesting question: how is this the same or different from a pharmacist's moral objection to fill a prescription?

From Newsday (NY):
Beryl Dsouza was late and in no mood for delays when she stopped at a Target store after work two weeks ago for milk, bread and bacon.

So Dsouza was taken aback when the cashier - who had on the traditional headscarf worn by many Muslim women - refused to swipe the bacon through the checkout scanner.

"She made me scan the bacon. Then she opened the bag and made me put it in the bag," said Dsouza, 53. "It made me wonder why this person took a job as a cashier." ...more

Online drugs can prove deadly: coroner

This death is a sad example of "buyer beware." I'd like to think that it might dissuade a few people to buy pharmaceuticals online from questionable websites, but the fact is a lot of people want to circumvent the typical route of going to the physician and getting a prescription, especially when it comes to certain types of drugs. Hopefully, people will now be able to identify some of the characteristics of the worst sites.

It sounds like she was ordering painkillers and sedatives, including one that is not available in Canada due to a high risk of overdose. In a lot of ways, this case has similarities to buying Oxcontin on the shady street corner in your own town. You never really know what you're getting. The only difference is that she bought it online.

From Vancouver Sun:
A few days before she died just after Christmas, Marcia Bergeron started losing her hair and had blurred vision -- telling friends on Quadra Island that she feared she was coming down with the flu.

It was only later that those investigating her death discovered the truth: She had slowly been poisoned.

But this is no murder mystery.

The B.C. Coroners Service announced Tuesday that it believes Bergeron, 57, was poisoned by tainted pills she ordered online from a bogus Canadian pharmacy. ...more

Online drug loss hard pill to swallow

The numbers are now verifying what we already knew. Canadian online pharmacies had a tough year in 2006. I think anyone who has survived this long has likely found their niche and will continue in business. However, there is no real sign of growth in the industry. With the manufacturer restrictions solidly in place and Medicare Part D entering its second year, the only factor that could change is the exchange rate. A sinking Canadian dollar may be the only way these pharmacies will see leaps in sales.

From the Financial Post:
Dozens of Canadian Internet pharmacies have closed shop or laid off staff after sales at the country’s online drugstores plunged by nearly 50% last year.

A report released Wednesday by IMS Health, a company that tracks pharmaceutical sales, suggests Internet pharmacies sold only $211-million worth of prescriptions into the U.S. in 2006, a steep drop from sales of $420-million in 2005.

The declining revenues forced about 30 online drugstores — whose chief business was selling cheap Canadian medication to U.S. seniors — to close around the country, according to the Canadian International Pharmacy Association. ...more

Buying online drugs: Dos and Don'ts

From CTV News:
Health agencies and experts are providing advice to Canadians who are considering buying drugs over the Internet, with the issue launched back into the spotlight after the recent death of a B.C. woman who took a drug she purchased online.

The B.C. coroner says the 57-year-old Vancouver Island woman bought a sedative not legally sold in Canada, and which has been linked to overdose deaths in other countries. ...more

Former Harper adviser lobbying for drug firm

I'm glad the HPV vaccination program cash was included in this week's budget. However, it's really bad optics when a senior PM advisor just started to work for the only company that can benefit from the program.

From the Ottawa Citizen:
A lobbyist with past ties to Prime Minister Stephen Harper was retained last month by the drug company that stands to benefit from a newly announced $300 million in federal funding for a vaccination program to prevent cervical cancer.

Ken Boessenkool, who served as Mr. Harper's senior policy adviser until 2004, registered to lobby the federal government on immunization policy on behalf of Merck Frosst Canada. ...more

Cancer society warns of untested drug

From CBC News:
The Canadian Cancer Society is warning people not to self-medicate with the cheap, widely available drug known as DCA.

Dichloroacetate is a drug used to treat lactic acid buildup in children as well as people with diabetes and AIDS — conditions that differ from cancer.

The drug has shown promise as a cancer treatment in studies on rats but it has never been tested on human cancer patients.

Heather Logan, the director of cancer control policy at the society who trained as a nurse, has worked with people fighting to prolong their lives. Logan said she sympathizes with those who are buying the drug and mixing it at home as a last resort, but stresses there are serious safety concerns. ...more

Pills bought online likely killed B.C. woman

From the Globe and Mail:
Pills bought on the Internet appear to have killed a 57-year-old woman on Vancouver Island, regional coroner Rose Stanton said Tuesday.

She said the woman, who lived in the Campbell River area, bought a sedative not legally sold in Canada and which has been linked to overdose deaths in other countries. ...more

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