The good news is that there are nine states with worse health than Georgia. But yeah, that means Georgia is ranked as the 10th worst state for overall health in the annual America’s Health Rankings from the United Health Foundation.
So what hurt our ranking? “Community and environment,” with the second-worst level of children in poverty, and low rankings for diseases like salmonella and chlamydia.
We didn’t do well for health policy, either — notably our high number of uninsured people (fourth worst in the country) and low funding for public health. And finally there’s “Clinical Care,” where Georgia ranked poorly for the number of children with low birth weight, plus a lack of dentists and primary care physicians. (Details here.)
Massachusetts and Hawai’i* topped the list, and Mississippi and Louisiana were at the bottom. Because we know you were wondering.
The company announced that its “commercially insured members” would not have to pay a thing to receive the anti-overdose drug. The logic: Co-pays were keeping people from getting it. “According to research from the drug manufacturer, nearly 35 percent of Aetna members prescribed Narcan between January to June 2017 did not pick up their prescription,” the company said. (Not clear: Does this cover both the nasal spray and the injector?)
Considering that in Georgia, patients do not need a prescription for naloxone, this means that someone with Aetna coverage can easily receive some to keep on hand in case a loved one is in danger of overdosing. (See GPhA.org/naloxone for details.)
The agency and Congress (both parties!) are planning an overhaul of the regs.
The issue is that rules for OTC products are created once and never budge — even when new information changes how the prescription version is used.
So, for example, prescription acetaminophen is limited to 325 mg per dose (you know, because of danger to the liver), while you can get it OTC with 500 mg or more.
The current regulatory process for over-the-counter, or OTC, drugs dates back to 1972, and is based on a simple but flawed assumption that most such products already on the market wouldn’t change much over time […] But the scientific understanding of the products — or the appropriate doses — is constantly evolving.
As flu season gets into full swing, let us not forget that it brings with it another, potentially worse condition: man flu.
[T]here’s a plethora of scientific studies out there suggesting that men are not “wimps.” Rather, they may have a weaker immune system that simply makes them respond differently to the illness.
Drug Channels’ Adam Fein says that, in 2016, drug spending didn’t grow nearly as fast as hospital and “professional care” (i.e., physician and clinical services).
Here’s his chart:
(Although, as at least one commenter pointed out, that only took into account outpatient drug spending. It’s not clear how much the increase in hospital spending can be attributed to drugs.)
GPhA is partnering with our friends at the UGA College of Pharmacy — we’re trying to get 500 pharmacists to complete a survey on naloxone dispensing and opioid misuse. The goal is to learn more about the issues pharmacists face when dealing with opioid overdose reversal.
The survey takes about 10 minutes to complete and it’s completely confidential. Please take the time to answer it — this kind of information can really make a difference!
When it comes to releasing clinical trial data, that would be Johnson & Johnson and Sanofi, both of which received perfect scores for clinical trial transparency.
We love the useful information that crops up on Medical News Today. For example, today’s edition covers both “What are the best ways to make yourself burp?” and “What to know about making yourself sneeze.”
—Andrew Kantor • Dec. 12, 2017
Here’s the story of how a Georgia State University student — who didn’t have health insurance — was finally able to get the insulin he needed to survive without resorting to buying it off Craigslist.
Free samples from a clinic helped tide him over until a pharmacist at the Morehouse School of Medicine helped him qualify for a patient assistance program.
[A]n investigation by The Atlanta Journal-Constitution found that the arm of state government charged with protecting the public from dangerous doctors — the Georgia Composite Medical Board — rarely yanks the licenses of physicians who behave more like dealers than healers.
Years into the opioid crisis, the Georgia board has taken public action against only a handful of doctors a year for improper opioid prescribing, the AJC found in a review of board actions since 2011. In almost every case, the doctor-dominated board allowed the errant prescribers to keep seeing patients, even if they have recklessly prescribed pain killers or been arrested on drug charges.
U.S. Rep. and pharmacist Buddy Carter weighed in: “I get very frustrated with the Composite Board of Medicine that they’re not doing more to reel in some of these physicians who are obviously out of control,” he said.
Drive-by flu-shots, that is, provided by county health departments in Cherokee, Fannin, Gilmer, Murray, Pickens, and Whitfield counties.
Just to be clear, we don’t support what’s happening here, but that doesn’t mean you shouldn’t be aware of it.
