Wednesday, December 22, 2010

I'm a believer: drug-supply startup proves its mettle

From the Edmonton Journal:
Chalk up another one for Sine Chadi.

When I first interviewed the CEO and majority shareholder of Edmonton-based Imperial Equities in 2007, he had big dreams for a tiny drug-distribution firm his company had just acquired.

I listened politely to Chadi's upbeat talk, but in truth, I didn't take it too seriously. After all, entrepreneurs are born dreamers and most of their schemes go nowhere.

Besides, I figured, what could a smallish local real estate operator with a market cap of just $30 million and a clutch of second-tier industrial and commercial properties know about delivering drugs to pharmacies?

That's strictly a game for the big guys, I reasoned -- namely corporate giants like McKesson Corp., whose annual revenues ($100 billion-plus US) dwarf the very largest companies in Canada, let alone a minnow like Imperial.

Well, it turns out I was wrong to dismiss Chadi's effusive outpourings. When I checked in with him a year ago, his drug-delivery service had grown to nearly $13 million in annual sales, up from just $1.2 million in 2006. ...more

Pfizer, Health Canada pull Thelin from shelves

From the Globe and Mail:
Health Canada and drug giant Pfizer formally announced Monday the company is taking a drug used to treat a rare, but serious, lung disease off the market due to risks of potentially fatal liver damage.

Pfizer Canada also said the company is abandoning all clinical trials of sitaxsentan sodium, better known by the brand name Thelin, and removing the drug from every country where it is sold.

The decision is raising questions about why the drug, used to treat pulmonary hypertension, was approved in Canada in the first place.

Parent company Pfizer Inc. announced more than a week ago its intentions to pull the drug off the market in Canada, Australia and Europe, as well as halt clinical trials. The decision was prompted by the deaths of three patients involved in clinical trials of the drug.

The company was conducting the trials in a bid to get the U.S. Food and Drug Administration to approve the drug in that country. ...more

Certain heart burn medications linked to increased risk of pneumonia

From the Montreal Gazette:
People on two types of widely prescribed heartburn medications may have a higher-than-average risk of developing pneumonia, a new research review finds.

The drugs in question belong to two classes frequently used to treat heartburn or stomach ulcers: proton pump inhibitors, which include drugs like Nexium, Prevacid and Prilosec; and H2-receptor blockers, such as Pepcid and Zantac.

In the U.S. alone, people spent $27 billion on these medications in 2005.

Some studies have found a connection between the heartburn drugs and a heightened risk of pneumonia. One theory is that by curbing stomach acid, the medications allow ingested bacteria that would otherwise be killed to instead survive and thrive -- and potentially get into the lungs. ...more

Windsor pharmacies running out of commonly-used drugs

From the Windsor Star:

Some commonly used drugs, including antibiotics and sedatives, "can't be found anywhere" in Windsor due to a national prescription drug shortage, a local pharmacist says.

The shortage, highlighted in a national survey, is creating problems across the region, says Peter Dumo, owner of Novacare Pharmacy in Windsor.

"There are some drugs that you can't get anywhere right now," Dumo said, listing among them Triazolan, a sedative, and Cephalexin, typically used to treat skin infections.

Dumo said he's experienced drug shortages before, but "I've never seen anything like this in Ontario."...more

Monday, December 20, 2010

updates

Updates resume Tuesday - sorry for the delay. I will end a message on Twitter when the site is updated. To sign up for our Twitter account, go to:

http://twitter.com/canadapharmnews

Sunday, November 28, 2010

Critics decry change in drug-approval process

From the Globe and Mail:
British Columbia’s widely applauded independent drug-approval process is being dramatically altered to make room for more input by pharmaceutical companies, a change decried by critics as potentially harmful to consumers, a conflict of interest and likely to increase spending on drugs.

An internal health ministry document says there will now be four separate opportunities for drug marketers to make their case while new products are being considered for coverage by B.C.’s PharmaCare plan.

At the same time, the government’s long-standing drug review body with an arms-length distance from the industry is being abolished. The Therapeutics Initiative’s cautious approach to drug approvals has been credited with saving lives and helping B.C. maintain the lowest per capita spending on prescription drugs in the country.

