Experts say early results from Avandia study not reassuring, despite Glaxo's claim

From the Canadian Press:
The maker of the controversial diabetes pill Avandia on Tuesday published preliminary results of a study that the company claims show the drug does not raise heart risks. However, experts say the results are inconclusive and even seem to suggest more risk from the drug.

More people on Avandia suffered heart problems than those on other diabetes drugs - a bad sign even if the difference was so small that it could have occurred by chance alone, some doctors said. ...more

More responsibility should mean more pay: pharmacist

This article really touches the bottom line when it comes to pharmacist prescribing: who is going to pay for it. If pharmacists are expected to go through extra training and take on extra responsibility, it's reasonable that they are reimbursed for this. However, it's unclear where the payment will come from.

In Alberta, the major drug plans will honour pharmacist-written prescriptions, but with the usual dispensing fee structure. Neither the drug plans or the provincial government will pay for the pharmacist's cognitive services. This lack of third party reimbursement will drive patients away from pharmacist prescribing for financial reasons alone.

From CBC News:
If New Brunswick pharmacists are required to take on some of the duties now performed by doctors, they'll expect to be compensated for it, warns Moncton pharmacist John Staples.

Health Minister Mike Murphy indicated on Monday that New Brunswick pharmacists will soon be given more professional responsibility, which could include the power to prescribe some medications.

"There seems to be a consensus that a larger role for pharmacists is needed. There's no question," Murphy said Tuesday. ...more

Health Canada expands Plavix approval

From the Toronto Star:
Pharmaceutical giants Sanofi-aventis of France and Bristol-Myers Squibb of the United States say Health Canada has given approval for the use of their blood-thinner Plavix to reduce the risk of heart attack, stroke or death in patients with all acute coronary syndromes.

The approval is an expanded indication for Plavix, which offers protection from all types of heart attacks.

"This new indication is an important advance in the treatment of ACS (acute coronary syndrome) for patients with STEMI (ST-segment elevation myocardial infarction) as myocardial infarction is a life-threatening condition," said Shamir Mehta, director of interventional cardiology at McMaster University and Hamilton Health Sciences. ...more

Smokers, vendors have summer to adjust

Alberta is planning on passing some tough new anti-smoking laws, including rules that would prevent sales of tobacco products in pharmacies. I'm curious to see how that will actually work in practice. Does this mean grocery stores with pharmacy departments will be prevented from selling cigarettes?

From the Edmonton Journal:
The provincial government signalled an end Thursday to Alberta's ranking as Canada's most smoker-friendly province, approving a provincewide ban on smoking in workplaces and other steps that would make Alberta one of the toughest anti-tobacco jurisdictions.

Conservative MLAs, a group that has long opposed cracking down on where smokers can light up, also decided to prohibit visible cigarette ads or displays in stores, and to ban sales of tobacco products in pharmacies, post-secondary schools or health facilities.

It's unclear when the plan will take effect, but it will also prohibit smoking near doorways and windows, to shield people from the toxins of second-hand smoke, Health Minister Dave Hancock said. ...more

Patients buy cancer drugs at new clinic

From the Ottawa Citizen:
A private clinic has opened in Ottawa, giving patients who can pay for them, cancer drugs not covered in Ontario.

The clinic, one of about 10 similar operations that have opened across Ontario since last fall, is part of a growing chain operated by Bayshore Home Health and "sponsored" by the pharmaceutical company Roche Canada.

Some of the federally approved drugs, administered intravenously, are already covered under health plans in other provinces. ...more

Layton asks for support on drug plan

From the Toronto Star:
NDP Leader Jack Layton is meeting with provincial premiers to drum up support for a national drug plan that would help Canadians cope with the cost of filling their prescriptions.

Layton says he's heard encouraging words already from Newfoundland and Labrador Premier Danny Williams, whom he met last month, and from British Columbia Premier Gordon Campbell. He plans to meet soon with Saskatchewan Premier Lorne Calvert.

"We think it's time to move," Layton said. "We intend to persevere until we get the kind of coverage that all Canadians deserve." ...more

The battle over a cancer pill

From the Globe and Mail:
British businessman Peter Sartorius has devised his own treatment regime for prostate cancer. Every day, he drinks a salty cocktail, a mixture of water and an experimental drug called DCA he orders over the Internet.

Jim, a retired handyman in Louisiana, has lung cancer, and has been told that he has only a few months left to live. He swallows homemade capsules filled with DCA that his son, Jason, puts together.

