Do you like Blackstreet’s “No Diggity”? Eminem’s “Lose Yourself”? We’ve got some bad news for you.
While you’re worrying about your SO’s musical taste, here’s another downer for you: What happens if and when Amazon enters the pharmacy business? Stat News sees three possibilities.
“[I]t is believed that Amazon will start by capturing share in both the cash paying and third-party mail order, and possibly specialty pharmacy segments,” wrote Leerink analyst Ana Gupte in a recent investor note.
We’re losing track of how many diseases a daily aspirin can prevent. The latest: gastrointestinal cancers. It can cut the risk in half.
Australia just has its worst flu season ever — and that doesn’t bode well for the western hemisphere. Get your shots. Give your shots. (And remember: No nasal vaccines this year.)
The presidential opioid commission released its recommendations — 53 of them — for combating the opioid crisis.
It called for (among other things):
Federal and state investigators want to know what’s going on with the soaring price of insulin — and patients are filing lawsuits.
They appear to be looking into potentially anti-competitive business dealings that critics have leveled at this more than $20 billion niche market of the pharmaceutical industry
The price of insulin — a lifesaving drug — has reached record highs as Eli Lilly, Novo Nordisk and Sanofi raised prices more than 240 percent over the past decade to often over $300 a vial today, with price rises frequently in lockstep,
Time once again to play our favorite game: “Prescription Drug or ‘Star Wars’ Alien?” Can you tell which is which?
Hint: There are four of each.
—Andrew Kantor • Oct. 31, 2017
Two Atlanta pharmacy owners — well, former owners — were ordered to pay $5 million in “community restitution” for filling prescriptions for a pill mill*. (The physicians who actually ran it were sentenced to four to seven years in federal prison back in June.)
The restitution money is to go to the Georgia Department of Behavioral Health and Developmental Disabilities and the Criminal Justice Coordinating Council for victims’ assistance in restitution for the public harm they caused.
Remember the toddler who needed a kidney, but Emory University Hospital refused to perform a transplant because his father had violated his probation on an unrelated matter? The boy was rushed to the hospital Sunday morning with an abdominal infection.
Emory Hospital told the family he would have to provide evidence of “good behavior” for the next three to four months before they would permit him to donate his kidney to his son. They said they would re-evaluate the situation in January 2018, but the family fears that may be too late.
The family held a prayer vigil Sunday in hopes of changing the hospital administration’s mind.
The House is expected to vote next week on whether to fund the Children’s Health Insurance Program. At issue is where the money would come from; the GOP wants to cut the public health fund and raise premiums for wealthy Medicare beneficiaries, while Democrats are eyeing the White House’s proposed tax cuts for the rich.
If for some reason we cannot fathom you actually like black licorice, the FDA warns that eating too much could cause heart problems.
Kids these days — they’re less likely to abuse drugs, more likely to use seat belts, and tend to avoid riskier behavior. So what are they doing? Hmm.
A Stanford University study attempted to cut through the anecdotes and answer the important question: Does marijuana increase or decrease sex drive? Spoiler: The answer is increase.
If you’re hoping to have kids, though, don’t live with your mother-in-law. No, really: “Living with own or husband’s mother in the household is associated with lower number of children: a cross-cultural analysis.”
Are you attractive? Of course you are. One downside: You may have trouble getting an “unattractive” job.
—Andrew Kantor • Oct. 30, 2017
Three months after announcing it, the Trump administration officially declared the opioid crisis a national emergency today. It’s not just a talking point; declaring a national emergency means changes to law and regulations.
In this case, the declaration includes…
One problem: Right not there is only $57,000 available in the public health emergency fund to pay for this. You can expect that to change fairly soon, though, as budget negotiations take it into account.
The supervisory pharmacist at the New England Compounding Center was cleared of 25 murder charges after people in Florida, Indiana, Maryland, Michigan, North Carolina, Tennessee and Virginia were killed by tainted drugs from the facility. But he was convicted of mail fraud and racketeering.
Premiums for silver-level private health insurance plans in Georgia will rise 48 percent in 2018, which is higher than the national average of 34 percent. The big jump is because President Trump halted subsidies to insurance companies that were designed to keep premiums lower.
