medications

CT sues McKesson for allegedly inflating drug prices

Mon, 02 Jun 2008 06:59:57 -0400

The Connecticut attorney general's office is suing pharmaceutical distributor McKesson Corp., contending that it's been illegally inflating the average wholesale price of more than 400 brand-name drugs, ultimately generating millions of dollars in unnecessary costs. The suit contends that McKesson conspired with drug-price publisher First DataBank to raise average wholesale prices (the amount pharmacies and providers charge consumers and insurers for medications) from 20 to 25 percent on many drugs. At the same time, it kept the prices pharmacies and providers paid for drugs at the same level. Under these circumstances, the higher retail prices gave the pharmacies and providers a much bigger profit margin, giving them a strong incentive to work with McKesson, the state says. The suit accuses McKesson of violating Connecticut's consumer-protection laws and the federal racketeering act.

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

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Senators plan bill countering pharma detailing tactics

Fri, 14 Mar 2008 07:59:58 -0400

Across the country, on an ad-hoc basis, isolated programs already have sprung up to counter tactics used by pharma sales reps to sell drugs. Now, Senators are considering a bill that would offer "academic detailing" programs nationwide to offer neutral information to physicians that counters the hype provided by reps. Senate Special Committee on Aging Chair Herb Kohl (D-WI) plans to introduce legislation this year, in cooperation with Sen. Richard Durbin (D-IL) that would create grant programs to fund counterdetailing programs. One grant program would help to create training materials that would further educate doctors on the comparative effectiveness and safety profiles for various common medications. Another would send specially-trained healthcare professionals to physician offices to offer fresh, neutral information sources on prescribing options.

To learn more about the proposal:
- read this Kaiser Daily Health Policy Report item

Related Articles:
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Trend: States try to counter pharma drug marketing

Mon, 03 Mar 2008 06:59:54 -0500

As we reported last year, a small but growing number of advocates have begun working to provide their own brand of drug education to doctors--without the sales message that pharmaceutical companies deliver. These "counter-detailers," as they are known in some quarters, are paid by groups outside the industry to visit with doctors and provide neutral, hype-free information on medications. Previously, we told you about one effort, paid for by the state of Pennsylvania, which sent out 500 clinicians to discuss prescribing options.

Over the past year, it appears that the idea has become more popular. Today, a handful of states, including Pennsylvania, Vermont and South Carolina, have rolled out programs presenting drug cost and effectiveness information. Vermont's program focuses on rural medical practices, and South Carolina's focuses on mental-health drugs. Pennsylvania, which spends $1 million a year on its "unsales" force, has reported that it managed to cut costs on drugs for seniors with the program; for example, the state began saving $60 on average per doctor on pain relievers within six months after an unsales visit. However, it's not clear the others are successful. (Small wonder, given that the pharmaceutical industry spends more than $7 billion a year on direct marketing to doctors.)

To learn more about this trend:
- read this Associated Press piece

Related Articles:
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"Counter-detailers" offer drug info alternative. Report

Study: Math mistakes can cause big med problems

Wed, 23 Jan 2008 06:59:54 -0500

A new study underscores that simple math errors by physicians can prove deadly when it comes to medications. In the study, which appeared in the Annals of Internal Medicine, researchers asked physician volunteers to give a hypothetical 5-year-old suffering from an allergic reaction 0.12 milligrams dose of epinephrine. Half the 28 volunteer doctors were given a bottle labeled "1 milligram in a 1 milliliter solution," while the others got bottles labeled "1 milliliter of a 1:1000 solution," both of which amount to the same thing. While 11 of the first 14 doctors got the math right, only 2 in the second group did, and one doctor in the second group administered what would have been eight times the correct amount. The study underscores that errors in converting from milligrams per milliliter could lead to errors by factors of 10, which can be very dangerous, researchers noted.

To learn more about the study:
- read this piece in The New York Times

DC passes pharma rep licensing rule

Thu, 10 Jan 2008 06:59:57 -0500

Though it backed out of plans for prescription-data-mining limits which have been struck down in New Hampshire and Maine, DC has passed what may be the country's first rules requiring the licensing of drug company sales representatives. DC's SafeRx Act of 2007 will not only require detailers to get licensed, it will subject them to fines or loss of their licenses for knowingly providing false information about their employer's medications. (Wouldn't this kind of behavior be considered fraud anyway?)

While some health systems have begun instituting strict rules for drug reps who visit their campuses, to my knowledge this is the first time a government entity has created this kind of licensing requirement.

