DEA’s telehealth plan

You probably know about the whole ‘telehealth prescribing of controlleds’ issue. During the pandemic it became a big thing. Afterwards, the DEA wanted to end the practice but got a ton of pushback so it postponed any changes for a year. Then it thought about doing it again, and got just as much pushback.

The latest: Seeing the writing on the wall, the DEA has now floated the idea — sorry, “released a notice of proposed rulemaking” — that would create three categories of telehealth prescribers.

Category 1: “Special registration” — for mid-level practitioners to prescribe schedule III-V controlled substances via telehealth.

Category 2: “Advanced special registration” — for those who want to prescribe schedule II controlleds. They could only prescribe within the state they practice in, and no more than half of their scripts could be via telehealth.

Category 3: For telemedicine platforms to prescribe schedule II-V controlled substances.

The agency is also proposing various fees for the registration (some of which are pretty hefty), as well as other requirements, e.g., checking PDMPs for abuse. But right now it’s just a proposal, so there’ll be more to come, for sure.

Cobb County is ticked off about insulin

Cobb County is suing insulin makers and PBMs, accusing them of colluding to keep the price of insulin high.

Officials say the county was overcharged “in a price-fixing scheme,” and it wants its money back. The words “racketeering” and “deceptive trade practices” turned up, so you know this is serious.

Who is the county suing? The usual suspects: Eli Lilly, Novo Nordisk, and Sanofi-Aventis, and CVS Caremark, Express Scripts, and OptumRx.

As usual, we’ll remind you that the scientists who first created insulin for diabetes 100+ years ago refused to patent it specifically so it would always be affordable.

UGA gets $$$ to fight opioids

Congrats to the UGA College of Pharmacy, which scored almost $1.2 million in a grant from the Georgia Opioid Crisis Abatement Trust (GOCAT) to help fight the opioid crisis in rural Georgia.

Specifically, the team will equip pharmacists in smaller communities with the tools, training, and support necessary to provide life-saving resources, reduce stigma, and establish essential support networks for individuals at risk for overdose.

If they don’t know you by now…

A survey by Rite Aid found that a lot of people don’t know what a pharmacist can do for them.

Here, have some numbers:

72% of people said they were familiar with the fact that pharmacists dispense medication. (Yes, that implies that 28% of people don’t know that pharmacists dispense meds.)

• 64% know that pharmacists can provide OTC product guidance.
• 55% know that pharmacists can provide advice for minor health issues.
• 53% know pharmacists can offer health and wellness advice.
• 53% know that pharmacists can give immunizations.
• 30% know that, in certain states, pharmacists can prescribe meds.
• 27% know about medication therapy management.
• 23% know pharmacists can help with smoking cessation.

Of course, you might not offer all these services — heck, you might not have time — but it’s worth knowing that there are a lot of people who think of pharmacists as just bottle-fillers … and apparently 28% think you just hang around as eye candy.

ICYMI: Georgia chickens get the flu

Bird flu was found on a commercial farm in Elbert County — the state’s first case of H5N1 in a commercial setting. That means not only are all operations within 10 km^* of the farm being quarantined pending further testing, but “… poultry exhibitions, shows, swaps, and sales (flea market or auction market) in the State of Georgia are suspended until further notice.”

^* Yes, the Georgia Department of Agriculture used kilometers. %$@*& commies.

“At no time did hydrocodone outperform the nonopioid”

Another case when you don’t need opioids: after wisdom-tooth removal. A study out of the University of Rochester found that not only did OTC medications (400 mg ibuprofen plus 500 mg acetaminophen), work, they worked better than the hard stuff (5 mg hydrocodone and 300 mg acetaminophen).

Participants taking the non-opioid medications reported significantly less pain during the first two days after surgery when pain is most severe and were more satisfied with their pain management and slept better, compared to those taking opioids.

Next Medicare negotiations

CMS is preparing the next round of its drug-price negotiations, and it released the list of 15 drugs that will be subject to the forces of capitalism. Not surprisingly, brand-name semaglutide (Ozempic, Rybelsus, Wegovy) is on the list.

According to CMS, “These 15 drugs, together with the 10 drugs that Medicare already negotiated, represent about a third of Medicare Part D spending on prescription drugs.” It’s actually about 36%, and yeah, that’s a lot.

Lowering the price Medicare pays will have a ripple effect, too — it will help reduce seniors’ co-pays (although those are now capped at $2,000 thanks to the Inflation Reduction Act), and it will also cut state and federal spending on Medicaid.

Next up: The drugmakers have until the end of February to choose whether to negotiate or not participate in Medicare.