Monthly Archives: July 2012

No takers for 10K seats in engg, pharma colleges

At least 25% of seats in engineering and pharmacy colleges have remained vacant after the first round of admissions here on Saturday.

Of the 43,000 engineering and pharmacy seats a whopping 10,200 seats have been left vacant after registration reporting of the first round of admissions granted by the Admission Committee for Professional Courses (ACPC) was completed on Saturday.

A total of 43,007 students had registered online seeking admission to engineering and pharmacy courses and were granted admission after the three mock rounds. After this, the students had to reporting for registration confirming their admission.

Consumer Reports: Labels on medicine can lack key facts

It’s comparable to driving a car without a seat belt — a new investigation from Consumer Reports Health finds that drug labels sometimes lack key safety warnings, and some pharmacies fail to include the medication guides required by the federal government.

For its investigative “spot check,” Consumer Reports Health sent staffers to five individual drugstores in Yonkers, N.Y. — Costco, CVS, Target, Walgreens, and Walmart — to fill prescriptions for warfarin. Warfarin (Coumadin and generics), a blood thinner used to prevent strokes, is one of the 20 most commonly prescribed drugs in the United States, according to IMS Health.

Most alarmingly, four of the five pharmacies failed to provide a federally mandated medication guide that is required for certain drugs, including warfarin. And while all of the pharmacies provided their own patient materials, known as consumer medication information (CMI), they differed from the FDA-approved guide for warfarin and contained conflicting warnings about alcohol. Warfarin can cause severe internal bleeding that can be life-threatening. It is the second most common drug implicated in emergency room visits in the United States.

Consumer Reports Health also wanted to see how drug labels, warning stickers and consumer drug information sheets varied among pharmacies. While the findings are not nationally representative for each chain, they raise significant concern.

Part of the problem, according to Lisa Gill, prescription drug editor, Consumer Reports Health, is that there’s no nationwide standard like “Nutrition Facts” on food packages or the “Drug Facts” on over-the-counter medication. While the U.S. Food and Drug Administration (FDA) requires certain details on labels such as a patient’s name and dosage instructions, it does not monitor drug labels; rather, each state’s board of pharmacy is responsible for their overall content. And whether there are warnings on the bottles is left to the individual pharmacist.

Merger would build PBM powerhouse

Express Scripts Inc.’s plan to buy its largest competitor, Medco Health Solutions Inc., for $29.1 billion would result in a seismic shift in the pharmacy benefits management marketplace.

The deal, jointly announced by the companies last week, would see Express Scripts pay $71.36 per share for its Franklin Lakes, N.J.-based rival, 28% more than Medco’s closing stock price the day before the deal was announced.

If and when the sale is finalized, the combined company would be the largest player in the pharmacy benefits management industry, representing roughly 34% of the U.S. market and an estimated 1.6 billion prescriptions administered or dispensed in 2013, according to JMP Securities L.L.C. Its closest competitor, Woonsocket, R.I.-based CVS Caremark Corp., would have 20% of the market and an estimated 937 million prescriptions dispensed in 2013, according to the San Francisco-based firm.

“It certainly gives (Express Scripts) additional clout,” said Constantine Davides, a Boston-based senior analyst at JMP Securities. “With the type of market share generated here, they’re going to have significantly increased leverage against pharmaceutical manufacturers and the retailers in their network.”

News of the proposed deal was accompanied by Medco’s announcement that it would lose its contract with UnitedHealth Group Inc. in 2013, an $11 billion account comprising about 17% of its business.
Pros and cons

While the proposed deal is likely to be opposed by industry groups representing pharmaceutical manufacturers and retailers, analysts said the merged company’s clients could benefit from its ability to apply pressure on supply partners and its expanded offering of products and services.

“More likely than not, I would think that employers are going to be better off if the companies are together, to the extent that their ability to squeeze their suppliers will more than make up for any higher margins that they earn,” said Matthew Coffina, an equity analyst at Chicago-based Morningstar Inc.

Combining the companies would join very different philosophies on the administration of pharmacy benefits. Express Scripts’ application of behavioral sciences in driving consumers toward diligent and more cost-effective prescription treatment—particularly generic medications and mail-order distribution—is a concept that would be relatively foreign for Medco clients, he said. Cost savings to be realized in improving generic penetration rates, mail order usage and prescription adherence “is certainly something for current Medco customers to be excited about,” Mr. Coffina said.

At the same time, Medco’s focus on clinical, therapeutic and pharmacogenomic research as well as its specialized pharmacists could provide employers enrolled with Express Scripts with ways to improve prescription adherence and reduce the frequency of adverse reactions from conflicting medications.

“Most likely, the combination of their expertise will create a much stronger offering and would certainly be one of the market share gains if the deal goes through,” Mr. Coffina said.
Antitrust considerations

Whether the deal will be completed is at best uncertain, as analysts expressed concern about potential antitrust challenges from the Federal Trade Commission, which must approve the sale.

The companies likely would argue that the increased bargaining leverage over health care providers, pharmaceutical manufacturers and retailers would result in lower prescription costs for employers, experts said. However, the sale also could result in the merged company gaining increased bargaining power over its customers.

“The antitrust issue is the key risk to the deal,” JMP Securities’ Mr. Davides said. “Express Scripts is going to have to prove that the deal is pro-consumer.”

