Latelines for Nov. 4, 2002
A group of North Carolina patients has sued Urgent Care Pharmacy, Spartansburg, S.C., even though state lab test results have not yet confirmed that the compounding pharmacy is the source of fungal meningitis that killed one person and sickened three others. The suit seeks to set up a fund of less than $75,000 per person to cover possible medical expenses of the estimated 870 North Carolina patients who received methylprednisolone injections supplied to clinics by the pharmacy. Urgent Care's owner has denied that his pharmacy is the source of the meningitis.
If NCPA has its way, AWP, WAC, MAC, and other reimbursement methodologies would all be replaced by a new one called the Pharmacy Payment Formula, or PPF. This payment system would cover pharmacists' product costs, overhead, dispensing fee, professional services fee, and a return on investment. So declared Jim Martin, outgoing NCPA president, at the group's annual meeting in Nashville last month. To help make this dream a reality, NCPA has hired The Regis Group, a transition management company, using funds from the Community Pharmacy Foundation, Martin revealed. He added that this initiative has the support of ASCP, ASHP, AMCP, NACDS, and APhA.
NCPA will be offering a new training program, through its National Institute for Pharmacist Care Outcomes (NIPCO), designed to teach pharmacists how to improve patient compliance, NCPA's new president Joe Smith told attendees at the group's recent annual meeting. Tentatively, this is a 15-hour certificate course developed jointly with Midwestern University in Arizona and funded by multiple manufacturers.
For the first time since the NCPA-Pharmacia Digest began, independent pharmacies have cut back on their third-party business. That was one finding from the final 2002 Digest, released at the NCPA annual meeting. The number of non-Medicaid, third-party prescriptions fell from 54% in 2000 to 53% in 2001. "That tells me you are evaluating those contracts and making the decision to turn down those that are not profitable for our business," said Bruce Roberts, executive v.p. and CEO of NCPA, in an address before members at the association's annual meeting. The authors of the Digest said they would shortly send respondents an individual analysis. This could not be done last year for lack of a database.
The FDA has approved ezetimibe (Zetia, Merck/ Schering-Plough), the first in a new class of drugs that inhibits the intestinal absorption of cholesterol. Ezetimibe is approved for use as monotherapy or in combination with a statin for the reduction of LDL cholesterol and total cholesterol in patients with hypercholesterolemia. The recommended dosage of ezetimibe is a 10-mg tablet each day, taken with or without food.
CMS has chosen PacifiCare, Prescription Solutions, QMed, and Alere to participate in its four-year disease management demonstration project serving 15,000 Medicare patients with congestive heart failure. Operating as HealthPartners, the firms will provide DSM services and a tiered Rx plan to the CHF patients, who may also have the comorbidities of coronary artery disease and diabetes.
Aetna will phase out its mail-service pharmacy contract with PBM Express Scripts over the next six months. The Hartford-based insurer will bring its mail-order operation in-house to go along with the rest of its $4 billion pharmacy operation. Aetna, which insures 14.4 million beneficiaries, believes it can achieve better cost control and offer high-quality integrated mail-order and clinical capabilities by eliminating the pharmacy middleman.
The International Drug Information Center of the Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, is updating its database on drug information centers. Please forward the name of your center, director, address, telephone, fax number, and e-mail address to IDIC@brooklyn. liu.edu, or call (718) 780-4004, or fax the information to (718) 488-1254.
Pharmacia has launched a new Nicotrol Step-down Patch to help smokers beat cigarettes one craving at a time. Pharmacia claims that unlike other nicotine patches that are worn for 24 hours, the Nicotrol Step-down Patch is worn for only 16 hours so nicotine can't disturb a smoker's sleep at night. The new product will be introduced in an ad campaign featuring an icon called Craving Man.
AstraZeneca Pharmaceuticals has announced it is changing the appearance of the labeling and packaging for quetiapine (Seroquel), indicated for the treatment of schizophrenia in adults. This change represents an effort to reduce confusion on pharmacy shelves with the anti-depressant nefazodone (Serzone, Bristol-Myers Squibb). AstraZeneca is creating new labeling for Seroquel that emphasizes the "QUEL" in a new font and color and new packaging that has a blue bottle cap, instead of white. The new labeling and packaging should be available shortly.
Rite Aid Corp. confirmed that it is being investigated by FTC to determine whether the chain violated consumer privacy guidelines through its Rx refill reminder service. The company hasn't been accused of any wrongdoing and is cooperating with the probe. FTC has asked for documents pertaining to refill reminders made to patients either by phone or by mail and for educational material related to drugs, including safety information. Walgreen Co. said it was also contacted by FTC last month concerning the same issue.
GlaxoSmithKline and Bristol-Myers Squibb have reinstated discounts to the Together Rx card and are sending refunds to seniors who bought medications after the discounts were reduced. The giant drug companies have been assured by the federal government that the Together Rx discounts will not trigger the Medicaid "best price" mandate. The prospect of having to give Medicaid the same price break led to the reduction in the Together Rx discounts.
The FDA has approved glipizide/metformin (Metaglip, Bristol-Myers Squibb) tablets for use, in addition to diet and exercise, as initial drug therapy for patients with Type 2 diabetes whose hyperglycemia cannot be satisfactorily controlled with diet and exercise alone. Metaglip has also been approved as second-line therapy for patients with Type 2 diabetes who are currently taking either metformin or a sulfonylurea to supplement a regimen of diet and exercise, but who have not achieved adequate glycemic control. Metaglip will be available in 2.5 mg/250 mg (glipizide/metformin) tablets, 2.5 mg/500 mg tablets, and 5.0 mg/500 mg tablets. The manufacturer plans to make Metaglip available in pharmacies this November.
The FDA has approved peginterferon alfa-2a (Pegasys, Roche) for the treatment of adults with chronic hepatitis C who have compensated liver disease and have not previously been treated with interferon alpha. Pegasys is a pegylated interferon that remains active in the bloodstream for a longer period of time and at a more constant level than interferon alpha. The drug entered pharmacies as of the last week of October. Roche has selected Priority Healthcare as the distributor for the Pegasys Monotherapy Sampling Program. The program will provide samples to physicians to treat approximately 15,000 patients over the first 12 weeks of therapy with Pegasys. After that, patients who respond to treatment will seek public or private reimbursement.
Marina Marketos. Latelines. Drug Topics 2002;21:7.