Plop, plop, fizz, fizz … you’re dead

Dissolving, fizzy acetaminophen (Metric: paracetamol) contains a lot of salt — too much, in fact, according to a study published in the European Heart Journal.

The researchers found the risk of heart attack, stroke or heart failure after one year for patients with high blood pressure taking sodium-containing paracetamol was 5.6%, while it was 4.6% among those taking non-sodium-containing paracetamol. The risk of death was also higher; the one-year risk was 7.6% and 6.1%, respectively.

And the longer patients took the bubbly drugs, the higher the risk. And, other researchers say, it will also apply to any other drugs that come in fizzy form.

Caring in your heart, certificate on your wall

Medication therapy management — it’s one of the best ways you can care for your patients (and it’s a potential revenue stream, too).

A big step to providing MTM, though, is making sure you’re giving— and getting — the most you can. Patients will appreciate that (and the slick certificate on your wall), and you can get paid for doing it!

Learn how to provide this valuable patient service when GPhA presents, “APhA’s Delivering Medication Therapy Management Services: A Certificate Training Program for Pharmacists.”

Sunday, March 27, 2022 8:00 a.m. – 5:00 p.m.
Live via Zoom

Click here to get the details, see the instructor, and register!

Covid news in 22 seconds

Cases and hospitalizations continue to drop big time — down 90 percent overall from last week. Deaths are finally down, too — only about 2,000 Americans are dying from Covid-19 every day*.

The Omicron sub-variant BA.2 is still out there, spreading as fast as regular (BA.1) Omicron but as deadly as Delta. But vaccinations, infections, breakthrough, and deaths are keeping it at bay. As one virologist put it, “BA.2 is kind of creeping up in terms of numbers, but it’s not the meteoric rise that we saw with BA.1.”

A return to normalcy seems just about within reach. Cross your fingers.

* Perspective: The pandemic was bad enough that today the equivalent of eight jumbo-jets crashing a day is considered good news.

Compounding pharmacies score a big win

If you do any compounding, a major court case has ended this week — one you might find interesting, especially if you have patients across the state line. It’s a complicated case, but here’s the broad-stroke retelling. Gather round, boys and girls….

Congress (in 1997): Compounding facilities are making a lot of bulk drugs for doctors’ offices, almost like drug makers. FDA, you need to get a handle on that — reach an understanding with the states. Make a memo about it. A memorandum of understanding.

FDA: Sure thing! We’ll work with state boards of pharmacy and all the stakeholders and come up with something everyone will love!

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More than 20 years pass.
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FDA (in 2020): OK, we’ve finally got that memorandum of understanding, but we didn’t really work with the states after all. Oh, even though Congress was worried about bulk distribution, we’re gonna apply it to traditional dispensing, too. Why not?

Compounders’ ears begin to prick up.

FDA: We’ll give states an all-or-nothing choice: They can sign the MOU, and then they’ll have to investigate and report any time a 503A compounding pharmacy distributes more than half its orders out of state. And we’ll let the states pay for all that.

Compounders: Wait, what? What if a state doesn’t sign? And what do you mean by “distribute”?

FDA: If a state doesn’t sign, compounding pharmacies there can only distribute 5 percent of their compounded meds out of state. And we say “distribute” means any and all compounded medications shipped — bulk or individual.

Compounders: Whatchu talkin’ ‘bout, Willis? The whole point was to get a handle on those bulk, office-use meds, not prescriptions for individual patients! And “Distribute” has never referred to individual prescriptions!

FDA (holds Sharpie): Well, we’ve redefined “distribute.”

Compounders: [expletives deleted] Patients won’t be able to get their meds, and this is gonna hurt small businesses, big time!

FDA: (ignoring compounders) States, sign or don’t sign, and do it fast.

Compounders: That’s enough. We’re suing. You can’t make major rules like this without consulting states. You didn’t even analyze its impact on small business. And you can’t just redefine standard terminology, even with a Sharpie.

Federal judge (in September 2021): They’re right, FDA. You broke the law creating the final MOU this way. Now you get two choices: “Either certify that [the MOU] will not have a significant economic effect on small businesses, or prepare a regulatory flexibility analysis.”

FDA (this week): [mumbles]

Court: What did you say?

FDA: We said we’ll withdraw the MOU.

Court: Annnnnd?

FDA: And we’ll start a formal rulemaking process like we should have done in the first place.

Court: Good choice.

FDA: Yeah, this make take several years….

As we said, this is very much a 30,000-foot overview of what happened. The good folks at the Alliance for Pharmacy Compounding have all the details if you want to know more. Full disclosure: Andrew Kantor, who writes the Buzz stories you like*, also works for APC.

* The ones you don’t like are written by … I dunno, Alan Smithee maybe.

You had your $11 billion chance

Kick yourself in the rear — today was the deadline to get your bid in, assuming you had $10.9 billion in the bank and were looking for more than another boat. You could have been in the running to own the Boots half of the soon-to-be-dismantled Walgreens Boots Alliance.

(As pharmacists, though, you’re not what they’re looking for. Auctioneer Goldman Sachs wants “financial investors with a track record of turning around high street retailers,” — meaning private equity firms that will bleed the company dry.)

Elsewhere: PBMs get whatfor

All these tidbits are courtesy of NCPA.

South Dakota and Virginia are considering anti-steering bills to keep PBMs in line. South Dakota’s has some extra teeth to it — it would…

“…prohibit PBMs from reimbursing non-affiliate pharmacies less than affiliate pharmacies, allow a pharmacist to decline to dispense if the reimbursement is below acquisition cost, prohibit PBM imposed fees and retroactive claim adjustment or “clawbacks,” provide for MAC appeals, and prohibit discriminatory payments for 340B prescriptions.

Washington State looks about to pass a bill that would prohibit PBMs from requiring patients to use mail-order pharmacies, and from reimbursing the pharmacies they own any more than other pharmacies.

Iowa, Mississippi, and New Hampshire are working on passing bills that would prevent PBMs from giving pharmacies low reimbursements. (Mississippi’s, for example, would require pharmacies to be reimbursed “at a rate no less than the National Average Drug Acquisition Cost plus $11.29 (the state Medicaid professional dispensing fee).”

Please let us know if you sell any of this

Following up on the blockbuster that was Crystal Pepsi, PepsiCo is unveiling Nitro Pepsi — “nitrogen-infused cola.” Health benefits? Nah. Just foam.

“[W]e wanted to come up with a new way for people to enjoy delicious Pepsi cola, but with a new experience around the bubbles.”