Both men started self-medicating this spring after University of Alberta researchers announced that DCA (dichloroacetate) dramatically shrank tumours in rats without damaging healthy cells. But the Edmonton team was having trouble finding money to see if DCA works in humans. ...more

Tubercular man apologizes to flyers

From the Calgary Sun:
The Atlanta lawyer quarantined with a dangerous strain of tuberculosis apologized to fellow-airline passengers yesterday.

He insisted he was told before he set out for his wedding in Europe he was no danger to anyone.

"I've lived in this state of constant fear and anxiety and exhaustion for a week now, and to think that someone else is now feeling that, I wouldn't want anyone to feel that way. It's awful," Andrew Speaker said. ...more

More kids prescribed Ritalin after divorce

From MSNBC:
Children from broken marriages are twice as likely to be prescribed attention-deficit drugs as children whose parents stay together, a Canadian researcher said on Monday, and she said the reasons should be investigated.

More than 6 percent of 633 children from divorced families were prescribed Ritalin, compared with 3.3 percent of children whose parents stayed together, University of Alberta professor Lisa Strohschein reported in the Canadian Medical Association Journal.

The study of more than 4,700 children started in 1994, while all the families were intact, Strohschein said. They followed the children’s progress to see what happened to their families and to see what drugs were prescribed. ...more

Jean Coutu closes deal to sell U.S. pharmacies

From the Toronto Star:
Jean Coutu Group (TSX: PJC.A) officially announced Monday that it had closed a US$3.9 billion deal to sell U.S. Brooks and Eckerd pharmacies and distribution centres to Rite Aid.

The Quebec-based company received US$2.36 billion in cash and 250 million shares of Rite Aid common stock that provide about 32 per cent common equity interest in the U.S. giant.

"The completion of this transaction is a transformational event for the shareholders of The Jean Coutu Group," pharmacy chairman Jean Coutu said in a news release. ...more

Drugs used for dementia raise death risk: Study

From the Toronto Star:
Older adults who suffer dementia and are given antipsychotic drugs have a slightly higher risk of death than those who aren't prescribed these medications, a large Canadian study suggests.

And the older variety of antipsychotics – known as conventional agents – seems to be associated with a higher risk of death than newer atypical antipsychotics, researchers said in the study of Ontario patients, published Tuesday in the journal Annals of Internal Medicine.

The study builds on previous research that led to warnings in the spring of 2005 from Health Canada and the U.S. Food and Drug Administration on atypical antipsychotics and dementia. ...more

Drug offers promise in treating advanced breast cancer: Cdn. drugmaker

From the Canadian Press:
A Canadian pharmaceutical company is touting the benefits of a drug to treat advanced breast cancer.

Results of two studies have been released at a cancer conference in Chicago on the effectiveness of Tykerb, made by Mississauga, Ont.-based GlaxoSmithKline.

Tykerb tablets are meant to be a once-daily oral treatment for women with HER-2 positive breast cancer.

They claim Tykerb reduced brain tumour volume in some women whose breast cancer had spread, and, when used in combination with another drug, paclitaxel, can improve progression-free survival times for women with HER2-positive advanced breast cancer. ...more

Pharmacists can have impact after surgery, say researchers

From News @UofT:
A new study by researchers from the Toronto General Hospital (TGH), University Health Network (UHN) and the Leslie Dan Faculty of Pharmacy has shown that including pharmacists as part of multidisciplinary teams in surgical pre-admission clinics can result in a 50 per cent decrease in medication discrepancies for patients after surgery.

The study, published in the Archives of Internal Medicine May 28, is the first randomized controlled trial to evaluate the effectiveness of a pharmacist intervention in a pre-admission clinic. Previous studies have shown that from the moment a patient is admitted to hospital to when they are discharged, there are several vulnerable moments for medication information discrepancies, which can escalate into medication errors and adverse drug events. ...more

Deaths linked to diabetes drug?

From the Winnipeg Free Press:
Health Canada says the deaths of several Canadians could be linked to the popular Type 2 diabetes drug Avandia, the Free Press has learned.

Last week, a report in the New England Journal of Medicine linked Avandia to a greater chance of heart attack and possibly death.

Initially, Health Canada told the media that 28 Canadians who were taking Avandia suffered heart attacks since 2000. They didn't say if any of the heart attacks were fatal.

