Valerie DeBenedette is managing editor of Drug Topics.

Valerie DeBenedette

Altaire Pharmaceuticals, Inc., is voluntarily recalling multiple OTC ophthalmic drug products and lots, within expiry, sold at Walgreens and CVS stores as well as the company's own label, Natural Ophthalmics and TRP Company, Inc. The company initiated the recall of specific lots over concerns regarding the sufficiency of quality assurance control in its manufacturing facility. 

The recall is being carried out at the retail level and is only for specific lots of products, which include lubricant eye drops and ointments. The Walgreens products were manufactured and labeled exclusively for and shipped only to Walgreens. The CVS products were manufactured and labeled exclusively for and distributed by CVS. 

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Altaire noted in its statement that it had not received any reports of adverse events due to use of the products.  

For more information on the recall of products Altaire manufactured for Walgreens, click 

For more information on the recall of products Altaire manufactured for CVS, click 

Customers with questions regarding this recall can contact Altaire Pharmaceuticals Inc., by calling 1-800-258-2471, or e-mailing 

 Monday through Friday from 8:30 a.m. to 5:00 p.m. ET. Customers should contact their physician or healthcare provider if they have experienced any problems that may be related to taking or using this drug product.

Articles

Update: Recall expanded to Natural Ophthalmics and TRP Company, Inc. 

Altaire Recalls Ophthalmic Products

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Mount Carmel West Hospital in Columbus, OH, has fired 23 employees in the aftermath of murder charges against one of its acute care physicians. Pharmacists are among those affected, according to the 

William Husel, DO, is charged with 25 counts of murder due to overdoses of fentanyl. The deaths took place over the course of four years and affected critical care patients at the hospital. Husel is pleading not guilty and was fired from the hospital in December.

A pharmacist was the person who alerted hospital authorities to the high doses of fentanyl being prescribed by Husel, according to 

. Mount Carmel West began an internal inquiry and found 35 cases handled by Husel that it deemed suspicious. 

According to the Columbus Dispatch, 48 pharmacists and nurses were reported to state licensing boards, including 30 who are still with the health system. The Ohio Board of Nursing has issued notices to 25 nurses saying that they could lose their licenses for their roles in the Husel case. The Ohio Board of Pharmacy has taken no public action. 

Ron O’Brien, the Franklin County prosecutor, focused on cases where doses of 500 to 2,000 micrograms of fentanyl were administered, amounts could have caused or hastened patient deaths and which are larger than doses typically used for post-surgical patients. Dozens of nurses, pharmacists and managers were put on administrative leave and either left their jobs or were in this firing. 

In addition to the 23 people fired from Mount Carmel West, which is part of the Michigan-based Trinity Health, one remains on administrative leave, and 11 others will be given a change to return to work after completing further training and education. 

Husel has a previous history of criminal behavior. In 1996, he pleaded guilty to improperly storing a destructive device or pipe bomb at a college in West Virginia, and he attempted to incriminate someone else for the crime. He was sentenced to six months in jail and one year of supervised release. Despite this, he was admitted to and graduated from Ohio University College of Osteopathic Medicine and did a residency and fellowship at the Cleveland Clinic Hospital. The Cleveland Clinic has conducted an audit of his time there, and says that is did not find conduct similar to what he is accused of doing at Mount Carmel West.

25 murder charges against one physician leads to multiple firings at Ohio hospital.

Pharmacists Among Those Fired in Hospital Fentanyl Deaths Case

CVS Health has announced that it will expand its HealthHUBs to 1,500 locations by the end of 2021. Fifty CVS locations in the Houston, Atlanta, Philadelphia/Southern New Jersey, and Tampa, FL, areas will be converted to offer expanded services. This is about 15% of the CVS Pharmacy locations in those markets.

 were opened in Houston earlier this year. The stores offer personalized pharmacy support programs and expanded MinuteClinic services, as well as one-on-one and group counseling on topics such as nutrition and weight loss. HealthHUBs will have a care concierge in each location, a person responsible for customer engagement, including educating customers about service offerings, helping them navigate in-store services and events, and connecting them to in-store healthcare providers. They will also have community spaces for group events such as health or yoga classes.

More floor space in each location will be devoted to the new services, while other offerings like greeting cards will get less space.

“HealthHUBs are a powerful example of how CVS Health can provide consumers with convenient, personalized and integrated access to local health care,” the company said in a 

. The statement outlined CVS Health’s strategies to accelerate growth.  "Our goal is to fundamentally transform the consumer health experience for the millions of Americans we interact with every day, while creating value for our patients, members, partners, and shareholders," says Larry J. Merlo, president and CEO, CVS Health. 

