Manufacturer warns of serious infections related to psoriasis drug

From CBC News:
The manufacturer of a drug that treats psoriasis has issued new safety information for doctors and patients.

EMD Serono Canada says Raptiva has been associated with a risk of serious infections, including progressive multifocal leukoencephalopathy, a rare and sometimes fatal brain disorder.

Raptiva suppresses the body's immune response to reduce psoriasis inflammation; however, the company says that by diminishing the body's natural defence system, it can also increase the risk of serious infections in some patients.

Signs and symptoms of PML may include difficulty thinking, walking or speaking, or other behavioural changes, weakness, loss of balance or co-ordination, visual impairment, partial paralysis of one side of the body, or seizures.

Other serious infections may be indicated by fever, weakness, cough, flu-like symptoms, warm, red or painful skin, or open sores on the body. ...more

Treating the flu isn't easy

From the Owen Sound (Ont.) Times:
Early signs from this flu season suggest doctors face a vexing dilemma in treating the illness. Testing to date in Canada, the United States and Europe shows that nearly all H1N1 viruses are resistant to oseltamivir (sold as Tamiflu) and susceptible to the adamantane drugs, amantadine and rimantadine.

The inverse is true for H3N2 viruses, which are universally resistant to the adamantanes and susceptible to oseltamivir.

Given that in reality little point-of-care testing is done to determine whether a patient actually has influenza, let alone which variety of the bug is behind the illness, the resistance situation could see doctors making choices that lead to treatment failure this season.

"It definitely adds to the complexity of trying to manage influenza,'' said Dr. Maria Zambon, head of the respiratory viruses unit of Britain's Health Protection Agency. ...more

Optimal Warfarin Dosing Improves Anticoagulation Control

From the Washington Post:
While the anticoagulant warfarin can be highly effective in preventing strokes and treating venous thromboembolism, doctors have long struggled with finding the best way manage the drug therapy.

Boston University School of Medicine (BUSM) researchers now claim to have figured out the optimal dosing levels to help patients, according to a study published in December online issue of the Journal of Thrombosis and Haemostasis.

The research team analyzed warfarin use in almost 4,000 patients to determine what are the most effective levels of the drug in a patient's system under different circumstances.

"The study suggests that anticoagulation control could be improved considerably by changing the warfarin dose only when the ratio is 1.7 or lower/3.3 or higher," lead author Dr. Adam Rose, an assistant professor of medicine at BUSM, said in a university news release. "In addition to offering warfarin to as many optimal candidates as possible, we also need to optimize warfarin dose management to fully realize the benefits of anticoagulation." ..more

Anti-smoking law forces retailer to phase out pharmacy

From the Edmonton Journal:
With the final phase of Alberta's Tobacco Reduction Act set to take effect on New Year's Day, Stadium Drug and Food Mart owner Jack Au had a business choice to make.

Either keep his grocery store where more than 50 per cent of sales come from tobacco products or hang on to the less lucrative pharmacy and watch his former smoking customers buy their cigarettes elsewhere.

"So I closed up the pharmacy. It made no sense to continue with that business when over 50 per cent of the business is tobacco here," Au said.

Au now uses the corner where the pharmacy once stood to rent out videos.

When Jan. 1 rolls around, he will permanently seal up the double doors leading to the pharmacy which moved next door.

There will be no access from his store. He intends to be in compliance with the province's anti-smoking legislation, considered by some to be among the toughest in the country.

Under the legislation, all pharmacies, stores that have a pharmacy in them, health-care facilities and post-secondary institutions in Alberta will no longer be allowed to sell tobacco products as of Jan. 1. ...more

Pharmacists take on expanded role starting January

From Arrow Lakes (BC) News:
As part of a new agreement between the government of B.C. and the B.C. Pharmacy Association, pharmacists will be taking on a bigger role when it comes to prescription medications.

As of Jan. 1, B.C. pharmacists will have the legal authority to renew or adapt existing prescriptions to better suit the patient.

Pharmacist Troy Clark of People’s Pharmacy in Nakusp says it’s a step up for the role of pharmacists.

“[It is] increasing our scope of practice,” says Clark. “It’s something that we’re capable of doing.”