But after the Free Press looked into Health Canada's adverse-reaction database, spokeswoman Renee Bergeron confirmed 19 people have died from heart attacks or heart failure while taking Avandia. ...more

Pharmacist urges Avandia users to keep using it

From the Peterborough (Ont.) Examiner:
Avandia — a Type 2 diabetes drug that's been possibly linked to six Canadian deaths — is still "excellent" for diabetics as long as they don't have heart conditions such as congestive heart failure, a pharmacist says.

Murad Younis, of Westmount Pharmacy on Charlotte Street, says he worries all diabetics will be scared off the daily tablets after the U.S. issued a safety alert last week.

The alert was in response to a New England Journal of Medicine (NEJM) study linking the drug to a greater risk of heart attack.

Avandia got more bad press when Health Canada reported Wednesday a preliminary review indicates the drug could be linked to the deaths of six people who died from heart attacks or heart failures. ...more

When drug-resistant tuberculosis goes extreme

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

They were wrong.

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

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

No prescription needed for contraceptive pill

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

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

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

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

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

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

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

Pharmaceutical companies behind push for Ottawa to pay for HIV drugs

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

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

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

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

But the articles ends with this:

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

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

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

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

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

Pricing pinches drugstores

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

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

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

Cardiac Safety of Avandia® (rosiglitazone maleate)

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

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

Sickest patients less likely to get full care

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

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

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

Drug use climbing

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

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

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

Canadian drug imports shrink in half from 2004

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

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

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

Cancer drug Avastin battleground in debate over fairness versus costs

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

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

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

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

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

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

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

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

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

Doctors too slow to embrace electronic health records

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

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

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

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

Shoppers has competitive advantage in Ontario: Analyst

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

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

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

Trade gambit doubles cost of cancer medicine

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

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

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

Pharmacist wins compensation

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

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

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

Vioxx, Avandia, what next?

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

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

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

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

Stronger warnings urged for herbal hot-flash remedy

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

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

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

Diabetes drug linked to heart attacks

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

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

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

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

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

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

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

Rapid spread of disease alarms experts

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

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

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

Experts scorn 'natural' products

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

"Lose 30 pounds in 8 weeks!"

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

"Lose 10.65 pounds fast!"

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

Province to cover new AIDS drug

From the Toronto Sun:
Brian Finch is thrilled the Ontario government is now reimbursing AIDS patients for a new drug that has kept his viral load of the disease undetectable for the first time in 10 years.

The Toronto man had run out of options for battling his HIV until Health Canada approved Prezista last year, a drug now listed on the Ontario Drug Benefit Formulary. ...more

Med money turnaround

From the Ottawa Sun:
For the first time in more than a decade, Ontario is the only province in the country expected to see a decline in prescription drug spending over the next few years.

That's the conclusion of a new report released by the Canadian Institute for Health Information (CIHI).

Ontario's situation is part of a greater trend: A projected slowdown in national drug spending. Last year, national spending was projected to rise 6.9%, down from an average increase of 11.2% between 1997 and 2004. ...more

Recent reports of black particles after reconstitution of Myozyme

From Health Canada:
Genzyme has received isolated complaints pertaining to an observation of black gelatinous particles after reconstitution of 50 mg vials of Myozyme® (alglucosidase alfa). Working in close consultation with relevant regulatory authorities, Genzyme immediately initiated an investigation and discovered that when certain types of needles are used to penetrate the rubber stopper on Myozyme vials, black gelatinous particles may appear in the product, on the stopper or on the needle. Although we have not received similar complaints with Genzyme's other products, we are writing to alert our customers to the potential that such particles might appear and to provide current advice and recommendations. ...more

$21B spent on drugs in Canada in 2006: report

From CBC News:
Spending on prescribed drugs in Canada reached an estimated $21.1 billion in 2006, up $1.4 billion from the previous year, although spending seems to be slowing, according to a report released Tuesday.

The Canadian Institute for Health Information's annual report, Drug Expenditure in Canada, highlights trends in public and private spending on both prescribed and non-prescribed drugs from 1985 to 2006.