In its note to investors regarding the sale announcement, Morningstar said its analysts were “floored” by news of the proposed transaction. The note went on to characterize the deal as having a “less than 50% chance” of meeting the approval of the FTC.

“No one thought this deal could get past regulators,” said Mr. Coffina. “It’s surprising that they’re even trying the deal, and it would be equally surprising if they actually get it done.”

An unfavorable evaluation by the FTC could be a problem for some employers enrolled with either company, said Jeffery Gruen, Washington-based head of health care services at PRTM Management Consultants Inc. The FTC could force the companies to shed some accounts as a condition of approving the deal.

“Some of those clients might see some disruption and would need to get associated with a different PBM,” Mr. Gruen said. “But that’s going to be a small minority, if any.”

Employer clients might benefit from the companies’ merger if it passes regulatory review, but some industry observers said the deal—especially given its size and market share—could be a harbinger of more consolidation in the PBM market, which they said could be detrimental for employers in the long run.

“The longer-term risk is that this aggregation forces other PBMs to aggregate as well in order to compete,” said Brenda Motheral, executive director of the Plano, Texas-based Pharmacy Benefits Management Institute. “Over time, employers really do have meaningfully fewer PBMs to choose from.”

Laurel Pickering, executive director of the New York-based Northeast Business Group on Health, said a merger like that proposed by Express Scripts and Medco would decrease “competition in the PBM market, which usually isn’t good for employers looking to get the most value from their PBM.”

“Anytime you decrease competition in the market, it reduces the incentives companies have to provide better prices,” Ms. Pickering said.

Express Scripts deal to realign pharmacy business

* Walgreen may have to rethink Express Scripts fight

* Pharmacies’ negotiating power could diminish

* Investor sees potential for drugstore consolidation

* Walgreen shares fall 5.3 pct, CVS shares rise 2.6 pct

By Jessica Wohl and Phil Wahba

CHICAGO/NEW YORK, July 21 (Reuters) – Drugstore leader Walgreen Co (WAG.N) may need to make amends in its $5 billion contract spat with Express Scripts now that the pharmacy benefits manager looks to be getting much bigger, industry watchers say.

Express Scripts Inc (ESRX.O) said on Thursday it would pay $29.1 billion to buy rival Medco Health Solutions Inc (MHS.N) and become the biggest U.S. pharmacy benefits company, with easily one-third of the market. [ID:nN1E76K024]

The deal could take a year or more to pass through regulatory hurdles, but in the interim it could already have the power to realign the industry, from rival PBM companies to drugstores and pharmaceutical companies.

The Walgreen fight may be the most immediate example. Last month it said it was breaking its relationship with Express Scripts over prescription pricing, risking more than $5 billion in annual sales. But it would not be able to afford to shut out a combined company with Medco. [ID:nN1E75K038]

“It would give Express Scripts a bargaining position with Walgreen that would be somewhat crippling,” said Bill Smead, portfolio manager of the Smead Value Fund.

Pharmacy benefit managers, or PBMs, administer drug benefits for employers and health plans. Express Scripts would gain even more leverage for negotiating drug prices if the deal went through.

Shares of Walgreen, which had no comment on the impact of the deal, fell 5.3 percent to $39.58.

The deal could take some pressure off CVS Caremark Corp (CVS.N), which has struggled to quiet critics who say that the $27 billion merger of CVS with the Caremark PBM in 2007 has not lived up to its promise and has been a drag on profitability.

CVS may also pick up some PBM business in the coming year from clients concerned that Express Scripts and Medco will be too distracted by their merger efforts.

CVS shares rose 2.6 percent to $37.90, while Express Scripts shares rose 6.1 percent to $55.76.

Shares of Rite Aid Corp (RAD.N), a distant No. 3 in the drugstore industry, were up 4.6 percent to $1.36.

While Walgreen may need to take a more conciliatory approach with Express Scripts, it may also become more aggressive in acquiring drugstores to preserve its clout, said Smead. His fund has held Walgreen shares for 3-1/2 years. CVS may take the same tack, he said.

Other retailers with pharmacies, such as Kroger Co (KR.N), Target Corp (TGT.N) and Wal-Mart Stores Inc (WMT.N) either could not be immediately reached or declined to comment.

WILL WALGREEN RECONSIDER?

Express Scripts has said that Walgreen gives its clients smaller discounts than other drugstores do. Walgreen finds Express Scripts’ rates “really, really below standard,” but may have little room to play hardball.

“This really hurts Walgreens. It has definitely tipped the scales in that discussion,” said Jefferies & Co analyst Arthur Henderson, who covers the PBM industry.

Raymond James analyst John Ransom estimates that losing the business of a combined company would hit Walgreen’s annual earnings per share by $1.00. Analysts are expecting the chain to have an EPS of $2.63 this year.

Walgreen has already sold off its PBM to Catalyst Health Solutions Inc (CHSI.O), potentially leaving it further exposed to major PBMs. In 2010, Walgreen fought with rival CVS Caremark, whose PBM stands to be the second-largest after the merger.

Prescriptions make up two-thirds of Walgreen’s revenue and draw in shoppers who buy general merchandise such as suntan lotion and food when they come in for their medications.

Jefferies & Co drugstore analyst Scott Mushkin said that the Express Script-Medco deal, which comes at the time of year when PBMs most actively try to land contracts with large employers, could prompt some to chose CVS Caremark rather than the huge combined Express Script-Medco.