A pamphlet available at People’s Pharmacy states benefits of the change include allowing your pharmacist to help manage medications for patients between visits to the doctor.

“This medication management thing that’s coming now, the new policy that’s come out, it’s just giving us the authority,” says Clark. “Now we have the legal authority to do some of those things that we were maybe doing already.” ...more

Application of pharmacy standards slackens

From VietNamNet:
Many drugstores at large hospitals have not yet applied the Good Pharmacy Practices (GPP), let alone private pharmacies, although the deadline is only one week away, said HCMC health officials.

The Ministry of Health last year introduced the GPP standard and required all drugstores at hospitals nationwide to brace for the standard before January 1 next year. The standard is aimed at helping State agencies ensure the quality of drugs, better manage drug manufacturing and distribution, protect the people’s health as well as prepare the market for foreign drug distributors who will be allowed to enter the market early next year.

Under the ministry’s requirements, all drugstores must operate in modern facilities, only sell drugs with known origin, employ qualified pharmacists and provide drug consultations. However, even in HCMC where the pharmaceutical market is more developed, the standard has not been attended to by drugstores, said Pham Khanh Phong Lan, deputy director of HCMC’s Department of Health.

She told the Daily that the GPP implementation in hospitals would fall behind the ministry’s deadline given the current progress.

“Up to this month, 52 hospital-based drugstores in HCMC have been completing procedures to apply the GPP plus about 10 district-level hospitals,” she said. Of this figure, only 30 drugstores have successfully deployed the GPP standard. ...more

Pharmac hits back at talk of stinginess

From Stuff.co.nz:
Medicine funding is "not about counting votes" or making popular decisions, says Pharmac chief executive Matthew Brougham.

In the national drug-buying agency's annual review, Mr Brougham hit back at accusations of stinginess.

This month the Government took the unprecedented step of bypassing Pharmac's independent decision-making process to directly fund 12 months' of the costly breast cancer drug Herceptin.

Earlier this year, a group of cancer patients took Pharmac to court over its decision to offer just nine weeks' treatment.

The High Court ordered Pharmac to do more "public consultation", which attracted more than 300 submissions, but did not overturn the original decision.

Mr Brougham said Pharmac was making efforts to improve the way it consulted with and relayed its decisions to the public. ...more

PCA wants rules to play by

From the Financial Post:
In all businesses, entrenched interests -- "the club" -- can and do play a large role in ensuring life isn't made easy for a bunch of newcomers, as existing players protect their interests by any and all means.

Enter Peter Suma and Don Waugh, founders of PCA Services, which regards itself as "an innovator of hardware and software for the dispensing and ongoing management of patient drug therapy." PCA (PharmaTrust) recently launched its second dispensary at Toronto's Sunnybrook hospital.

Getting to that stage hasn't been easy. The 40-person company has invested $9-million in a kiosk that allows patients to talk to a pharmacist via video conferencing and enables the pharmacist to monitor and control each step of the dispensing process from a video call centre. Medication is dispensed from the kiosk by the pharmacist in a few minutes. And PCAS has fought numerous battles with the club. "Only a wet baby likes change," said Suma, whose MBA from the University of Chicago makes him a supporter of free and open markets. PCA wants rules to play by

Old-time remedies best when it comes to fighting kids’ colds

From the Lethbridge (AB) Herald:
When coughs and colds hit kids, old remedies may be the best.

That’s the message from local pharmacist Rick Siemens, after Health Canada announced this week that children under six years old shouldn’t be treated with over-the-counter cough and cold medications, because the potential risks outweigh any possible benefits.

Siemens, pharmacy manager at London Drugs in Lethbridge, was busy Friday moving the store’s supply of children’s cough and cold medicine behind the pharmacy counter. He said parents should consult with a pharmacist to determine whether such medicines are the right solution and if so, what kind of dosage to give.

“Those medications, if they’re used properly, are safe. It’s just that the effectiveness has never been proven to be that great for any cough and cold medication,” Siemens explained. ...more

Health Canada says children under 6 shouldn't get cough and cold medication

From the Canadian Press:
Children under six years old shouldn't be treated with over-the-counter cough and cold medications because the potential risks outweigh any possible benefits, Health Canada says.

The warning follows a recently completed review of scientific data on the products by the federal department, which recommended in October 2007 that children under two shouldn't be given the cough and cold remedies.

