According to the National Multiple Sclerosis Society, an estimated 10,000 new cases of multiple sclerosis are diagnosed every year. The most common form of MS at the time of diagnosis is the relapsing-remitting form, in which acute signs and symptoms occur intermittently and will go into intermission either spontaneously or with steroid therapy.
I remember being bawled out by a manager when he caught me telling a bawdy joke to a small group of male customers. I knew all of these men. They liked to tell me jokes. I shared jokes at the drugstore. It's what they expected of me.
The decision by a county comptroller on Long Island to sponsor a prescription drug discount card open to all citizens has New York pharmacists worried that the program might spread nationwide and send the last cash-paying customers into extinction.
The federal government is raising Medicare outpatient prospective payment system (OPPS) rates for 2005, but pharmacists are not cheering. Hospital pharmacy departments will see little, if any, of the increase.
There are increasing concerns about the frequency and duration of drug product shortages that have led to adverse patient outcomes. The current U.S. shortage of flu vaccine exemplifies the potential negative consequences of patient care either delayed or not provided. Healthcare professionals have devised methods of dealing with drugs in short supply, but some methods have led to product confusion and/or calculation errors resulting in the inadvertent administration of the wrong drug or wrong dose.
Two Philadelphia-area hospitals recently received patient safety awards for medication administration improvements that ranged from the very simple to the very technical. The Delaware Valley Medication Safety Award was shared in November by Northeastern Hospital of the Temple Health System and the Albert Einstein Medical Center of Jefferson Health System. The two hospitals split a $5,000 cash prize.
According to the 1999 Institute of Medicine report, To Err Is Human: Building a Safer Health System, medication errors are responsible for approximately 7,000 deaths annually. Said Raymond Muller, M.S., R.Ph., associate director of pharmacy services at Memorial Sloan-Kettering Cancer Center in New York City, "More people in the United States die from medical errors per year than die from motor vehicle accidents, breast cancer, or AIDS." Muller addressed a session at The Chemotherapy Foundation symposium, Innovative Cancer Therapy for Tomorrow, held recently in New York City. The symposium was sponsored by the Mount Sinai School of Medicine.
With another calendar year just weeks away, forecasting experts are speculating on what the pharmaceutical pipeline will deliver in 2005. Lee Vermeulen, R.Ph., M.S., along with his colleagues at the University of Wisconsin Hospital and Clinics, believes the action in 2005 will be in biotech and that pharmacists should not ignore the agents currently being reviewed by the Food & Drug Administration.
Get set for possible sticker shock when wholesale distribution contracts come up for renewal. Drug wholesalers are starting to charge drugmakers fees for distributing their products. Pharmacy providers-retail pharmacies, managed care organizations, and health systems-will see the change reflected in new contract prices.
Rising gasoline prices. Escalating healthcare costs. Continued unemployment. The ongoing war in Iraq. These factors could dampen holiday sales figures. Pharmacies are still optimistic that folks will deck the halls with gifts plucked from drugstores' shelves. Results from the annual Holiday Consumer Intentions and Actions Survey from the National Retail Federation (NRF) offer hope that customers will indeed make cash registers jingle in 2004.
Having covered the administrative, physical, and technical safeguards in the last three installments, two matters remain: the "organizational requirements" and "policies and procedures and documentation requirements."
After getting extensive comments and other information from the pharmacy community over the past 10 months, the Centers for Medicare & Medicaid Services has significantly increased the "supplying fees" it will pay to pharmacists next year for the anticancer drugs and other medications that are paid for under Medicare Part B.
The Medicare Modernization Act (MMA) that established the system's first outpatient drug benefit gives pharmacists more questions than answers. The reason is clear: politics. "The entire process is driven by politics," said Dan Mendelson, president of the Health Strategies Consultancy, a Washington, D.C., health policy firm. "Medicare is a political act, and the changes you will see to it will be politically driven."
Consultant pharmacists (CPs) can breathe a sigh of relief. Other professionals in long-term care value and appreciate pharmacists and pharmacy services. That is the conclusion of the 2004 Senior Care Source, an interdisciplinary survey of long-term care health professionals. The annual survey, sponsored by Novartis, includes pharmacists, medical directors, nursing directors, and nurse practitioners (NPs) in long-term care. The survey was released at the American Society of Consultant Pharmacists Annual Meeting & Exhibition held in San Francisco last month.