After stumbling in 2009 and losing a major contract, CVS Caremark is having a good selling season this year, landing a major contract with the Federal Employee Program. (Additional reporting by Lewis Krauskopf in New York; Editing by Michele Gershberg and Gerald E. McCormick)

UT Knoxville, UT Health Science Center Offer Dual Degree in Pharmacy, Business

How do you cut costs without cutting quality of care? It’s a question many health care professionals face in today’s health care environment. A new University of Tennessee program aims to develop students who are uniquely equipped to make decisions on key business issues facing the pharmacy today.

The program joins the forces of UT Knoxville’s College of Business Administration and the UT Health Science Center (UTHSC) to offer a dual degree leading to a Doctor of Pharmacy (PharmD) and a Master of Business Administration (MBA). It is designed to meet the critical need for pharmacist executives with fundamental business skills necessary to operate within the contemporary economic and health care environments.

“As the health care field becomes more competitive, leaders in the field of pharmacy are challenged to make decisions that require an understanding of health care as well as business processes,” said Amy Cathey, executive director of the full-time MBA program. “For example, which of three drugs should a particular patient begin treatment with when the evidence shows all have similar effectiveness, but one is much less expensive based on the negotiated price with the source? Decisions have to be made every day that require balancing cost and customization, all with a focus toward the best possible patient care.”

The five-year program consists of 172 hours of coursework in which the PharmD degree from UTHSC is awarded first and the MBA from UT Knoxville is awarded second. The efficient cross-acceptance of elective classes saves students one semester of coursework. The PharmD educational program includes a strong focus on the appropriate and evidence-based use of medications, medication therapy management, drug actions and properties, critical thinking, and communication skills. The MBA program includes opportunities to work on applied projects that focus on innovation, business analytics, shopper marketing, and supply chain management.

Career opportunities include management and leadership positions in institutional and retail pharmacies, state and federal governments, the pharmaceutical industry, and pharmaceutical consulting firms.

“Change is one thing that most people can agree upon regarding health care,” said Peter Chyka, professor and executive associate dean at UTHSC. “This program can develop the knowledge, skills, and attitudes of a well-educated and informed pharmacist who can provide the business leadership and insight to develop and measure the many aspects of health care as they relate to the safe and effective use of medications.”

VoicePort Partnership With Unwired Nation Extends Services to Mobile Apps, Benefiting Pharmacy and Pharmaceutical Industry

VoicePort, LLC, a leading developer of advanced speech recognition and customer service applications for the Pharmacy and pharmaceutical industry, today announced it has entered into a strategic alliance with Austin-based Unwired Nation, the Mobile-Apps-As-A-Service company. The two companies together will work to take VoicePort’s customer service solutions, widely regarded in the pharmacy and pharmaceutical industry, to smartphones and tablets quickly, easily, affordably. This news is being issued this week during two independent pharmacy events in Las Vegas — Cardinal Health and AmerisourceBergen — and in advance of the upcoming National Association of Chain Drug Stores (NACDS) show at the end of August in Boston where the VoicePort mobile solutions will be demonstrated.

VoicePort uses advanced speech recognition self-service technology to automate interactions, especially in industries such as the pharmacy and Brand pharmaceuticals. VoicePort solutions, such as its PharmaPhonetics, focus on out-bound proactive notification and messaging. VoicePort is partnering with Unwired Nation to leverage its Kinita platform to enable the rapid deployment of their customers’ existing web investments, in combination with extensions to its PharmaPhonetics platform, to create high value, native mobile applications. VoicePort is working with Unwired Nation first to expand its pharmacy-focused offering, but the two companies intend to work together for joint clients and strategic mobile needs across the enterprise, anywhere there is a need to develop new mobile applications in a very rapid timeframe.

“We know our clients need to communicate with their customers — patients — simply, clearly, and via whatever smartphone or tablet that customer is using,” said Christopher Mann, President and CEO of VoicePort. “Unwired Nation helps us deliver this to our pharmacy and pharmaceutical clients today, and we see opportunities to leverage this mobile technology in the near future, augmented and accelerated by our own integration expertise, in our other businesses’ verticals that include Media, Publishing and Enterprise Solutions.”

VoicePort’s PharmaPhonetics Patient solutions deliver cost-effective, automated, personalized, and intelligent interactive communications that speak directly to patients on behalf of the pharmacy. Services include patient prescription pick-up, refill reminders and health awareness messaging, all delivered in a HIPPA-approved model, and integrated with that pharmacy’s management database system. PharmaPhonetics enables personalized permission-based phone, text, e-mail — and via Unwired Nation’s Kinita platform — now mobile phone communications that dynamically respond to the individual patient’s needs.

“Medication Adherence continues to drain the U.S. HealthCare system with cost estimates of up to $300 billion dollars a year due to patient non-compliance,” said Alphonse J. Sasso, VoicePort’s Vice President of Business Development. “Enabling a variety of communication options — phone, text, e-mail and now mobile phone — to pharmacies to deliver messages based on each customer’s preference will help increase compliance, and more importantly, will improve overall health of patients.”