Fear not! Most consumers will not pay the higher prices because the ACA provides tax breaks directly to offset the higher premiums.
In Georgia, 90 percent of exchange customers this year get subsidies or discounts that reduce their premiums. And as premiums go up for 2018, so will their individual subsidies, cushioning the blow from these rate hikes.
The irony is that it will actually cost the federal government more in the long run — that’s thanks to a combination of those tax breaks, plus additional people expected to turn to Medicaid if they can’t afford private insurance.
The upside is that Congress is still working to get those subsidies flowing and stabilize the system.
Civil lawsuits from states, counties, and cities are one thing. Now federal prosecutors have begun a criminal investigation into Purdue Pharma.
U.S. Attorney Deirdre Daly is gathering documents about Purdue’s claim that Oxycontin provides 12 hours of pain relief. A Los Angeles Times investigation, published last year, found that Purdue ignored evidence showing the drug’s effects failed to last that long in some patients, increasing the risk of withdrawal, abuse and addiction.
It ain’t Purdue’s first time at this rodeo, either. In 2007 it paid more than $630 million in civil and criminal penalties for “misbranding” Oxycontin and deliberately misleading physicians about opioid risks.
First GSK showed its new shingles vaccine (Shingrix) works better than Merck’s Zostavax. Now an FDA panel has officially recommended it over Zostavax.
Note to pharmacists: The panel also said that people who have received Zostavax also get the new Shingrix vaccination.
The CRISPR* gene-editing technique looks about to get some big new tools. Put simply, CRISPR is a powerful “cut” tool for genes, but the “paste” part was left up to the DNA’s own repair tools.
More. [cue the ominous music]
The phrase to remember is “base editor” and it’s the pencil to CRISPR’s scissors. (At least that’s the analogy that everyone’s using.)
One team from Harvard and the Howard Hughes Medical Institute created “ABE” (adenine base editor), a base editor that can edit DNA, while another team from the Broad Institute and MIT created “REPAIR,” which can edit RNA. The latter is notable because edits don’t affect the germline — they aren’t passed down.
Obviously these new techniques are in their infancy and will only ever be used for good.
* Yes, we know it’s “CRISPR/Cas9.” Don’t be picky.
Speaking of CRISPR, a team of Chinese scientists have found a great use for it: They created a better, lower-fat bacon. Oh, yeah, and it also helps the pigs adapt better to colder weather, but whatever. Bacon!
“This is a paper that is technologically quite important,” says R. Michael Roberts. “It demonstrates a way that you can improve the welfare of animals at the same as also improving the product from those animals — the meat.”
Reuters reports that Pfizer will begin to auction off its consumer healthcare business in November. It’s expected to sell for more than $15 billion.
Several global companies, including GlaxoSmithKline and Reckitt Benckiser, have expressed interest in bidding for the unit, which had sales of about $3.4 billion in 2016.
—Andrew Kantor • Oct. 26, 2017
Georgia State Senator Renee Unterman (R-Buford) said the state should look at expanding Medicaid. Not with a traditional expansion via the ACA, but — possibly — through a federal waiver.
“We have to open that box and look just a little bit and see what’s available,” Unterman said. “Hopefully, if you draw down federal dollars, you can free up some of those state dollars. Right now, we’re just pumping out state dollars to stay in the midst of the crisis.”
In an editorial following Unterman’s comments, the Savannah Morning News expressed its support of her idea.
About 400,000 Georgians earn too much to qualify for Medicaid without some kind of expansion, but too little to qualify for federal subsidies.
CVS Health, the parent company of the CVS Caremark PBM, announced that it’s launching a nationwide network of pharmacies — including CVS, Walgreens, and 10,000 independent pharmacies.
Performance measures for participating pharmacies will include demonstrated medication adherence for chronic conditions that impact to client costs, such as hypertension, diabetes, respiratory conditions and behavioral health. Network pharmacies are urged to implement their own programs and workflow to help deliver results related to the measures being tracked, CVS said.
The new network is expected to be available to Caremark clients in March 2018.
