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VHA has resurrected a familiar method for hospitals to save money: Trim pharmacy costs. But instead of urging its 2,400 member hospitals to simply slash pharmacy budgets, the not-for-profit hospital alliance is helping members save by shifting prescribing practices.

What's in a name? Plenty, it seems, when it comes to medications.

A huge focus on patient safety, a severe nursing shortage, and a shift in philosophy about how traditional medicine has come to view the role of pharmacy have led to health-system pharmacists playing a much larger role in critical care and emergency medicine. Nationwide, especially at large tertiary care centers, pharmacists have become permanent and welcome members of healthcare teams in intensive care units, trauma centers, and coronary care units. The demand for pharmacists is so great that some facilities have developed critical care residencies for pharmacists.

Current safe-handling procedures for vials containing chemotherapy products are apparently insufficient. Recent U.S. and European tests have determined that product residues adhering to the outside of chemotherapy vials are a pharmacy hazard.

Even though the law was adopted two years ago, many pharmacists are just now waking up to the fact that there's a Medicare prescription drug benefit heading straight for their pharmacy counters, according to the president of the American Pharmacists Association.

The statin drugs have so thoroughly dominated the market for treating high cholesterol levels and dyslipidemia that many in the healthcare community may need to be reminded that other medications still have their place. Patients who cannot regulate their lipid levels by means of lifestyle changes or for whom statins are not sufficiently effective can be treated with drugs such as fibrates, niacin, and with combination therapies.

A new, gel-based, delivery system containing a common benzodiazepine may provide a needed safety net for patients with epilepsy who are refractory to traditional mono- and combination pharmacotherapy and who experience bouts of increased seizure activity. Last month, Valeant Pharmaceuticals announced that it had received Food & Drug Administration approval to market Diastat AcuDial (diazepam rectal gel).

Drug wholesalers should be licensed by the federal government instead of state pharmacy boards, according to a position paper issued by the Healthcare Distribution Management Association (HDMA).

Nevada mandates Rx transfer Wal-Mart tops with Medicare crowd Longs Drug Stores raises funds for hurricane victims Survey: Women at risk of taking pregnancy test too early Wyeth's smallpox vaccine to carry black box warning MedVantx forms alliance with Aetna Specialty pharmacies change hands Pharmacy board executives leaving Second expert resigns over FDA delay on Plan B FDA removes sinusitis indication from OTCs Bristol-Myers Squibb reports BiCNU outage Berlex donates Rx medication to hurricane victims Keltsch Pharmacy changes name

Last month's column addressed Medicare prescription drug benefits for persons with Medicare and low incomes. This group includes about six million people who are enrolled in Medicaid; they will be enrolled automatically in a prescription drug plan (PDP) if they do not choose a plan on their own. Another eight million people with limited income and assets are eligible for assistance with paying the premium and out-of-pocket expenses under the Part D program. The Social Security Administration is now accepting applications for assistance and is able to answer individual questions about the various Part D options.

I told my brother, "I'm not going to write about it." I was stubborn. "Too many people are writing about it." I was speaking about the refusal of a small group of pharmacists to fill legal prescriptions based on their uncompromising moral stance.

Ten states have the lowest level of pharmacist shortage in this country. At the top of the heap is Hawaii, followed by Rhode Island, South Dakota, North Dakota, Delaware, Nebraska, New Jersey, Vermont, Idaho, and Montana. Most of these states, with the exception of New Jersey, have fairly small populations.

With only three months to D-Day, as in Medicare Part D, many unanswered questions about how the prescription drug program will be implemented and how it will impact pharmacy are causing a lot of unease, according to members of the Drug Topics Editorial Advisory Board.

The FDA has granted priority review status to the New Drug Application for sorafenib for patients with advanced renal cell carcinoma. Sorafenib is an oral multi-kinase inhibitor—under development by Bayer Pharmaceuticals and Onyx Pharmaceuticals—that targets tumor cell growth and angiogenesis by blocking both the RAF kinase and vascular endothelial growth factor receptor.