Unwired Nation’s Kinita cross-platform mobile application system uses a simple web-services interface, enabling clients to rapidly deploy and manage mobile web applications that come alive with native features and platform-specific interfaces. VoicePort leverages Kinita Messenger(TM) and other Kinita patent-pending technologies to enable cross-platform push messaging for clients’ apps, providing access to real time dedicated-inbox functionality with native device capabilities for mission-critical enterprise application or high-touch consumer applications. Kinita allows VoicePort clients to manage their mobile web assets as usual, while Kinita manages new platforms, feature updates, app stores, operating system updates and multiple device and OS fragmentation — all as a service.

“We are thrilled to be partnering with VoicePort and bringing our mobile smarts to the pharmacy and pharmaceutical industry, as well as others,” said Eric Smith, Unwired Nation CEO and co-founder. “Any time a company — or a company’s clients — want to take a piece of their business mobile, we hope they turn to Unwired Nation. We’ve figured out the secret sauce in mobile: taking whatever a company has already built in web applications and moving them to native mobile apps in a rapid and scalable manner within hours.”

PNI Digital Media Renews Contract with CVS/pharmacy for Online Photo Services

PNI Digital Media CA:PN
-3.67% (“PNI” or the “Company”), the leading
innovator in online and in-store digital media solutions for retailers, announced that the Company has entered into an agreement to extend the term of its Internet Services Agreement with CVS Pharmacy Inc. (“CVS”) to provide and operate the CVS/pharmacy online photo service www.cvsphoto.com , which is connected to over 7200 CVS/pharmacy locations across the US for an additional three year period. The service will continue to allow CVS/pharmacy customers to easily upload and place orders for photo prints, greeting cards, calendars, photo books, posters, canvas prints and other photo gift items on the CVS Photo website, with options to pick-up photo prints within an hour and/or have orders shipped to them.

“CVS/pharmacy has been incredibly innovative in their approach to the online photo market,” said Kyle Hall, Chief Executive Officer of PNI Digital Media. “The ability to work with them has been a very rewarding experience for the whole PNI team and we are pleased to have the opportunity to continue the relationship for this extended period.”

About PNI Digital Media – PNI Digital Media operates the PNI Digital Media Platform, which provides transaction processing and order routing services for major retailers. The PNI Digital Media Platform connects consumer-ordered digital content, whether from online, in-store kiosks, desktop software or mobile phones, with retailers that have on-demand manufacturing capabilities for the production of personalized products such as photos, photo books, photo calendars, business cards and stationery. PNI Digital Media successfully generates millions of transactions each year for retailers and their thousands of locations worldwide.

The statements that are not historical facts contained in this release are forward-looking statements that involve risks and uncertainties. PNI Digital Media’s actual results could differ materially from those expressed or implied by such forward-looking statements. Factors that could cause or contribute to such differences include, but are not limited to, changes in technology, employee retention, inability to deliver on contracts, failure of customers to continue marketing the online solution, competition, general economic conditions, foreign exchange and other risks detailed in the Company’s annual report and other filings. Additional information related to the Company can be found on SEDAR at www.sedar.com and on the SEC’S website at www.sec.gov/edgar.shtml . The information contained herein is subject to change without notice. PNI Digital Media shall not be liable for technical or editorial errors or omissions contained herein.

The TSX Venture Exchange has neither approved nor disapproved the information contained in this release. PNI Digital Media relies upon litigation protection for “forward-looking” statements.

Neither TSX Venture Exchange nor its Regulation Services Provider (as that term is defined in the policies of the TSX Venture Exchange) accepts responsibility for the adequacy or accuracy of this release.

People’s Pharmacy: the benefits and risks of vitamin D

Q: I get a health newsletter from a respected medical center. I noticed in the last issue that vitamin D could raise the risk of heart attack and stroke by up to 20 percent. Any comments?

A: Several research reports have created considerable confusion. A year ago, researchers reported that people taking calcium supplements were 30 percent more likely to have a heart attack than those getting placebos (BMJ online, July 29, 2010). Although this finding came from a meta-analysis of 11 studies involving more than 12,000 people, many health professionals were skeptical and objected that vitamin D intake was not part of the analysis.

This year, a new study in BMJ (online, April 19, 2011) confirmed the original finding with a twist. Even women taking vitamin D with their calcium had a higher risk (20 percent) of heart attack or stroke compared with placebo. We suspect that this is what your newsletter was reporting.

More recent research shows that vitamin D alone appears to protect men from heart attacks and strokes (American Journal of Clinical Nutrition online, June 8, 2011).

Excess calcium may be the culprit, while vitamin D may be neutral or protective for the heart.

Q: I am a 66-year-old retired physician who has taken simvastatin for the past two years. During this time, I noted a gradual decline in my erectile function.

My physician did not believe that simvastatin was the cause. After reading in The People’s Pharmacy and elsewhere of a possible connection, I took myself off the drug.

Within three weeks, I had complete resolution of my problem. In addition, I have far fewer episodes of heartburn and musculoskeletal pain. In the gym, my strength and endurance have improved dramatically.

A: There is surprisingly little research on this topic. Although the official prescribing information for simvastatin (Zocor) mentions erectile dysfunction, many physicians have not heard about this link.

A study from France suggested that statins may cause or worsen erectile dysfunction (Drug Safety, July 2009). Italian researchers have reported that statins may reduce testosterone levels (Journal of Sexual Medicine, April 2010). This might explain your experience.

