What to Know

In 36 hours, two dead in Forsyth

In just 36 hours this past weekend, two people died (including a 19 year old) and four were hospitalized after overdosing on what appears to be fentanyl in Forsyth County.

Great video explaining PBMs

The good folks at NCPA have created a short (not even three minutes) animated video that explains what’s wrong with PBMs — great for sharing with laypeople.

The PBM Story offers an overview of how PBMs got their start, how they morphed into money-making machines, how exactly they make that money, and the documented effect they’ve had — and continue to have — in increasing prescription drug costs.

Check it out, and share it with the people who don’t realize the problem.

(Psst: The voiceover is fantastic.)

Mylan sued over EpiPen price status

In the latest brouhaha over Mylan Pharmaceuticals, it’s come to light that the company — in the first and only move of its kinda — sued the state of West Virginia to force the state to give EpiPens “preferred” status under Medicaid, rather than to it’s less-expensive competitor.

Mylan sued over EpiPen price games

In the latest kerfuffle over Mylan Pharmaceuticals,the company is being sued by Sanofi, which claims Mylan jacked up the price of its EpiPens, then offered huge rebates to PBMs, in order to keep Sanofi’s Auvi-Q competitor off PBMs’ formularies.

The suit also points out that Mylan refused to give EpiPens to schools at a discount unless the schools agreed never to purchase a rival product.

Are you as covered as you should be?

Don’t forget to at least check out our voluntary insurance products. Members get a great deal, and these are the kinds of policy you might not have from your business or employer.

Enrollment closes this Friday — April 28. Check out EnrollVB.com/GPhA.before then, and cover what your medical plan doesn’t!

Anthem, Express Scripts break it off

After a lawsuit alleging that Express Scripts inflated prices and refused to negotiate in good faith, Anthem has had enough. The company said it will not renew its contract with Express Scripts when it expires at the end of 2019.

Despite the lawsuit — in which Anthem said it had lost $15 billion because of Express Scripts — the PBM’s CEO said he was “perplexed” at the decision. He also cited the company’s “98 percent retention rate.” That referred to the number of clients, not their size; Anthem represented at least 17 percent of Express Scripts’ revenue in 2016.

It’s World Malaria Day

Here’s why it’s important:

Malaria transmission has been ended in the U.S., but it still appears in hospitals (1,500 cases a year) when people catch it after travelling. And remember, measles was almost wiped out, too.

—Andrew Kantor • Apr. 26, 2017


Diabetes Self-Management Education is a fertile ground for pharmacists to engage in advance patient care. Unfortunately, the thought of “accreditation” and lingering questions of “do I need to be a CDE” prevent many pharmacists from diving into this opportunity.

Join Jake Galdo on May 11 at 7:30 PM for a one-hour program entitled DSME and You. Jake will provide the 30,000-foot view and checklist on how you can be the next provider in your neighborhood.
Click here to register for DSME and You. It’s free!

—Phil Ratliff • Apr. 24, 2017


It’s two, two, two epidemics in one

BuzzFeed News* explains how the ‘painkiller epidemic’ in the U.S. is actually two separate but equally important events: Prescription painkillers are hitting the middle-age and older crowd, while heroin is killing the young.

  • Not to be confused with plain ol’ BuzzFeed, home of click-bait lists

There is no headline I can use here that the boss will approve

Remember Addyi, aka flibanserin, the “female Viagra” that never really caught on? It’s still out there — and now it’s appearing in those creepy OTC supplements we like to make fun of (e.g., LabidaMAX, Monkey Business).

Are you ready for the next pandemic?

The latest National Health Security Preparedness Index is out — it measures how well states (and the country) are prepared for a public health emergency.

It took into account factors such as detecting health threats early; communication between government, community, and individuals; and healthcare delivery.

The good news: “Consistent National Progress: The U.S. posted a fourth consecutive year of gains in health security for disease outbreaks, disasters and other large-scale health emergencies.”

The not-as-good news: We’re still behind the rest of the developed world.

The bad news: If something happens in Georgia, head to North Carolina. We’re below average, N.C. is above it.

Georgia hospitals and the economy

Georgia hospitals play a huge role in the state’s economy. How big? To the tune of bringing $47.8 billion each year in the form of healthcare spending and jobs.

Despite that, according to the latest DCH figures, almost half of all hospitals — and more than two-thirds of rural ones — lost money in 2015, mostly due to uncompensated care. And that’s expected to increase in the future.

