In some cases, Spark Therapeutics can cure a rare form of blindness (retinal dystrophy) with a new gene therapy. But how much to charge?
Experts: One. Million. Dollars.
Spark: Nah. How about the bargain price of $850,000? (You can get one eye done for half that, if you like.)
Pundits: Such a deal!
A federal investigation found that just 10 misclassified drugs* cost Medicare $1.3 billion in just four years.
Worse, only four drug makers were responsible for more than half of those “errors,” and just two drugs accounted for 90 percent of those lost rebates.
What drug makers? What drugs? The HHS inspector general won’t say.
Wait wait, it gets better. The problem could be worse, but even if CMS thinks there’s some shenanigans going on, the agency has no power to compel drug makers to provide information. (Mylan got caught in 2016 because its competitor tipped off the government.)
The inspector general thinks this should change.
There’s been a quiet epidemic of C. difficile infections around the country over the past 20 years (“the most common microbial cause of healthcare-associated infections in U.S. hospitals,” per the CDC), and no one knew where it was coming from.
Until now. It turns out the culprit is a sweetener called trehalose, which started being added to a lot of food in the early 2000s when the manufacturing cost dropped. Two particular strains of C. diff have genes that let them metabolize it. Result: Infection City.
This is pretty shocking: Some pharmacists are apparently reluctant to dispense naloxone to people in danger of overdosing on opioids, citing either the cost (they’re afraid of not being reimbursed) or simply the lack of desire to help addicts.
Yes, really; 29 percent of Kentucky pharmacists said they were simply unwilling to dispense it.
Remember: In Georgia (like most states) pharmacists do not need a prescription to dispense naloxone, nor any extra training. You only need a copy of the standing order of the commissioner of public health, available at GPhA.org/naloxone.
AbbVie was pharma’s biggest advertising spender in December 2017, shelling out $30.9 million on ads for Humira.
Pfizer wasn’t far behind, though, with a combined $26.6 million to promote Xeljanz XR and Lyrica during the month. (If you include the $16.7 million it and Bristol-Myers Squibb spent promoting Eliquis, Pfizer actually tops the list.)
Johnson & Johnson took the number-three spot with $23.5 million on Xarelto.
—Andrew Kantor • Jan. 04, 2018
It looks like chocolate will be gone in about 40 years as the cacao plant succumbs to global warming.
But there’s a ray of hope: Scientists from the University of California are teaming up with Mars (the company, not the god) to use — you guessed it — CRISPR to try to save the plant.
Cacao plants occupy a precarious position on the globe. They can only grow within a narrow strip of rainforested land roughly 20 degrees north and south of the equator, where temperature, rain, and humidity all stay relatively constant throughout the year. Over half of the world’s chocolate now comes from just two countries in West Africa — Côte d’Ivoire and Ghana.
As the climate changes, it pushes the growing area further up the mountains to the point it becomes inaccessible.
Yes, humans can tell if one another are sick just by looking. So says a paper published in the Proceedings of the Royal Society B*. But why read a dry academic paper when you can read the plain English version from the Washington Post?
Drug Channels’s Adam Fein writes about what he says are going to get a lot of attention this year: Co-pay accumulator programs.
In a nutshell:
But that, says Fein, is starting to change. Health plans are beginning to say, “If the drugmaker gives you a coupon, it doesn’t count against your deductible.”
And that will be a shock for a lot of patients, who suddenly have to bear a much larger share of their annual prescription costs because these coupons effectively count against them.
As Fein explains, adding insult to injury, PBMs give these policies names like “Out of Pocket Protection program.” And, he says, “Every word in those names is wrong.”
No, avoiding cow’s milk doesn’t prevent diabetes. So concludes a fairly large, long-term study that found “Cow’s Milk Doesn’t Play a Critical Role in Development of Type 1 Diabetes.” (That’s the news story, click here for the study in JAMA.)
APhA reports that 51 U.S. senators have now co-signed the big provider-status bill, the Pharmacy and Medically Underserved Areas Enhancement Act.
It would have Medicare pay for “certain pharmacist services that: (1) are furnished by a pharmacist in a health-professional shortage area, and (2) would otherwise be covered under Medicare if furnished by a physician.”
Contact your senators and ask them to support S. 109.
