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

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

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

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

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

CIPA responds

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

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

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

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

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

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

OPINION: The world is not an ice cream cone

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

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

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

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

FDA stands by warning against Canadian web pharmacy

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

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

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

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

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

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

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

FDA Warns Consumers About Mediplan

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

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

Health Canada cuts off sick man’s pot supply

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

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

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

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

Mass. city ends drug plan that defied US

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

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

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

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

Customs seizes Canadian meds

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

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

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

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

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

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

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

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

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

Oral rotavirus vaccine okayed for infants

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

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

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

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

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

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

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

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

Many HIV Canadians not following drug plan: study

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

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

The link to the JAMA abstract is here.

How to wipe out AIDS in 45 years

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

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

Drug insurers dispense warning

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

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

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

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

Pharmacists Rap New Version of Decongestants

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

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

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

Pharmacies chafe at changes to First Nations drug plan

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

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

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

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

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

It's been a while

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

Time to get started....

US Senate votes to end seizures of Canadian drugs

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

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

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

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

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

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

Canadians may soon be able to drink their nicotine

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

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

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

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

for the Public
for Health Professionals