Cities, counties, and schools across the country are buying their employees’ drugs from Canada and other countries. The legality is questionable*, but it’s saving local governments millions — and that’s tax dollars we’re talking.
Drug manufacturers try to say that drugs bought internationally aren’t safe, but that claim pretty much gets a collective eye roll; this is Canada, England, and New Zealand we’re talking about — not East No-Where-Land.
From the story:
While the nation grapples with soaring prices of drugs, dozens of cities, counties and school districts across the country have quietly found a solution they say protects their budgets and saves workers money: They are helping their employees buy medicines from pharmacies in Canada and overseas, where prices are up to 80 percent cheaper.
So posits Slate, in a piece written by a medical student, “Could Pharmacists Help Fix Health Care?”
[A[s costs continue to grow for health care systems here and around the world, pharmacists have become increasingly utilized as direct patient care providers, rather than just as overqualified dispensaries.
The conclusion is an unqualified “Yes” — and that’s a good thing. “The possible rise of pharmacists in American health care, resulting from the CVS-Aetna merger,” he writes, “could ultimately help alleviate primary care shortages across much of our country.”
Expected to open in August 2019, it’s going to be training doctors of osteopathic medicine (DOMs) to serve patients in rural communities. It’ll be called PCOM South Georgia. No word yet on whether it will expand its curriculum into pharmacy.
Of course it’s too good to be true. Turns out that a diet rich in it might hasten dementia … in mice, anyway. Here’s the AJC’s coverage of the story. Grain of salt, though, folks.
—Andrew Kantor • Dec. 11, 2017
Expensive enough that just those drugs pushed up the country’s retail prescription drug spending noticeably in 2014 and 2015, according to CMS figures.
Retail prescription drug spending hit $328.6 billion in 2016, up 1.3% versus 2015, according to a new analysis by the Office of the Actuary at the Centers for Medicare & Medicaid Services. The figure pales in comparison to 12.4% spending growth in 2014 and 8.9% in 2015.
What caused the deceleration? According to the agency, it was a decrease in hepatitis C costs […] fewer new drug launches, and a moderation in price hikes.
Healthcare spending in total grew 4.3 percent last year to $3.3 trillion.
A Danish study (those Danes have been busy lately) found that women who use hormonal birth control have, on average, a 20 percent greater risk of breast cancer.
Sounds bad? It’s actually about the same risk as drinking alcohol regularly. And it depends significantly on how long it’s used. And it’s incredibly low compared to other environment-cancer risks (e.g., smoking, HPV).
The little blue pill is getting a cheaper generic brother — the little white pill, also by Pfizer. It’s half the price (only about $33) of the identical brand name version.
In other words you’d pay an extra $32 just for that blue coloring. Or wait for other companies’ generics for even lower prices.
Surgeons at the University of Michigan found a simple way to reduce the chance of opioid addiction: They gave their patients lower doses right after surgery.
First they asked patients about their post-op pain, and about how much pain medication they took. Then they used that information to develop new prescribing guidelines for the hospital.
The takeaway: After surgery, patients are getting prescribed more opioids than necessary and doctors can reduce the amount without experiencing negative side effects.
Within five months of the new guidelines taking effect at Michigan Medicine, surgeons reduced the volume of prescribed opioids by about 7,000 pills.
What happens when it’s more profitable for hospitals to treat an illness than to prevent it? Just what you might expect.
In Baltimore, home of Johns Hopkins and the University of Maryland Medical Center, “The perverse incentives of the health care payment system have long made it far more lucrative to treat severe, dangerous asthma attacks than to prevent them.”
There’s plenty of yapping* about the power of social media in marketing, but there’s a lot of that metaphorical iceberg that’s hidden under the water.
“Dark social” refers to the social sharing that can’t be tracked — private messages via e-mail, instant messages, texts, Snapchats, mobile apps … you get the idea.
It’s not easy to take advantage of it, but it’s powerful enough that it might be worth it.
What it means: Researchers have developed a temporary superglue to seal shut an eyeball when it’s been sliced open.
—Andrew Kantor • Dec. 07, 2017
We have journeyed to the Temple of Apollo at Delphi* to consult the Oracle(s) about the CVS/Aetna merger. What does it mean?
Health care business consultant David Williams: Who knows?
Sharona Hoffman, professor of health law and bioethics at Case Western Reserve University: Could be good (more negotiating power with drug companies), could be bad (mergers typically lead to higher costs). But maybe not all that groundbreaking:
[A] consolidation along the lines of a CVS/Caremark and Aetna merger would not be unprecedented. The nation’s largest health insurance company, United Healthcare, operates its own pharmacy benefits manager, OptumRx.