Johnny Isakson: Phone: (770) 661-0999; fax: (770) 661-0768
David Perdue: Phone: (404) 865-0087; fax (404) 865-0311
—Andrew Kantor • Jan. 03, 2018
If you aren’t a GPhA member, your last GPhA Buzz e-mail will be Monday, January 8. That’s when it — along with some major sections of the GPhA.org website — go members-only.
If you’d like to continue to receive Buzz, no worries, just join GPhA! The daily news is just one of a host of member benefits, including a lot of free and deeply discounted CE courses. (And remember, it’s a license-renewal year.) Joining is easy: Just head over to GPhA.org/join!
It’s in 13 states (Georgia is not among them). The likely culprit: romaine lettuce, according to Canadian authorities.
Interestingly, though, they’re limited to glucose and sucrose. (Fructose doesn’t cross the blood-brain barrier, so that didn’t have an effect.)
A study in New Zealand found that, “[P]articipants who had consumed glucose or sucrose tended to perform worse on the cognitive tests than those who had consumed fructose or sucralose.”
Do we need to say more? (Georgia’s numbers are a bit outdated, though — the last report from DPH was from December 9, 2017.)
About 35 of the state’s hospitals — that’s about 35 percent — are being hit with Medicare penalties in 2018 because of patient injuries. That makes Georgia the sixth-worst state in the country; nationally about 23 percent were penalized.
The good news: Hydraulic fracturing (aka, “fracking”) has cut U.S. energy costs tremendously, and reduced pollution by cutting the use of coal.
The bad news (besides earthquakes): Babies born within about two miles of fracking sites have a much higher risk of “infant mortality, ADHD, asthma, lower test scores, lower schooling attainment, and lower earnings.”
The good news: These effects are very local; “the study found no evidence of impacts on infant health among babies born to mothers living farther than about 2 miles from a fracking site.”
You might want to warn them that, if they’re taking varenicline to quit smoking, there are some potential dangers.
If they have had heart issues, a study found that they’re “34 percent more likely to be hospitalized or visit the ER due to a heart problem while taking the drug.” (For people without heart problems, the risk of a cardiovascular event only goes up about 12 percent.)
Despite the best efforts of anti-vaxxers, measles deaths worldwide have fallen below 100,000 per year for the first time in history, thanks to “widespread donor-supported vaccination that began in the early 2000s.”
Effective January 1, a bunch of pharmaceutical companies are raising the prices of their drugs in the U.S. Allergan raised its prices across the board by 9.5 percent; Teva’s increases ran from 2.3 to 9.4 percent.
—Andrew Kantor • Jan. 02, 2018
C2 Medical Solutions, owned by GPhA members Chandler Conner, was also named to UGA’s Bulldog 100 — the list of “the fastest-growing businesses owned or operated by UGA alumni.”
It looked like Georgia’s ACA enrollment was going to be quite a bit lower than last year … until a last-minute surge pushed the 2018 numbers to just about the same level as 2017. And it’s not over yet.*
Bottom line: In 2018, about half a million Georgians — at least 483,000 — will be getting their health insurance thanks to the ACA exchange. (That’s part of 8.8 million Americans total.)
For the second time in two years U.S. life expectancy has dropped, most likely because of the opioid epidemic. It’s now at 78.6 years, trailing all other Western nations, and just below Chile, Costa Rica, and Slovenia. Yeesh.
The U.S. House passed a temporary funding bill that will (among other things) pay for the Children’s Health Insurance Program so 8.9 million children — including 232,000 Georgians — can still afford health care.
The emergency funding bill, though, doesn’t provide any money for Puerto Rico or the U.S. Virgin Islands.
Catheter design is tougher than you might think. The problem: “How do you keep a very thin tube flexible enough to snake into hard-to-reach places but rigid enough to withstand insertion?”
The answer is both what you think and NOT what you think.
The HHS’s Office of the Inspector General found that drugmakers — and not just Mylan, which already got caught and fined — may have misclassified generic drugs as branded ones, resulting in $1.3 billion in extra government payments from 2012 to 2016.
Apple (the tech company) doesn’t want Roswell-base Red Apple Pharmacy to trademark its logo because it contains an apple and thus might be confused with the tech giant. That’s because Red Apple is going by “Red Apple Interactive Pharmacy,” so, you know, there’s that tech angle.