Prescribed drugs have been one of the fastest-growing components of total health spending over the past two decades and continue to outpace most other health sectors, including spending on hospitals," said Michael Hunt, manager of pharmaceutical programs at the institute. ...more

Recall of two Valproic acid drugs, Depakene 500 mg and Ratio-Valproic 500 mg

From Health Canada:
Health Canada is warning patients taking the anti-epilepsy medications Depakene 500 mg and ratio-VALPROIC 500 mg that they may not be getting the full dose of the active drug, which could result in inadequate treatment of their seizures. These products are being recalled and patients using Depakene 500 mg and ratio-VALPROIC ECC 500 mg (valproic acid) are advised to contact their physician or pharmacist immediately to obtain another suitable product. Patients should not discontinue their medication before consulting their health care provider.
For the Public

Use of IRESSA® in patients with Squamous Cell Carcinoma of the Head and Neck (SCCHN) failed to prolong survival and increased bleeding events

From Health Canada:
AstraZeneca Canada Inc., in consultation with Health Canada, would like to inform all patients in the IRESSA Patient Registry (IPR) Program of new information from a clinical trial on the use of IRESSA in patients who have head and neck cancer. It should be noted that head and neck cancer is not an approved use for IRESSA, but patients with this diagnosis may be participating in the IPR Program if benefiting from therapy.
For the Public

To market a drug

From the Vancouver Sun:
When Finance Minister Jim Flaherty announced $300 million in federal money for a program to vaccinate girls and young women against the human papilloma virus, it was hailed as the most important development in women's reproductive health since the pill.

This vaccine promises to tackle more than the warts caused by certain strains of HPV. It is billed as the first anti-cancer vaccine designed to prevent the vast majority of cervical cancer cases.

But it's too early to tell whether this is just a victory for women's health or also the triumph of an aggressive, multimillion-dollar marketing campaign that has infiltrated our living rooms and the political backrooms. Probably it's both. ...more

Canada stays out of Afghan opium poppy harvest

This barely qualifies as a Canadian pharmacy story, but I thought I'd include it anyway. Why aren't coalition forces governments working with pharmaceutical companies to buy the opium produced in Afganistan? I would think that this would be really helpful to get the average farmer behind the coalition and against the Taliban. The drug companies need raw material to produce narcotics anyway. I'd even be in favour of giving them a tax break or some kind of incentive to buy these poppies.

From CTV News:
Afghanistan is on the verge of harvesting its latest record opium crop, and Canadian troops are staying out of the way.

"We have nothing to do with poppy eradication. We stay away from it as far as we can," Maj. Steve Graham of the Royal Canadian Dragoons told CTV News.

The plan is to attack the insurgency first and leave the battle against drugs for another day. ...more

Experimental drug is Ian's only hope

From the Hamilton Spectator:
Hope was the last thing Ian MacPherson expected.

Pompe Disease was marching through his body on schedule, disabling his muscles and lungs. There was nothing doctors could do to stop it.

"I didn't expect any treatment in my lifetime," he said.

But then his parents discovered Myozyme on the Internet. The drug was so new it was still being tested in rabbits. Desperate, they requested it anyway. They were denied. It was too experimental and expensive. ...more

Cancer patients protest cost of medication

From CTV News:
A group of cancer patients angry over the massive out-of-pocket expenses they pay for unfunded treatments stood up and turned their backs on Health Minister George Smitherman on Saturday as he spoke about his government's commitment to medicare.

About 25 protesters wore shirts bearing the slogans "Cancer patients need a credit card'' and "Where did medicare go?'' at a groundbreaking ceremony for a new home for patients with terminal illnesses at Toronto's Trillium Health Centre.

Protest organizer Roman Gawur said Ontario ranks ninth out of ten provinces for the amount of funding it puts toward cancer drugs. ...more

Court fines OxyContin maker $634M US

From CBC News:
The maker of the narcotic painkiller OxyContin and three executives pleaded guilty Thursday to making false claims about the drug's risk of addiction, a U.S. federal prosecutor and the company said.

Purdue Pharma L.P pleaded guilty in a Virginia court to felony misbranding of OxyContin with the intent to defraud. The company's president, chief lawyer and former chief medical officer also pleaded guilty to charges of misbranding – a crime of mislabelling, fraudulently promoting or marketing a drug for an unapproved use.

"With its OxyContin, Purdue unleashed a highly abusable, addictive and potentially dangerous drug on an unsuspecting and unknowing public," U.S. Attorney John Brownlee said in a release. ...more

Association between Long-Term Treatment with ACTOS® (pioglitazone hydrochloride) Tablets for Type 2 Diabetes Mellitus and Fractures in Women

From Health Canada:
Eli Lilly Canada, after consultation with Health Canada, would like to bring to your attention important safety information concerning ACTOS® (pioglitazone hydrochloride) tablets, used in the treatment of type 2 diabetes mellitus and the occurrence of bone fractures in female patients.
For health professionals
For the public

Sinus drug linked to liver damage, skin peeling

From the Vancouver Sun:
Somewhere near Quebec City lives a young mother who spent four weeks in a burn unit last year after a suspected drug reaction covered her body with burn-like red blisters and peeled off her skin from head to thigh.

