Georgia fails against smoking

The annual report from the American Lung Association calls on Georgia to increase its cigarette tax, currently at on 37 cents a pack, the levy is among the lowest in the country. And it gave the state an overall F for its tobacco policy.

The Peach State’s ‘Fs’’ were in funding for state tobacco prevention programs; the level of tobacco taxes; coverage and access to services to quit tobacco; and for not raising the minimum age of sale for tobacco products to 21.

Infant ibuprofen recall

Products made by Tris Pharma and sold at CVS, Family Dollar, and Walmart have been recalled because of potential excessive ibuprofen concentration.

The products: Ibuprofen Oral Suspension Drops, USP, 50 mg per 1.25 mL.

For details and lot numbers, click here for the FDA list.

Burning the crisis at both ends

All sorts of interesting info is coming out of the various opioid lawsuits. Here’s one: Perdue Pharma, which made and heavily marketed OxyContin, was apparently looking into expanding into the “attractive market” of opioid-addiction treatment.

Out of the frying pan…

On the one hand…

“Vaping much better smoking cessation aid than gum, patches”

But on the other hand…

“Survey Finds Higher Risk Of Stroke Among E-Cigarette Users”

Vitamin D might fight diabetes

At least that’s what a new study shows — it appears to increase the body’s sensitivity to insulin.

We know you’d do the same

Those of you who own a snowmobile, that is.

The long read when you’re by yourself

“Scientists are working on a pill for loneliness”

Huge news: Georgia’s MCOs agree to abandon “spread” pricing

After working with GPhA, Georgia’s four Medicaid managed care organizations (MCOs) have announced that they will be switching to a pass-through pricing model in their PBM contracts.

The agreement between GPhA and the Georgia Quality Healthcare Association (which represents those four MCOs) will take effect as each organization renews its PBM contracts.

Click here to read the details of this huge step toward fairer pricing.

Three measles cases in Atlanta

The headline says it all, other than reminding people of the fact that we were this close to eradicating the disease entirely. (sigh)

Don’t be afraid

Pharma companies were wary of putting drug prices in their ads, thinking consumers will be scared off by the full list prices. But not to worry: A study finds that adding info about co-pay assistance (“You could pay $0!”) makes everything copacetic.

Anthem PBM to launch soon

“Hey, what’s up with that Anthem PBM — IngenioRx?” you ask. The answer: Expect a launch in the next few months. The company decided not to wait till 2020.

Zinc deficiency linked to hypertension

But researchers aren’t sure which is the cause and which is the effect. They do know that sodium processing plays a role, and the latest experiment shows…

[M]ice that ate a diet with lower levels of zinc developed hypertension. […] They fed half of the animals on a diet that contained adequate levels of zinc. As expected, their blood pressure soon returned to normal.

A good reason not to read the news

According to an NIH study, even mild head injuries — like, say, from banging your head against a wall — can lead to mental health disorders.

Testing tick spit

The title: “Dissecting Flavivirus Biology in Salivary Gland Cultures from Fed and Unfed Ixodes scapularis (Black-Legged Tick)”

The translation: Researchers are looking at tick saliva to learn how viruses spread … and why some spread so quickly.

The first rule* of SCUBA diving

Scientists at an Israeli company say they’ll have a cure for cancer within a year.

“Our cancer cure will be effective from day one, will last a duration of a few weeks and will have no or minimal side-effects at a much lower cost than most other treatments on the market,” [company chair Dan] Aridor said. “Our solution will be both generic and personal.”

* Don’t hold your breath.

The long read: CBD

“Cannabidiol: Rising star or popular fad?”

GPhA’s Duke elected president

Congrats to Dr. Lori Duke, UGA College of Pharmacy assistant dean for Experience Programs. She’s been elected president of the Accreditation Council for Pharmacy Education (ACPE).

Drug prices: A different view

Looking at data from IQVIA, Adam Fein from Drug Channels argues that drug prices are not, in fact, skyrocketing.

While the list prices of “protected” drugs (i.e., there’s no generic competition) rose 5.7% in 2018, if you look at the net price — what pharmacies actually pay after rebates and other discounts — it only rose 2.1% that year. And that’s a trend that goes back at least several years.

Assuming IQVIA’s data are correct, it certainly puts a spin on all the talk about prices, don’t it?

UGA sans Francisco

A fond farewell to Dr. George Francisco, associate dean for academic affairs at UGA, who is retiring after almost four decades with the College of Pharmacy.

Who deserves an award

You’re running out of time to nominate a pharmacy professional for one of GPhA’s prestigious awards:

• The Distinguished Young Pharmacist Award
• The Excellence in Innovation Award
• The Generation Rx Champion Award
• The Larry Braden Meritorious Service Award
• The Bowl of Hygeia

Get more information on what each of these awards represents, then nominate someone to receive one — all at GPhA.org/awards!

Whatever happened to beta blockers?

“No other class of drugs in cardiovascular medicine has such a broad list of clinical indications,” writes Baylor University cardiologist and researcher Milton Packer.