Purdue Pharma, which has been accused by, well, everyone, of helping fuel the opioid epidemic by pushing its Oxycontin pain reliever is fighting back against the lawsuits, investigations, and judicial rulings with … an ad campaign.
—Andrew Kantor • Dec. 22, 2017
The FDA says it’s planning to crack down on homeopathic “remedies” and other flim-flam (we’re looking at you, Zicam) that may do more harm than good.
The NIH has lifted its three-year ban on experiments involving genetically altered viruses*. As long as these experiments don’t escape from the lab, we’ll all be fine.
They’re called “gain of function” studies, and they look to figure out what makes a pathogen spread faster.
Oh, why was the moratorium in place? Because of two cases when viruses (avian flu) or bacteria (anthrax) at CDC labs inadvertently got loose.
But don’t you worry: A government panel will make sure experiments are safe.
If you’re a certified pharmacy tech, you can now get extra certified as a compounded sterile preparation technician (CSPT), which can help you get a (better-paying?) gig at a compounding pharmacy.
The certification comes from PTCB, the same folks who give the standard pharmacy-tech certification. It’ll cost $50 to apply and $149 for the exam. (There’s a $50 discount if you do it by January 31, 2018.) Seems like you’d be able to earn that $149 back pretty quickly with that line on your résumé.
In the U.S., where people go bankrupt over healthcare debt, hospital corporations find there’s more money to be made collecting that debt than in saving lives.
Congrats to GPhA member Michael Azzolin, COO and co-founder of PharmD on Demand, who was named a member of the Bulldog 100 — one of “the fastest-growing businesses owned or operated by UGA alumni.”
Fewer than half of college students get flu shots — we’re talking about 46 percent. Why? How about that 59 percent think the vaccine can cause the flu? Seriously. What college are these kids going to?
Bonus: 61 percent said they would get the shot if they got food or cash to do so.
We moved from “widespread” down to “regional,” which is good news (although typically this will go up and down during the season). So far no deaths, but 61 hospitalizations.
—Andrew Kantor • Dec. 19, 2017
How do you stop parents from trying to opt their kids out of immunizations? In Washington state, requiring counseling (and a signed letter from a physician) worked.
With the crisis in full swing and opioid use being tracked (and sometimes limited), physicians are looking at options from NSAIDs to acupuncture to SSRIs to chiropractors.
Over the past 300 years they’ve been growing steadily, and that growth has accelerated since the 1990s. Science!
Did you know people in Georgia with HIV can be sent to prison for up to 10 years for not disclosing that fact to a partner? And up to 20 years for spitting at a cop? (It falls under “bodily fluid.”)
Those laws are relics from the 1990s, and not surprisingly, people are asking for a change.
Amazon’s Alexa can now tell you the cheapest local pharmacy to buy any given drug (for people paying cash).
The good news is, there’s a scientifically proven way to stop the hiccups. The bad news is, you’re not gonna want to try it.
—Andrew Kantor • Dec. 18, 2017
Georgia Tech gave a musician a prosthetic arm that allows him to play the piano. This is a Really Big Deal, because typical prostheses don’t offer that kind of motor control. Until now.
But wait, there’s more:
This is the second device Weinberg’s lab has built for Barnes. His first love is the drums, so the team fitted him with a prosthetic arm with two drumsticks in 2014. He controlled one of the sticks. The other moved on its own by listening to the music in the room and improvising.
Yeah, welcome to the future.
Several members of the Georgia House of Representatives are proposing some big changes to help residents of rural areas of the get healthcare.
One of those changes, per Georgia Health News: “allowing expanded responsibility for health care providers who are not physicians.”
The others include a Medicaid waiver to expand coverage, and a change to how the state licenses healthcare facilities via certificates of need. Read about it in GHN.
A Consumer Reports survey found that almost one in four Americans (22 percent) rations their medication because of cost.
When drug costs rise, consumers often resort to desperate measures, our survey suggests. People who experienced price spikes in their meds were more likely to say that, like Smith, they rationed their own meds by not taking them as often as they should. They were also more likely to split their pills without first talking with a doctor, or to use expired medication. And a shocking number—about 20 percent—said they didn’t fill their prescription at all.