"The current decision expands on those preliminary recommendations," Dr. Marc Berthiaume, director of Health Canada's marketed pharmaceuticals and medical devices bureau at Health Canada, said Thursday from Ottawa.

The review, which included advice from an expert scientific advisory panel, concluded "there is limited evidence supporting the effectiveness of these products in children," the agency said.

"In addition, reports of misuse, overdose and rare side-effects have raised concerns about the use of these medicines in children under six. The rare but serious potential side-effects include convulsions, increased heart rate, decreased level of consciousness, abnormal heart rhythms and hallucinations." ...more

Pushing more doctors to ditch the prescription pad

From the Associated Press:
The push for paperless prescriptions is about to get a boost: Starting in January, doctors who e-prescribe can get bonus pay from Medicare.

For patients, the benefits are obvious — from shorter drugstore waits to increased safety, as pharmacists no longer squint to decipher doctors' messy handwriting.

But persuading U.S. doctors to ditch their prescription pads for electronic prescribing so far has been a long, uphill battle. Only about 10 percent of doctors are taking the plunge like Dr. Ted Epperly in Boise, Idaho, who's adopting the technology now.

Still, the movement is gaining steam as Medicare warns that its bonus payments are for a short time only: Holdouts still sticking to paper in 2012 will find their Medicare payments cut.

And continuing the push for medical information technology is a key part of President-elect Barack Obama's health-reform plans, in hopes that moving to computerized records — not just prescriptions, but all those troublesome paper charts that contribute to medical errors and wasted care — ultimately could save millions of dollars a year. ...more

Pill to be given out by chemists

From BBC News:
A pilot scheme allowing pharmacists to give women the contraceptive pill without a prescription has been given the go-ahead for next year.

Women and girls aged over 16 will be able to get the pill at two London primary care trusts, Southwark and Lewisham, Pulse magazine says.

If the pilots are successful, the pill could become available over the counter like the morning after pill.

Officials say this might help reduce the UK's high teen pregnancies.

Although the teenage pregnancy rate in Britain is falling in many areas, it remains the highest in Western Europe.

A spokeswoman for the Department of Health said: "We want to improve women's access to contraception and help reduce the number of unintended pregnancies without undermining patient safety. ...more

Liver function a concern for lung cancer patients taking Tarceva

From CBC News:
Drug company Hoffman-La Roche is telling doctors prescribing Tarceva to lung cancer patients to closely monitor the liver function of those who recently have taken or who are taking the drug.

The drug Tarceva (erlotinib) is used to treat patients with non-small-cell lung cancer at an advanced stage when chemotherapy has not helped to stop the disease.

The letter issued by Hoffman-La Roche says a study of patients with advanced cancer and moderate liver impairment found that a higher number of patients died during treatment or within 30 days of the last dose, compared to patients with normal liver function. ...more

Seniors' drug plan unveiled

From the Edmonton Journal:
Low-income seniors in Alberta will be paying less and in some cases nothing for prescriptions under a new pharmaceutical plan that will also hike drug costs for high-income seniors and triple the premiums for those on Blue Cross.

"I think it's a good idea," said Patricia O'Reilly, a volunteer at the Seniors Association of Greater Edmonton. She and her husband have an income lower than $42,650, so they won't have to pay for drugs under the new pharmaceutical strategy, which kicks in January 2010.

Currently, seniors have to pay 30 per cent of their prescriptions up to $25 for each drug, no matter what their income. A senior on 10 different drugs, for instance, would be paying $250 or less, depending on the cost of the medications.

Under the new regime, couples earning less than $42,650 and singles earning less than $21,325 won't have to pay anything.

The new program will save O'Reilly, 66, between $45 and $50 each month. "Sometimes, it's a bit tough with the cost of living," she said. "Everything else goes up. I will definitely benefit from it." ...more

No benefit from multiple steroid injections in preterm births: study

From CBC News:
Giving many courses of steroids to women at risk of giving birth prematurely increases the risk of having a smaller-sized baby, a Canadian-led international study suggests.

A single course of corticosteroids has been shown to reduce the risk of death in newborns, respiratory distress and bleeding in the brain of infants born to women at risk of giving birth before 37 weeks of pregnancy.