Treatment outcomes for alcoholism are likely to improve significantly in the next decade. However, in order to provide these treatments, a new paradigm and structure are needed that will integrate alcohol treatment with mainstream medical and mental health care.

Women in menopause, particularly when it is surgically induced, often suffer decreased sexual desire and activity, even if they are on estrogen replacement therapy.

Pharmacist, get your flu shot! That's the admonition from the Centers for Disease Control & Prevention and ASHP.

With the launch of Actoplus met (Takeda Pharmaceuticals) on Oct. 24, it's going to be easier for patients to treat their Type 2 diabetes with just one tablet. Although Actos (pioglitazone) has been indicated for use in conjunction with metformin for some time, combination therapy has necessitated a prescription for each. As a pioglitazone/metformin combination, Actoplus met offers convenience, greater patient compliance, and perhaps an improvement in diabetes outcomes.

CMS has approved Community Care Rx (CCRx) as one of 10 national Medicare Part D prescription drug plan sponsors. NCPA, MemberHealth Inc., and Computer Sciences Corp. created CCRx as a Medicare-approved discount card program that was expanded to become a full Rx plan. CCRx will offer three plans with premiums ranging from $26.25 to $45.23. Services offered include 90-day scripts at retail and pharmacist-provided medication therapy management services for qualified beneficiaries.

The problem of serious physical risks associated with medications is not going away. Consider the following recent drug recalls: Vioxx (rofecoxib, Merck), Bextra (valdecoxib, Pfizer), and Tysabri (natalizumab, Biogen Idec).

It was a challenging year for supermarket pharmacies, according to the latest findings of the "2005 Supermarket Pharmacy Trends Survey" by the Food Marketing Institute (FMI). Here are some of the highlights of the survey.

Have you always assumed a drug product marketed without a proprietary (brand) name to be a generic drug? If your answer is Yes, you may have inadvertently substituted and dispensed products that are not therapeutically equivalent. For example, the drug product albuterol sulfate HFA, manufactured by IVAX, was approved without a proprietary name on Oct. 29, 2004, under NDA 21-457. Since the IVAX albuterol sulfate HFA product is labeled with only the established (generic) name, one could easily assume this is a generic version of one of the other two currently marketed albuterol sulfate HFA products: Proventil HFA and Ventolin HFA.

ASHP waives dues for members affected by hurricanes CVS outlines Medicare 2006 strategic plan Walgreens helps seniors understand Medicare Rx plan WellPoint, Walgreens to serve Medicare beneficiaries Epilepsy group issues call to action to reduce birth defects Walgreens to acquire Schraft's specialty pharmacy Pfizer provides access to clinical trial information CIGNA, Duane Reade to market Medicare Part D plans Walgreens Wellness tour kicks off in Atlanta Medicare booklet errs on Rx plans CARE Pharmacies offer diabetes days Most think Vioxx verdict too tough on Merck Legal issues stall Nevada Rx imports R.Ph. buys tablet counting technology firm CVS/pharmacy promoting patient-R.Ph. relationship Maine's Rx discount program saves more than Ohio's ADHD drug safe for kids, adults cautioned FDA selects groups to help track drug safety ISMP's Cohen to use grant to fund med-error prevention

An abrupt change in the Drug Enforcement Administration's stance on serial prescribing of Schedule II controlled substances has stirred fear among pharmacists and compromised patient care, according to pharmacy leaders.

Osteoporosis: Exploring its many causes and treatment options. Supported by an educational grant from Eli Lilly and Co.

MedManage Systems launches third generation online sampling service Y-ME partners with Walgreens in 'Pass It On' promotion New Jersey to expand discount drug program Dynavax introduces Tolamba and Heplisav Walgreens Home Care announces contract with PHCS Web site offers Medicare Rx information Web tool estimates Medicare Rx costs APP recalls fluorouracil 10-ml vials R.Ph. arrested in Net Rx drug bust DrugMax expands Worksite Pharmacy business VA drug program cheaper than Medicare? MinuteClinic opens at seven CVS stores in Indianapolis

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.