The woman had been prescribed the antibiotic Ketek for a simple sinus infection.

But the 26-year-old developed toxic epidermal necrolysis, an extremely rare drug reaction where people essentially shed the outer protective layer of their skin. ...more

Drug import limits stand

From the Birmingham (AL) News:
The Senate voted on Monday to preserve current restrictions on the importation of lower-cost prescription drugs from Canada and other countries, fearing that such imports could pose risks to consumers, even with new safeguards.

By a vote of 49 to 40, the Senate approved a measure saying that imports will not be allowed unless the secretary of health and human services first certifies that they "pose no additional risk to the public's health and safety," and that they will significantly reduce costs to consumers. Alabama's Republican Sens. Richard Shelby and Jeff Sessions voted against the measure.

Consumer advocates have long favored such imports as a way to make medicines more affordable. But health officials in the Clinton and Bush administrations have blocked such efforts, saying they cannot guarantee the safety of imported medicines. ...more

Poor prognosis prompts action

From the Financial Post:
Canada is facing a critical shortage of health care professionals as Baby Boomers retire and too few graduates are emerging from medical schools to care for the ageing population.

While all health care provider roles stand to be affected, the number of nurses in particular is falling rapidly. The Canadian Nurses Association (CNA) projects by 2011, the nation will be in need of 78,000 nurses; if no action is taken, the system will be down 113,000 nurses by 2016.

The prognosis has prompted organizations representing medical professionals to band together in an effort to boost education and recruits. ...more

Fatal chemo overdose prompts Alberta reforms

From CBC News:
An investigation into a fatal chemotherapy overdose has led Alberta to revise procedures for the administration of some cancer drugs.

On Tuesday, the Institute for Safe Medication Practices Canada released its independent report on the death of 43-year-old Denise Melanson last summer at Edmonton's Cross Cancer Institute.

Denise Melanson, 43, died last summer at Edmonton's Cross Cancer Institute.
A pump was supposed to deliver fluorouracil, a drug used to treat tumours, over four days, but it was given to Melanson over four hours, along with another chemotherapy drug, cisplatin. ...more

U.S. Senate guts latest attempt to legalize bulk drug imports from Canada

From the Canadian Press:
The U.S. Senate gutted the latest attempt Monday to legalize prescription drug imports from Canada and other countries.

Despite a lot of support for the plan from both Democrats and Republicans, senators ultimately decided to require that the Food and Drug Administration first certify the imports are safe and effective.

Federal officials have said for years they can’t do it. So the requirement, passed on a 49-40 vote, effectively quashed the imports effort.

Even if the bid for expanding the drug trade had made it through without any caveats, the administration said it would have recommended a veto from President George W. Bush. ...more

Drugs produced dramatic change in HIV patient

I have been able to see the use of these two new Tibotec drugs in action. Both look to be quite promising. TMC125 is most notable in that it's a new non-nucleoside reverse transcriptase inhibitor (NNRTI). We haven't seen a new drug in this class in some time. Its resistance profile is quite good as well. Typically, if the HIV virus is resistant to one of the existing NNRTI's, the virus is resistant to all drugs in this class. TMC125 appears to be effective in these resistant patients.

One addtional bit of info not included in this article: TMC125 has been given the generic name of etravirine. I have not heard of a suggested brand name yet.

From the Vancouver Sun:
The human immunodeficiency virus could have killed Vancouver artist Tiko Kerr 20 years ago, just as it claimed so many other promising lives.

Instead, his successful battle to live is now propelling him on a whirlwind world tour, talking to drug researchers, doctors and scientists about his story of survival and the two controversial AIDS drugs that helped him beat the odds.

"I've really come to the conclusion that the worse you have to go through, the greater the reward," Kerr says of his dramatic change in fortune.

The tour began in December, when Kerr, just shy of the one-year anniversary of his initial treatment with TMC114 and TMC125 as part of a small clinical trial at St. Paul's Hospital, travelled to New Jersey where he was invited to speak at the corporate headquarters of pharmaceutical giant Johnson & Johnson, and its subsidiary, Tibotec, which developed the two drugs. ...more

Agency decisions threaten cancer patient health: doc

From the Edmonton Sun:
An Edmonton doctor says the health of Canadian cancer patients is being threatened by a government-appointed agency that makes decisions on provincial drug funding.