Q: You might wish to tell readers to beware taking both Plavix and Nexium. After installing a stent near my heart, my doctor said no changes were needed in my list of medications, even though I would be mixing Nexium with Plavix for the next year.

I checked this advice on our computer and saw another specialist. He immediately stopped the Nexium and changed my GERD medication to pantoprazole.

A: There is uncertainty about the interaction between acid-suppressing drugs like esomeprazole (Nexium) and the anti-clotting drug clopidogrel (Plavix) that you need to keep your stent open. Some studies suggest the acid-suppressor will interfere with the effectiveness of Plavix or even aspirin. Pantoprazole (Protonix) appears to be the best choice if a GERD (gastroesophageal reflux disease) medicine is needed (Thrombosis and Haemostasis, June 2011).

Canada Pharmacy Online Suggests Less Sugar Intake to Avoid Health Concerns

Sugar is the common additive in food, but Canada Pharmacy Online suggests that people should avoid high levels of sugar in their daily diet, as it can trigger weight gain, is capable of accelerating growth of cancer cells, and is directly related to accelerating the process of aging.

One of the cheapest ingredients in food, sugar adds flavor and is often use to replace spices from the food. Along with salt and water, it can be added to desserts, sweets, candies, pastries, cakes, and many other sweetened products freely available in the market.

Sugar has traditionally been used to make cookies and cakes at home. It is usually used to supplement regular food in small quantity. However, marketing and commercialism has allowed manufacturers to brand certain products containing high amounts of sugar to unsuspecting people. Large amounts of cakes and pastries are consumed leading to obesity based on easy lifestyle. Once obesity creeps in, regular exercise is reduced, and people find it difficult to expend higher energy levels induced through excess sugar intake.

The World Health Organization has already published a review establishing that populations of the world with high sugar intake faced a higher risk of getting chronic diseases. Problems related to dental caries and obesity were increasing on a regular basis. Researchers suggested that total dietary intake should not exceed 10% on a regular basis.

People often buy Cymbalta and other drugs from Canada Pharmacy Online to fight depression. However, high intake of sugar is responsible for depression as well as several other diseases such as hyperactivity, mood swings, panic attacks, hypoglycemia, chronic fatigue, high cholesterol, dental problems, obesity, and mineral deficiencies. If neglected, chronic diseases such as diabetes, cancer, and heart disease could strike.

Keeping the right balance in blood sugar levels is vital for maintaining proper health and stamina. Excess sugar is the number one reason why people experience fatigue. Often, refined carbohydrates lead to high sugar levels which can be equally damaging. Soft drinks can contain eight to nine teaspoons of sugar. More importantly, these aerated drinks often contain high salt content which makes people thirstier after consuming the drink.

A safe way to go about avoiding high sugar intake is to begin with avoiding caffeine, alcohol, and do away with bad habits like smoking. Fried and fatty foods, fast foods, candies, and other food material that contains high quantity of sugar must be avoided. Sugar by itself will not indicate symptoms directly, but once obesity and other chronic ailments set in, people will have low resistance levels that will force them to resort to different prescription drugs in order to live a full and active life.

Canada Pharmacy Online suggests that people adopt exercise therapy for cleaning up the lymph and blood supply system. Good circulation helps in strengthening the immune system, builds up endurance power, and rejuvenates tissues of the body. Regular sugar intake may not be damaging, but a busy lifestyle makes it difficult to compensate for several conditions associated with obesity and anxiety, both at the workplace and at home. By reducing sugar intake, people are giving themselves a better chance to fight off chronic illnesses.

A 3-point plan to battle prescription drug abuse

Chuck Schumer has proposed a three-pronged attack on the rising abuse of prescription drugs: doctor training, law enforcement and information exchange.

“I remember back in the ’80s and ’90s when crack began to rear its head and we didn’t do enough about it early, and it became an epidemic and our society paid a price for it,” said Schumer, D-N.Y. “The worry is that it could happen again.”

Schumer, who discussed his plan on Monday at Marra’s Pharmacy in Cohoes, has proposed legislation that would:

Require medical professionals to receive training for prescribing addictive painkillers. Doctors would learn guidelines for safe pain management and early warning signs of addiction.

Increase prison sentences for those who rob pharmacies or commit other crimes related to prescription drugs. The penalty for prescription drug crimes would double from 10 years to 20 years in prison.

Make $25 million available for states to create or upgrade prescription drug monitoring systems, and explore creating a federal system in which information could be shared across state lines.

Schumer also has called on credit card companies to deny transactions that involve illegal online pharmacies — much like credit card companies have done with organizations involved in child pornography and online gambling.

“This is the fastest-growing drug problem in the country,” he said.

The legislation, the Prescription Drug Abuse Prevention and Treatment Act of 2011, attempts to improve state systems for tracking prescriptions and identifying drug-seeking patients who visit numerous doctors and attempt to get multiple prescriptions. The initiative meshes with a bill recently proposed by state Attorney General Eric Schneiderman that would improve the state’s monitoring system. Schneiderman wants to make the state system “real time” and require doctors and pharmacists to check the database before writing or filling prescriptions for controlled substances.

The tougher prison penalties are aimed at organized crime rings that deal prescription drugs and would bring penalties in line with illegal activity involving cocaine, heroin and other illegal drugs.