Health and group benefits pharmacy practice consultant Nadina J. Rosier: “[I]t will at least create an environment by which information can be shared and innovation can take place.”
B. Douglas Hoey, CEO of NCPA: “Given that many people change insurance plans frequently, ‘you may be bounced from kingdom to kingdom‘.”
David Dross, PBM expert at Mercer (the consultant, not the university): ‘Employers may be in a better position to demand guarantees about overall costs.’
David Mitchell, founder of Patients for Affordable Drugs: “They’re not doing this to provide better care to people. They’re doing this to make more money.”
If they’re taking it for an RAS-related cancer (lung, pancreatic, colorectal), they might benefit from taking an aspirin as well. A very early study on mice found that Sorafenib and aspirin seem to work well together, and might even require a lower dose of anti-cancer meds.
With the use of hydrochlorothiazide. The popular hypertension treatment seems to lead to an increase in skin cancer (we’re talking a seven-fold increase), according to research from Denmark:
“We found clear dose-response relationships between hydrochlorothiazide use and both [basal cell carcinoma] (BCC) and [squamous cell carcinoma] (SCC).”
The companies lost their first Xarelto lawsuit and have been ordered to pay $28 million.
—Andrew Kantor • Dec. 06, 2017
And it could hit hard around the holidays, according to CDC tracking.
Check the chart. When the number of “influenza-like illness” reports cross the black line, it’s flu season:
Right now it looks like that’ll happen … well, this week nationally. Georgia looks like it’ll be on the earlier end of the trend this year, too.
That’ll combine a health insurer, PBM, and nationwide pharmacy chain. The company says it’ll be great for consumers.
Brooklyn to Manhattan. Cheap. See Joe.
Novartis’s erenumab looks like it has a major effect on migraine duration — it apparently blocks a particular calcitonin gene-related peptide path.
Phase three trial data on nearly 1,000 patients showed that it typically cut between three and four “migraine days” per month. In half the patients treated, migraine duration was reduced at least by half.
“Going digital” in this case means letting patients use the Web to order and confirm refills. Here’s a piece — admittedly, from the company that provided those digital services — about how Porter Pharmacy in Cochran (pop. 5,150) leveled the playing field with the big boys.
This means that Porter Pharmacy & Gifts, which was previously only open between 8:30a.m. and 6p.m. on the weekdays, was now a 24 hour operation. Customers immediately responded to this higher level of convenience. [Owner Rob Dykes] estimates that upwards of 40% of digital prescriptions that come through are submitted after hours or on Sunday.
Maybe so. No one knew why it didn’t work, but now they may have figured it out: “a previously unnoticed genetic mutation” in the virus used to make it.
When the researchers reversed the mutation in one of the viruses, the virus became more active, making copies of itself – which is known as replicating – more quickly in cultured human nasal cells and inducing a stronger production of immune proteins [that protect against flu infection].
It has the potential to cause hairy tongue. (Don’t click the link if you want to enjoy the rest of your day to its fullest.)
—Andrew Kantor • Dec. 01, 2017
That’s one way to do it: DEA is mandating a 20 percent cut in opioid production for 2018. (If you didn’t realize the DEA could enforce manufacturing quotas, you’re not alone.)
A comedy about a retail pharmacy? Yep — it’s called “Vials” and it’s from Amazon. Check out the trailer here:
It’s a medium-sized regional chain, but it got into the MTM game in a big way. And it hit the big time.
In 2013, the chain began efforts to make its MTM services more robust. Pharmacist clinical coordinators traveled from store to store, training pharmacists and technicians to perform MTM interventions such as comprehensive and targeted medication reviews.
Even against national players, it won United Healthcare’s Targeted Intervention Program (TIP) Challenge in 2013, 2014, and 2015, and placed high in 2016.
Many health care plans now contract with Giant Eagle directly instead of going through vendors, and the chain has added a clinical call center to support its growing operations.
If you’re looking to go beyond filling bottles, that’s one example worth following.
But tobacco companies are finally, grudgingly admitting that their products are dangerous. Smoking kills 1,200 people a day, and now Altria/Phillip Morris and R.J. Reynolds will have to spend about $30 million admitting it over the next year.
They spend about $8 billion each year in marketing.