Remember to check out our insurance products

The enrollment window for GPhA’s voluntary insurance — life, accident, and critical illness products, offered through UNUM — is open through April 28.

Look for your e-mail from Enroll VB or visit EnrollVB.com/GPhA.

These policies supplement your medical coverage — they take care of things your medical plan does not cover. Check ’em out!

Tomorrow, eye of newt

Yesterday it was an anti-viral from frog mucus. Today it’s an antibiotic from dragon’s blood. Really.

—Andrew Kantor • Apr. 21, 2017


Snot what you think

Somewhere, someone got the idea to test the mucus of some frogs. (Science!)

The result: “An Amphibian Host Defense Peptide Is Virucidal for Human H1 Hemagglutinin-Bearing Influenza Viruses.”

In human terms, “Frog mucus can kill some flu viruses.” Like bread mold gave us penicillin, this could lead to a new type of flu treatment.

PBMs say pharmacist greed is behind the push to limit DIR fees

PBM clawbacks via DIR fees are getting a look-see in Congress, where a bill — the Improving Transparency and Accuracy in Medicare Part D Drug Spending Act — would prohibit Medicare Part D plan sponsors and PBMs from “retroactively reducing payments on accurate reimbursement claims submitted by pharmacies.”

The PBMs claim pharmacies just want to keep more money for themselves and not offer lower costs for Medicare beneficiaries. Seriously. That’s, like, almost an exact quote from the VP of strategic communications for the Pharmaceutical Care Management Association.

This is the flu that never ends

It just goes on and on, my friends.

We’re begging here

Come on, folks — please take our annual member survey. It’s about 10 minutes, you could win $100, and it’s important for us to know what we’re doing right and what we can change.

Just go to GPhA.org/2017survey. Answer some questions about your practice setting and some GPhA services. Tell us what you think. That’s it.

We’ve extended the deadline to May 5. Shilpa Durbal of Prestige Pharmacy in Snellville is the first $100 winner — the next one could (should!) be you.

GPhA.org/2017survey. Quick, easy, painless, helpful.

When grassroot is artificial turf

A non-profit organization, the “Partnership for Safe Drugs,” is fighting against the idea of allowing people (and pharmacies) to import less-expensive drugs from Canada.

Why? While the implication in the name is that somehow Canadian drugs are less safe (they aren’t), the real reason is that the group has ties to the Pharmaceutical Research and Manufacturers of America — PhRMA, the U.S. pharmaceutical industry lobbying group.

Spring break was never like this

Thousands of sterile males* lookin’ for action were released in Key West, with the goal that they would mate with females who would then be unable to give birth. It’s a pilot project to see about eradicating, or at least reducing, the population of Zika-carrying Aedes aegypti mosquito.

* male mosquitoes, that is

Pharmacy owners, wanna make some more money?

Our friends at the National Community Pharmacists Association are offering a “jam-packed two-day training” event — the Re-Engineering Your Pharmacy Boot Camp. The focus: how to offer and operate an enhanced service business.

Successful pharmacy owners share streamlined workflow, staff buy-in strategies, branding and more. Networking, training, and implementation support you need to take your pharmacy to the next level May 5-6 in the New York City metro area*. Reserve your seat today!

*They mean New Jersey

—Andrew Kantor • Apr. 20, 2017


Re-funding the FDA

Congress is looking to reauthorize user fees — money paid by pharma companies and makers of generic drugs and medical devices that essentially funds the FDA’s drug- and device-approval process..

We’re spending, so why not tax?

Some states — and the U.S. Congress — are considering taxing opioid manufacturers (1 cent per milligram) to help pay for the ERs that are dealing with overdoses.

Are you prepared?

Face it, there’s a decent chance you’re gonna get robbed or burgled. So why not be prepared?

We’ve got three free CPE webinars (1.5 hours each) coming up in April and May — free thanks to Compliant Pharmacy Alliance.

  • One covers the steps you need to take when controls are stolen.
  • One covers physical improvements you can make to your pharmacy.
  • And one covers how to be prepared for an armed robbery to keep everyone safe.

Check them all out at GPhA.org/cpeasy.

Lecture and CPE from Emory on the legislative session

The Rollins School of Public Health at Emory has a free lecture that offers 1.5 hours of CPE. The subject: a recap of the 2017 Georgia legislative session including the impact on public health in Georgia.