“If you are drug runner and you are running crack or cocaine, or you are running Vicodin or OxyContin, you should get similar penalties,” Schumer said.

CVS Pharmacy Technician Caught Forging Prescriptions, Dealing Drugs

Her day job was working at a pharmacy, but police say a 26-year-old Bloomington woman’s moonlighting gig as an online drug dealer is what got her into trouble.

Police say Jenna Erickson was surrounded by drugs while working at the CVS Pharmacy counter, and probably would have been caught sooner if she had been stealing outright — but investigators said she figured out a way to go almost completely undetected by bringing her work home with her.

“This person would find a patient date in computers at CVS, steal that patient data — along with the doctor’s name — and take that name home and create her own prescriptions at home,” said Sgt. Matthew St. George, of the Minneapolis Police Department’s Financial Crimes Unit.

St. George, the only cop in Minnesota who deals with prescription drug fraud full time, said investigators found evidence on Erickson’s computer that she had fabricated more than a dozen prescriptions for Oxycodone, a powerful, potentially addictive, and much-sought opiate painkiller.

Detectives accused Erickson of selling prescriptions to others she’d met on the internet in exchange for cash or drugs to feed her own habit.

Erickson worked as a floating pharmacy technician, stationed at the CVS in Minneapolis at Franklin and Nicollet as well as at another CVS location in Eden Prairie. In that role, she assisted the pharmacist — but there is no licensing requirement in Minnesota and very few state regulations for technicians other than they must be certified.

On Wednesday, CVS apologized to its customers, saying in a statement:

“As soon as we learned of Ms. Erickson’s alleged theft of confidential patient information, her employment was terminated.”

CVS also said no social security numbers, credit card numbers or bank information was exposed or lost.

Among teenagers, only marijuana is more commonly abused than prescription drugs, which are now the leading cause of fatal overdoses. Now, it seems the new drug dealer isn’t the one hanging out on a street corner. In some cases, she’s right behind the counter at your local pharmacy.

It is unknown whether Erickson underwent a background check to work at the pharmacy, and FOX 9 News did not find a criminal record under her name; however, police said she has been involved in a couple of theft cases.

Erickson has been charged with one count of felony identity theft and six counts felony of fifth-degree possession of a controlled substance. If convicted on all charges, she could face up to 50 years in prison.

Proposed Value-Based Pricing System Triggers Fear in British Pharmacy Industry

It seems that Britain’s health watchdog, National Institute for Health and Clinical Excellence (NICE) will retain its esteemed role of contributing to the state-run National Health Service (NHS).

In such an attempt, NICE’s Chief Executive claimed that NICE might play a key role in a value-based pricing system for new medicines due to take effect from 2014. Though the details of the project are yet to be finalized, the manufacturers are expected to get largely benefitted from the new scheme for developing new medicines.

For the last 12 year, the NICE has been examining the pharmacy industry for the benefit of Britain’s state health system.

NICE boss Andrew Dillon, on Thursday, claimed, “The government wants a system that is as predictable as possible … so that it will be very easy for companies to work out whether or not the NHS is likely to find their price acceptable”. It’s being claimed that no hassle will exist in case the drug falls below the threshold price, though a temporary halt can be predicted in case the price moves beyond the permissible limit.

Contrary to the popular belief that Britain is the most industry-friendly location, the new scheme, based on value-based pricing, has raised concerns in the pharmaceutical industry.

Canada Pharmacy Online Suggests Less Sugar Intake to Avoid Health Concerns

Sugar is the common additive in food, but Canada Pharmacy Online suggests that people should avoid high levels of sugar in their daily diet, as it can trigger weight gain, is capable of accelerating growth of cancer cells, and is directly related to accelerating the process of aging.

One of the cheapest ingredients in food, sugar adds flavor and is often use to replace spices from the food. Along with salt and water, it can be added to desserts, sweets, candies, pastries, cakes, and many other sweetened products freely available in the market.

Sugar has traditionally been used to make cookies and cakes at home. It is usually used to supplement regular food in small quantity. However, marketing and commercialism has allowed manufacturers to brand certain products containing high amounts of sugar to unsuspecting people. Large amounts of cakes and pastries are consumed leading to obesity based on easy lifestyle. Once obesity creeps in, regular exercise is reduced, and people find it difficult to expend higher energy levels induced through excess sugar intake.

The World Health Organization has already published a review establishing that populations of the world with high sugar intake faced a higher risk of getting chronic diseases. Problems related to dental caries and obesity were increasing on a regular basis. Researchers suggested that total dietary intake should not exceed 10% on a regular basis.

People often buy Cymbalta and other drugs from Canada Pharmacy Online to fight depression. However, high intake of sugar is responsible for depression as well as several other diseases such as hyperactivity, mood swings, panic attacks, hypoglycemia, chronic fatigue, high cholesterol, dental problems, obesity, and mineral deficiencies. If neglected, chronic diseases such as diabetes, cancer, and heart disease could strike.

Keeping the right balance in blood sugar levels is vital for maintaining proper health and stamina. Excess sugar is the number one reason why people experience fatigue. Often, refined carbohydrates lead to high sugar levels which can be equally damaging. Soft drinks can contain eight to nine teaspoons of sugar. More importantly, these aerated drinks often contain high salt content which makes people thirstier after consuming the drink.

