Latelines for Jan. 21, 2002
Alarmed by a proposed revision of JCAHO's medication use standard, ASHP issued a call for letters to oppose the move that threatens to leave pharmacists out of the loop. The JCAHO proposal would no longer mandate a prospective review by a pharmacist of every script if the institution uses a computerized physician order entry (CPOE) system. Where CPOE is in use, an R.Ph. would have to do only a retrospective review "as soon as possible" after medication administration. ASHP also raised the possibility that JCAHO's language could be interpreted to mean that a pharmacy is not required for a hospital to be accredited.
RxHub has selected Quovadx Inc. to handle member identification and indexing for its electronic-prescribing initiative to connect physicians, pharmacies, PBMs, and health plans. The software will link beneficiary data stored in different systems to allow all users to access the same information. RxHub is a joint venture created last year by the big three PBMs: AdvancePCS, Express Scripts, and Merck-Medco Managed Care.
How did retail drug chains fare this holiday season? Walgreens spokesman Michael Polzin said, "December monthly sales were up 14.4%, and same-store sales were up 8%. Christmas wasn't quite as strong as we thought it would be. We found gift items under $20 sold very well; items over $20 didn't sell as well. That reflected people cutting back a little bit on their spending. We're still waiting for the flu season to hit." The company does not disclose numbers on on-line sales of holiday items.
CVS' same-store sales rose 7.1% in December; front-end same-store sales increased 4.2%. Total sales for the five-week period ended Dec. 29, 2001, jumped 8.2%, to $2.46 billion, compared with $2.27 billion in the year-earlier period.
Rite Aid reported December sales for the four weeks ended Dec. 29 were up 6.8% with pharmacy same-store sales up 10.5% and front-end same store sales up 2.6%. The company reported "strong gains in holiday decor and gifts as well as seasonal candy due to strong promotions."
Investigators are exploring whether the Florida teen-ager who crashed an airplane into a high-rise in Tampa, Fla., could have been influenced by a drug for which he had a prescription. The drug is Roche's acne remedy Accutane (isotretinoin), which has been linked to depression and suicide in some patients. The authorities don't know yet whether he was taking the drug. In a separate development, brochures and letters about Roche's SMART (System to Manage Accutane-Related Teratogenicity) program have just been mailed to pharmacists and physicians. Under this program, pharmacists are not supposed to fill any prescription for Accutane unless it bears a special yellow sticker attached by the physician. The program is designed to reduce the risk of birth defects among patients.
Giant Food is joining forces with US Wellness, Gaithersburg, Md., to open 40 wellness centers in Giant Food stores. The Wellness Centers will offer consumers preventive healthcare services, including diagnostic screening and testing. The centers, slated to roll out over 2002, will be located adjacent to Giant pharmacies and will offer more than 25 consumer-directed lab tests, such as thyroid, kidney, and allergy tests.
A Massachusetts legislator has introduced a bill to allow the state pharmacy board to fine pharmacists up to $5,000 for misconduct. The proposed legislation would also permit the board to order up to 100 hours of community service, mandate additional training, or require immediate rehabilitation for an impaired R.Ph. The pharmacy board did not originate the bill but does support it as part of a continuous quality improvement effort, said executive director Charles Young. Noting that 40 other pharmacy boards can impose fines, he added that his board would most likely target pharmacy owners rather than R.Ph.s. if the bill becomes law.
The pharmaceutical industry suffered a major setback when a federal judge in Tallahassee, Fla., let stand a state law that seeks rebates from drug manufacturers in exchange for being included on a list of preferred Medicaid drugs. The ruling is expected to prompt other states to pass laws similar to Florida's. PhRMA, which had filed the original suit to block the Florida law, said it would appeal its case to the 11th U.S. Circuit Court of Appeals in Atlanta. Jan Falks, assistant general counsel for PhRMA, said the judge's ruling would strip Medicaid recipients of access to needed drugs and "could seriously harm the health of these patients."
It seems the old real estate mantra of location, location, location applies to how many and which medications patients receive as well. This is according to an Express Scripts study of 527,512 adults and 194,538 children randomly selected from 700 of the PBM's clients. Last year, the percentage of adults who got at least one Rx ranged from 71% in Kansas to 58% in California. The average number of scripts per member per year ranged from 8.3 in New York to 12.2 in Kentucky. Generally, Rx drug use was lower in the Northeast and West and higher in the South and Midwest.
The FTC filed a friend of the court brief opposing Bristol-Myers Squibb's efforts to extend its BuSpar (buspirone) patent and keep generic competitors at bay. The FTC brief said that if BMS prevails, the antitrust watchdog agency would consider it a "matter of grave concern." The suit was filed by Mylan Laboratories and Watson Pharmaceuticals after BMS submitted a last-minute patent on BuSpar to the FDA. The patent maneuver also upset some consumer groups, which filed numerous lawsuits seeking class action status against BMS. Attorneys general from 29 states also sued the drug company.
The FDA and Bristol-Myers Squibb have added a black box warning and strengthened the warnings, contraindications, and precautions sections in the labeling for Serzone (nefazodone HCl), an antidepressant. Rare cases of liver failure leading to transplant and/or death in patients have been reported. A new patient package insert is provided in the product packaging. For more information, visit www.fda.gov/medwatch/SAFETY/2002/safety02.htm#serzon .
Independent pharmacies operating under the Leader Drug Stores banner can take advantage of services now bundled in LeaderNETqs. The program of managed care solutions packages several service modules at fees lower than if they were acquired separately. Offerings include an audit assistance program, subscription to a publication on HIPAA issues, and Rx claim editing and switching services. Leader is a division of Cardinal Distribution.
Fearing it would harm low-income patients, a Michigan judge put the state's plan for a formulary on hold. The plan requires manufacturers to give the state rebates in order to get their products on the list of preapproved drugs for about 1.6 million beneficiaries. However, physicians would be able to seek state approval to prescribe nonformulary drugs. The judge ruled that the state did not have authority to require the rebates and that the plan was adopted in an unconstitutional manner. The state plans to appeal the ruling in the case, which was filed by PhRMA.
The Coalition of Eastern Pharmacy Organizations, a new joint venture between Legend Health Systems and Co-Op Power, is designed to further cooperation among their independent members. Organizations that join CEPO will share existing programs and services without giving up their autonomy, according to officials. The coalition will also serve as a unified voice on the national level within the Federation of Pharmacy Networks. For more information, phone (631) 630-4713.
Marina Marketos. Latelines. Drug Topics 2002;2:7.