Australia took a different tack, requiring cigarette boxes to have some serious warnings:
To change their gut bacteria after C. diff treatment, swallowing poop is both effective and preferable to having it, um, delivered the other way*.
The only downside, as one patient noted, was the sheer number of pills. Participants had to down 40 within an hour, or one dose every minute and a half.
One bit of good news:
In reality, the pills actually don’t have any taste or flavor, which is probably best, all things considered.
Gilead is selling it’s hep-C cure Sovaldi in China … but at a fraction of the U.S. price. A small fraction — we’re talking less than $9,000 for a full course, compared to $84,000 here at home.
And while we’re on the subject: “Finally Putting Some Fun in Erectile Dysfunction.”
Wasteful medical care — whether intentional (like that ear piercing), because of an abundance of caution, or simple overtreatment — costs us billions. And “us” means as individuals and as taxpayers. Read it and weep.
Widespread in Oklahoma and Louisiana, but Georgia is in the next tier: “regional.” We know you’ve had your shots, but make sure your patients do, too.
—Andrew Kantor • Nov. 29, 2017
If you are enrolled in a PEO plan through GPhA — or if you are interested in enrolling in one — open enrollment ends Friday, December 8.
To enroll (or just find some more info) reach out to Denis Mucha at firstname.lastname@example.org or (404) 419-8120.
Current participants must confirm their enrollment, even if there are no changes to their plan or coverage status (employee, employee+spouse, etc.). They can do this by going to EnrollVB.com/gpha — but remember, it has to be by December 8.
And again, if you have questions, Denis Mucha is your guy: email@example.com or (404) 419-8120.
Background: Bacteriophages have tremendous potential for treating infection, but they’ve been mostly ignored in the West because of the availability of antibiotics. But now, with antibiotic resistance on the rise, phage therapy is popping up in the news more and more.
Phages are virus that attack bacteria. If you have an infection, chances are there’s a phage out there that will kill it. But those phages have to be matched; what kills one infection won’t affect another. It’s like hunting for a key that fits a particular lock.
The good news is those keys can be found just about everywhere — in soil, in ponds, on trees — but it’s trial and error to match one to the bacteria you want to kill.
Story: Now two Georgians, including a UGA grad student, have launched a directory of phages. If it takes off, the idea is that a physician looking to fight a particular bacteria could turn to the directory to find someone who has the matching phage, or who is willing to hunt for it.
Two cool bonuses: First, bacteria can’t grow resistant because phages can evolve with them. Second, phages look absolutely awesome:
(Personal note: Yeah, your humble editor is into this topic. I’ve been writing about it since 2006.)
That’s right: Starting in January, GPhA Buzz (and some major parts of the GPhA.org website), will only be available to GPhA members*.
Actually, not. It turns out that the E. Coli that lives in hamburger meat can also thrive quite nicely in the dry environment of flour. Ergo, cookie dough can kill you.
“We’re not trying to ruin people’s holidays but we want them to be aware of the risks,” claimed CDC’s Samuel Crowe, the lead author of the study — just as he ruined everyone’s holidays.
Good news: This doesn’t include the cookie dough in ice cream, nor the pre-packaged kind for people too lazy to make their own cookies. You know who you are.
What’s with the company’s acquiring a manufacturing pharmacy license in the state? Is it just to allow it to relabel packages?
“Becoming an FDA-registered relabeler means UPS now has the ability to take products from a manufacturer, relabel them, and sell under their own label or brand. Because of FDA requirements, we will soon know what UPS will relabel.”
The FDA would like to remind you that do-it-yourself gene therapy is illegal.
(Actually, the agency says it’s illegal, but it’s not clear exactly what law would be broken.)
—Andrew Kantor • Nov. 28, 2017
Eli Lilly is considering whether to trademark the phrase “A chance to live longer.” Bristol-Myers Squibb wants to register it, but Lilly used it first.
That’s almost 120,000 Georgians who have bought healthcare coverage through the Obamacare exchange. (The U.S. total so far is about 2.3 million.) Even with the shorter sign-up period, the state is expected to meet if not exceed its 2017 total.
Researchers have looked into possible health benefits of cinnamon for a while. And while there’s no evidence it helps with glucose levels, it does seem to help burn fat better. And a new study gets a little deeper into why that happens.
Downer: There are two types of cinnamon (Ceylon and cassia), and while the cassia is what you find in your supermarket, it’s the Ceylon version that has the medicinal properties.
