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Medco Health Solutions, one of the nation's largest pharmacy benefit managers, has joined forces with the University of Medicine & Dentistry of New Jersey (UMDNJ) to study major public health issues and their effects on prescription utilization and healthcare costs.

You might see specialty pharmacies compete tooth and nail under a new Medicare Part B program proposed by the Centers for Medicare & Medicaid Services. Under the proposal, physicians can continue buying Part B drugs on their own. Under this scenario, their reimbursement switches from average wholesale price (AWP) minus 5% to average sales price (ASP) plus 6%. Or physicians can opt into a competitive acquisition program (CAP).

A California hospital recently lost its accreditation from the Joint Commission on Accreditation of Healthcare Organizations, and another one is at risk of losing it. In both cases, medication-related problems accounted for part of the reason for their predicament. Their experience could signal a tougher approach by JCAHO.

Health-system pharmacists are taking a wait-and-see attitude about proposed rule changes for hospitals' conditions of participation (CoPs) in Medicare that were announced recently by the Centers for Medicare & Medicaid Services. When the feds first proposed these rules eight years ago, it provoked a firestorm of protest from R.Ph.s.

For the third year in a row, a record number of pharmacists had their licenses transferred to other states in 2004, according to an annual year-end review by the National Association of Boards of Pharmacy.

Sensing that the time has come for the profession to take responsibility for policing what many view as a pharmacist"s cherished prerogative—compounding—Kenneth Baker has accepted the job of implementing a way for compounding pharmacies to earn a stamp of approval from the Pharmacy Compounding Accreditation Board (PCAB).

One percent of the world's population has rheumatoid arthritis, accounting for more than nine million physician visits and 250,000 hospitalizations in the United States annually. Abatacept, the first in a new class of agents called selective T-cell co-stimulation modulators, is in development by Bristol-Myers Squibb for the treatment of this joint disease.

The Food & Drug Administration recently approved entecavir (Baraclude, Bristol-Myers Squibb) for the treatment of chronic hepatitis B virus infection in adults with evidence of active viral replication and evidence of either persistent elevations in serum aminotransferases or histologically active disease. Entecavir Tablets are currently available in U.S. pharmacies. Entecavir Oral Solution will be launched at a later date.

The Food & Drug Administration recently approved mometasone furoate 220 mcg once-daily inhalation powder (Asmanex Twisthaler, Schering-Plough), the first inhaled corticoste-roid to receive clearance for once-daily initiation therapy. Asmanex is approved for first-line treatment of asthma as preventive therapy in patients 12 years of age or older. It is also approved for patients on bronchodilators alone or who require oral corticosteroid therapy, when adding Asmanex may reduce or eliminate the need for oral corticosteroids. Schering plans to launch the product in the fall of 2005.

Perhaps nothing is as professionally frustrating to today's health-system pharmacists as the gap between the promise and reality of computerized physician order entry (CPOE). Concern may have risen to a new level in March with publication of a report in the Journal of the American Medical Association that said CPOE could cause as many medication errors as it prevents. Add that to a growing awareness among R.Ph.s that many physicians hate the systems and the fact that most hospitals can't afford them, and CPOE's promise of improved patient safety seems a dream.

The Centers for Disease Control & Prevention recently released detailed recommendations to state health departments that are considering mandatory public reporting of healthcare-associated infections (HAIs). "HAIs are a major public health problem in the United States," said Patrick Brennan, M.D., chairman of the CDC's Healthcare Infection Control Practices Advisory Committee (HICPAC), which wrote the document.

How do you increase the dispensing rate of generic prescription drugs in a state that's in the backyard of some of the largest name-brand pharmaceutical companies? That was the dilemma facing Horizon Blue Cross Blue Shield of New Jersey and Horizon Healthcare Services Inc., New Jersey's largest health insurer.

As mandatory mail-order pharmacy continues to grow and encroach on the market share of traditional pharmacies, the National Association of Chain Drug Stores met in Philadelphia last month and discussed ways to respond to this competition. Potential solutions included: retail pharmacies' contracting with their own pharmacy benefit managers to service mail-order plans, mounting a public relations campaign to attack the accepted belief that mandatory mail plans save money, and offering alternative 90-day retail programs that provide mail-order savings but retain contact between patient and pharmacist.

Uncle Sam has given up to 145 clinical pharmacists the job of reviewing the formularies of drug plan sponsors seeking to be part of the Medicare prescription drug benefit that is set to begin on New Year's Day, 2006.

According to the Home Safety Council (HSC), falls at home cause an average of more than 4,700 deaths and 1.1 million medical visits each year among adults aged 65 and older. In 2002, approximately 38% of all unintentional injury deaths among older adults were caused by falls, and many were associated with medication use.

In light of the continuing confusion over what women should do to alleviate their symptoms of menopause, the National Institutes of Health held a state-of-the-science conference on this subject recently. But the conference may have raised more questions than it answered. The NIH-sponsored panel confirmed that there is still much to be learned about this condition. And the same is true of most medications used to treat menopausal symptoms.

According to a recent study, invasive candidiasis kills approximately 10% to 40% of infected immunocompromised patients. Fortunately, there's a new treatment available. The Food & Drug Administration recently approved micafungin (Mycamine, Astellas Pharma US) for injection for the treatment of patients with esophageal candidiasis and the prophylaxis of Candida infections in those undergoing hematopoietic stem cell transplantation (HSCT).

The Food & Drug Administration approved pramlintide (Symlin, Amylin Pharmaceuticals) injection recently as an adjunct treatment in patients with Type 1 or Type 2 diabetes who use mealtime insulin and have failed to achieve desired glucose control despite optimal insulin therapy.

Drug counterfeiting has swelled into one of the world's largest black market industries, its rapid growth spurred by lucrative promises, minimal risk, and aggressive consumer demand. In a recent study, the World Health Organization determined that up to 10% of medicines worldwide are counterfeited, a deadly hazard that costs the pharmaceutical industry about $46 billion a year.

The FDA has approved ondansetron (Zofran, GlaxoSmithKline) injection for the prevention of postoperative nausea and vomiting (PONV) in children as young as one month of age and chemotherapy-induced nausea and vomiting (CINV) in children as young as six months.

Lung cancer is the leading cause of cancer death among both men and women in the United States. According to the American Cancer Society, an estimated 163,510 deaths (90,490 in men and 73,020 in women) will be attributed to the disease in 2005. The five-year survival rate for lung cancer patients is approximately 14%. Late diagnosis is a significant obstacle to improving lung cancer outcomes.