prescription drugs

NH considers database tracking frequently-abused drugs

Anne Zieger — Mon, 30 Jun 2008 22:57:27 -0400

New Hampshire's attorney general has started to push the state to develop a centralized database tracking frequently-abused prescription medications such as painkillers and stimulants. Attorney General Kelly Ayotte is calling for the database to be developed, in part, because over the past two years, drug abuse deaths have exceeded traffic deaths in the state. Ayotte would like to establish the database to allow physicians and pharmacists to see whether patients have already gotten a prescription for these abused drugs elsewhere, a practice commonly known as "doctor shopping." To date, legislators in the state have rejected this notion. However, officials in other states have already established similar databases. For example, one Wisconsin county has worked to establish a database allowing area doctors to track painkiller scripts.

To learn more about the NH initiative:
- read this Modern Healthcare article (reg. req.)

FTC comes down on IL bill restricting retail clinics

Wed, 04 Jun 2008 06:59:58 -0400

The Federal Trade Commission has let it be known that it isn't thrilled with pending legislation that could place limits on the state's growing retail clinic industry. The agency found that the bill, which is backed by the Illinois State Medical Society, could "excessively restrict retail clinics to the detriment of Illinois healthcare consumers." The 12-page analysis, which was requested by state Rep. Elaine Nekritz, found a number of problems with the bill, including a definition it said could be interpreted to exempt retail clinics owned by hospitals or physicians from the rules.

It also objected to several other provisions, including proposed rules limiting medical directors to overseeing no more than two clinics; prohibiting payers from negotiating lower co-pays and deductibles for retail clinic services; barring retail clinics from opening in establishments that sell alcohol or tobacco; and requiring that retail clinics have a designated receptions and waiting area.

The controversy over this bill is not the first conflict over retail clinic regulations--a few states, including Massachusetts, have already seen heated battles over this issue--and it probably won't be the last. For example, the AMA continues to challenge the safety of retail clinic services, as well as their potential for posing a conflict of interest by being housed where prescription drugs are sold. Other critics (such as Boston's Mayor Thomas Menino) have proposed rules barring clinics from operating where tobacco is sold, which de facto prevents the clinics from operating in drugstores that rely on tobacco income.

To learn more about the FTC analysis:
- read this Modern Healthcare piece (reg. req.)

Related Articles:
AMA demands retail clinic regs, backs off ban
Kroger chain invests in retail clinic operator
MA doctors protest CVS retail clinic expansion
Wal-Mart plans 2,000 retail clinics

CA bill would let pharmacies sell patient prescription data

Thu, 29 May 2008 06:59:57 -0400

A new California bill working its way through the state Senate would allow pharmacies there to sell patient prescription information to third-party marketing firms working for pharmaceutical companies. The legislation, which is expected to pass the Senate, would let pharmas send mailings directly to patients. The bill's supporters say that the intent of the mailings would be to remind patients to take their meds and order refills.

It's worth noting, by the way, that this goes well beyond the so-called "data mining" that already routinely takes place in most states (other than those that have banned the practice). In those cases, pharmaceutical industry intermediaries like IMS Health collect data on physician prescribing patterns. Pharmas buy the data from IMS and its peers, then go out to the practices to sell doctors using the knowledge they've gained of that doctor's prescribing patterns. This, on the other hand, is a direct-to-consumer communications initiative.

Opponents like the Consumer Federation of California contend that the bill would allow the pharmas to intrude into consumers' private lives. The California Medical Association also opposes the measure, contending that it could harm patient safety and physician-patient relationships, particularly in the case of patients with sensitive medical issues like mental illnesses. Supporters, however, say they've addressed this issue by allowing people to opt out of the mailings when they go to pick up their prescriptions.

To learn more about the bill:
- read this San Francisco Chronicle piece

Related Articles:
WA attempts prescription data mining ban
Fight continues over state limits on prescription data mining
Data providers challenge prescription-privacy laws

FTC: Pharmas cut 14 deals to delay generic sales in '07

Tue, 27 May 2008 06:59:57 -0400

Makers of brand-name prescription drugs reached 14 agreements with makers of generic drugs to delay the generic drug makers entry into the market, according to a new report released by the Federal Trade Commission. The FTC says these deals, which it has dubbed 'pay-for-delay,' are harmful to consumers, but it hasn't been very successful in blocking them to date. The agency is on record as supporting legislation that would ban such deals, but such measures haven't made much progress on the Hill due to opposition from both brand-name and generic drug makers.

The 14 deals discussed were part of a total of 33 deals between brand-name and generic drug makers for FY 2007 reported to the agency (as required by 2003 Medicare legislation). In each of the 14 deals, the generic maker got some kind of compensation to delay the market entry of their generic product, and in 11 of the agreements, the brand-name drug maker agreed not to sell its own generic when its patents expired.

To learn more from the report, and get more context:
- read this Kaiser Daily Health Policy Report item

Related Articles:
FTC assails generic-delaying deals
FTC criticizes delay of generic competition
AstraZeneca, Par collaborate on authorized generic
US Senate to take on authorized generics

Heparin scare leads to new dosing issue

Fri, 16 May 2008 06:59:55 -0400

While efforts to make dosing safer in the wake of recent heparin-related deaths make sense, such efforts have created a fresh set of safety concerns for providers who use it, observers say. For one thing, with providers turning to new suppliers, the drug is arriving in different quantities and strengths than many medical staffs are used to administering, raising the risk that the drug will be dosed incorrectly. Specifically, new packaging isn't coming in the single-dose form typically distributed by Baxter; instead, many vials contain larger or more potent quantities of the drug.