Our favorite vitamin (that’s vitamin D) might reduce the risk of kids developing diabetes — at least, if they aren’t getting enough of it. Or, as the study’s authors put it, “higher childhood [vitamin] D was associated with lower IA [islet autoimmunity] risk.”
Know them. Follow them. Live them. The highlights:
Click here for the detailed law, but we’ll also be updating you here, on the GPhA.org website, and in Georgia Pharmacy magazine.
You will be able to designate two technicians per shift or rotation to access the PDMP as “delegates” to identify potential abuse, misuse, or underutilization, BUT NOT YET.
DPH is working on an online training course, “The Georgia Prescription Drug Monitoring Database: Understanding Your Responsibilities.” Anyone who is delegated to enter data into the PDMP will be required to take and pass the course, so you won’t be able to designate delegates until it’s available.
You’ll also need to instruct any delegates in PDMP security, and obtain a signed responsibility statement (DPH will soon be releasing that) from the proposed delegate and place it in the delegate’s personnel file.
DPH is also asking that dispensers and prescribers delay delegating until January 2018 due to logistical issues.
A-yup. At least to high-risk patients. The issue seems to be that GPs aren’t tracking patients’ risk over the long term, which would better show the need.
The study suggests that patients at high risk of CVD are being undertreated, and the researchers stress that all patients should have a documented 10-year risk score before statin initiation.
A startup called Kick is offering minty propranolol lozenge (yes, you read that correctly) to treat performance anxiety — stage fright, that is. All it takes is a 10-minute consultation to get a prescription.
They’re not “body brokers” — they’re “non-transplant tissue banks.” They’ll let you sell your loved one’s body (after death, obviously) for science. And in this case “science” means “to be dissected and sold to a medical research facility.”
Are you ready to say “HOLY MOLY”? Here you go — from a story about one broker called “Southern Nevada Donor Services“:
Outside Southern Nevada’s suburban warehouse, the circumstances were far from comforting. In the fall of 2015, neighboring tenants began complaining about a mysterious stench and bloody boxes in a Dumpster. That December, local health records show, someone contacted authorities to report odd activity in the courtyard.
Health inspectors found a man in medical scrubs holding a garden hose. He was thawing a frozen human torso in the midday sun.
(In case you’re wondering what happened, the guy with the hose pleaded guilty to a misdemeanor pollution citation. Today he’s an Uber driver. The defrosted torso was rented to some surgeons and cremated.)
A-fib patients on anticoagulants have a significantly lower risk of developing dementia — that’s from a Swedish study in the European Heart Journal.
—Andrew Kantor • Oct. 25, 2017
Yep, that’s Georgia’s Fulton County. It’s filing a suit against opioid makers for their role in the crisis — a crisis that’s costing the county millions every year.
Statins, which are on the short list to earn Buzz’s Wonder Drug™ designation (like aspirin and caffeine), might increase the risk of diabetes — at least in patients that are already at risk for the disease.
Meanwhile, another study finds that — maybe (and that’s a strong “maybe”) a daily aspirin for hepatitis B patients can reduce the likelihood of liver cancer.
And no, it’s not for medical marijuana (that’s what we thought, too). It’s because Colorado has a better Medicaid program, and she can get treatment for her son, who has severe brain damage. But hey, we’re still a great state for business!
Apparently, if you post photos to Instagram, you’re also giving away clues to your mental health based on what filters you use on your images.
(For you non-Instagram users, the site lets you post photos and add “filters” to them for a variety of effects, from simple black-and-white to all sorts of colorful and funky options.)
A study found that….
…depressed participants used fewer Instagram filters […] When these users did add a filter, they tended to choose “Inkwell,” which drains a photo of its color, making it black-and-white. The healthier users tended to prefer “Valencia,” which lightens a photo’s tint.
“People in our sample who were depressed tended to post photos that, on a pixel-by-pixel basis, were bluer, darker and grayer on average than healthy people,” said Andrew Reece, a postdoctoral researcher at Harvard University and co-author of the study.
The Georgia Clinical Transformation Team is offering a free 30-minute webinar on tobacco cessation. It’s Tuesday, October 31 from 12:30 to 1:00 p.m.
It will tell you about resources available, and go over concerns about e-cigarette use as an alternative.
