Vaping mystery continues

A couple of weeks ago we told you about a mysterious spate of people going to the ER with some sort of vaping-related condition. Health officials don’t know what it is — vaping itself, some common ingredient nationwide, THC oil, or something else.

Update: The first death from vaping has been reported in Illinois of a “mysterious lung illness linked to vaping.”

In Georgia, Georgia’s public health officials are also looking into it. DPH “has requested that health care providers ask patients with severe respiratory illness whether they have used devices for vaping nicotine and/or THC.” If they have, they need to contact the Georgia Poison Center at (800) 222-1222 or (404) 616-9000.

And this is interesting: Four years ago, doctors at West Virginia University described “acute lipoid pneumonia” occurring because of vaping. Little did they know that it was to be the first of many cases.

Don’t forget: CE at the Braves!

Join the Georgia Pharmacy Association for an afternoon at the Atlanta Braves — the last home game of the season, in fact. We’re offering a one-hour CPE program before the game: “Put Me In, Coach: The Pharmacist’s Role in Sports Medicine.”

The game is Sunday, September 22, 2019. The CE starts at noon; the game begins at 1:20 p.m. It’s a mere $42.00 for GPhA members, which includes CPE and a ticket to the game. (Want to come for the game only? That’s $38.00.)

Check out GPhA.org/braves for more!

Good news in Georgia’s latest opioid stats

Georgia is seeing signs that the prescription opioid epidemic might be waning in the state, with opioid scripts dropping by 13 percent between 2016 and 2018.

The better news is that opioid-related deaths dropped by almost the same amount (12 percent). That seems to indicate that people are not simply turning to street drugs, but are actually quitting their painkillers.

CDC announces flu vaccine guidelines

For the upcoming 2019-20 flu season, the CDC has its list of recommendations. Check them out in detail, but here are the basics:

Offer vaccination by the end of October and keep going throughout the season.

Children (6 months to 8 years) get two doses — the first dose should be given ASAP so they can receive the second dose, which must be given at least 4 weeks later, by the end of October.

The CDC gives no preference to either quadrivalent or trivalent vaccines.

The CDC gives no preference for recombinant vaccines or ‘standard’ vaccines.

Give preference to the following groups if vaccine supplies become limited:

• People under 5 years old or over 50
• Adults and children who have chronic pulmonary (including asthma), cardiovascular (excluding isolated hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus);
• People who are immunocompromised due to any cause;
• Women who are or will be pregnant during the influenza season;
• Children and adolescents (aged 6 months through 18 years) who might be at risk for Reye syndrome after being infected by the flu;
• Residents of nursing homes and other long-term care facilities;
• American Indians/Alaska Natives; and
• Extremely obese people (with a BMI ≥40).

The long read: The meds no one can afford

“The $6 Million Drug Claim”

Elsewhere: Headache edition

If you have a patient with a headache that hasn’t gone away in 30 years, perhaps there’s a worm involved.

Sign of the times

If you happen to be sitting in traffic on I-575 North just past exit 14, check out the new billboard from Drug Free Cherokee, made possible thanks to the Georgia Department of Behavioral Health and Developmental Disabilities:

DCH facing budget cuts

The agency is preparing to trim its budget by $10.4 million, most if not all in administration. The Kemp administration, which won’t raise taxes to make up budget shortfalls, wants to be able to make more money available for other programs.

Texas toast

If vaccination rates continue to decline, Texas is doomed. At least, that’s the finding of an analysis of a simulated measles outbreak — and, of course, it applies to any large metro area where vaccinations dip below a certain threshold.

A 5% decrease in vaccination rate was associated with a 40% to 4000% increase in potential outbreak size, depending on the metropolitan area.

Prices in drugs ads: The Saga Continues

HHS was going to require that drug makers put the prices of any medication that costs more than $35 in their television ads*!

Drug makers challenged the rule, saying HHS didn’t have the legal authority, and that requiring them to provide that info would violate their First Amendment rights (and would be too complex). They won in court based on the first argument.

Now HHS is going back to court (as expected), filing a notice of appeal that it’s challenging that ruling.