Heparin already is one of the five "high-alert" drugs most commonly associated with medication errors in hospitals, and this only raises the ante. As a result, some medical centers are having to establish extra precautions. For example, in some hospitals, pharmacists are reminding nurses to draw the drug from a vial instead of using a pre-filled syringe, and have asked the hospitals to remove the syringes so nurses won't make a mistake while switching between products.

To learn more about this issue:
- read this article from the Baltimore Sun

Related Articles:
Number of heparin-related deaths reported triples
Baxter provides update on heparin reactions
Post-heparin, no oversight excuses

Study: More than half of insureds on chronic-care meds

Wed, 14 May 2008 06:59:54 -0400

A new study suggests that for the first time, more than half of insured Americans are regularly taking prescriptions for chronic health problems. The most popular drugs include those used to lower blood pressure and cholesterol, according to Medco Health Solutions, which manages prescription benefits for about one in five Americans.

According to Medco data, 51 percent of American children and adults were taking one or more prescription drugs for a chronic condition, marginally up from 50 percent the previous four years and 47 percent in 2001. Use of medication for chronic conditions was spread across age groups. However, the biggest jump in the use of such medications was in the 20- to 44-year-old age group, due largely to more use of drugs for depression, diabetes, asthma, attention-deficit disorder and seizures.

To learn more about the study:
- read this Associated Press article

Related Articles:
Primary care MDs should manage chronic diseases
MN officials focus on chronic disease care
Employers offering free meds for chronic diseases
SPOTLIGHT: PA commission studying care for chronic conditions

FDA says hospitals may still have recalled heparin

Mon, 12 May 2008 06:59:57 -0400

Despite widespread publicity about heparin problems, several California hospitals were found to still have recalled heparin products in their supply chains, suggesting that the problem could still be an issue nationally, according to the FDA. The agency now has issued a request for hospitals and healthcare workers across the U.S. to search storage areas for possibly overlooked supplies of the drug, tainted versions of which have been blamed for 81 deaths. The recalled products were found last week during visits to California hospitals by the FDA and Baxter International, which made the batches that have since been recalled.

To learn more about the FDA's request:
- read this Modern Healthcare piece (reg. req.)

Related Articles:
Number of heparin-related deaths reported triples
Post-heparin, no oversight excuses

OH pharmacists lobby health plans to expand patient care role

Mon, 12 May 2008 06:59:56 -0400

Fresh from the success of a 10-year demonstration in Asheville, North Carolina, Ohio pharmacists are lobbying insurers to convince them to pay for care coordination services. The pharmacists contend that they're among the only ones in a position to know all of the drugs patients are taking, particularly those with complex, chronic conditions such as diabetes or asthma.

The pharmacists are taking their cue from the "Asheville Model," under which the city of Asheville and another local employer paid a fee to pharmacists to consult with patients. The program also gave employees an incentive to see the pharmacists, such as waived co-pays. The program has produced positive health results, including improvements in patient blood pressure and cholesterol levels, researchers have found.

To learn more about this initiative:
- read this Cleveland Plain Dealer piece

Related Articles:
Pharmacists a valuable asset in the ER
Errors encouraged by fast pharmacy pace
Study: Pharmacist oversight improves cardiac outcomes

Studies show problems with four big-name drugs

Tue, 29 Apr 2008 06:59:56 -0400

It looks like yet another set of popular drugs are facing allegations that they pose safety risks. Drugs named this week in unfavorable studies include Fosamax, which may create heart problems for women who take it for osteoporosis and epilepsy med Dilantin, which may put young women at higher risk of developing osteoporosis. Another study concludes that diabetes drugs Avandia and Actos double or triple the odds of non-spinal fractures, particularly among patients who took the drugs for a year or more. Particularly given other drug safety controversies still very much in the public eye, this can't be giving pharma marketers a warm and fuzzy feeling.

To find out more about the studies:
- read this FiercePharma item

Related Articles:
Merck expects $1.8B hit on Fosamax
Avandia problems erode GSK profits
Takeda touts Actos as heart attack-free
Despite safety issues, Vioxx still in demand

Louisiana MDs win legal battle over patient record disclosure

Fri, 18 Apr 2008 06:59:56 -0400

A group of Louisiana physicians have won their battle to keep their patients' records out of the hands of a pharmaceutical company--though they may face future challenges on the issue. The dispute comes as part of the Louisiana attorney general's suit against Janssen Pharmaceutic, which the state says has been illegally promoting off-label uses of Risperdal. The AG also is arguing that in so doing, Janssen defrauded the state's Medicaid program. Though no doctors or patients are parties to the suit, Janssen got a court order allowing it to subpoena physicians for the medical records of up to 6,000 Medicaid beneficiaries who received Risperdal prescriptions. The order also allowed the pharma to depose individual doctors on their Risperdal prescription decisions. However, the state's physicians contested the order, with judges concluding that Louisiana's laws governing medical privacy would invalidate the request.

To learn more about the case:
- read this AMNews article

Related Articles:
Lilly accused of promoting off-label Zyprexa use
Schering fined $435M for off-label marketing
Health plans target off-label use
Medicare patients can't get drugs for off-label uses