Wondering about billing for pneumococcal vaccines? (Or seasonal flu shots?) CMS has you covered with its detailed guide including billing codes, FAQs, and more.
Gilead claimed its high drug prices were because the company needed the money to pay for innovation. But the facts show otherwise.
[T]he evidence that Gilead itself uses its profits to “innovate” is thin at best. In 2016, the company reported profit of $13.5 billion. It spent $11 billion to repurchase its own shares, and about $2.5 billion on stock dividends. So the buybacks and dividends together came to $13.5 billion, in effect consuming 100% of the company’s profit. […] Innovation? Gilead spent $5 billion on research and development, according to its annual report.
—Andrew Kantor • Oct. 24, 2017
Just a reminder to remind your patients that it’s the most wonderful time of the year: Medicare open enrollment! It started October 15 and runs through December 7. This is the only time Medicare folks can enroll in or change their current policies.
File under “Holy moly.” The further west in a time zone you live, the greater your risk of cancer, thanks to there being less sunlight — and more artificial light — during waking hours.
Risk increased from east to west within a time zone for total and for many specific cancers, including chronic lymphocytic leukemia (both genders) and cancers of the stomach, liver, prostate, and non-Hodgkin lymphoma in men and cancers of the esophagus, colorectum, lung, breast, and corpus uteri in women.
A California judge has thrown out a $417 million jury verdict against Johnson & Johnson over claims its talcum powder caused a woman’s ovarian cancer. The judge said there were errors during the trial, jury misconduct, and a lack of evidence to support the huge amount of punitive damages.
There was also the issue of the lawsuit being filed against the parent company, which the judge said could not be held liable for failing to warn about possible cancer risks because a subsidiary actually made and marketed the powder.
National Drug Take-Back Day is coming up (next Saturday, October 28), and Georgia officially kicked off the week in a metro Atlanta Walgreens, with Attorney General Chris Carr, GPhA’s VP of Public Policy Greg Reybold, and others.
Reybold spoke to the group of healthcare officials and media about how drug take-back efforts were important, but also needed to be part of a broader effort to combat the opioid epidemic.
More on this in the coming days.
Wondering which supplements (probably) work and which are smoke and mirrors? We’ve got you covered. Here’s a link to our favorite, regularly updated resource, “Snake Oil Supplements?”
(Psst: Have you read the latest issue of Georgia Pharmacy? Our cover story mentions GPhA pharmacist Ira Katz, who color codes supplements in his pharmacy so he can recommend them to patients.)
The FDA has approved a second shingles vaccine: GSK’s Shingrix. In tests, it showed greater protection than the existing vaccine (Merck’s Zostavax).
Today’s fun fact: Flu pandemics actually emerge in the spring and early summer, not the winter.
Not only is the company’s patent deal with the Mohawk unraveling, now another company says it’ll be offering a compounded version of Allergan’s Restasis for a fraction of the price.
Allergan said that using compounded version of the drug will somehow put patients at risk.
If you’re curious when the Trump administration will actually declare a national emergency over opioids, it’s still in the works … and rather than this week as suggested, it might be a while.
Why? There’s a big gap between the president saying we’re going to declare one and it actually happening.
Some Georgia Medicaid providers put restrictions on patients before they’ll approve treatment for hepatitis C — and that earned the state a grade of C for treatment from the Center for Health Law and Policy Innovation.
Those restrictions — including waiting for liver damage and requiring enrollment in a substance-abuse program — might be contrary to law. In 2015 states were warned by CMS against “imposing conditions for coverage that may unreasonably restrict access” to hepatitis C drugs. By law, Medicaid programs must pay for all medically necessary treatments.
—Andrew Kantor • Oct. 24, 2017
At least don’t exercise too much. It can lead to serious cardiovascular problems. Really.
White men who exercise at high levels are 86 percent more likely than people who exercise at low levels to experience a buildup of plaque in the heart arteries by middle age, a new study suggests.
On the other hand, another study finds a little light walking can make a huge difference.
The Senate is having hearings about drug prices and why they’re so high. Who’s at fault? “In Congressional spotlight, drug industry groups blame each other.”