CVS will expand its health offerings, including nutrition and weight loss.

CVS Will Offer HealthHUBs at 1,500 Stores 

The National Community Pharmacists Association and the National Association of Chain Drug Stores issued a joint statement expressing their frustration at the release of HHS’s 

 for Medicare and Medicaid. The final version of the rule fails to reform pharmacy direct and indirect remuneration (DIR) fees.

“We are disappointed and frustrated that this final rule fails to finalize pharmacy DIR reform as proposed, to the detriment of seniors and community pharmacies,” the statement says. 

The statement notes that the fees are based on a regulatory loophole that health insurance plans have exploited to increase beneficiary drug costs. “These fees are being misused by payers to claw back reimbursement to pharmacies for the prescription drugs that they provide to Medicare beneficiaries. For example, payers impose penalties for pharmacies’ alleged failure to achieve certain benchmarks-many of which are vague, undefined, inconsistent, unachievable, or outside of the control of pharmacies.”

The two groups say that there are misinterpretations of some terms used in the Medicare program related to pharmacy reimbursement and drug pricing. This misinterpretation has led to “these claw-backs, and ultimately to higher out-of-pocket drug costs for patients and increased costs for the government,” according to the statement.

“Our organizations have been joined by many pharmacists, pharmacy stakeholder groups, patient advocacy organizations, patients, and members of Congress in advocating that all pharmacy price concessions be included at the point of sale-or eliminated altogether – to provide senior patients with lower costs and pharmacies with more certainty.”

The proposed rule noted the recent 45,000% increase in pharmacy price concessions, which NCPA and NACDS say is unsustainable. “Pharmacies are in a tenuous situation, and our organizations are exploring all options to accomplish desperately needed reforms to pharmacy DIR. It is necessary for community pharmacies and for the benefit of seniors that this reform take effect as soon as possible.”

Between them, NACDS and NCPA represent more than 62,000 pharmacies drug stores and supermarkets or mass merchants with pharmacies. 

Both pharmacy groups state that rule should have addressed DIR fees.

NACDS and NCPA Issue Joint Statement on Drug Pricing Rule 

State prosecutors from forty-four states have joined a lawsuit filed in Connecticut that claims several of the largest makers of generic drugs conspired to inflate or manipulate prices on more than 100 products. 

Puerto Rico is also a party to the lawsuit. 

“We have hard evidence that shows the generic drug industry perpetrated a multibillion-dollar fraud on the American people,” Connecticut Attorney General William Tong. The suit says that prices for generic drugs were inflated by more than 1,000% in some cases. 

The companies named in the suit include Teva, Pfizer, Novartis, and Mylan. In addition to the companies, the suit also names 15 company executives in sales and marketing departments and who were involved in pricing. 

The suit alleges that these generic drug makers had an agreement not to compete with each other and to avoid competition that would push drug prices down. Company executives were said to meet and conspire on drug prices at industry events, parties, and golf outings to reduce the amount of written communications.

The lawsuit was featured in a segment on CBS’s 

which said it might be “the biggest price-fixing scheme in U.S. history.” The Association for Accessible Medications (AAM), the trade group for generic drug makers, issued a statement in response: “We have established procedures and policies to help ensure compliance with the antitrust rules at our board meetings and all other AAM meetings. We will continue to assess our antitrust policies because we are committed to the idea that robust competition is the key to providing affordable and accessible medicines to patients while also constraining health care costs.” 

Teva denies the allegations. “Teva continues to review the issue internally and has not engaged in any conduct that would lead to civil or criminal liability,” the company says in a statement.

Connecticut has been investigating the prices of drugs for several years. This is the second lawsuit that the state has brought over drug prices; a similar suit was brought in 2016. “Between 2013 and 2014, a bottle of doxycycline shot up 8,281% from $20 to more than $1800. A bottle of asthma medication, albuterol sulfate, jumped more than 4000%, from $11 to $434. Pravastatin, a cholesterol drug, up more than 500%, from $27 a bottle to $196,” Tong told 

The drugs noted in the suit include lamivudine-zidovudine, budesonide, fenofibrate, amphetamine-dextroamphetamine, oral antibiotics, anticoagulants, oncology drugs, contraceptives. and antidepressants.

Suit filed in Connecticut alleges companies conspired to inflate prices on more than 100 generic drugs.