But doctors have moved beyond what the evidence supported and repeated courses of the prenatal drugs — also known as antenatal — has become common, according to a commentary that accompanies the study in the Dec. 20 issue of the medical journal The Lancet.

In the largest trial to date, Dr. Kellie Murphy of the department of obstetrics and gynecology at Toronto's Mount Sinai and her colleagues analyzed data on more than 1,800 women at risk of preterm birth who received one course of prenatal corticosteroids 14 to 21 days before the study began. ...more

On-site pharmacy must monitor care home's drugs, owner says

From the Globe and Mail:
Sunridge Place residents whose medication costs have shot up since they were forced to move out of Duncan's Cowichan Lodge care home can complain all they want. But whether it's vitamins, minerals, herbal remedies or prescription medications, there's no way around purchasing the pills they need from the private-care home's on-site pharmacy.

According to Bob Mehr, owner of Pacific Compounding Pharmacy, the company under contract to Sunridge Place, said the B.C. College of Pharmacists requires that the same designated provider supply all medications for long-term care residents.

"When you have a contract with a particular nursing home, you are responsible for all the medications provided at that particular nursing home, including vitamins and over-the-counter medications," said Mr. Mehr, who owns nine pharmacies on Vancouver Island, including three that are located in P3 long-term care homes.

"Where you are in a care facility, everything the patient gets has to be prescribed by a physician and the pharmacy is obligated to supply that. If we don't we are interfering with the doctor's care." ...more

Medical schools urge limits to drug makers' influence on students

From CBC News:
There may soon be no more free lunches — or fridges to store them in — in the student lounges of Canadian medical schools.

No talks given by physicians' experts paid handsomely by pharmaceutical companies. Or unsupervised meetings with drug reps.

The association that represents Canada's medical schools announced Tuesday it is endorsing the principles that lie at the core of rules such as these introduced by its American counterpart earlier this year.

The Association of Faculties of Medicine of Canada said the aim is to limit the influence the pharmaceutical industry has on medical students and residents and assuage the public's concerns about the perceived cosiness between medical schools and drug makers.

"There's no question that the environment within which you're trained will have some sort of impact on the way you perceive these issues," Irving Gold, the association's vice-president of government relations and external affairs, said from Ottawa. ...more

Indonesia scraps plans to tag HIV patients

From the International Herald Tribune:
An Indonesian province beleaguered by a spiraling HIV infection rate scrapped plans to implant microchips in those with full-blown AIDS on Tuesday, following strong opposition from government officials, health workers and rights activists.

Papua's parliament agreed to drop a section of the health development bill that supported the tagging of some HIV patients with small computer chips inserted beneath the skin — part of extreme efforts to monitor the disease, lawmaker Weinard Watori said. ...more

Generic drug maker suit against federal government reaches trial stage

From the Canadian Press:
Federal regulations that bar Canada's generic drug makers from copying brand-name products for eight years after patents expire will come under the judicial microscope Tuesday as a two-year-old lawsuit reaches Federal Court.

The generic drug makers want the court to set aside rules that they argue cost consumers $115 million in extra drug costs every year.

The regulations, implemented in 2006 under the Food and Drugs Act, were designed to protect the extensive and expensive data that manufacturers need to seek approval for a drug. The data include the results of studies and clinical trials.

The rules prohibit Health Canada from licensing a generic version - generally cheaper than the brand-name equivalent - until after the eight-year period for those drugs where patent protections have lapsed. ...more

Most Alberta seniors to pay less under new drug plan

From CBC News:
About 60 per cent of Alberta's seniors will see their prescription drug costs lowered or eliminated starting in January 2010, but others will pay more, Alberta Health announced Monday.

Single seniors with an annual income of less than $21,325 and senior families with an annual combined income below $42,650 will not have to pay for medication.

But other seniors who have high incomes will pay more for drug coverage.

Deductibles will be based on a sliding scale and the highest earners could pay up to $7,500 a year if they have high medication costs.

Alberta Health Minister Ron Liepert said the change will make the system fairer to everyone.

"We have a philosophy in government that we need to — and it's our responsibility to — ensure that those who can't afford it or don't have it, that there are programs in place by government," he said. ...more