A group of more than 100 veterans or their families are suing four pharma companies (and General Electric), saying those companies paid bribes to Iraqi officials and “transacted business with a post-Saddam health ministry that was controlled by Shiite terrorists.”
Eye drops are way too big — by design. And that’s not a good thing. In fact, almost half of a given bottle goes to waste.
Eyedrops overflow our eyes because drug companies make the typical drop — from pricey glaucoma drugs to a cheap bottle of Visine — larger than a human eye can hold. Some are so large that if they were pills, every time you swallowed one, you’d toss another in the garbage. The waste frustrates glaucoma experts like Dr. Alan Robin, whose patients struggle to make pricey bottles of drops last. He has urged drug companies to move to smaller drops — to no avail.
Late edit: Apparently there’s a lawsuit about this very issue.
Moms in Disney films have as much chance of surviving as the cop who’s “just three days from retirement.”* But you know what? It’s a great opportunity to talk to your kids about death.
The FDA has approved Kite Pharma’s Yescarta, only the second gene-altering immunotherapy for cancer patients.
The treatment, considered a form of gene therapy, transforms the patient’s cells into what researchers call a “living drug” that attacks cancer cells. It is part of the rapidly growing field of immunotherapy, which uses drugs or genetic tinkering to turbocharge the immune system to fight disease. In some cases the treatments have led to long remissions.
You know all that talk about your gut microbiome? Next up: Your skin’s microbiome. As in, a couple of researchers have used probiotics for the skin to treat eczema.
Maybe. They believe the problem is the color-receiving cone cells in the eye and is easily detectable.
In people with the reading disability, the cells were arranged in matching patterns in both eyes, which may be to blame for confusing the brain by producing “mirror” images, the co-authors wrote in the journal Proceedings of the Royal Society B.
States’ Medicaid spending has been slowing since 2015, when Obamacare first took effect in a big way. Enrollment is expected to go down as more people get private or employer insurance.
What’s causing the biggest increases now? Rising prescription-drug spending tops the list.
What’s going to cost more in the future?
About one in five Americans is covered by Medicaid — 74 million or so.
MIT and Harvard have reached an agreement for using CRISPR/Cas-9 gene editing for agriculture. In unrelated news, “Day of the Triffids” is playing next Thursday….
—Andrew Kantor • Oct. 19, 2017
Anthem is launching it’s own, new PBM: IngenioRx, which will debut in 2020. It’s going to be working with CVS Health to run the new company, although it’s not clear what (if any) connection there will be between IngenioRx and CVS’s Caremark.
(Unfortunately, Anthem came up with the name before checking to see if a company with that name already exists. It does. Oops. You can find more info about Anthem’s company at ingenio-rx.com — don’t forget the hyphen.)
Georgia police are working to keep people from shooting dementia patients.
Two senators have devised what looks like a bipartisan deal to provide health insurers the subsidies they were promised under the Affordable Care Act to help pay for low-income patients. President Trump has refused to pay that money in an effort to undermine the ACA, but Congress can override that by funding the subsidies.
Trump both said he supported the plan and that he will continue to work to destroy the ACA.
The plan would also allow states to get more types of ACA waivers and would also offer protections for low-income people and those with serious illnesses. It would also restore money cut by the White House for publicizing the options available under the ACA.
All that said, the bill still has to get through Congress. Fun! Although at least some members from both houses and both sides of the aisle said they support it.
GPhA member extraordinaire* Michael Crooks spoke yesterday at the UGA College of Public Health’s annual “State of the Public’s Health” conference. The topic (not surprisingly) was opioids. Check it out in Online Athens.
The paper’s title is “N-back Versus Complex Span Working Memory Training.” Part of the abstract reads, “Participants completed adaptive training on either a dual n-back task, a symmetry span task, or on a non-WM active control task.”
What does it all mean? If you want to improve your memory, head back to the 1980s and get your Simon.
An Alabama woman who claimed Johnson & Johnson’s talcum powder caused her cancer had won $72 million, but now that verdict’s been vacated by a Missouri appeals court because neither the woman nor J&J are based in that state.
The woman’s lawyers said that the company did some packaging and labeling in Missouri, so that was enough. The court disagreed.