* Remember, only the U.S. and New Zealand allow direct to consumer pharma ads.

Lyme disease vaccine comeback?

So you know there’s a vaccine for Lyme disease, right? It used to be available for humans, but now only dogs can get it; a combination of side effects, low demand, and vaccine fear got it pulled from the market.

That might change, though. The warming climate is increasing the range of disease-carrying ticks, leading to more cases of Lyme and more people thinking, “Y’know, it’s not fair that Rover is vaccinated but I’m not.” Two potential replacements are in the works.

Don’t say we weren’t warned

Newly released documents show that two government scientists sounded the alarm about opioid abuse, especially among teens, back in 2006.

[T]he directors from the National Institute on Drug Abuse and the National Institutes of Health flagged “disturbing” data showing a dramatic uptick in opioid addiction — including among teenagers — and requested urgent action.

Nothing was done.

Don’t inhale

Oh, air pollution, what can’t you do?

• Early death: “A new international study has found that air pollution is linked to increased cardiovascular and respiratory death rates.”
• Macular degeneration: “Vehicle exhaust pollutants linked to near doubling in risk of common eye condition”.
• Psychiatric disorders: “Environmental pollution is associated with increased risk of psychiatric disorders in the US and Denmark”.

Elsewhere: Yes, you can be embarrassed

Just as measles is making a comeback in the U.S. thanks to uninformed anti-vaxxers, Nigeria announced that its widespread vaccination program has eliminated polio from the country — making the entire continent of Africa polio-free.

Science!

You know about services that will make custom pill packages for patients. But how about combining all their meds into a single, personalized pill?

[R]esearchers from the Athlone Institute of Technology’s Materials Research Institute have combined the fields of materials science, additive manufacturing and injection moulding to create a rather unique pill. Instead of taking a number of different pills in a given day, this personalised pill could combine the different medications into just one tablet.

Opioid abuse — winning and losing

Opioid abuse is decreasing dramatically … at least in some states. While the nation as a whole is seeing an 11 percent drop, states that expanded Medicaid are seeing much better numbers, in part because of buprenorphine. (The ACA requires insurers, including Medicaid, to cover medication-assisted addiction treatment.)

In Medicaid-expanding states, buprenorphine prescriptions increased from 40 to 138 per 1,000 enrollees, Urban researchers found. In non-Medicaid-expanding states, they increased from 16 to 41.

Two drugmakers settle two opioid suits

Endo Pharmaceuticals (2017 revenue: $3.5 billion) has agreed to pay $10 million* to settle lawsuits from two Ohio counties for its role in the opioid crisis.

Allergan (2018 revenue: $15.8 billion) has agreed to pay $5 million** to those counties for its role.

Flu shots: Remember when we were the good guys?

Migrant children being held in U.S. detention camps won’t be given the flu vaccine this year, even though three have already died from flu-related complications. Concentration with other immigrants makes it easy for infectious diseases to spread, making the problem worse.

Gender, cost, and diabetes meds

A new survey finds that, among the people who can’t afford their diabetes meds, women are more likely than men to skip doses to save money (14.9% compared to 11.6%) but are also slightly more likely to ask for a lower-cost alternative.

Also of note: People over 65 are more likely not to skip their meds than younger folks.

Smoking: the gift that keeps on giving

Former smokers are even more likely to suffer from depression and substance abuse than either non-smokers or current smokers.

On the other hand: Quitting smoking cuts cardiovascular risk in as little as five years.

Sorry, jet-setters, you still have to suffer

Hetlioz, the anti-jet-lag drug from Vanda Pharmaceuticals, still hasn’t gotten FDA approval, leaving the company “perplexed.”

Pain in the brow

Imagine a patient comes to you with a painful eyebrow. What advice can you give? Medical News Today has some answers.

Allen visits Barney’s

U.S. Representative Rick Allen stopped by Barney’s Pharmacy in Augusta, where Ashley London (right) said they spoke in detail about DIR fees. We’ll keep saying it: Invite your legislators to your pharmacy. Tell them the issues you’re facing. Your voice matters!

