Latelines for Oct. 1, 2001



Vote to scrap AWP on tap in Congress

AWP's days may be numbered. Key lawmakers want Congress at least to change the way manufacturer-inflated AWPs are used as the reimbursement basis for the limited number of outpatient Rxs Medicare covers. The current rate is AWP minus 5%. Rep. James Greenwood (R, Pa.), chairman of a House investigations panel, said the system is costing Medicare and beneficiaries about $1 billion a year in overcharges. Greenwood said he would include a different reimbursement mechanism in an omnibus spending bill likely up for a vote this month. "Our efforts to resolve this problem will hopefully serve as an example for those state Medicaid programs and other third-party payers who face similar issues in their reimbursements for the cost of drugs," he added.

Chain pharmacy destroyed in WTC collapse

A Duane Reade pharmacy on the concourse level beneath the World Trade Center's twin towers was destroyed in the Sept. 11 terrorist attack on New York City. All employees were safely evacuated, with a few sustaining minor injuries, the company said in a statement. Twenty of the chain's 193 remaining stores south of 14th Street in lower Manhattan were closed for several days. The company has been donating Rxs, first-aid supplies, and essential consumables to hospitals and emergency service workers. By Sept. 24, the company reported that only two of its pharmacies were not open during normal business hours.

NACDS seeking ways to thwart pharmacy holdups

Purdue Pharma, whose OxyContin (oxycodone HCl) is the Rx of choice among pharmacy bandits, is funding a study by NACDS to identify ways to better protect employees, customers, and stores from armed robbers. King Roberts, a consulting firm specializing in assets protection, will present the results to NACDS in time for its fall conference in San Antonio, Oct. 28-31.

Lidocaine patches need child-resistant packaging: CPSC

The Consumer Product Safety Commission (CPSC) told Endo Pharmaceuticals to replace the outer carton of its orphan drug Lidoderm (lidocaine patch 5%) with a child-resistant (CR) reclosable pouch containing six resealable foil envelopes, each containing five patches. The company must tell R.Ph.s that they have to dispense Lidoderm envelopes in the outer pouch, CPSC said, to protect children against poisoning. Furthermore, additional outer CR pouches must be provided to R.Ph.s on requests for prescriptions of less than a full carton. Originally, CPSC wanted Endo to have each patch in a CR pouch or a single resealable CR pouch for all the patches, but the company said that would be cost prohibitive, and it would stop making the treatment for post-herpetic neuralgia.

Feds issue newFUL for Medicaid generics

CMS has released a new federal upper limits (FUL) list for more than 500 generic drugs. The list sets the maximum rate at which the federal government will reimburse for states that use the maximum allowable cost (MAC) system for Medicaid Rxs. The latest list can be found on the Web at .

ADHD Rxs not being abused in schools—GAO

GAO investigators do not believe that "the diversion or abuse of attention disorder drugs is a major problem at middle or high schools." They based their findings on a survey of 735 school principals. The survey also found that 60% of the schools used registered nurses to distribute the Rxs to pupils.

Switches to generic Prozac to grow over time

Because generic fluoxetine (Prozac, Lilly) is now priced at only a 30% discount over its branded version, generic substitution for this antidepressant is expected to be limited at this time. However, with paroxetine (Paxil, SmithKlineBeecham) expected to go off patent in 2002 and citalopram (Celexa, Forest) in 2004, generic fluoxetine will probably cut its price further, leading to higher rates of substitution. This is one conclusion of a newly released study from Decision Resources. The study interviewed pharmacy directors from seven large HMOs. None said their plans are mandating generic substitution of fluoxetine. They believe the tiered pricing structure of their formularies will be sufficient incentive for doctors to prescribe the generic form.

HHS clears Florida Medicaid changes

HHS secretary Tommy Thompson has approved a Florida Medicaid plan that requires participating pharmacies to charge Medicare beneficiaries no more than the Medicaid rate. He also approved the state's supplemental rebate plan. Pfizer and Bristol-Myers Squibb have offered the state disease management programs, backed by money-saving guarantees, in lieu of rebates to get their products on the state's preferred Rx list. PhRMA has sued to overturn the supplemental rebate requirement.