If you’re an opioid, that depends. According to a Columbia University study, if you were born between 1947 and 1964, you have “a significantly higher risk of death from overdose of both prescription opioids and heroin.”
BUT … if you were born between ’79 and ’92, you have a higher risk of overdosing specifically from heroin.
Why? Because Boomers had a “high rate of illicit drug use,” while Millennials just like new experiences.
The FDA approved GSK’s Juluca, a two-drug combo to treat HIV. Until now, the only approved treatments were three or more drug regimens*.
The company’s CEO called the drug “critical,” but not for treating HIV — for ‘filling the revenue gap’ left by declining sales of Advair.
Remember rofecoxib, aka Vioxx? It was supposed to treat pain but caused heart attacks and strokes instead.
Now a small pharma company wants to bring it back — but this time as a hemophilia treatment. Unlike other pain killers, Vioxx doesn’t raise the risk of internal bleeding — and it’s not an opioid, either.
—Andrew Kantor • Nov. 22, 2017
It’s paying $815 million in cash. H.D. Smith subsidiaries Triplefin and its PSAO Arete Pharmacy Network are not included in the sale.
Meet the Nike Tanjun sneaker. What’s so special? RunnerClick named it the most comfortable shoe for standing all day. (Rounding out the top three picks were the ironically named Skechers Go Walk 4 Exceed and the New Balance W1765v2.)
Who comes up with this stuff, anyway? Reality (and it’s kinda sad people had to take time to debunk this): Annual vaccinations are more likely to strengthen your immune system.
That’s the result from a Norwegian study that found…
immune system CD4 and CD8 T-cells — which target viruses — had more disease-fighting capability “after multiple annual vaccinations” than those in people who didn’t get the yearly flu shot, the investigators found.
Bonus: The story includes a quote from a doctor with the Best Name Ever: Infection expert Debra Spicehandler.
Check out this story about the last handful of people in America still using iron lungs; they have polio. (Nowadays, of course, vaccinations prevent polio — so no one ever has to suffer this fate again. Sorry, Jim Carrey!)
N-Acetylcysteine is supposed to treat the common cold. But it also seems to attack breast cancer cells — if not outright kill them, at least stop them from spreading.
—Andrew Kantor • Nov. 21, 2017
The White House’s Council of Economic Advisers has calculated the cost of the nation’s opioid epidemic at $504 billion — and that was in 2015. (That’s 2.8 percent of the country’s entire gross domestic product.)
That number takes into account treatment, lost wages, first responders … you get the picture. In other words, it’s money that could be spent on something else.
While you were enjoying your weekend, we were enjoying seeing a couple of* our folks making headlines.
President Liza Chapman was featured on ABC’s WSB Atlanta affiliate, talking about “how pharmacists are stepping up to help with the opioid crisis” (and viewed, we’re told, by about 96,425 people).
Meanwhile, GPhA’s VP of public policy, Greg “Fireball” Reybold, was quoted in the Valdosta Daily Times about the availability of naloxone in Georgia — specifically, that not every pharmacy has it in stock.
“There’s not a huge number of people coming in and looking for this,” he said, but “there’s a huge number of people who could benefit from it.”
The company would like to settle those opioid lawsuits in one fell swoop. In fact, it’s talking to states that haven’t sued it yet, too, and it’s hired the “Queen of Torts” to help it reach a settlement.
Except DEATH — death by the impending bird flu pandemic. Which researchers really don’t want to be alarmist about, so consider it a very quiet scream — like the kind you’d hear from a bird-flu researcher from inside his well-stocked bunker in Iceland.
Nevada prison officials really want to execute some people, and they’re planning to mix some drugs they have on hand — including diazepam and fentanyl — to try to do just that. But Pfizer, which makes those drugs, says, “No way.” It sold the drugs to help prisoners, not for lethal injections.
Nevada, though, is refusing to return the medication: “We are under no obligation, once we’ve made a purchase, to return it.”
Pfizer and most other pharmaceutical companies refuse to sell their products for executions. The United States is the only modern Western nation to still have the death penalty on the books.
Amsterdam will be the new, post-Brexit home of the European Medicines Agency.
Other than as a side dish, that is. It seems that squirrel brains (such as they are) experience the same lack of blood flow during hibernation that humans experience during a stroke.
Now, a team of NIH-funded scientists has identified a potential drug that could grant the same resilience to the brains of ischemic stroke patients by mimicking the cellular changes that protect the brains of those animals.
—Andrew Kantor • Nov. 21, 2017