Click here for more info and to register.


A bill in Nevada to reduce the cost of diabetes meds (by requiring transparency in pricing) is getting opposition from… patient groups? Huh? Why? Because those ‘patient groups’ are actually funded by pharmaceutical companies.

—Andrew Kantor • Apr. 18, 2017


Senate tackles opioids

A bipartisan bill in the U.S. Senate would limit opioid meds to a seven-day supply for acute conditions — prescriptions for chronic conditions would not be affected.

Shocker: “Drugs don’t work in patients who don’t take them”

Did you know that prescription non-adherence costs Americans between $100 million and $289 million a year?

  • 20 to 30 percent of scripts are never filled.
  • 50 percent of meds for chronic conditions isn’t taken as prescribed.
  • Non-adherence causes 10 percent of hospitalizations each year — and 125,000 deaths.

Today’s no-brainer

Several states, including Georgia, are working to make it legal for kids to use sunscreen when going on school field trips. Say what? Yep, because sunscreen is considered a drug, kids aren’t allowed to use it. Even teachers or school nurses can’t apply it. Really.

Reality, checked

When states are considering covering “abuse-deterrent” opioids under Medicaid, how do drug companies try to convince them? Not just by lobbying to cover them, but by lobbying analysts to lower the cost estimates.

“The last of the pricing Mohicans”

At least one generic drug maker is continuing to jack up its prices despite investigations and even an anti-trust probe.

Happy 100th!

Aqua Velva launches “5-in-1 Sensitive After Shave Balm.” In other news, Aqua Velva is still a thing.


Missouri is ever-so-close to having a prescription drug monitoring program. The bill has passed the house, but the state senate went and changed it, so it’s back to the house…. If this thing ever passes, it will mean all 50 states (and DC) finally have a PDMP.

Arkansas’s plan to execute eight men this past Friday fell apart when it turned out the state had acquired the execution drug from McKesson under false pretenses.

—Andrew Kantor • Apr. 18, 2017


Are Vitamin D supplements necessary?

A 2008 study found that “vitamin D supplementation decreases all-cause mortality in adults and older people,” but a New York Times article finds that doctors and researchers are skeptical — and think too many people are taking too much.

Diabetes might be worse than we thought

When figuring out what kills us, researchers look at death certificates. Those often list the immediate cause, not the underlying one — which is often diabetes.

Mortality rates attributed to diabetes are imprecise largely because death results from both immediate and underlying causes, and not every one of them gets recorded.

If that’s correct, diabetes could be the third leading cause of death in the U.S., according to a new study — and could be responsible for 12 percent of Americans’ demises.

Save the kittens

Every time someone takes our annual membership survey, a kitten gets a forever home.

Please, folks, take 10 minutes to do the survey and tell us how we’re doing.

Naloxone for colleges

Colleges nationwide will be able to get naloxone free thanks to a grant from the Clinton Foundation and Adapt Pharma. They’re making 40,000 doses available.

A 2015 survey found about one in six college students took opioids without a prescription, and almost a third knew someone who overdosed.

Bring our yer meds

Time for the annual National Prescription Drug Take Back Day! Yay! It’s April 29 — and the DEA will happily help you find a drop-off location and spread the word.

Remember to check out our insurance products

The enrollment window for GPhA’s voluntary insurance — life, accident, and critical illness products, offered through UNUM — is open through April 28.

Look for your e-mail from Enroll VB or visit EnrollVB.com/GPhA.

These policies supplement your medical coverage — they take care of things your medical plan does not cover. Check ’em out!

Press releases at 10 paces, gentlemen

PhRMA (representing drugmakers) and PCMA (representing PBMs) are still going at it; they have finger-pointing down to a science.

It started when PhRMA launched a new ad campaign urging PBMs to “Share the Savings.”

Note: An earlier version of this story reported that the U.S. was sending a carrier battle group in response to the ad launch. The carrier was actually being sent because of a North Korean missile launch. We regret the error.


Alabama could become the first state to classify Xanax as a C-II drug — up there with hydrocodone and fentanyl, and almost as bad as marijuana.

Maryland’s general assembly passed a law that gives the state’s attorney general power to impose penalties on drug companies that implement “unconscionable” prescription drug price increases.

—Andrew Kantor • Apr. 11, 2017


Logical fallacies

When addicts can’t get their opioids, they’re turning to… Imodium. Really.