R.Ph.s to feds: Don't step in after dilution case

Nine pharmacy organizations have asked Sen. Christopher Bond (R, Mo.) to withdraw his request for an HHS probe into whether "a larger federal role" in policing pharmacists' conduct is warranted following the recent incident in which a pharmacist allegedly supplied diluted cancer drugs to Kansas City doctors. The groups said, "This isolated incident of alleged criminal behavior does not support the restructuring of a well-designed state-based regulatory system. Patients ... throughout the country would be better served by shifting the focus to ensuring sufficient support for state regulatory activities rather than challenging the performance capabilities of those very regulators." The nine groups are the Missouri Pharmacy Association, Missouri Society of Hospital Pharmacists, American College of Clinical Pharmacy, APhA, American Society of Consultant Pharmacists, ASHP, Food Marketing Institute, NACDS, and National Council of State Pharmacy Association Executives.

NIPCO tackles men's health

Funded by a grant from Pfizer Inc., the National Institute for Pharmacist Care Outcomes (NIPCO) has created a men's healthcare program for community pharmacies. Pharmacists who complete the program will receive a NIPCO-accredited certificate in men's health care. An outcomes study of 400 patients will be conducted in 20 community pharmacies, which will be paid for providing counseling sessions. The program will be unveiled this month at NCPA's annual meeting.

New anemia drug simplifies treatment for renal patients

An improved version of epoetin alfa has been approved. It's Amgen's Aranesp (darbepoetin alfa), which treats anemia associated with chronic renal failure in dialysis and nondialysis patients. Unlike epoetin alfa (Epogen, Amgen; Procrit, Ortho Biotech), which must be given up to three times per week, Aranesp can be administered once weekly. The recommended starting dose is 0.45 mcg/kg, given intravenously or subcutaneously. Aranesp is contraindicated in patients with uncontrolled hypertension.

Walgreens will no longer accept Visa debit cards

Walgreen Co. will no longer accept debit cards using the Visa Interlink network, effective Oct. 13. The decision follows Interlink's doubling of the transaction fee it charges Walgreens. The chain said the new fee structure would result in its transaction costs increasing from an average of 15 cents to 30 cents per transaction. Walgreens will continue to accept debit cards processed through other networks, including Star, MAC, NYCE, and Pulse Networks. Credit card transactions aren't affected by this decision.

Migraine drug unveils new strength

AstraZeneca's Zomig-ZMT (zolmitriptan) Orally Disintegrating Tablet for migraine will now be available in a 5-mg dosage form as well. The new form, like the 2.5-mg version, is an orange-flavored tablet that dissolves on the tongue in seconds without the need for a beverage.

New bank caters to independent pharmacy

An initial private stock offering of up to $8 million has been issued by Horizon Bank, which will cater to independent pharmacy owners nationwide as well as to businesses in California's San Fernando Valley. Pharmacists Mutual Insurance Co. will market the bank's services to pharmacy owners, said CEO Kirk Hayes, who is a bank investor and board member. Founded by R.Ph.s and an investment group, the bank was partly an outgrowth of the $723 million Rx price discrimination lawsuit. The settlement left many independents with a cash-flow problem, no longer able to get loans from wholesalers until they were reimbursed for third-party Rx claims.

Glyburide lots recalled

Pharmacia Corp. is voluntarily recalling three lots of Micronase (glyburide tablets, USP), and Greenstone Ltd. is voluntarily recalling 42 lots of glyburide tablets. Both drug companies said fungal organisms traced to a raw material contaminated some lots. Patients are urged to continue taking their existing glyburide to avoid loss of blood sugar control. The Micronase lots are 84DWB, 91DYR, and 67FPP. The Greenstone lots are listed at .

Texas executes robber who killed R.Ph.

James Roy Knox, 50, was executed by lethal injection in Huntsville, Texas, for the 1982 shooting death of Joe Sanchez, a pharmacist who refused to hand over drugs during a robbery at Joe's Pharmacy in Galveston. On parole from a drugstore robbery in Alabama, Knox fled the pharmacy with about $15 and four bottles of Demerol. He was arrested two years later and tried twice for capital murder after his original conviction was thrown out.

Renagel patient assistance launched

Low-income hemodialysis patients can tap into the Renagel Patient Assistance Program launched by Genzyme Corp. and the American Kidney Fund. The program will give Renagel (sevelamer HCl) 800-mg tablets to qualified patients referred by their nephrologists and social workers. Patients with no private insurance or federal, state, or local assistance are eligible for this safety net-type program. For more information, phone 1-(800) 638-8299, ext. 6674; or go to .


Latelines. Drug Topics 2001;19:5.

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