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Inquirer Daily News

Archive: May, 2013

POSTED: Wednesday, May 29, 2013, 6:00 AM
Filed Under: Daniel Hoffman

Does the private control of drug development and health care in general bestow better health and prosperity on Americans?  For people in the C-suites, their bluestocking shareholders and some others, it undoubtedly does.  For most Americans, it doesn't appear to work so well.

Earlier this year the US National Research Council and Institute of Medicine issued a report (see here) that compared the health status of Americans to fifteen other affluent, democratic countries.  These include Australia, Canada, France, Italy, most of the Nordic countries, Spain, and the UK.

Echoing the findings of many previous studies, the Council found that despite spending the highest per capita amount on health care, Americans don't live as long.  In fact, compared to people in the other democratic countries, people here are the least likely to reach the age of 50.  Throughout the course of their lives, Americans suffer poorer health from birth all the way to age 75.

POSTED: Wednesday, May 22, 2013, 6:05 AM
Filed Under: Michael Cohen

You may find it hard to believe, but FDA has no say in how many over-the-counter drugs are named. That’s a Figure 1. New Allegra Anti-Itch product (left) has same stylized Allegra name and similar package design as the original Allegra product (right).great help to companies who want to market their drugs but it’s a problem for those of us concerned about drug safety.

OTC users sometimes fall victim to a potentially dangerous situation that exists with many “over-the-counter drugs” (ones sold on grocery store or pharmacy shelves without a prescription). It’s a problem that the public is largely unaware of, and it has led to confusion and medication errors made by consumers.

Here’s the issue. I’m sure that you’ve noticed that companies often use the same trusted brand name for an entire line of products, even if the ingredients in each product are completely different. That happens with soap suds and deodorants but with OTC drugs people sometimes use the wrong medicine – to their detriment. So watch out if you’re searching store shelves for Benadryl, Claritin or Zyrtec Eye Drops, Triaminic, Sudafed, Betadine, Surfak, Kaopectate, or AZO. What is in these products may not be what you expect.

POSTED: Tuesday, May 21, 2013, 10:05 AM
Filed Under: Daniel Hoffman

All sectors in the health care business face major turning points within the next three years.  This means the pharmaceutical industry and other manufacturers, together with providers such as physicians and hospitals, will operate in a different environment by the end of this decade.  The important question is just how well each sector is preparing its course corrections to meet the new challenges.

What's behind these enormous changes that will remake health care businesses?  Basically they can be summarized with the phrase, "value-based reimbursement."  Stated in its simplest terms, value-based reimbursement (VBR) means that the large public and private payers have decided the price they're prepared to pay for any health care product or service will depend upon how much it improves outcomes and reduces overall costs.  Although various countries and private payers may differ in their specific methods of applying VBR, a worldwide trend is making it the cornerstone of health care.

The impetus behind VBR lies in the fact that per capita health care costs are rising faster than overall economic growth and the disparity will get worse until some radical changes occur.  Health care already accounts for 18% of GDP in this country and it will rise to 20% within the next few years.  In a sluggish global economy, the need to devote increasingly larger proportions of a nation's wealth to health care remains simply unacceptable.

POSTED: Thursday, May 16, 2013, 9:35 AM
Filed Under: Michael Cohen

Occasionally, things go wrong when prescriptions are being prepared at the pharmacy. For example, one person's medicine may be placed into a bag that is labeled with someone else's name. Or a label prepared for a prescription may be mistakenly placed on a bottle containing another person's medicine.

Another reason that a patient might receive a medication intended for another patient is often because the patient was not properly identified before the medication was given. For example, if the pharmacist identifies the patient only by name it can cause a mistake if there is another patient with the same or similar name is listed in their computer system or their prescription bag is also ready for pick-up. Also, patients who are confused or hard of hearing might answer "yes" even if they are called by the wrong name.

One of the most important things you need to do when picking up medicine from the pharmacy is to confirm that what you’ve been handed is actually for you.   

POSTED: Monday, May 13, 2013, 9:27 AM
Filed Under: Daniel Hoffman

Did anyone in Big Pharma post improved results for the first quarter?  Pfizer, Merck, Bristol-Myers Squibb, AstraZeneca, GlaxoSmithKline, Sanofi and Novartis (the last two in their pharmaceutical operations) all generated lower sales this past quarter, compared to the same period last year.

Some companies  (such as Roche, Novo Nordisk, and AbbVie) did post gains in their pharma units, but overall it was a dismal quarter for the branded drugs sector. 

Throughout the year a number of observers wondered when investors would start to see a major disconnect between the soaring stock prices of Big Cap pharmas, most of which hit 52-week highs many times this past quarter, and some very shaky fundamentals.  As it turns out, it may not take all that long.  

POSTED: Thursday, May 9, 2013, 12:10 PM
Filed Under: Michael Cohen

Nearly 1,200 patients in Canada received lower doses of their cancer drugs as a result of poor communication between a compounding pharmacy supplier and several hospitals that utilized the service. The drugs were cyclophosphamide and gemcitabine, used as part of a regimen for breast and lung cancer as well as lymphoma and leukemia. Patients received watered down doses for about a year without anyone realizing there was more saline solution in the bags than stated on the label. Finally, a pharmacy technician at one of the hospitals noticed more fluid in the bags than expected and brought it to the attention of others.

When preparing chemotherapy, cancer drugs are added to ready-to-use intravenous fluid bags from a manufacturer, but the bags typically hold a greater volume of diluent than stated on the label, a situation known as “overfill.” Overfill takes into account that some evaporation might occur from the plastic bags and also that some fluid will be left in IV tubing after injection. Additional fluid is also added to the individual cancer drug vials to make a solution out of the powder inside before adding them to the bag.  

About a year ago, the hospitals stopped outsourcing chemotherapy preparation from a pharmacy they’d worked with previously and contracted with a new provider. In this recent incident, the new pharmacy labeled the product differently than in the past. The total amount of drug in the bag was labeled correctly but the final drug concentration listed on the label did not take overfill into account.

POSTED: Tuesday, May 7, 2013, 10:50 AM
Filed Under: Daniel Hoffman

Last week the US Justice Department filed suit against Novartis that essentially accuses the company of bribing physicians with lavish dinners, trips and speaking fees so they would prescribe the company's drugs.  The suit alleges, "In many instances Novartis made payments to doctors for purported speaker programs that either did not occur at all or that had few or no attendees."  While Novartis considers these programs as continuing education sessions for physicians, the prosecutors claim "thousands of programs were held all over the country at which few or no slides were shown and the doctors who participated spent little or no time discussing the drug at issue."  In other words, there was not even a pretense at medical education.

In fact, the suit contends that "Many speaker programs were also held in circumstances in which it would have been virtually impossible for any presentation to be made, such as on fishing trips off the Florida coast.  Other Novartis events were held at Hooters restaurants."

About this blog

Check Up covers major health events in our region and offers everything from personal health advice to an expert look at health reform. Read about some of our bloggers here.

For Portions of this blog may also be found in the Inquirer's Sunday Health Section

Michael Cohen id the president of the Institute for Safe Medication Practices in Horsham.

Daniel Hoffman is the president of Pharmaceutical Business Research Associates (PBRA) in Glenmoore, Pennsylvania, a healthcare research and consulting company specializing in key account positioning and messaging.

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