Michael McBane of the Canada Health Coalition said no other provincial drug plan allows as much industry involvement as B.C. is proposing. ...more

Cautionary note sounded on HIV-protection drug

From the Globe and Mail:
AIDS-prevention advocates are hailing a pill newly shown to protect against HIV as a great tool for disease prevention. But they caution that no drug alone can address social factors blamed for the persistence of the epidemic. And they say concerns remain about who will pay for the costly treatment.

A study released on Tuesday showed that daily doses of a drug called Truvada, already used to treat HIV infection, cut the risk of new infections among healthy gay men.

The overall study, published online by the New England Journal of Medicine, involved about 2,500 men at high risk of HIV infection in Peru, Ecuador, Brazil, South Africa, Thailand and the United States.

Susan Buchbinder, director of the San Francisco health department’s HIV-research section, called the findings on the drug a “tremendous step forward.” But she took pains to point out that among the several HIV-prevention studies she has overseen, this latest had especially strict requirements for making sure participants stayed on track. ..more

Monday, November 22, 2010

Twitter

CanadaPharmacyNews.com is now on Twitter. Follow us at #canadapharmnews where we will give you a head's up when the blog is updated and also provide you with links to stories of interest.

www.twitter.com/canadapharmnews

Dying patients ask: Where are the $1 billion in drug savings?

From the Toronto Star:
Deborah Warkus spent the last moments of her life fighting the Ontario health ministry to gain access to a $4,000-a-month drug to treat her invasive breast cancer.

By the time the province agreed, it was too late and the 50-year-old Brampton mother died.

Lucas Maciesza, 26, is lying in a Guelph-area hospital, bleeding to death, because his parents can't afford to pay the $500,000-a-year cost for his medication.

In the last four years, a bold drug reform scheme — which includes bulk purchasing and eliminating professional allowances to pharmacists — has saved the province more than $1 billion.

Those savings are supposed to be used to add new, often pricey drugs to the Ontario Drug Benefit Program formulary.

But patients suffering in the final stages of cancer or with rare diseases say their desperate needs are being ignored. ...more

Health Canada announces restrictions on diabetes drug

From CTV News:
Health Canada has announced new restrictions and a consent form for the diabetes medication rosiglitazone, sold under the brand name Avandia, because of an increased risk of heart-related illness.

The national drug regulator said Thursday that it changed the restrictions after reviewing recent data and in conjunction with manufacturer GlaxoSmithKline Inc.

The drug may increase the risk of serious heart problems, including heart failure, angina (chest pain), heart attack or fluid retention (with or without rapid weight gain). It should not be used by patients who have or have had heart problems, the agency said in a release Thursday.

Health Canada says the medication should be used only in patients with Type 2 diabetes when all other diabetes medicines taken orally have not lowered blood sugar enough, or are not appropriate. ...more

Advances made in developing hepatitis C vaccine

From the Vancouver Sun:
Scientists are zeroing in on a promising vaccine to treat hepatitis C, an international symposium was told Friday in Montreal.

Three preliminary clinical trials in England are showing that a so-called therapeutic vaccine can boost the immune response in those infected with the hepatitis C virus.

Still, a viable vaccine is a decade away, said Paul Klenerman, a University of Oxford physician researcher who is conducting the trials.

"Other vaccine trials have been done already, but ours is the first where we're treating people (with drugs) and giving them the vaccine at the same time," he said.

"What's possible is that you can have a good drug that can get most of the virus, but you might still need a bit more immune response to tidy it all up, because what you don't want to do is have all these drugs suppress it and then it comes back again, which is typically what happens." ...more

Friday, November 19, 2010

Not many pharmacists prescribing medication

As one of those 107 prescribing pharmacists, I thought this was interesting but missed the point a bit. Compensation is part of the reason that pharmacists haven't embraced prescribing. But I don't think pharmacists expect the government or third parties to pay a fee based on number of Rx's written for example. Pharmacists want a clear method to be able to charge government for clinical services like a physician can. Prescribing might be an action done during these clinical services, but not always just as a physician gets paid for a visit and associated clinical services, not an amount based on the number of prescriptions they wrote during a visit.