The bill had originally included rules making it illegal to make commercial use of prescription information that included patient or prescriber information, but this language was stricken when council members decided that it might not pass legal review. Not surprisingly, the Pharmaceutical Research and Manufacturers of America, the trade arm for drug companies, has come out against the bill.

To find out more about these rules:
- see this FiercePharma report
- read this Modern Healthcare piece (reg. req.)

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Study: Antipsychotics don't manage aggressive outbursts

Fri, 04 Jan 2008 06:59:55 -0500

In a finding that would potentially mount a challenge to, among other treatments, the widespread practice of sedating agitated nursing home patients with antipsychotics, a new study suggests that these drugs may be no more effective than placebos in managing aggressive outbursts. The study, which didn't address Alzheimer's patients directly, focused on 86 adults with low I.Q.'s in community housing in England, Wales and Australia. It found that that adults taking the placebo actually saw a 79 percent reduction in aggressive behavior, while the reduction was 65 percent or less among those taking antipsychotics. Those taking the medications received Janssen's Risperdal or traditional antipsychotic Haldol.

Researchers speculated that it was attention from caregivers in the study, not the drugs themselves, that may be responsible for changed behaviors. They're recommending that physicians stop prescribing the use of such drugs for aggression.

To find out more about the study:
- read this New York Times piece

Related Article:
Trend: Nursing homes big users of antipsychotic meds. Report

SPOTLIGHT: Treating children with pneumonia at home

Fri, 04 Jan 2008 06:59:52 -0500

Particularly for worried moms, this may seem counterintuitive, but a new study suggests that children with severe pneumonia can be treated just as effectively at home as they can be in a hospital. Not only will children be more comfortable at home, their treatment is dramatically less costly, as appropriate medications are very inexpensive, researchers noted. Article

SPOTLIGHT: More debate over nursing home antipsychotic use

Thu, 20 Dec 2007 06:59:52 -0500

As we've discussed here previously, there's a hot debate going on over the use of antipsychotic medications in nursing homes to calm down agitated dementia patients. That's spurred, in part, because Medicaid is paying for many of these scripts, spending $5.4 billion on atypical antipsychotics in 2005 alone. As this article notes, critics say that it would be far better to use these funds to hire more staff members to manage demented patients. Article

Amgen spending millions to fight CMS anemia drug limits

Wed, 14 Nov 2007 06:59:55 -0500

Hoping to get CMS to change its mind on new anemia drug reimbursement limits, Amgen is spending millions lobbying on Capitol Hill to gin up sentiment for an override. During the first six months of 2007 alone, the company spent $9 million on lobbying, up from $10.2 million during all of 2006, according to recent reports. The lobbying investment is no surprise, given that its anemia drug Aranesp generated $4.1 billion in sales last year.

In addition to hitting the Hill, the drugmaker is asking cancer patients to submit testimonials on how the drug worked for them and asked them to write their legislator. (Physicians, don't be surprised if your patient asks you for help, too--pharma communications departments definitely know how to get consumers engaged.)

Right now, CMS plans to limit Medicare coverage of anemia medications in cancer patients. The agency only wants to pay for drugs like Amgen's Aranesp when used to treat anemia associated with certain cancers. Restrictions originally proposed earlier this year by CMS could half cut use of these drugs by as much as one-half, according to the pharmas.

To find out more about the lobbying effort:
- read this Kaiser Daily Health Policy Report item
- read a more-detailed review of proposed CMS rule

Related Articles:
Anemia drug rebates challenges. Report
Regulators question anemia drugs. Report
New study points to danger of anemia drug. Report
Amgen stock slips as anemia drug concerns rise. Report

House bill would reverse Medicare anemia drug limits

Wed, 03 Oct 2007 06:59:56 -0400

Of late, anemia drug administration has become a hot potato, particularly when Medicare announced that it would not cover use of anemia medications in some situations. Now, a pair of U.S. Representatives have introduced a resolution which would forcibly change CMS's policy.

Medicare said in July that it would cover use of Aranesp and Procrit when a patient had anemia caused by chemotherapy, but not when the anemia was caused by cancer. The move upset many House members, 250 of whom signed a letter sent to CMS last year arguing that the decision would inappropriately cause more cancer patients to undergo blood transfusions.

To learn more about the bill:
- read this Kaiser Daily Health Policy Report item

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FDA group recommends anemia drug limits. Report
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New study points to danger of anemia drug. Report