Don’t overtreat diabetes

This quote says it all:

Researchers found that in the U.S., people with diabetes often receive much more medication than their hemoglobin A1C levels would require.

That overtreatment, those Mayo Clinic researchers found, “resulted in 4,774 hospital admissions and 4,804 emergency department visits in the span of 2 years.” That link is to the article; click here for the full study in Mayo Clinic Proceedings.

Time to dust off your tinfoil* hat

A small study in Canada found that a higher estimated fluoride consumption by pregnant women may lead to a lower IQ for her children. There are so many caveats to the study, but you probably won’t see those when the news circulates on Facebook.

* Tin foil has actually never been used (except in a handful of niche products). It’s just quicker to say than “aluminum** foil.”
** And worse for the Brits with their “aluminium foil.”

Satisfaction improvements

Takeaways from a new J.D. Power study about consumer satisfaction with their pharmacies.

• Most customers interact in person, but those who do so electronically tend to be more satisfied.
• The more topics you discuss — up to four — the more satisfied patients will be.
• Only about 20% of patients use a pharmacy’s app, but those who do really like it.

Teens, HPV vaccine, and parental permission

We told you not too long ago how, without the HPV vaccine, Texas’s cervical cancer rate is higher than that of several third-world countries. On the heels of the ongoing measles epidemic caused by anti-vaxxers, other states don’t want to be embarrassed. Read “When parents say ‘no’ to HPV shots, teens have no choice. Some states are changing that.”

Speaking of measles

No, it hasn’t gone away. We’re at 1,203 cases reported so far this year.

The other drug spending

In case you’re curious, Americans spent $150 billion on illegal drugs in 2016, the majority on marijuana and heroin (which they bought in about equal dollar amounts); coke and meth markets were sizable but much smaller.

The Long Read: It takes an army

What happened when a toddler would die without a $2.1 million medication her family couldn’t afford? They recruited an army — Maisie’s Army.

Mercer welcomes new student pharmacists

Congrats and welcome to Mercer University’s incoming class of student pharmacists! The college held its white coat ceremony on Friday (August 16), when 124 student were “coated”. The class of 2023 is 69% female and 30% male*, with 111 students from the U.S. (including 81 Georgians), and 13 from other countries.

* 1% “did not report”

Out and About: Greg Reybold at PUTT

Our resident legal ninja, Greg Reybold, spoke at the Pharmacists United for Truth and Transparency’s (PUTT — truthrx.org) 2nd Annual Political Summit this past weekend, offering a case study of Georgia’s new patient anti-steering law.

Here he is answering the question, “What are the chances the PBMs will start doing good for pharmacists?”

Uninsured numbers increase for the first time

The U.S. is back above the 10% mark for people without health insurance, hitting 10.1% — the first increase since the Affordable Care Act took effect. That means about 700,000 more Americans do not have coverage.

There’s a big split between states that expanded Medicaid and those (like Georgia) that didn’t. Non-expansion states had an average uninsured rate of 14.3% (up from 13.7%), while expansion states have held steady at 7.6%.

Another interesting note: “Non-Medicaid expansion states lost marketplace coverage at twice the rate of expansion states.”

PCOM teachers of the year

The PCOM Georgia School of Pharmacy chose its two teachers of the year: Xinyu (Eric) Wang was selected as Teacher of the Year for the Department of Pharmaceutical Sciences, and Mandy Reece was selected for the Pharmacy Department of Pharmacy Practice. Congrats to both!

Novartis’s ills continue

Now it comes out that a company exec sold his Novartis shares soon after the company notified the FDA that it had manipulated some of its data, but before the FDA made that information public.

A new organ

Yep, Swedish researchers have identified a new organ in the skin, “comprised of glia cells with multiple long protrusions and which collectively go to make up a mesh-like organ within the skin.” It’s sensitive to mechanical damage such as pricks and pressure.

Remember to hydrate!

If you thought July was hot, you were right — it was the hottest month ever recorded*, in fact. (July is the hottest month of the year, so ‘hottest July’ = ‘hottest month’, period.) The CDC has recommendations for dealing with the heat.

