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The Centers for Medicare & Medicaid Services wants to change the way it pays for drugs administered by hospital outpatient services. Starting in 2006, CMS proposes to pay hospitals the average sales price (ASP) plus 8% under the Outpatient Prospective Payment System (OPPS).

Beta-blockers are the top choice for prevention of postoperative atrial fibrillation (AF) and control of ventricular rate, according to the first evidence-based clinical guidelines for the prevention and management of postoperative AF after cardiac surgery, published recently by the American College of Chest Physicians (ACCP).

Heart failure (HF) is a major health problem and a leading cause of hospitalizations among the elderly. Keeping pace with the new treatment approaches, the American College of Cardiology (ACC) and the American Heart Association (AHA) task force recently released updated Guidelines for the Diagnosis and the Management of Chronic Heart Failure in the Adult.

Several articles, published over the past several years, have demonstrated the benefit of clinical pharmacy rounding in intensive care units. Benefits documented include improved quality of care as well as cost savings to the institutions. Our health system recently added clinical pharmacists to patient rounding and found that it has improved our patients' outcomes.

Community pharmacists, beware. Congress is considering ways to reduce Medicaid spending. The goal is to save $10 billion over the next five years. Among the pharmacy product payment options Congress is evaluating are average selling price (ASP), average manufacturers' price (AMP), and wholesale acquisition cost (WAC) to replace average wholesale price (AWP), which many think has been responsible for Medicaid overpaying for Rx drugs.

The Centers for Medicare & Medicaid Services has published a proposed rule in the Aug. 15 Federal Register that would require long-term care (LTC) facilities to vaccinate all residents against influenza and pneumococcal disease as a condition of participation in Medicare and Medicaid.

Picture this scenario. A patient goes into a chain pharmacy, walks over to a kiosk, touches a bull's eye on a screen and is instantly connected with a pharmacy technician. They can see and hear each other, thanks to interactive video conferencing. The patient fills a new prescription, receives counseling from pharmacy staff, and orders OTC products. The order can be picked up at any of the chain's stores, or the items can be delivered free of charge.

CMS is pursuing changes in the durable medical equipment (DME) benefit under the Medicare Modernization Act (MMA) that will have a profound effect on the way beneficiaries receive services and the way pharmacies and other DME suppliers provide those services. Laurence Wilson, director of the Chronic Care Policy Group for CMS' Center for Medicare Management, delivered this message to attendees of the National Association of Chain Drugstores Pharmacy and Technology Conference held recently in San Diego.

Beginning Oct. 13, Medicare beneficiaries and pharmacists trying to help them can go to a Web site to compare the devilish details in the prescription drug plans that will be offered in their area.

I was questioned by a doctor when he prescribed Bextra (valdecoxib, Pfizer). It was just days after Vioxx (rofecoxib, Merck) had been withdrawn from the market. I told his patient that Bextra and Vioxx were members of the same family.

Pharmacists and potential plan sponsors finally got the ground rules from Uncle Sam on how they can market prescription drug plans (PDPs) to Medicare beneficiaries, who can begin enrolling in Part D on Nov. 15.

Advances in delivery systems for gonadotropins, and specifically the pen/cartridge delivery system for FSH (follicle-stimulating hormone), were the focus of "Managing Great Expectations," a recent program on infertility held in New York City. Sponsored by Organon USA, a division of Akzo Nobel, the event included presentations by Steven D. Spandorfer, M.D., a reproductive endocrinologist affiliated with Cornell University, and Judy Kuriansky, Ph.D., a clinical psychologist.

Last month, in an effort to make it easier for health professionals to identify and treat patients with heavy drinking and alcohol-use disorders, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) released Helping Patients Who Drink Too Much: A Clinician's Guide. One major difference in the 2005 guide, which replaces an earlier 2003 version, is the recommendation that medications be considered in addition to traditional therapies as part of the treatment process.

Surgeons perform an estimated three million cataract surgeries annually in this country. To help reduce inflammation following ophthalmic surgery, eye care professionals commonly prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.

Latebreakers

The indications for Novo Nordisk's NovoLog (insulin aspart [rDNA origin]) injection have been expanded to include the treatment of diabetes in children. NovoLog was found to be safe and effective in patients aged two to 18 years who have diabetes. The rapid-acting insulin analog was approved in 2000 for use in adults.