(If you can’t get the article from the Web, click here for a PDF version.)
State Senator Renee Unterman told the Gwinnett Daily Post that she’s going to be introducing an “omnibus” bill to address the opioid crisis in Georgia. The specifics haven’t been nailed down, but she expects to have the details ready by the beginning of the legislative session.
No joke. A gene therapy trial — a human trial — has just been published. It looks at though it has actually cured hemophilia. Yes, it’s just a first human trial, but this is clearly well past the “lab” stage and even the “mice in lab” stage. Grain of salt: It was only on 13 patients.
This phase 1–2 dose-escalation study took 13 patients with severe haemophilia A and found the treatment successfully improved levels of the blood-clotting protein in all patients. Most exciting was the follow-up study 19 months later that found 11 of the patients displayed normal or near normal levels of the protein. All 13 patients were able to discontinue any prior regular treatments for their disease following this experimental therapy.
Pharma investors want to know whether executive pay is adding to drug price hikes. Yes, of course it is, but that’s not exactly what they mean. They’re wondering if tying executive compensation to short-term goals will hurt the long-term investments, as it might invite pushback from payers … including government.
Australian scientists have sequenced the entire genome of the extinct Tasmanian Tiger. They claim it’s to better study how genetic diversity impacts extinction, but in reality we know it’s just one step closer to creating the chickenosaurus.
“Imagine a world where that patient can walk into a CVS pharmacist, they can engage with a nutritionist about their diet. They can talk to a nurse practitioner, perhaps have their blood glucose level checked, talk to their pharmacist about medication.”
—Andrew Kantor • Dec. 15, 2017
Why is the flu shot only 10 percent effective this year? Eggs. As in, even though it’s the same strain of the virus, the version that’s circulating is “antigenically less similar” than the version grown in eggs and used to make vaccines, according to the CDC.
PeachCare is about to run out of money. The program, which provides health insurance for about 130,000 kids across the state, relies on federal funding that expired in September — the Children’s Health Insurance Program.
Because Georgia didn’t expand Medicaid, these kids’ families fall in the ‘hole’ where they earn too much to qualify for state coverage, but still can’t afford private health insurance.
Congress is still arguing how to pay for the program, which amounts to about $400 million per year for Georgia.
The good folks at the UGA College of Pharmacy are looking for 500 pharmacists to complete a survey on naloxone dispensing and opioid misuse. Give ’em a hand, would you? It takes about 10 minutes and is completely confidential. “The study results may be used to help other pharmacists, providers, and patients better understand ways to prevent opioid-related overdose and death.”
The editors of the journal Chest looked at remedies for cough associated with the common cold (CACC they call it). They pored over 10 years of research to see what works for those coughs — the goal was to revise their official recommendations.
They discovered that there’s very little solid evidence that anything works that well to control CACCs — not honey, not NSAIDs, not expectorants, not antihistamines. So the recommendations they could make?
If you think that sounds like a lot of shrugging, you’re right. The problem, the editors point out, is that “The evidence supporting the management of CACC is overall of low quality.”
Think you saw a lot of pharma ads this year? You’re not mistaken — it was a record-breaking year for spending, and it ain’t over yet.
HHS has agreed to allow a pilot program in which pharmacists providing MTM services would have access to certain patient-discharge information.
The program, which will be conducted by an unnamed pharmaceutical manufacturer, an unnamed trade association (no, not GPhA), an unnamed hospital, and an unnamed Medicare Advantage plan will involve using a new electronic system to share patient information in the hopes of reducing readmission.
Georgia Health News: “HIV in America is increasingly a Southern problem.” Half of all new AIDS diagnoses are in the South, and Metro Atlanta has the nation’s fifth highest rate of new infections.
[T]here are many factors that lead the South to have a high HIV burden. They include the region’s high poverty and uninsured rates; problems in access to health care; the stigma attached to the disease; income inequality; and the persistently high rate of sexually transmitted infections.
It’s manufacturing is back — well, mostly — since the Russian cyberattack earlier this year. (But its Puerto Rico facilities still haven’t recovered, and neither has the island.)
—Andrew Kantor • Dec. 14, 2017
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