The Common Drug Review (CDR) is using a decision-making process that is flawed, said Dr. Scott North, a medical oncologist at the Cross Cancer Institute.

North explained that the CDR recently reviewed two new drugs for the treatment of kidney cancer.

One of the drugs, Nexavar, was found to be especially effective halfway through one recent clinical trial, North said. ...more

New drug drastically reduces fractures, research shows

From the Globe and Mail:
A drug that needs to be injected only once a year can sharply reduce fractures in women suffering from the bone-weakening disease osteoporosis, according to a new study.

Annual treatment with zoledronic acid produced impressive results in a large clinical trial, including:

A 70-per-cent reduction in spine fractures;

A 41-per-cent drop in broken hips;

A 25-per-cent reduction in other fractures, such as broken wrists.

On the downside, the drug appears to increase the risk of atrial fibrillation, a heart condition that greatly increases the risk of stroke. ...more

Bid to allow drug imports advances - Los Angeles Times

From the Los Angeles Times:
The Senate, giving a boost to a measure long favored by congressional Democrats, opened the door Thursday to letting American consumers save money on prescription medicines by ordering them from Canada and other developed countries where prices are lower.

But the move could have an unintended side effect — derailing a long-awaited, bipartisan effort to improve the Food and Drug Administration's faltering system for protecting patients from potentially dangerous medications. The reform plan includes increased funding for drug safety and the creation of a nationwide computer surveillance system designed to spot problems with medications.

The proposed improvements were developed in response to highly publicized safety lapses, including the belated withdrawal of the diabetes drug Rezulin and the painkiller Vioxx. ...more

Edmonton pharmacy billionaire steps up with surprise offer of $145 million for Oilers

From the National Post:
Edmonton drugstore billionaire Daryl Katz, the reclusive owner of the 1,800-store Katz Group pharmacy empire, has launched a surprise $145-million bid to acquire the Edmonton Oilers.

The all-cash offer by Katz, 45, an Edmonton native and University of Alberta law school grad whom Forbes magazine now ranks among the world's richest men, was made to the 37-member Edmonton Oilers ownership group earlier this week.

Under terms of the offer, disclosed to The Journal late Friday by a source familiar with information shared at the meeting, the Oilers would remain in Edmonton. ...more

Man who robbed pharmacy jailed 3 1/2 years

From the Sault (Ont.) Star:
Police caught up with an Alberta man wanted for a robbery at a Sault Ste. Marie pharmacy when his stolen car ran out of gas north of the city.

Jody Berge was arrested south of Wawa on April 16, about two hours after he robbed the Great Northern Road Medicine Shoppe of $350 worth of drugs.

Berge, 33, of Lethbridge, pleaded guilty Friday to robbery in a Sault court for stealing morphine and other drugs while using threats of violence. ...more

Shoppers boss unfazed by drug laws

From the Globe and Mail:
The new chief executive officer at Shoppers Drug Mart Corp., who must contend with new drug laws, insists that an aging and more health-conscious population creates huge business opportunities for everything from prescriptions to organic foods and premium skin-care products.

Jurgen Schreiber, at his first Shoppers annual meeting, dismissed "rumours" that new generic drug pricing laws, which came into full effect on April 1 and reduce the amount Ontario will pay for generics, could put a damper on Shoppers' stellar financial performance. ...more

Ont. cancer patients say having to pay for drugs violates Canada Health Act

There are a couple of comments at the end of this article that intrigue me.

"(Patients) are paying a hospital for injections of a medically necessary drug, and from their perspective that's a violation of the Canada Health Act."

Perhaps there will be a day in the not-too-distant future where someone will take a hospital and their provincial government to court over this issue. The impact of such a ruling could be huge. Agreement by the court could essentially bankrupt the health care system. I think eventually we are going to hit a point where people will want their government to do more for them than put virtually every tax dollar accumulated into health care and it still isn't enough. Denial by the court could open the door for more private plan involvement in the system.

From the Canadian Press:
There's no public or private health insurance plan in the country that could afford to pay for all of the latest cancer drugs, Ontario's health minister said Wednesday amid criticism from patients paying for expensive drugs not covered by the province.

Ontario has more than doubled spending on new cancer drugs, but it would be impossible to cover every new medication that's developed, Health Minister George Smitherman said, describing the province's medication approval system as the best in the country.