Pharmacy colleges nationwide offer hurricane aid Walgreens launches exclusive line for women of color California R.Ph.s design consumer Rx booklet Florida pharmacy firm offers MTM Spanish fact sheets to help seniors take meds safely Hutchinson appointed to AIHC post Florida county to use in-house R.Ph. Brooks Eckerd to provide in-store nurse practitioner Parents unaware of diarrhea guidelines for kids Nevada approves seven Canadian pharmacies MTM programs save $1 million Walgreens expands senior pharmacy services

Wal-Mart and SAM's CLUB to host free diabetes screenings USW, NPhA form Pharmacists Council HHS looking for volunteers who want to help hurricane victims ACAM defends use of FDA-approved therapy CMS offers document on Medicare Rx drug coverage Medicare Today partnership: Rx plans will benefit beneficiaries Ten Canadian pharmacies apply to Nevada Mail order use declined, survey finds FDA wants clarity on conditions for dual Rx-to-OTC drug status Analyst positive about 2006 market Medi-Span adds to Rx info CMS readies Medicare provider satisfaction survey Follistim AQ adds 900-IU formulation to product linebr> New Jersey toughens Rx drug trafficking law New Alphagan formulation gets FDA nod Pharmacist personnel firms merge Get your genetic tests at these pharmacies

Osteoporosis is a result of a disproportionate rate of bone resorption compared with bone formation, which disrupts the structural integrity of bone. The most common type of osteoporosis occurs in postmenopausal women.

A new type of pharmacy benefit manager has sprung up, preaching transparent pricing. The ideal is to disclose ingredient and dispensing costs, rebates, discounts, and all other financial details to plan sponsors. Rebates, discounts, and other payments flow through to the sponsor. Administrative fees are the PBM's only revenue source.

Reactions throughout the health-system pharmacy community have been overwhelmingly favorable regarding the new federal legislation that would protect medical error information from being used against healthcare practitioners who report adverse events and medication errors.

Undoubtedly the public will be hearing much more about Medicare Part D as prescription drug plans (PDPs) are selected and begin promoting their programs. At least one group of people with Medicare already received preliminary information in mailings from the Social Security Administration (SSA): those with low incomes who may qualify for extra help with their out-of-pocket costs associated with the Medicare plans.

Many Type 2 diabetes patients also have a type of dyslipidemia characterized by elevated triglycerides and reduced levels of HDL cholesterol, with total and LDL cholesterol levels normal or elevated. Dual alpha/gamma PPARs (peroxisome proliferator-activated receptors), or glitazars, not only activate PPAR-gamma (as the current glitazones do) but also target the PPAR-alpha to reduce triglyceride concentrations and enable HDL-C increases.

The first-ever guideline for the treatment of uncomplicated skin infections, produced in January of this year by a panel of six physicians with funding by Abbott Laboratories, is undergoing major revisions and may result in the production of several other algorithms for treatment by other medical specialists. So reported speakers at an Abbott-sponsored symposium in conjunction with the recent annual meeting of the American Academy of Dermatology (AAD) in Chicago.

The FDA has approved Tercica's Increlex (mecasermin [rDNA origin] injection) for the long-term treatment of growth failure in children with severe primary IGF-1 (insulin-like growth factor-1) deficiency (IGFD) or with growth hormone gene deletion who have developed neutralizing antibodies to growth hormone. Increlex is identical to IGF-1, the natural hormone produced in the body that has a broad range of activity central to growth and metabolism.

Hurricane displaces pharmacy students Wholesalers are meeting customer needs in New Orleans New Orleans hospitals forced to evacuate Most want DTC advertising banned for Rx drugs Albuminar recalled Indictments handed down on counterfeit Lipitor Tech firms partner for electronic health record Cholestyramine for oral suspension gets FDA nod FDA MedWatch issues warning for Trypan FDA recalls Medline alcohol-free mouthwash, hygiene kits

Hospitals are seeing the advent of a new generation of systems in the context of computerized physician order entry (CPOE) that are more user-friendly and yield a quicker return on investment (ROI). Several products have evolved in the marketplace. These products are called Paperless Pharmacy Order Systems (PPOSs). They provide a paperless environment in pharmacy and a work-flow engine between pharmacists and clinicians.

Insomnia, a common sleep disorder, affects more than 70 million Americans. According to the National Sleep Foundation's 2005 Sleep in America poll, about 75% of adults have experienced a symptom of a sleep problem a few nights a week or more in the past year.