A safe way to go about avoiding high sugar intake is to begin with avoiding caffeine, alcohol, and do away with bad habits like smoking. Fried and fatty foods, fast foods, candies, and other food material that contains high quantity of sugar must be avoided. Sugar by itself will not indicate symptoms directly, but once obesity and other chronic ailments set in, people will have low resistance levels that will force them to resort to different prescription drugs in order to live a full and active life.

Canada Pharmacy Online suggests that people adopt exercise therapy for cleaning up the lymph and blood supply system. Good circulation helps in strengthening the immune system, builds up endurance power, and rejuvenates tissues of the body. Regular sugar intake may not be damaging, but a busy lifestyle makes it difficult to compensate for several conditions associated with obesity and anxiety, both at the workplace and at home. By reducing sugar intake, people are giving themselves a better chance to fight off chronic illnesses.

Innovative program establishes pharmacist as health coach, partner

Pope illustrated one of its benefits by describing a patient case he recently managed, in which the patient was prescribed metformin. Checking into the online account through which Pope helps her work toward her individual health goals, the patient repeatedly stated that she had not taken her medication properly, so Pope called her to find out what was going on.

She complained of a terrible stomach ache but didn’t want to tell her doctor or Pope that she just couldn’t take the medication. Pope explained that a side effect of the medication was gastrointestinal upset; the good news was that studies showed it appeared to decrease after 2 weeks of treatment. The patient agreed to continue to take the medication for the next 3 weeks; after that, Pope said, if her stomach distress continued, he would help her speak with her physician. Her stomach pains went away and the patient continued her prescription successfully.

“She would not have taken that medicine if she had not checked in with her pharmacist; so that’s the key,” Pope said.

The HealthyHeart.com program that Pope describes is designed to empower pharmacists as health coaches who will help patients at risk for heart disease set and reach health goals, including diet, exercise, and medication adherence, and to improve overall health outcomes.

The new program, which was recently featured on the U.S. Government’s AHRQ.gov site as an innovation in healthcare, provides pharmacists the tools and support they need to attract patients who need to lower blood pressure, cholesterol, or weight for an overall healthier lifestyle that ultimately reduces their chances of cardiovascular events.

“As pharmacists, we do disease-state management really well; we know that whenever pharmacists get involved, outcomes improve,” Pope said. “At the same time, we know that the secondary windfall benefit of attracting that chronic care patient to the store means a great deal to the pharmacy, because, for instance, a diabetic patient is going to spend between $6,000 and $12,000 a year. The top 1% spends $28,000.”

Program cornerstones

The program, which was designed through collaboration with pharmacists and feedback provided by physicians and patients, uses the power of the pharmacist to support the physician by providing education, accountability, and encouragement to patients at risk for chronic illness.

The program consists of an initial in-person consultation between the pharmacist and the patient to discuss health-related goals; weekly e-mail check-ins, through which the pharmacist can keep track of the patient’s progress toward goals and offer additional support or guidance; and a monthly group class in which the pharmacist meets with all the members of the program to answer questions and to offer educational presentations on general wellness topics. The Healthy Heart Club team supplies the scripted presentations, and a user-friendly website provides easy-to-understand information on healthy eating and exercise, as well as a variety of tools for both the patient and pharmacist to track progress and to keep the patient’s physician updated.

The time commitment is essentially 1 hour per month for the educational classes and an additional 15-30 minutes a week, during which the pharmacist checks on patients through his or her HealthHeartClub.com account, which Pope says can be integrated into the morning routine. “I check mine while I’m checking in my morning order,” he said.

Pharmacist support

Support for pharmacists is provided by business coaches who explain how to use the tools and how to set up a profile and account within the system; there are also blogs about new ideas or new services in the pipeline, Pope said. Additional support and marketing services are available through the company’s Market Pharm service. And Cardinal Health, which has developed a Specialized Care Center program around the Healthy Heart Club platform, is offering a 9-hour continuing education course on cardiovascular risk reduction at the upcoming Retail Business Conference in Las Vegas.

Most pharmacists charge patients a minimal fee of $15-$20 per month. According to Pope, they have found that patients are more than willing to pay, even in the type of population served by as his pharmacy, which includes many Medicare/Medicaid patients. The company is currently holding discussions with insurance companies and pharmacy benefit managers who are interested in the program.

The company is currently in the middle of a year-long pilot study in collaboration with Cardinal Health, monitoring return on investment and medication adherence, among other things. The company also has just finished designing a study with University of South Carolina that will look more closely at patient outcomes and overall healthcare costs. Pope said the initiative is actively seeking funding; he expects the study to begin within the year.

According to Pope, pharmacists are stepping outside their comfort zones a little, but the effort is paying off in big ways. The demand is out there and the response has been overwhelming, he said.

Drug shortages forcing late treatments in Ore.

Tom Childers drove up the hill to Oregon Health & Science University one morning last January for his monthly chemotherapy — only to be told to come back tomorrow. The drug his life depended on was in short supply.

His doctor, Michael Mauro, assured Childers the clinic was doing all it could to get more leukemia medicine. “I accepted that at face value,” recalls Childers, 67.

Mauro, however, was frustrated that a lifesaving treatment relied on a drug shipment for which there was no guarantee. “If we didn’t get the drug for this gentleman — as days passed, or maybe if it went longer than that, if weeks passed — he would relapse,” says Mauro. “What are we, a Third World country?”