* Since 1880, when records started being kept; July is the hottest month of the year

A mascot that’s not popular

Mr. Mucus, Reckitt Benckiser’s Mucinex spokes…thing, bottomed the list of product characters in every ranking of positive emotions.

Mr. Mucus ranked as the most annoying, most creepy, least likable, least personable and least trustworthy.

Elsewhere: Brexit reality check

Despite what HM Government has been saying, the UK really is facing drug shortages in the wake of a no-deal Brexit. We know this thanks to the leak of the official document (“Operation Yellowhammer“) that contradicts what Downing Street has been saying publicly.

“With significant disruption lasting up to six months across the Channel,
this will have an impact on the supply of medicines and medical supplies unless there is mitigation via other sources.”

The long read: No one can say they didn’t warn us

“A Nun, a Doctor and a Lawyer — and Deep Regret Over the Nation’s Handling of Opioids”

They saw addicts, overdoses, and robberies, and they knew the opioid crisis was coming … in the late ’90s.

The three also believe that the Justice Department could have changed the behavior of other opioid makers if it had charged executives of Purdue Pharma in 2007 with felonies, as federal prosecutors had recommended, in connection with OxyContin’s illegal marketing.

Instead, department officials negotiated a deal under which the executives pleaded guilty to misdemeanor charges that did not include jail time.

Legionnaire’s update

Sheraton Atlanta: Come on back, the quarantine’s been lifted!

CE at the Braves!

Join the Georgia Pharmacy Association for an afternoon at the Atlanta Braves — the last home game of the season, in fact.

Even better, we’re offering a one-hour CPE program before the game: “Put Me In, Coach: The Pharmacist’s Role in Sports Medicine.”

The game is Sunday, September 22, 2019. The CE starts at noon; the game begins at 1:20 p.m. It’s a mere $42.00 for GPhA members, which includes CPE and a ticket to the game. (Want to come for the game only? That’s $38.00.)

Check out GPhA.org/braves for more!

Pharmacists can cut antibiotic use

Duke researchers looked at small, understaffed community hospitals and found that half of antibiotic use was inappropriate. So they tested two ideas.

1. Pharmacists reviewed antibiotic prescriptions before refill.
2. Pharmacists reviewed antibiotic prescriptions after three days.

Idea #1 didn’t change antibiotic use. But idea #2 doubled the rate of identifying inappropriate antibiotic prescriptions. In other words, bringing pharmacists ‘officially’ into the workflow quickly cut antibiotic use considerably.

FDA takes virtual Mjölnir to approval rate

The FDA has set … no, broken … nay, shattered its generic-drug approval record, and it’s only July.

• 2019 so far: 1,028 approvals
• All of 2018: 971 approvals

The downside is that it likely will have little effect on drug prices: “[R]esearch shows that the highest driver of prescription drug costs is specialty drugs for chronic conditions such as cancer.”

Another good reason to keep your blood pressure down

Hypertension in middle age seems to lead to a greater chance of dementia later.

Or, as the study’s authors put it, “Sustained hypertension in midlife to late life and a pattern of midlife hypertension and late-life hypotension, compared with midlife and late-life normal BP, were associated with increased risk for subsequent dementia.”

A different Alzheimer’s target?

Beta-amyloid plaque has long been assumed to be the culprit in Alzheimer’s, but every effort to fight it has failed. But what if the culprit is something else? Say, lysosomes that have been ‘broken’ by undigestible proteins?

“Lysosome storage” (broken lysosomes clogging cells) might be the actual issue — at least according to UC Riverside researchers.

Although the timeframes are different…

“The brains of people who have lysosomal storage disorder, another well-studied disease, and the brains of people who have Alzheimer’s disease are similar in terms of lysosomal storage. “

Pill Club vs CVS

CVS (the PBM) apparently changed how much it reimburses pharmacies — specifically Pill Club — for birth control. This being 2019, naturally the fight went to Twitter. Enjoy an 1,100-word story about it: “The strange tale of how a battle between 2 healthcare companies morphed into a viral Twitter backlash against CVS“.