"In a world where there will be a new product available every day - which sometimes is offering very, very modest enhancements to life, measured sometimes in days - it's going to be very, very challenging for any insurance system, public or otherwise, to be in a position to buy every product that is out there," he said. ...more

Methadone victim's family sues clinic, doctors

From the Ottawa Sun:
Parents of a man who died of a methadone overdose administered by accident at a downtown addiction treatment clinic are seeking a half-million dollars in damages in a lawsuit.

The statement of claim filed April 24 by Linda and Douglas Hatt, and on behalf of their son Wade Lamont Hatt, names as defendants the Ontario Addiction Treatment Centres and a number of doctors and nurses connected with the centre. ...more

U.S. FDA rejects painkiller Arcoxia, Merck's Vioxx successor

I would think that the FDA rejection of Arcoxia is not going to help its chances of being approved in Canada. As far as I'm aware, it's still somewhere in the Health Canada approval process.

From CBC News:
The U.S. Food and Drug Administration rejected Merck & Co.'s request to market a successor to its withdrawn arthritis drug Vioxx in the United States, the drug maker said Friday.

The move was widely expected, after a panel of FDA advisers two weeks ago voted 20-1 against approving the drug, Arcoxia.

Arcoxia is in the class of anti-inflammatory drugs called COX-2 inhibitors, which are touted as less likely to cause stomach bleeding and other dangers but have been linked to cardiac risks. ...more

Shoppers Drug Mart profit jumps almost 19 percent

From Reuters:
Shoppers Drug Mart (SC.TO) reported an 18.7 percent jump in first-quarter profit on Monday, as Canada's largest drugstore chain continued to enjoy robust prescription and front-store sales.

Shoppers said it earned C$85.1 million ($76.6 million), or 39 Canadian cents a share, for the quarter ended March 24, up from a profit of C$71.7 million, or 33 Canadian cents a share, in the corresponding period a year earlier.

Solid top-line growth, an enhanced sales mix and an ongoing commitment to cost reduction helped power profit higher in the quarter, the company said, noting those factors offset higher operating costs and increased amortization in new and relocated stores. ...more

Pfizer says Canadian court blocks generic Celebrex

From the Financial Post:
Pfizer Inc. said yesterday the Federal Court of Appeal of Canada has blocked generic drugmaker Teva Pharmaceutical Industries Ltd. from launching a copycat form of its Celebrex arthritis drug in the country until 2014.

Pfizer said the court, in its ruling, reversed a lower court ruling that would have permitted Teva's Novopharm affiliate to launch its form of Celebrex in Canada.

The patent concerned the chemical composition of Celebrex, Pfizer spokesman Bryant Haskins said. ...more

Depression May Be Early Sign of Parkinson's Disease

We know that dopamine plays a role in both illnesses, so it makes sense that a link between the two exists. I find it surprising that it's taken this long for the connection to be shown in a study. I think this information will be considered essential in the future and may result in the faster diagnosis of Parkinson's Disease.

From CBC News:
In some cases, depression can be an early manifestation of Parkinson's disease, new research suggests.

Researchers at the Harvard School of Public Health compared antidepressant use among more than 1,000 individuals with Parkinson's disease to more than 6,600 age- and gender-matched individuals without the degenerative neurological illness.

They found that people currently on antidepressants had an 80 percent higher risk of developing Parkinson's disease than those who had never taken antidepressants. This was true for both men and women, regardless of age or the class of antidepressant used. ...more

Updates coming soon

I will have new posts online tonight.

Hiatus

New posts will resume in the early part of next week, likely around April 29 or 30.

Drug ads would spark $10B frenzy: Study

While I agree that prescription drug advertising would increase sales, I have a hard time believing the numbers in this study. It says in the article that Canadians spent $16.6 billion on prescription drugs in 2005. But to suggest that more advertising would result in a $10 billion increase above current levels seems a bit much to me.

A copy of the study is available at the new online medical journal Open Medicine. The link is here.

From the Toronto Star:
Allowing American-style drug ads in Canada would lead to massive increases in pharmaceutical spending and severely stress an already vulnerable health-care system, a new study suggests.

Canadians might expect to see a $10-billion-a-year increase on drug spending in the aftermath of such mass advertising in this country, says study author Steve Morgan, a University of British Columbia health economist.

"It could increase our total expenditures on pharmaceuticals by 30 per cent," says Morgan, of U.B.C.'s Centre for Health Services and Policy Research.

