Martin Sipkoff

Retail pharmacy managers are discovering that many third-party administrators do not agree that their inventory information approval systems meet compliance requirements set by the Internal Revenue Service for customers' use of flexible spending accounts.

When manufacture of biogenerics is a legal reality, brand manufacturers will still retain a strong market share for several years.

When is $4 not $4? Apparently when it's the cost of a Wal-Mart generic in a state where the retail giant and its competitors may be violating predatory-pricing laws. Those laws ban selling products below cost in order to kill off competitors and may apply to prescription drug sales in 21 states, according to the National Conference of State Legislatures (NCSL) and the National Community Pharmacists Association.

Sometimes in medication safety the simplest solution is the best.

As propofol utilization increases, so do the safety risks of fast-acting anesthesia. Readily adaptable oversight procedures for propofol management by clinical pharmacists have led to the awarding of medication safety awards to two hospitals by the Delaware Valley Healthcare Council in Philadelphia (DVHC).

Recognizing that health systems are failing to success-fully manage inpatient diabetes, the Joint Commission on Accreditation of Healthcare Organizations and the American Diabetes Association (ADA) joined forces recently to implement the inpatient diabetes certification of distinction program.

NeoFax recently released an updated version of software for the preparation of total parenteral nutrition solutions for neonatal infants. Named WebApp, the software's data are based on what company officials say is the most widely used neonatal drug manual in the world- NeoFax: A Manual of Drugs Used in Neonatal Care-first published nearly 20 years ago.

A new software version for managing orders and calculations for total parenteral nutrition (TPN) compounding was released by Baxa Corp. in August. The company supplies about 70% of the nation's hospitals with automated TPN compounding products.

New legislation in California takes hospital reporting of serious medication errors to a new and very public level. Signed by the governor in late September, the law requires all hospital medical errors posing serious harm, including medication errors, to be posted on the state Department of Health Services' Web site. The Web site must include a description of the error, any corrective steps taken by the hospital or the state, and the name of the facility.

Diabetes is undertreated among inpatients, especially acute care patients, sometimes with devastating results. "Blood glucose levels are too often not treated as intensively as other medical conditions among floor patients," said Almut G. Winterstein, Ph.D., assistant professor of pharmacy health care administration at the University of Florida College of Pharmacy. "If hospitals made a more aggressive effort, it could save quite a significant number of lives."

At 5:00 a.m. one April morning last year, agents of the Drug Enforcement Administration and some sheriff's deputies burst into Scherer's Medical Clinic, a pain management center in Slidell, La., near New Orleans. Additional raids that day at area clinics and pharmacies led to the arrest of Scherer's owner, a nurse named Cookie Armstrong, and three staff doctors. All were charged with running narcotic pill mills. Twenty-three patients were also arrested over the next few days.

A pharmacy technician from Seattle has created a disposable, single-use tray and spatula to eliminate the risk of cross-contamination during pill counting in pharmacies.

Debris, powder, loose pills, and broken capsules. The very real possibility of medication cross-contamination during automated pill counting is becoming an increasing safety concern. Manufacturers of the semi-automated and fully automated, or robotic, counting technology used in many retail and most hospital pharmacies say they consider cross-contamination a major issue. It's so important, in fact, that system design is used as a marketing tool in a highly competitive field.

Nothing is as powerful as an idea whose time has come, said Victor Hugo. He was talking about a revolution, and that is what the Diabetes Ten-City Challenge represents. It is a significant and potentially powerful transformation in the delivery of pharmacist care to employees with diabetes.

After 11 years in business on Main Street in Aspen, Colo., Rodney Diffendaffer, R.Ph., knows too well that the struggle between community pharmacists and the mail-order industry is heating up, with generics fueling the fire. "They get to sell three months of drugs at what comes close to my one-month price," he said. "I'm not allowed to sell a three-month supply. It's not a level playing field. Never has been."

Drug restocking is the resale of previously sold medication that has been returned to a pharmacy or mail-order company unopened. The returns to pharmacies are by a long-term care or assisted living facility after a patient has died or had a prescription that has been discontinued.

Reducing the interim between the final entry on a medication administration record and printing out the MAR can result in a significant improvement in patient safety. That's what a small rural hospital in Pennsylvania discovered using a software application that created virtually up-to-the-minute daily MAR printouts. By decreasing lag time from more than two hours to less than 15 minutes, the hospital pharmacy reduced medication errors by 40%.