—Andrew Kantor • Oct. 19, 2017
Georgia’s preterm birth rate is higher than the national average — and rising. It was 11.2 percent in 2016 — that’s up from 10.8 percent in 2015 according to the Department of Public Health. The national preterm birth average was 9.8 percent in 2016.
That whole brouhaha* over Allergan selling its Restasis patents to the Mohawk Indians may be moot: A federal judge has invalidated four of those patents. Allergan pledged to appeal, natch.
*Aka, slightly larger than a kerfuffle
The Trump administration will soon declare the opioid crisis as a national emergency. In August the president said he would make the declaration (“we are drawing documents now”), but it hasn’t actually been done yet. Expect the paperwork to be filed in the next week — maybe sooner.
Emory University Hospital won’t give a two year old a kidney transplant until his father — who’s donating the kidney — can prove he hasn’t violated his parole. The hospital said that it’s committed to the highest quality of care for its patients.
Thinking about waiving a co-pay as a favor to a patient? Think twice. Those co-pays are there to keep patients from getting unnecessary healthcare. So what you call “being nice” the Office of Inspector General calls “a kickback.”
A 2016 law, championed by Rep. Tom Marino and others, made it much harder for the DEA to stop suspicious sales of hundreds of millions of opioid pills. (You may have caught the “60 Minutes” piece.)
Now Sen. Claire McCaskill is introducing legislation to repeal that law: “Media reports indicate that this law has significantly affected the government’s ability to crack down on opioid distributors that are failing to meet their obligations and [are] endangering our communities.”
Ironically, Marino was expected to be tapped at the national “drug tzar,” but today withdrew his nomination.
The good folks at the Goldenson Center for Actuarial Research created a calculator to figure out not just how long you’re likely to live, but how many of those years will be healthy ones. Give it a shot.
—Andrew Kantor • Oct. 18, 2017
The White House’s latest attempt to collapse the ACA was foreseen, so most insurers had already requested higher rates — a jump of more than 50 percent. Kaiser Permanente is the only one not to have requested a big rate hike, but now that’s expected as well.
Federal tax breaks will compensate for the price hikes for most people, but about 15 percent — those earning more than $48,240 (or $98,400 for a family of four) — will have to pay the higher premiums.
Eighteen states (and Washington, DC) have sued to stop the White House from halting those payments. Donald Trump said the ACA is “imploding” as he works to dismantle it “step by step.” About 10 million Americans get their health insurance through Obamacare exchanges.
So, you’re a smart person? There’s good news and bad news….
The Mohawk Tribe, responding to criticism of its purchase of Allergan’s patents, sent a letter to the Senate Judiciary Committee. Four senators had requested that the committee look into the deal the tribe made with Allergan. (The Indians bought the patent for Restasis, and are licensing it back to Allergan to avoid facing patent challenges under U.S. law.)
The letter points out that the tribe possesses “the same sovereign authority exercised by state governments and public universities” when it comes to patents, and, in fact, “[I]n 2012 the four states represented by the Senators who objected to the deal owned over 7,000 patents combined.”
Atlanta has made possession of small amounts of marijuana akin to a traffic ticket. (“Decriminalized” is the common term.) Could Savannah be next?
Acerta Pharma made acalabrutinib, and anti-leukemia drug. It published an article in the journal Cancer Research showing the drug had a significant effect on tumors in mice.
AstraZeneca liked what it saw and in 2015 bought a majority share in Acerta for about $4 billion.
But now Acerta has retracted that paper saying the results were fabricated. AstraZeneca — which got FDA “breakthrough designation” for the drug — says that other studies show that yes, it really is effective, and one falsified study won’t change anything.
And yet, bright midday light might help treat bipolar depression.
* Manfred Mann, Schmanfred Mann. The Springsteen version is better.
Good news: The teen birth rate in the U.S. continues to drop — 9 percent from 2015 to 2016. In fact, the overall U.S. fertility rate is at its lowest level ever. That said, while the birth rate for women from 15 to 29 years old is down, the rates for women 30 to 49 was slightly up in 2016.
—Andrew Kantor • Oct. 16, 2017