“Give me your tired, your poor, Your huddled masses yearning to breathe free, The wretched refuse of your teeming shore”

At least seven medical groups — including the American Academy of Family Physicians, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American Osteopathic Association, American College of Physicians, American Psychiatric Association, and the National Association for Children’s Behavioral Health — joined another 16 organizations* in a joint letter condemning the Trump administration’s “public charge” rule against immigrants.

* Including the Children’s Defense Fund, Families USA, the March of Dimes, MomsRising, and the United Way

Elsewhere: Down Under edition

“Staff left shaken after pair storm Ascot Vale pharmacy with machetes”

Elsewhere: Up Yonder edition

Like the rest of the modern world*, Canada has universal health care. But what it doesn’t have is universal prescription coverage. But now a group of “more than 1,200 Canadian health care and public policy experts” have asked that all Canada’s political parties include national prescription coverage in their platforms.

They say comprehensive public medication programs have improved access and reduced costs everywhere they’ve been implemented and want to keep national pharmacare in Canada from becoming a partisan issue.

* With one small exception

A vaccine for cat allergies?

It could be on its way. Researchers in Switzerland and the U.K. have developed a vaccine for cats that suppresses the Fel d 1 protein — which is what most allergy sufferers suffer from. (Link goes to news story; click here for the paper.)

This means a couple of things. No longer will your significant other be able to use “I’m allergic” as an excuse not to adopt a cat. And because the cat has to get the shot, you still have an excuse not to invite weird cousin Kevin to dinner.

Fun fact: It’s not cats’ dander that’s an allergen; it’s their saliva.

A vaccine for chlamydia?

Could be. Those shifty Danes have completed an initial study and found a potential candidate. It’s still early in the process, though, and the researchers have admitted there’s no certainty even these positive results will lead to an actual vaccine.

Terrifying anti-smoking rules

The FDA wants to require cigarettes to have graphic warning labels — and we mean graphic as in “incredibly disturbing.”

It’s released 13 proposed warnings, each including “text statements accompanied by photo-realistic color images depicting some of the lesser-known health risks of cigarette smoking.”

And if you think those images are disturbing, you should see what they use in Australia.

Deadliest tuberculosis cured

Scientists have developed a three-drug regimen that cures the deadliest form of TB — the XDR strain, which essentially resists all antibiotics and is the world’s leading cause of death from infectious disease. (It exists in 28 countries, including the U.S.)

The drug regimen tested on Ms. Msimango has shown a 90 percent success rate against a deadly plague, extensively drug-resistant tuberculosis.

How much vitamin D?

The answer isn’t settled — or simple. Rutgers researchers say that there’s no one-size-fits-all amount to prevent bone loss, despite there being at least two professional guidelines. Age, skin color, race … they can all factor into an individual’s needs.

As for its potential to reduce “all-cause mortality,” they say the research isn’t definitive yet.

Vaping is sending kids to hospital

Across the country, teens are vaping something that’s sending them to the ER. Trouble is, no one is sure what it is — nicotine? Cannabis oil? Something illicit? Or is it a chemical in the vaping cartridge?

Dr. Emily Chapman, chief medical officer for the Children’s Minnesota hospital system, said that in the last month or so, it had treated four cases of acute, severe lung damage — including respiratory failure — in teenagers who had been vaping.

Meanwhile….

The FDA wants to begin to review vaping products for safety, but e-cigarette companies are suing to stop it. The FDA wants to allow only safe products on the market, but vaping companies say — seriously — that it’s too expensive for them to have to meet FDA safety requirements.

Gobs of new CPEasy programs!

Looking to score some sweet, sweet, continuing ed credits but tired of the same old courses? Check this out: GPhA has added 19 new courses to our CPEasy lineup.

CPEasy: 60- to 90-minute webinars. Pharmacists and techs. Watch from home or wherever you have Internet access. Take the quiz, get the ACPE-approved CE credit. $20 for GPhA members, $42 for non-members. GPhA.org/cpeasy.

