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The Centers for Medicare & Medicaid Services is proposing additional changes to Medicare outpatient drug programs. Earlier this month, CMS requested proposals for a system to calculate the true out-of-pocket (TrOOP) cost for patients buying drugs under the Part D benefit that begins in 2006.

Recognizing a need for healthcare systems to be able to evaluate employee attitudes about patient safety and quality improvements, the Medical Errors Workgroup of the Quality Interagency Coordination Task Force (QuIC) sponsored the development of a survey tool. The tool will help hospitals, and their departments, evaluate employees' support-or nonsupport-of safety and quality issues.

Most hospitals are not complying with standard guidelines for antibiotic (ABX) prophylaxis before surgery. Barely more than half of patients in a recent study received antibiotics within one hour of the initial incision. Less than half of patients were taken off ABX prophylaxis within 24 hours following surgery. The result is an unknown number of surgical site infections that could have been prevented with more appropriate treatment.

An e-prescribing initiative announced recently by the Big Three automakers might help business, said Hassane Fadlallah, R.Ph. "If this is a move that could bring more prescriptions to us, that would be great,' said the owner of Dix Drugstore in Dearborn, Mich., adding that nearly two-thirds of his business comes from automaker employees and their families." It's got to be a better step for us than some of their other moves, like mandatory mail order."

Long-term care pharmacists can expect to see more scrutiny of how they manage residents' pressure ulcers and weight control in the coming months. CMS, the Centers for Medicare & Medicaid Services, will add quality measures on weight loss and pressure sores to evaluations of nursing home quality.

Medication therapy management (MTM) is mandated in the new Medicare drug benefit. And Gina Upchurch, R.Ph., MPH, hopes that will bring attention to the kind of comprehensive service provided by the MTM program she directs and supported by the local pharmacists in Durham, N.C.

Connetics' investigational acne drug Velac—a once-a-day mixture of topical clindamycin and tretinoin in hydrogel—may be more convenient and at least as safe as either workhorse acne agent alone, say new studies. The findings could be hopeful news for the estimated 17 million or more Americans with acne. These results were reported at the American Academy of Dermatology annual meeting in New Orleans last month.

Flying High

Are rising wages and generous benefits enough to attract pharmacists and keep them from roaming? Find out in Drug Topics exclusive salary survey

Breaking News

Which were the top 10 drugs based on total prescription volume for retail pharmacies in 2004? According to NDCHealth Corp., the list includes the following, in descending order: hydrocodone w/APAP, Lipitor (atorvastatin, Pfizer), lisinopril, atenolol, Synthroid (levothyroxine sodium, Abbott), amoxicillin, hydrochlorothiazide, Zithromax (azithromycin, Pfizer), furosemide, and Norvasc (amlodipine besylate, Pfizer). So six out of the 10 products are generics, and three out of the remaining four are from Pfizer.

Toys. Hardware. Digital photography. Concentrating on these three niche areas can provide regional drug chains with a way to increase their front-end profitability.

A civilian pharmacist at a medical clinic tied to the U.S. Naval Hospital at Pensacola, Fla., was suspended for two weeks without pay last month for refusing to let a technician check prescriptions he had filled.

The sacrifices a woman has to make to have a full career are much more profound than those a man has to make. A man is expected to work for 40 straight years. Society, his family, and his friends don't even take a second look at his going to work five days a week when he has a new baby in the family. His worth as a husband and a parent are never questioned.

Gauging that the time is right to help independent pharmacies get into the long-term care marketplace, the National Community Pharmacists Association plans to build a network of practitioners trained to deliver pharmacist services to seniors.

Several high-profile drug safety issues have eroded the public's confidence in the Food & Drug Administration in recent months, according to a national poll. At the same time, the majority of those polled want more funding and an independent review of the agency's operations. And they're ready to vote against politicians who want to cut funding for FDA safety programs.

Zylet (Pharmos/Bausch & Lomb) treats inflammation and infection of the eyes. This medicine is a combination of a corticosteroid and an antibiotic.

An estimated 39 million people worldwide are currently infected with the human immunodeficiency virus (HIV). According to the Centers for Disease Control & Prevention, more than 44,000 new cases of HIV infection were diagnosed in the United States in 2004. Many of these patients will be taking drug "cocktails" consisting of highly active antiretroviral therapy (HAART).

Supposedly technicians are not allowed to screen for drug therapy problems, but isn't that exactly what they're doing when they routinely zip past a blizzard of DUR alerts?

It's not hard to imagine a pharmacy operating in a strip mall in conjunction with nurse practitioners, dieticians, and certified educators who are available at designated times to answer patients' questions.

The Joint Commission on Accreditation of Healthcare Organizations has backtracked on its prohibition against the use of potentially unsafe abbreviations. Rather than eliminating the use of QD (daily), U (units), and other shortcuts within the organizations it surveys, JCAHO is pushing to restrict abbreviation use in handwritten, preprinted, or in free text entry of patient care and medication records.

Highly active antiretroviral therapy (HAART) has reduced the incidence of opportunistic infections (OIs) among HIV-infected patients with access to adequate medical care. Unfortunately, some patients in the United States and elsewhere do not have access to sufficient care. Others do not have a sustained response to antiretroviral agents for many reasons, including poor adherence. In these two patient groups, OIs will continue to cause significant morbidity and mortality.

Enablex (Pfizer Inc.) treats conditions that cause loss of bladder control, such as overactive bladder, urinary incontinence, urgency, and frequency.

It's not hard to imagine a pharmacy operating in a strip mall in conjunction with nurse practitioners, dieticians, and certified educators who are available at designated times to answer patients' questions.

Medicare prescription rules are final, but we won't know how the system works until it is thrown into the real world, said a former Department of Health & Human Services policy official who did early work on the program. It is there that the drug plans will strategize to make money and the Centers for Medicare & Medicaid Services will attempt to maintain oversight.

New data, which were published in the Feb. 1, 2005, issue of Clinical Infectious Diseases, demonstrated that Vicuron Pharmaceuticals' investigational antibiotic, dalbavancin, administered once per week, is more effective in treating catheter-related bloodstream infections than is twice-daily treatment with vancomycin.

The federal government has proposed rules for electronic prescribing in the Medicare prescription drug benefit and the verdict from the folks putting the technology together is that the bureaucrats got it right.

General Motors' decision to drop Walgreens as its drug provider has prompted the chain to fight back by publicizing "the myth of mail order." Walgreens claims employers can save money by giving workers the choice to fill 90-day supplies of chronic meds at retail or mail-order pharmacies rather than by requiring them to use the latter exclusively.

Richard Bertin's optimism is contagious. Bertin, the executive director of the Board of Pharmaceutical Specialties (BPS), expressed enthusiastically and in no uncertain terms that the future of specialized training is not only secure but also in the midst of a growth spurt. Bertin's confidence is bolstered by the fact that 2004 was BPS' strongest year in terms of number of new candidates. A total of 1,004 candidates at 34 sites worldwide were administered specialty certification or recertification exams.

When three night-shift nurses at a large metropolitan medical center in the Northeast recently called in sick, the skeleton crew on a busy medical/surgical unit ignored the usual protocol involved in the bedside bar-coding of medications. Instead of scanning each patient's wristband and then the bar code on the medication package while at the patient's bedside, the nurses created surrogate patient bar codes and scanned all of them prior to going into patient rooms as a way to save time.