The logic? Opioids cause constipation. What else causes constipation? Diarrhea drugs. Ergo, take a few hundred Imodium a day.

Doxycycline could treat PTSD

The antibiotic appears to “disrupt the formation of negative associations in the brain” and potentially prevent people from suffering from PTSD.

Researchers admit the obvious problem: “[I]n the real world we don’t know when a traumatic event is about to occur.”

Zika is coming

As mosquito season looms, Georgia is — well, not quite in the crosshairs of Zika, but close enough. That’s according to new research out of Saint Louis University that found 507 “high risk” areas based on mosquito population (for transmitting the virus) and presence of STDs (which indicates higher-risk sexual activity).

Paging Ozzy Ozbourne

The CDC is investigating Fresh Express salads sold in Walmarts throughout the Southeast after a dead bat was found in one in Florida. They’ve been recalled in Georgia and seven other states.


Maryland’s legislature passed a law allowing pharmacists to supply birth control pills without a prescription.

—Andrew Kantor • Apr. 10, 2017


Our number-two story today

Synergy Pharmaceuticals, maker of “novel gastrointestinal therapies,” has launched a free app: The Poop Troop. It allows you to insert a variety of poop-themed emojis into your conversations. (Android version. iPhone version.)

Why would you possibly do this, assuming you’re no longer in 7th grade?

So you can text/e-mail your healthcare providers about your poop without being embarrassed.

Seriously. It’s part of the company’s “Confront Constipation” initiative, “designed to encourage conversation and allow people to better express the physical and emotional impact of chronic idiopathic constipation.”

The “anthropomorphic turds” (Synergy’s words, not ours) range from “Plugged Up Paulie” to “Splasher Asher” to “Runny Ron.”


Each character in the free keyboard app represents a type of bowel movement—from constipation, to normal, to diarrhea—and an emotion that people with CIC often associate with each, including “stressed,” “depressed,” “angry,” “relieved,” “cool,” “euphoric,” “surprised,” “concerned” and “embarrassed.”

An Atlanta-based* gastroenterologist physician assistant points out, though, “These emojis are not intended to serve as a diagnostic or a medical tool.”

*We wanted to get a Georgia angle in here

Generic EpiPens are NOT recalled

While many “branded” Mylan EpiPens have been recalled, the “generic” version (also made by Mylan) has not.

The clear and concise guide to PBMs

Our friends at the National Community Pharmacists Association have a cool new resource that does an amazing (seriously, it’s great) job of explaining how PBMs are affecting drug prices.

It’s called “The PBM Storybook,” and it’s a well-written and -illustrated explanation of PBMs’ place in the pharma market.

What’s great is that it’s short, concise, and in plain English.

It comes in six- and 12-page formats (depending on your printing needs). Perfect for giving to, say, legislators or employers or journalists. Grab it by clicking here.

New device can do quick head-injury assessment

A handheld EEG can determine whether a head injury is severe enough (i.e., has caused brain bleeding) to require hospitalization.

In other states, er, state

New Mexico is the first state to require police to carry naloxone.

—Andrew Kantor • Apr. 07, 2017


You know there’s a vaccine for that, right?

More than 40 percent of Americans 18-59 have some form of genital HPV, according to a new report from the CDC, and almost a quarter have a high-risk variant.

Each year, 31,000 men and women are diagnosed with cancers caused by HPV — which, in most cases, would have been preventable with the HPV vaccine.

Aspirin continues to work miracles, remains candidate for sainthood

It’s not just heart disease. Long-term use appears to mean a lower chance of dying from cancer.

You’ll be getting this e-mail…

It’s from Enroll VB. It’s not spam — this is the company GPhA is working with to offer voluntary insurance through UNUM: life, accident, and critical illness products.

Enrollment for these voluntary products is open again through April 28. So you really should take a look at the policies available exclusively to GPhA members at EnrollVB.com/GPhA

In other states

Missouri could finally have a PDMP — it’s the only state without one. The holdup? Physicians didn’t want to have to use it.

If you’re planning a vacation to Hawai’i, watch out for brain-eating parasitic worms. (Yes, that’s how we’re spelling Hawai’i. We’re hipster that way.)

People in Louisiana and Virginia are complaining about having to pay for poor people to have medical care.

Meanwhile California is considering a single-payer plan.


—Andrew Kantor • Apr. 07, 2017