Some of the new courses:

• The 2019 annual pharmacy law update
• “Reducing Benzodiazepine Use in Older Adults”
• “Cannabis Oil and Hemp/CBD Oil”
• “Fraud and Abuse: What Every Pharmacist Should Know”

You can even get your annual OSHA bloodborne-pathogen update.

Visit GPhA.org/cpeasy to see the new lineup and start taking some fresh courses!

Shake that mouse

That’s not a euphemism: While investigating bone loss in space, researchers at the Medical College of Georgia (Go Jaguars!) found that vibrating mice regularly can reduce glucose and inflammation.

Applying 20 minutes of whole body vibration produced a dramatic drop in A1C levels, a measure of blood glucose, over a few months.

The possible mechanism might have to do with Alistipes bacteria in the gut — a bacteria common in cows and other ruminants — which increased 17-fold when the mice were shaken*.

* Not stirred

Libido shot, for a price

Vyleesi: it’s not just a leftover Game of Thrones character — it’s a “female libido injectable therapy” recently approved by the FDA that will sell for a mere $899.

Women will be able to buy a pack of four injectors of which one needs to be administered at least 45 minutes before anticipated sexual activity, the company said on Tuesday. It will compete with Sprout Pharmaceuticals’ Addyi, a once-daily pill.

Hepatitis is a notion / sweepin’ the nation

Hepatitis A, that is — it’s a consequence of the opioid epidemic, and while it may start in prisons and with the homeless, it doesn’t stay there for long.

Since 2016, the virus has spawned outbreaks in at least 29 states, starting with Michigan and California. It has sickened more than 23,600 people, sent the majority to the hospital and killed more than 230.

‘Industrial disinfectants should not be swallowed’: FDA

The FDA would like to remind you that drinking bleach is bad for your health, no matter how sincere the guy selling it as a medical treatment seems to be.

If you’re drinking “Miracle” or “Master” Mineral Solution or other sodium chlorite products, stop now. […] Both sodium chlorite and chlorine dioxide are the active ingredients in
disinfectants and have additional industrial uses. They are not meant to
be swallowed by people.

Because no one lies to their doctor

The U.S. Preventive Services Task Force* is considering a recommendation that physicians screen all adults — but not adolescents — for illicit drug use. By “screening” it meant simply asking or by using screening tools (e.g., the six-question “Brief Screener for Tobacco, Alcohol, and Other Drugs”). It’s not suggesting blood or other tests.

Want to comment? You have until September 9; use the link above.

* “An independent, volunteer panel of national experts in prevention and evidence-based medicine”

Another Canadian roadblock

Bloomberg points out that, in order to import drugs from Canada beyond the small scale, the Trump administration will need the cooperation of the drug manufacturers. And, to put it bluntly, that ain’t likely to happen.

“We’re not in the business of exporting,” said Daniel Chiasson, president of the Canadian Association for Pharmacy Distribution Management representing distributors like Gamma Wholesale Drugs Ltd. and McKesson Corp.‘s Canadian unit. “There is no merit to doing so — in fact, there is a disincentive.”

Shocking conclusion

Walnuts might protect against ulcerative colitis, according to a study out of UConn (Go Huskies!) and Texas A&M (Go Aggies!) … and funded by the California Walnut Commission. Imagine that.

The long read: Georgia marijuana edition

“Medical marijuana in Georgia: A closer look” from Connect Savannah.

Welcome, UGA class of 2023

UGA held its white coat ceremony for the incoming class of 136 student pharmacists. Check out their happy, stress-free, haven’t-got-a-student-loan-bill-yet faces (click to enlargenate):

A nice bit of news

Ebola is no longer incurable.

The two antibody-based treatments, REGN-EB3 and mAb-114, work by blocking a critical protein in the Ebola virus. Patients receive them once, intravenously, and “ideally, as soon as possible” after infection. […] They saved about 90 percent of patients with low levels of infection, according to preliminary data released from the trial.

Compounding: The times they are a-changin’

New rules for compounding are taking effect on December 1 (less than five months from now!), and you and your practice need to be sure you’re prepared. Don’t be caught out of compliance!

