Provider status is in Congress now

The bill is the Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 2759 and S. 1362), and was introduced in Congress earlier this week. In short, it would recognize pharmacists as health care providers for Medicare patients (imagine that!), grant them “provider status,” and make sure they’re fairly compensated.

You have two options:

1. Sit back and keep your fingers crossed.
2. Let your representative and senator know they need to vote for this.

Phone calls are great (“I’d like to leave a message for Congressman Jones…”), faxes work too (they don’t get many of those), or you can use the handy-dandy “pre-written, editable advocacy alert” from our friends at APhA to do the heavy lifting for you.

Pro tip: Choose option 2. Because you know those folks are getting calls from people who don’t want you to be treated like medical professionals.

Give ’em number 2

Pharmacists: GIVE THE SECOND DOSE. Too many people are not getting their second Moderna or Pfizer vaccine because of access issues, so federal health officials want pharmacies to deliver them — no matter where patients got their first one. (Just be sure to match Pfizer to Pfizer, Moderna to Moderna, because the jury is out on whether you can mix and match.)

Cranking remdesivir up to 11

Remdesivir is helpful for fighting Covid-19 — it can shorten a hospital stay, although it’s far from a cure. But a group of researchers figured out that a cocktail of remdesivir and four hepatitis C drugs (grazoprevir, paritaprevir, simeprevir, and vaniprevir) “boosted the efficacy of remdesivir by as much as 10-fold.”

It’s a cool story, in fact. First they used a supercomputer — as one does — to test for what drugs might stick to the right spot on the SARS-CoV-2 virus. Once they narrowed it down to seven, another team tested them in the lab, where they found those four did a bang-up job when combined with remdesivir.

“Because these HCV drugs are already approved for use and their potential side effects are known, such a combination therapy could be tested in humans more quickly than for a new drug.”

Withdrawal or relapse? Flip a coin

A patient stops taking an antidepressant. Bad things start to happen. Is it withdrawal or a relapse?

Bad news: It’s almost impossible to tell (found Aussie researchers). There just isn’t enough information, not enough studies, and no clear protocol for going off antidepressants.

“Ultimately, we really need more studies about discontinuing antidepressants — especially in primary care given that’s where most prescribing takes place — before we can make more definitive conclusions.”

You know what else we’re clueless about?

Vitamin D. We know what happens when you don’t have enough (not just rickets, but more susceptibility to other Bad Things), but there is no clear guidance on how much to supplement. In fact, reports can be contradictory, so the value of screening for it is questionable.

“It has been challenging to demonstrate nonmusculoskeletal effects of vitamin D,” say researchers with the U.S. Preventive Services Task Force.

Fun fact: Mordor Intelligence predicts the U.S. vitamin D supplement market “will grow by a compound annual growth rate of 5.8% to reach $1.3 billion by 2025.” (Obvious question: Who would name their company “Mordor”?)

Buprenorphine blockers

Sure, HHS is now allowing more prescribers to give patients buprenorphine, but there’s an unexpected roadblock: pharmacists. A study out of Oregon found that 20 percent of pharmacies refused to dispense the anti-withdrawal drug, and that “independent pharmacies and those in southern U.S. states were significantly more likely to restrict buprenorphine.”

One issue with this: It can hurt the perception of pharmacists as true healthcare providers.

“[C]ommunity pharmacists should be encouraged to work collaboratively with a patient’s provider to ensure there is continuity of care in all stages of treatment.”

They’ve joined forces

Okay, full credit to the writers. I did not expect them to tie last season’s storyline (the opioid epidemic) into this season’s (Covid-19.) But now it seems that physicians are more likely to give opioid scripts to people with long Covid, leading to “alarmingly high rates of opioid use among Covid survivors.”

The study was done at VA facilities, but there’s no reason to think it’s not more widespread, especially with about one in 10 survivors having those long-Covid symptoms.

“Physicians now are supposed to shy away from prescribing opioids […] Is this really happening all over again?”

No tips

Did you know there’s a global shortage of pipette tips? Now you do. (And pandemic demand is only part of the issue.)

The pipette tip shortage is already endangering programs across the country that screen newborn babies for potentially deadly conditions […]. It is threatening universities’ experiments on stem cell genetics. And it is forcing biotech companies working to develop new drugs to consider prioritizing certain experiments over others.

In COPD, cilia don’t sweep

Johns Hopkins researchers discovered something important about COPD by studying the humble amoeba: Patients with the disease have less expression of a gene called ANT2. (So do mice exposed to cigarette smoke. No coincidence.)

What does ANT2 do? It helps ‘lubricate’ the cilia in the lungs. Less ANT2, less lubrication, and the cilia can’t sweep away the mucus. Thus “In COPD patients, mucus becomes too thick to sweep out of the lungs.”

In a perfect world, the next sentence would be, “And such-and-such a drug supercharges ANT2 production.” This isn’t a perfect world, so the next step is “develop[ing] gene therapy or drugs to add ANT2 function back into lung-lining cells as a potential treatment for COPD.”