Community Care Rx (CCRx), the discount card created by the National Community Pharmacists Association, will pay pharmacists for medication therapy management services (MTMS) to help position the profession as a player when the Medicare prescription drug benefit comes on line in 2006.
In the belief that transparency creates competition and lowers costs, several states have created Web sites that post comparative retail drug prices. Consumer groups say this is a step in the right direction to make drugs more affordable, especially for the elderly and uninsured. But many pharmacists say it's a fool's errand by the states-prices change quickly and postings are rarely up to date. That leads to confusion and consumer anger more than to increased competition, say pharmacists.
Amylin Pharmaceuticals' pramlintide acetate (Symlin) is a synthetic version of amylin, the hormone secreted with insulin by the beta cells in the pancreas. It is the first member of a new class of medications known as amylinomimetic agents, or amylin receptor agonists. Amylinomimetic agents mimic the actions of amylin and have demonstrated activity in blood glucose regulation. The company recently submitted a complete response to the Food & Drug Administration's December 2003 approvable letter for pramlintide and is anticipating a six-month review.
Norditropin Nordiflex (Novo Nordisk) treats problems caused by insufficient natural growth hormone.
The remarkable advances in the treatment of cancer allow us to use terms like remission and cure, but, regrettably, some of these most effective therapies tend to wipe out the patient along with the disease. And so, researchers scramble to fill the great unmet need of developing the "wonder" drug-one that holds the promise of both efficacy and tolerability. For non-small-cell lung cancer (NSCLC), many have placed their hopes on a new class of agents that inhibit various growth factors. Iressa (gefitinib/AstraZeneca) was the first from the class to be approved, and Tarceva (erlotinib) is the latest.
Expanding its reviews of products, such as cars and appliances, Consumer Reports will compare the effectiveness and costs of a few types of widely used prescription drugs. Beginning Dec. 9, the free service was made available on the Consumer Reports Best Buy Drugs Web site at www.crbestbuydrugs.org.
Duloxetine approved for maintenance of MDD
The inclusion of medication therapy management services (MTMS) as part of the new Medicare outpatient prescription drug benefit (Part D) was one of the American College of Clinical Pharmacy's priorities during the past year, said C. Edwin Webb, Pharm.D., M.P.H., ACCP's director for government and professional affairs. He told attendees at the ACCP annual meeting in Dallas last month that the Part D benefit, to be implemented in 2006, is focused on "high-risk" patients. Those considered to be high-risk require multiple medications, have multiple chronic conditions, and are likely to incur substantial medication costs, he explained.
With the 2006 deadline looming to deliver useful patient drug information at the counter, the pharmacy profession has failed to meet the legal challenge laid down by the U.S. Congress, according to the Pharmaceutical Printed Literature Association (PPLA).
Patients with end-stage renal disease (ESRD) tend to develop hyperphosphatemia, which, if left untreated, can lead to calcification of the heart and blood vessels. Dietary phosphate restriction is the first line of therapy for reducing phosphorus levels in these patients. However, it is often unsuccessful, thereby creating quite a challenge for the more than 300,000 Americans with ESRD.
Medicare's Outpatient Prospective Payment System (OPPS) took a hit recently. A report from the Government Accountability Office detailed problems in the way OPPS rates are set.
Medication therapy management services (MTMS), as outlined in the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA 2003), is likely to have a significant impact on pharmacy practice, Jannet Carmichael, Pharm.D., told attendees at the American College of Clinical Pharmacy annual meeting, held last month in Dallas. She is PBM manager at VISN 21 Health Care Services at the VA Sierra Pacific Network in Reno.
A severe shortage of pharmacy directors and assistant directors could put a damper on progress made by pharmacists at a time when they are poised to take commanding ownership of medication and patient-safety leadership positions in hospitals.
A workforce shortage combined with federal government funding cutbacks may complicate the lives of an incoming generation of pharmacists. So claimed two of the profession's topsiders at an ASHP leadership conference, held recently in Chicago.
Anesthesia awareness-the unexpected cognizance that occurs when anesthesia lightens during surgery-is the subject of a recent Sentinel Event Alert issued by the Joint Commission on Accreditation of Healthcare Organizations. Forty-eight percent of patients who experience awareness report auditory recollections, 48% report being unable to breathe, and 28% report pain-without being able to communicate this to the surgical team.