"That is a staggering amount. You could hire 40,000 doctors and pay them $250,000 a year for that amount." ...more

A date with drugs

From the Toronto Star:
Hack, wheeze, sputter ..... achoo! You feel something coming on.

Swing open the medicine cabinet, reach for the cough syrup and out dribbles sludge.

If it were Buckley’s, the taste is so bad (but effective!), it would be hard to tell if it had gone off.

What about that leftover prescription of antibiotic? Do you ingest it and risk coming down with God knows what?

Spring cleaning target zones may well include your medicine cabinet. Just like the best-before dates on food — to which we pay at least a little attention — there are expiry dates on your prescription and over-the-counter drugs. ...more

Return herbal sleep aid, Health Canada says

From the Kitchener-Waterloo (Ont.) Record:
Health Canada is urging people who bought a specific herbal product that's promoted as a sleep aid to return it to the store where it was purchased.

The product, called Eden Herbal Formulations Serenity Pills II, contains the undeclared drug estazolam, which can be habit-forming when used for a few months, an advisory says.

Users should talk to a health-care professional before they quit taking it because there's a risk of withdrawal symptoms. ...more

Reliability of drugs from Canada questioned

From the Trenton (NJ) Times:

Fred Billingham was waiting to shoot pool at the Hamilton Senior Center. Former U.S. Rep. Jim Greenwood was hundreds of miles away in Washington, D.C., but they were of like minds on one topic: Purchasing cheap medication from Canada scares them.

"I wouldn't trust them," said the 78-year-old retiree, "because you don't know what you're getting."

And Greenwood, a former Bucks County, Pa., legislator who now is president of the trade association the Biotechnology Industry Organization, said, "There is a very legitimate safety issue that has to be taken into consideration."

That safety concern is why state investigators make no apologies for the tactic they used last week to shut down a local company that helped American patients buy lower-cost medications from Canada. ...more

Shoppers ramps up premium cosmetics offerings

From the Globe and Mail:
Shoppers Drug Mart Corp. is expanding its coveted high-end Estée Lauder Inc. cosmetics line, yet another blow to department stores that have depended on those sales to draw customers.

The move comes less than a month after Jurgen Schreiber, a former beauty and health retail executive in Europe, took over the chief executive officer job at Shoppers.

Mr. Schreiber "is having a positive impact on Shoppers Drug Mart's relationships with major prestige cosmetic brand owners," Keith Howlett, retail analyst at Desjardins Securities, wrote in a research note yesterday. ...more

Erythropoiesis-stimulating agents (ESAs), Aranesp (darbepoietin alfa) and Eprex (epoetin alfa)

From

Health Canada:

The manufacturers of the erythropoiesis-stimulating agents (ESAs), in consultation with Health Canada, would like to inform you of updated safety information and pending label changes based on completed or ongoing clinical studies regarding treatment with ESAs. Two such ESAs, Aranesp® and EPREX, are marketed in Canada.
For Health Professionals
For the Public

Pharmacists can manage prescriptions under bill

I'm not exactly sure what "manage prescriptions" means, but Missouri pharmacists now have the authority to do so. It's not prescribing, but hopefully it's a mechanism to get pharmacists more involved in patient care.

From the Belleville News Democrat:
Lawmakers gave final approval Thursday to a bill that gives pharmacists greater authority in managing prescriptions.

The measure, approved 154-1 by the House, would allow pharmacists to go beyond just receiving a prescription and filling it. They could work with doctors and patients to evaluate prescriptions and create a "medication therapeutic plan" to help patients taking multiple drugs. Senators previously passed the bill, which now goes to Gov. Matt Blunt.

Supporters say the bill would allow Missouri pharmacists to more fully participate in the new federal drug assistance program Medicare Part D. Several other states already give pharmacists the authority to help manage prescriptions for patients. ...more

Unsafe sleepwalking, sleep driving linked to pills

From CBC News:
Rare, bizarre and potentially dangerous side-effects of some prescription sleeping pills have prompted the U.S. Food and Drug Administration to warn patients and doctors about the medications, including one that is available in Canada.

The FDA has linked the best-selling sleep-inducing drug zopliclone, sold in Canada under the brand name Imovane, to sleepwalking behaviours. The agency has also linked the drug to sleep driving — driving a car while not fully awake after taking a sedative-hypnotic drug, with no memory of doing so.

In the U.S., the FDA said there have been dozens of reports of bizarre behaviour during sleep among people who have taken a sleeping pill called Ambien. While Ambien is approved for use in Canada, it is not available for sale ...more

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