And when I mention pharmacists want a way to bill the government, I mean the actual pharmacists - not the drugstore they work for. A recent attempt to reimburse pharmacists in Alberta for clinical services called PPMI never made it past the pilot project stage. One aspect of that pilot I didn't like was that a pharmacist could not bill the government directly like a physician could but all reimbursement had to go through a pharmacy. I would think that the majority of the 107 prescribing pharmacists in Alberta do not own their own drugstore and therefore would have to cut a deal with a drugstore so that they could submit their billing to the government. This definitely limits an individual pharmacist's options as far as how they can set up their practice.

From CTV News:
Pharmacists were given the ability to prescribe medication under a new plan introduced a few years ago to take some pressure off family doctors.

But since the plan took off, only 107 of the more than 4,000 pharmacists in Alberta have signed up.

Anjli Acharya was one of the few pharmacists who applied. She said she can now prescribe to her patients at the Bowmont travel clinic.

But she said the application process took four months of work. She also doesn't get paid to prescribe drugs.

Those are some of the reasons many pharmacists haven't applied, says Todd Gehring, who owns and operates his own community pharmacy.

He says prescribing medication takes time and pharmacists need to be paid appropriately. ...more

Thursday, November 18, 2010

Health council calls for better testing of drugs

From the Toronto Star:
Some prescription drugs the federal government approves for the market may not be as safe as people think they are, says a new report from the Health Council of Canada.

“Pharmaceuticals offer significant health benefits, but the risks associated with their use in the real world remain largely unknown when they enter the market and large numbers of people start taking them,” says the report released Wednesday. “This can leave users of medicines exposed to unanticipated drug effects.”

The report noted that some drug safety issues, such as the 2004 recall of the anti-inflammatory painkiller known as Vioxx, gain a lot of media attention, but the problems are not limited to such high-profile cases.

“Most Canadians are not aware of the limitations inherent in pre-market testing of prescription drugs, nor do they realize that there is no systematic scrutiny of people’s experiences with drugs after they have been approved and are available for sale,” says the report. ...more

Drug reforms bring profits down, Shoppers says

From the Toronto Star:
Profit at Canada’s largest drug store chain fell less than expected last quarter as Shoppers Drug Mart made gains in private label generic drug sales, cosmetics, healthy living products and non-prescription drugs.

Still, the retailer said Ontario’s drug reforms cut into its operating and profit margins during the first full quarter since the new rules came into effect.

The reforms saw the Ontario government cut the amount it pays for generic drugs in half and end professional allowance payments to pharmacists by drug manufacturers.

Shoppers Drug Mart, which fought the changes, said it expects to benefit in the long term from increasing consolidation in the pharmacy business.

The provincial drug reforms, which analysts estimate will cut $750 million from pharmacists’ budgets over three years, were expected to hit smaller independent stores hardest.

Shoppers has made few acquisitions so far because “we feel the price per square foot did not come down to the right level to justify the investment to buy and integrate small stores,” president and chief executive officer Jurgen Schreiber told analysts on a conference call Wednesday afternoon. “We are confident this will happen as the reforms kick in year after year.” ...more

Painkiller sting hurts druggist

From the Toronto Sun:
There wasn't a prescription Gregory Melville wouldn't fill.

And when the London pharmacist couldn't help with a doctor's script, he had other ways to help fill a customer's need.

Now, in a twist more like the fate of a street drug dealer than a pharmacist who had his own store, Melville will pay -- his licence will be yanked, he no longer has his pharmacy and he's working in a call centre.

That's on top of the court penalties dished out to the 46-year-old Tuesday -- a two-year conditional sentence that includes nine months of house arrest, two years' probation and 75 hours of community service.

The rare tale of how the druggist went down was the fallout of a London police sting.

Tuesday, Melville pleaded guilty to four charges -- possession of crime proceeds valued under $5,000, possession of oxycodone and two counts of drug trafficking -- stemming from a police investigation two years ago.

Oxycodone, a powerful painkiller known as "hillybilly heroin" on the street, is widely trafficked to addicts, some of whom get hooked after legitimately using it to relieve chronic pain. ...more

Breast-cancer risk of hormone therapy overblown: Gynaecologists

From the Montreal Gazette:
Women arrive at Dr. Wendy Wolfman's menopause clinic carrying shopping bags filled with herbal remedies. Most of it, she said, "is just completely a waste of money."