GPhA is offering a full-day workshop that will get you up to speed. We’ve got great instructors lined up, and it’s only $149 for members.

It’s Saturday, September 14, 2019, from 7:30 a.m. – 4:30 p.m. at GPhA’s HQ classroom in Sandy Springs.

DEETS

• A full day compounding workshop
• Saturday, September 14, from 7:30 a.m. – 4:30 p.m. in Sandy Springs
• Covers the new USP <795>, <797>, and <800> regs
• Features two of the best instructors in the country
• 8 hours of CE for pharmacists and techs
• Lunch included, easy parking

Visit GPhA.org/changin for more and to register today!

“It’s time for it to crash and burn”

Laws, tariffs, export controls — Canada is not happy at all with the Trump Administration’s plan to allow Americans to buy drugs from the Land of Maple Syrup, and they’re getting ready to start implementing them. Occasional groups of diabetics looking for inexpensive insulin is one thing, but on a larger scale? No thanks, eh.

You are coming as Americans to poach our drug supply, and I don’t have any polite words for that. Our drugs are not for you, period.” —Amir Attaran, law and medicine professor at the University of Ottawa

They point out that, rather than piggyback on Canadian price controls, the U.S. can, you know, enact its own. Or — an interesting possibility — wait for the threat of Canuck imports to convince drugmakers to lower their prices here.

Novartis is not having a good week

After having been caught manipulating study data to get its Zolgensma therapy approved, the company is facing a Senate misconduct probe, is shuffling its pharma management, and of course is still facing an FDA investigation. Oh, and it lost a major court case against Amgen.

Cervical cancer: cause and effect

Texas stopped mandating the HPV vaccine, and now its cervical cancer rate is higher than that of some third-world countries. Meanwhile, Australia had the opposite policy … and looks like it might eliminate cervical cancer in the next decade.

Death by 1,000 drops

The amount of unused — and disposed — eyedrops after cataract surgery is high enough that there’s a significant environmental and financial impact.

We’re talking an average of 83 liters per month (more than 21 gallons) at every site that performs these surgeries.

The long read: buprenorphine

“It’s The Go-To Drug To Treat Opioid Addiction. Why Won’t More Pharmacies Stock It?“

Georgia to get $835K for treatment

Five medical centers in eastern Georgia will each receive a $167,000 grant to help prevent and treat substance abuse. They are:

• Coastal Community Health Services in Brunswick
• Curtis V. Cooper Primary Health Care in Savannah
• Diversity Health Center in Ludowici
• J.C. Lewis Health Center in Savannah
• McKinney Medical Center in Waycross

Diabetes: No steps forward

For all the work you would think has been done on diabetes, the latest figures show virtually no improvement at all in care from 2005 through 2016.

“It appears that advances in diabetes care over the past decade have not translated into meaningful improvement in population-level treatment outcomes.”

Vaping and seizing

The FDA continues to investigate reports of e-cigarette users having seizures and other neurological incidents, and is still taking reports from healthcare providers. As of August 7 it’s received a total of 127 reports of seizure or other neurologic symptoms among e-cigarette users, including 92 new reports since April when it first announced the potential issue.

Cannabis, opioids, depression

A study out of the University of Houston finds that, “adults who take prescription opioids for severe pain are more likely to have increased anxiety, depression and substance abuse issues if they also use marijuana.”

Yet more autism genes

Inherited autism — it’s a lot more complicated than originally thought. UCLA researchers found an additional 16 genes (bringing the total to 69) that appear to increase the risk of autism. And it gets even more complex:

Researchers also identified several hundred genes they suspect may increase the risk of autism based on their proximity to genes that were previously identified to carry an increased risk. The study further revealed several new biological pathways that had not previously been identified in studies of autism.

Brexit: Med shortfalls in Europe?

As Brexit, the world’s slowest-moving train wreck, approaches the concrete wall of October 31, not only Brits are looking at potential medication shortages — the rest of Europe might be hit as well. The issue isn’t just delays at newly erected border crossings, but because of licensing changes as well.