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If you want to understand the immediate impact of Wal-Mart's recent announcement that it will charge only $4 per prescription for nearly 300 generic drugs, just ask Nick Patel, R.Ph. Patel's West Coast Pharmacy, Tampa, Fla., is located one block from a Wal-Mart location and suddenly finds itself at the epicenter of a new healthcare debate. "I've had people come in with the list," Patel reported to Drug Topics. "But so far, I haven't lost any customers." Like many in the industry-especially those in the Tampa area-Patel is watching closely to see what happens next.

Specialized Pharmacy Services and its parent corporation, Omnicare Inc., have agreed to pay $52.5 million to settle one of the largest Medicaid fraud cases in Michigan. The company was charged with billing Medicaid for medication dispensed to beneficiaries who were deceased and failing to credit Medicaid for drugs that were not consumed, among other charges. As a result of the settlement, a Corporate Integrity Agreement will be in place for two years; it is designed to improve the company's Medicaid billing practices and to demonstrate the company's commitment to comply with Medicaid pharmacy policy and procedure.

A new era is coming for the Medicaid program-one that will spare the state and federal governments from overpaying for drugs and provide more pricing transparency to all parties involved.

Hoping to stem a new season of confusion over Medicare's Part D prescription drug benefit, the Centers for Medicare & Medicaid Services is asking pharmacists to prepare patients for the upcoming enrollment period.

The Medicare Modernization Act (MMA) set minimum federal standards for prescription drug coverage. Plans wanting to participate in the program could offer the standard benefit or a variation that was approved as actuarially equivalent by CMS. Most plans elected to modify the standard design with their own formularies and combination of enhanced benefits. Each plan sought the right combination of premium level, benefit package, formulary structure, and tiered co-pays that they believed would attract and keep an acceptable share of the market while generating a profit to the plan.

On behalf of the Senior Outpatient Medication Safety (SOS Rx) Coalition, the National Consumers League (NCL) recently commissioned Harris Interactive to conduct three surveys, one each of patients taking oral anticoagulants, their caregivers, and physicians who frequently prescribe these medications. The survey was made possible by an unrestricted educational grant from AstraZeneca.

Picture this: A patient who is taking the blood-thinning medication Coumadin (warfarin sodium, Bristol-Myers Squibb) visits his community pharmacy to have his blood checked. The pharmacist makes sure his dosage is correct and that his blood isn't getting too thin or too thick.

For the fifth consecutive year, consumer satisfaction with pharmacies has risen, according to the 2006 Pharmacy Satisfaction Digest. Ninety-eight percent of respondents reported that they were either highly satisfied or satisfied with their pharmacy, up from 95% in 2002. Moreover, the number of respondents indicating that they were highly satisfied rose to 58%, a gain of 5% over the 2005 results and 13% higher than the 2002 results.

When Gov. Jon Corzine recently signed the New Jersey Prescription Drug Retail Price Registry bill into law, he hailed it as a "significant step toward making health care more affordable." The law creates a database of prices for the 150 most common prescription drugs. Consumers will be able to access the database via a toll-free telephone number or search it on-line. Despite the Governor's optimism, however, many pharmacists doubt the law will have much impact on either pharmacists or consumers.

With conflicting statements from the Food & Drug Administration, Centers for Medicare & Medicaid Services, and a Federal District Court judge, the definition and legality of pharmacy compounding once again seems headed to the Supreme Court or Congress for sorting out.

Like it or not, accreditation is expanding from acute care to other healthcare settings, so get ready for it.

A public interest law firm has sued the government over the restrictions placed on pharmacists and other healthcare providers in helping Medicare beneficiaries choose a Part D plan. The suit claims that the rules in the marketing guidelines are a violation of free speech.

With dramatic demographic shifts under way in this country, pharmacies should tailor their marketing to multiethnic groups.

We know that about 400,000 people in the United States currently suffer from multiple sclerosis (MS), and it's more common in women and Caucasians. We also know that early treatment of the condition makes a difference. Recently, we've read that Biogen Idec and Elan Corp. were given the go-ahead to reintroduce natalizu-mab (Tysabri) for the treatment of relapsing forms of MS. But beyond that, we haven't heard too much lately regarding the treatment of this devastating disease. What, if anything, coming down the pipeline looks promising? Here are a few of the possibilities.

All symptomatic patients with HIV disease should begin antiretroviral therapy right away, according to new guidelines published by the International AIDS Society-USA and presented at the International AIDS Conference held in August in Toronto. Based on several new developments, the revision marks the seventh time since 1996 that the organization has updated its recommendations for HIV treatment.

DEA recently proposed a rule change that would allow doctors to prescribe up to a 90-day supply of Schedule II controlled substances. The rule must go through a two-month comment period, which ends on Nov. 6, before it can take effect. Schedule II drugs include a wide range of medications such as codeine and OxyContin (oxycodone, Purdue Pharma). The Controlled Substances Act does not allow refills for Schedule II drugs, forcing many doctors to give multiple prescriptions or to have patients with chronic conditions return regularly. "We believe that the statement and proposed rule will help the medical professional ensure that only patients who need medication for pain relief get it," explained DEA administrator Karen Tandy in a written statement.

The Cosmetic, Toiletry, & Fragrance Association (CTFA) has filed comprehensive comments with the FDA on the science and regulation of nanoparticles in personal care products.

Touro College is moving forward with plans to open a new pharmacy school campus in Manhattan for the 2008 school year.

The Office of Inspector General (OIG) has issued a final report on the "Review of Durable Medical Equipment Providers? Medicaid Claims for N.Y. Residents of Assisted Living Programs."

The Duke Clinical Research Institute in conjunction with the FDA will create a virtual electronic database of more than 200,000 electrocardiograms (ECGs) in order to identify as early as possible the potential effects that drugs and devices may have on the heart.

Anti-TNF therapy infliximab (Remicade, Centocor) is now approved for the treatment of adult patients with chronic severe plaque psoriasis who are candidates for systemic therapy.

Lamotrigine (Lamictal) has been approved for its fifth indication as an antiepileptic—this time as an add-on therapy to treat primary generalized tonic-clonic seizures in children two years of age and older and adults.

Rare cases of a brain-capillary leak syndrome called reversible posterior leukoencephalopathy syndrome have led to a revision in the Warnings and Adverse Reactions sections of the prescribing information for bevacizumab (Avastin, Genentech).

The first buccal tablet form of fentanyl was recently given the green light by the FDA, according to manufacturer Cephalon Inc.

Tibotec Pharmaceuticals has announced the opening of an expanded-access program for TMC125, an investigational non-nucleoside reverse transcriptase inhibitor (NNRTI) for the treatment of HIV-1.

President Bush has named Leslie Norwalk acting administrator of CMS, according to a report from the Associated Press.