Some women are willing to try anything to deal with debilitating hot flashes, mood swings and other menopausal symptoms, Wolfman said.

Anything but hormones.

"They're afraid to take hormones because the publicity is they're going to get (breast) cancer," said the director of the menopause unit at Mount Sinai Hospital in Toronto.

Now, the Society of Obstetricians and Gynaecologists of Canada is urging Canadian women to rethink their aversion to hormone therapy. The doctors' group says that women have been needlessly frightened off a "safe and effective therapy" by reports implicating hormones in breast cancer.

In an article titled "Misinformation. Misinterpretation. Missed opportunity." posted on the gynecologists' group's website, executive vice-president Dr. Andre Lalonde says the organization has supported the breast-cancer cause "for years." ...more

Sunday, November 14, 2010

Drug shortages trouble pharmacists

From the Toronto Star:
There are shortages of some prescription drugs — including tetracycline and some anti-nausea medications for heart and cancer patients — forcing pharmacists to scramble to meet patients’ needs, industry sources say.

The trouble lies with supply shortages, such as difficulties for some manufacturers in getting the active ingredients to make the medicines, creating a domino effect in which demand for similar drugs is going up and leading to sellouts.

“It’s a real problem,” said Dennis Darby of the Ontario Pharmacists Association, adding it was not caused by the provincial government’s reforms forcing a 50 per cent cut in the price of generic drugs last spring.

The shortages are being reported across Canada and beyond.

“There’s lot of things the drug reforms are causing but this isn’t one of them,” added Darby, alluding to complaints from pharmacies that the reforms eroded their profitability and would lead to staff and service cuts. /...more

Generic drugs not the same: experts

From the National Post:
As Canadian governments turn increasingly to generic drugs to try to rein in health-care costs, some researchers suggest duplicates can sometimes differ significantly from the brand-name original, potentially causing serious trouble for patients.

One Montreal psychiatrist recently documented adverse effects in patients who were switched to generic medications, and alleged that the cost savings of generics are outweighed in certain cases by the dangerous impact on users.

"I've seen it enough times to know it's a real phenomenon," said Dr. Howard Margolese. "It's sort of another element a physician has to consider if he has a patient who does well, and starts to relapse. ... There needs to be a little more caution and there needs to be a whole lot more study done before a generic is deemed to be equivalent."

Other experts, Health Canada and the generic industry, however, say there is no reliable evidence that the copies are problematic, with some arguing that the skepticism is being fuelled by a brandname sector worried about its bottom line. /...more

Home breast cancer screening device recalled, Health Canada says ineffective

From the Winnipeg Free Press:
Breastlight, a product being sold as a home screening device for the early detection of breast cancer, is being pulled from the market because there is no evidence it works, Health Canada says.

PWB Health Ltd. is recalling Breastlight and asking pharmacies and other distributors to immediately stop selling the product, following Health Canada's evaluation of information about the safety and effectiveness of the technology.

The company has marketed the device as an aid to help women notice changes in their breasts over time and as a component of "breast awareness."

But there is no clinical evidence that the Breastlight can be used effectively as a screening device for the early detection of breast cancer, Health Canada said in an advisory Friday. "As such, it may present a potential risk to women relying on it for early detection of breast cancer." ...more

Monday, November 08, 2010

Websites selling counterfeit drugs, Health Canada warns

From CBC News:
Health Canada has identified three websites that are selling prescription drugs not authorized for sale in Canada, the agency said Wednesday.

The websites — www.northdrugmart.com, www.northdrugstore.com and www.pharmacyrxworld.com — sell products containing references to brand names and resemble drugs that are approved for sale in Canada.

Health Canada said it suspects the products are counterfeit.

"This may lead consumers to believe they are purchasing drugs that have been reviewed for safety, efficacy and quality by Health Canada," the department said in a news release.

"It is important to note that counterfeit drugs may contain no active or unsuitable ingredients, or dangerous additives. To this end, counterfeit drugs may pose a higher risk than other forms of unauthorized drugs." ...more: