NCPA sues HHS over DIR fees

The National Community Pharmacists Association has had enough: It’s suing HHS over DIR fees. Specifically, it’s suing over the exception in Medicare regulations — the loophole, really — that allows PBMs to continue to charge clawbacks to pharmacies filling Medicare Part D prescriptions.

“HHS initially said the exception would address a very narrow set of circumstances,” NCPA wrote, “but instead has opened a ‘Pandora’s box’ for Part D plans and their PBMs.”

Pointing out that DIR fees rose a whopping 45,000 percent between 2010 and 2017, and that calls for reform have been rejected, “a lawsuit challenging the validity of pharmacy DIR fees is necessary to protect the downstream consumers.”

The suit claims that the rule “violates the plain language and intent of Congress when [it] passed legislation creating the Medicare Part D program,” that the rule is arbitrary and capricious, and that it “was not adopted through proper notice-and-comment rulemaking.”

You can read the details of the suit here (PDF).

Last week in Georgia

The long version, from the amazing Amber Schmidtke (how does she do this?): https://amberschmidtkephd.substack.com/p/the-week-in-review-11-17jan2021

The bullet points:

• Hopeful signs include “an 11% decrease in cases and 8% decrease in COVID-19 hospital admissions,” but it’s hard to tell if that’s a blip or a trend.
• Georgia had its deadliest week yet — 750 died from Covid-19, a 93 percent (!) jump from the previous week.
• “If the case/hospitalization decrease is real and the start of a descent, then we are probably looking at 2-3 more weeks of high death counts, at least.”
• Plenty of testing is still being done (because testing labs aren’t involved in the vaccine rollout).

Why don’t antihistamines always work for eczema?

Itching is a common side effect of eczema, but (like the headline says) antihistamines don’t always stop it. Now some Washington University researchers think they know why.

It seems that, while itching and pain are usually carried along the same pathway to the brain, that’s not the case here. “These new findings show there’s another pathway entirely that’s causing these episodes of acute itching in eczema patients.”

The typical pathway for itching in eczema patients involves cells in the skin that are activated and then release histamine, which can be inhibited with antihistamine drugs. But with this acute itching, a different type of cell in the bloodstream transmits itch signals to the nerves. Those cells produce too much of another non-histamine substance that triggers itch; therefore, antihistamines don’t work in response to such signals.

It’s legislative update time

Yep, the 2021 Georgia Legislative Session is starting, and GPhA’s lobbyist, attorney, and VP of public policy, Greg Reybold, is there.

From Covid testing stations (“several legislators did test positive”), mandatory masks, and tight security — and, of course, discussions about pharmacists and vaccinations — you can read the details of week 1 right here.

Metformin, diabetes, and Covid-19

To cut to the chase: Diabetics who are taking metformin have a much lower risk of dying from Covid-19. To be clear: They have to be taking it before the diagnosis. So found University of Alabama researchers, although exactly why is still unclear.

The UAB findings suggest that the mechanisms may go beyond any expected improvement in glycemic control or obesity, since neither body mass index, blood glucose, nor hemoglobin A1C were lower in the metformin users who survived as compared to those who died.

Technicians, listen up!

The feds say you can give the Covid-19 vaccines (under the supervision of a pharmacist). So get yourself as ready as possible with GPhA’s Immunization Delivery Training for Pharmacy Technicians — a 5-½ hour CE program consisting of both home-study and live training.

The home study you can do any time. GPhA is offering the live training twice on Sunday, February 7, 2021. Space is limited due to social distancing guidelines, so don’t wait — click here for all of the details and to register now!

Shout out to Jonathan Marquess

At some point he’s gonna go deaf from all these shout-outs, but we can’t high-five him until the pandemic’s done.

That said … GPhA past president Jonathan Marquess was quoted in an ABC News national report on the wait for vaccines: “Vaccine push gains steam but many still face wait”.

Alcohol and the heart: At some point they’ll make up their minds

Alcohol is bad for you. No, a little is good. Nope, it’s always bad. Well, a little red wine is good. Actually, a little alcohol is probably fine.

And the latest, courtesy of the European Society of Cardiology: “One small alcoholic drink a day is linked to an increased risk of atrial fibrillation.”

Do you hear dead people?

You’re not alone! A legit scientific study looked at auditory hallucinations in both “spiritualist mediums” and regular folk, and found that hearing the dead isn’t all that rare. It doesn’t necessarily have to do with whether people believe in the supernatural or not — engaging in “immersive mental activities” and other personality traits seem to play a role.

Pro tip: Hearing dead people is probably okay, but doing what they tell you to do … yeah, skip that part.

ICYMI: Don’t Do This edition

“A Man Injected Magic Mushroom ‘Tea’ Into His Veins, And Fungus Grew Inside Him”. No, he’s not OK, but he’s alive.

ICYMI: Generics Bandwagon edition

“Billionaire Mark Cuban Wants To Lower Drug Prices With Generics Startup”