Childers, from Dufur, stayed at a friend’s house in Portland that night. He returned to the clinic in the morning only to be told more supplies had not arrived. He returned home. After a week of worry for his family, Childers received a call to return for his medicine. In April, after three more chemotherapy sessions, his leukemia was declared in remission.

While things worked out for Childers, the incident jolted Mauro.

He hadn’t realized the extent to which OHSU pharmacists wrestled with shortages. The last-minute decision to delay treatment for Childers and several other relatively healthy patients reflects a national problem.

The number of individual drugs in short supply nationwide has climbed from 70 in 2006 to a record 211 last year — and more than 150 already this year.

Shortages are hitting every aspect of health care in rural and urban areas alike. As a result, patients are getting late treatments, substitute medications or decreased drug doses for illnesses in which survival rests on getting the best medicine available.

“It was pretty bad to have to look someone in the eye and say, ‘Look, we can’t treat you right now,'<” Mauro says. “In the United States in 2011, that seemed like a pretty ridiculous thing.”

The problem boils down to profits, quality, and supply and demand.

Supplies of Childers’ drug dwindled when several manufacturers shut down production of cytarabine — a popular chemotherapy drug that is irreplaceable in fighting certain types of leukemia — due to quality problems or a shortage of raw materials.

Overall, about half of pharmaceutical shortages stem from quality problems, according to the nonprofit Institute for Safe Medication Practices. Other shortages concern production issues, such as when companies consolidate and close factories.

Many common generic medications also can be hard to find. When drug patents expire, it opens the door to other manufacturers but lower profits.

That’s why supplies of generic leucovorin, a B vitamin proven to make cancer treatments more successful, have been short since late 2008. A patented, more expensive version remains plentiful. Many observers say shortages are exacerbated by hoarding and speculation by third parties who purchase large quantities of drugs and sell them at a premium like scalpers outside a concert.

“In the industry, we call them the pirates,” says Mike Brownlee, OHSU pharmacy director.

Cancer doctors like Gerald Segal have become vocal critics. Segal, who works at Northwest Cancer Specialists in Northeast Portland, has had to tell patients that because of shortages, they’re receiving reduced doses of leucovorin that may not be as effective.

“I never in my life thought something like this would happen in the United States,” he says.

Perhaps most disturbing to him is that even though the medical establishment has sounded alarms, no one sees a way out.

“The shortages are growing worse at such an exponential rate,” says Erin Fox of the University of Utah’s Drug Information Service. She works with the American Society of Health System Pharmacists to document shortages. “I feel that we’re at a tipping point of a health care crisis.”

Besides shortages of key cancer drugs, sedatives crucial to emergency rooms and intravenous nutrients have been crimped. So have certain antibiotics, ADHD drugs and even drugs to put inmates to death.

In the United States, no deaths have been directly attributed to lack of medicine. However, surveys of pharmacists and other health care professionals attribute hundreds of near misses and treatment errors to drug shortages, and that’s probably underestimated, according to the ISMP.

Two bills in Congress would require manufacturers to give more notice of impending shortages so health care providers and the government can adjust. When the Food and Drug Administration learns of the shortages in advance, it often is able to boost foreign imports, according to FDA spokeswoman Tamara Ward.

However, the bills’ fates are unclear, and even some senators with a strong reputation in health care, such as Oregon Sen. Ron Wyden, are not signing on. Wyden “has questions as to whether or not the legislation as introduced gets at the root problem of why there are shortages to begin with,” says his spokesman, Tom Caiazza.

With no solutions on the horizon, doctors and pharmacists are adjusting.

OHSU’s Mauro pushed for a cancer-drug shortage committee to improve shortage response times.

“Usually, it’s a mad scramble,” says Majid Tanas, an OHSU pharmacy manager. He says the committee evaluates each patient to determine minimum drug dose or a possible substitution.

“It’s day-to-day micromanaging of a precious stock to make sure our patients are well taken care of,” he says.

OHSU drug buyers use social media to soak up the latest scuttlebutt, and the pharmacy has a “clean room” where a remote-controlled robot divides large vials of drugs when smaller doses are unavailable.

Like most of the health care community, OHSU frowns on hoarding scarce drugs. But pharmacists there are considering increasing reserves of certain medications.

Most doctors and hospitals try not to buy from third-party suppliers because the drugs’ origin and quality are unknown. But, in some cases, shortages can mean choosing between denying necessary treatment or buying drugs of unknown quality.

“You don’t know where the product is coming from,” said Kathy Stoner, pharmacy director of Legacy Health Systems. In an email, she added, “We have, very rarely, used them when in dire need.”

Other times, providers make difficult choices on rationing, as with the long-running leucovorin shortage.

Dr. Samuel Taylor, an oncologist with Celilo Cancer Center in The Dalles, says his group has rationed leucovorin. Colon cancer patients considered curable receive full doses. Patients considered terminal, but who could have years to live with full treatment, instead receive a partial dose, he says.

“I’m not sure that there would be a measurable detriment to patients with that, but it is a modification that is not recommended,”

Taylor says. “These are issues that at least do compromise our standard of treatment.”

Segal, the Portland oncologist, says the free market is no longer taking care of patients’ needs. He thinks the country may need a drug czar to ensure supplies.

“Somebody’s got to grab this situation,” he says, “and do something about it.”