Despite overwhelming evidence of efficacy, most patients with heart failure do not receive proper doses of beta-blockers in clinical practice. There is no good reason for the lack of prescribing. There is no dispute about their efficacy. Patients with heart failure typically tolerate them very well. And they are not expensive.

Cancer patients may have undiagnosed hepatitis

If some of your patients are getting cancer treatment, especially immunotherapies, you might suggest they get screened.

A large proportion of patients with past (87 percent) and chronic (42 percent) hepatitis B infections were undiagnosed prior to the study, as were as 31 percent of patients with hepatitis C, according to the report.

Tongue biome can indicate pancreatic head cancer

A study of the bacteria on patients’ tongues found that people with pancreatic head cancer (PHC) had a noticeably different microbiome. From the study:

[The] analyses revealed that PHC patients were colonized by significantly different tongue coating microbiota compared with healthy controls.

Don’t want to read the paper itself? Fine, fine. Here’s the news story.

The long read: Whatever happened to “right-to-try”?

The law passed, but then what? The short answer: It didn’t change anything. But the details and stories are a bit more complex.

Elsewhere: ICYMI edition

The Washington State measles outbreak has convinced the governor there to declare a state of emergency. Vaccinate your kids, people! (The state’s legislature is now considering a bill to ban non-medical exemptions from vaccination requirements.)

Learn to take better care of your patients

Americans are taking more drugs than ever. They need medication therapy management from their pharmacists. And the pharmacists who provide it will stand out from the crowd. Be that pharmacist.

Learn how to step up and provide the best patient care — earn an APhA medication therapy management certificate through GPhA. February 17, 2019, 8:00 a.m. to 5:00 p.m., Sandy Springs. Click here for details and pricing.

The New York Times notices pharmacists

It starts to sing a few bars of “The Unsung Role of the Pharmacist in Patient Health.”

In medicine, we often focus on the traditional doctor/patient interaction. We tend to ignore practitioners who come into contact with patients more than physicians.

The BP – dementia link

Treating high blood pressure aggressively might stave off dementia.

People who received intensive treatment for hypertension were less likely to develop minor cognitive problems than those receiving standard treatment.

Yes, there’s probably going to be a shortage

With multiple recalls of valsartan, you can expect other BP meds to feel the ripple effect.

Don’t cuddle your hedgehog

That’s not a euphemism. The CDC is warning people to resist the urge to kiss or cuddle any hedgehogs they come across because of a salmonella risk.

The long read: Is it time to get into specialty pharma?

By 2021, half of all drug spending is expected to be on specialty drugs. Are you ready for that market? Should you be? http://www.drugtopics.com/specialty-drugs/independent-pharmacies-chains-enter-specialty-pharmacy“>Drug Topics explores the question.

The power of the follow-up

Pretty simple: When pharmacists follow up with a simple phone call, hospital readmission rates drop.

NY analysis: PBMs add to costs

New York, too, is finding that PBMs are adding a lot to the cost of medication.

“For years, small pharmacy owners have been complaining that PBMs have been shortchanging them,” so our friends at the Pharmacists Society of the State of New York paid for an analysis. Read on to see what they found (not that you’ll be surprised).

Do we finally know the cause of Alzheimer’s?

This time the answer could very well be “Yes.” And the culprit is P. gingivalis.

Multiple research teams have been investigating P. gingivalis, and have so far found that it invades and inflames brain regions affected by Alzheimer’s; that gum infections can worsen symptoms in mice genetically engineered to have Alzheimer’s; and that it can cause Alzheimer’s-like brain inflammation, neural damage, and amyloid plaques in healthy mice.

Reality check

CVS is putting warning labels on products where the packaging features unrealistic Photoshopped images.

One-day workshop: Mastering Pharmacy Ownership

Waypoint Pharmacist Advisors is offering a full-day workshop for pharmacy owners and potential owners. Sessions include topics from marketing and contracts to inventory management and PBM changes.

Saturday, March 23, 9:00 a.m. to 4:00 p.m. in Atlanta.

The $99 fee includes all eight sessions and meals. Click here for info and registration.

Elsewhere: Literature edition

A British poet is opening a “Poetry pharmacy.”

Alma is reluctant to hand out general poetry prescriptions on demand, as she says each “patient” needs a proper consultation before being given a poem.

If CRISPR babies are outlawed, only outlaws will have CRISPR babies

Two big U.S. science organizations are planning to create a commission to set limits on used gene-editing technology on human embryos.

She’s a jolly good fellow

A big ol’ GPhA shout-out to Monali Majmudar, PharmD, of Alpharetta. She was just named a fellow of APhA Academy of Pharmacy Practice & Management.

Majmudar works for GlaxoSmithKline’s adult vaccine portfolio, and “is a champion for immunizing pharmacists everywhere, serving as a mentor and expert resource within her state and across the country.”

Congrats!

And now stage two of our master plan

Pharmacists for Healthier Lives — a campaign spearheaded by the American Association of Colleges of Pharmacy and fully supported by GPhA (and a growing number of state pharmacy associations) — has completed the first stage of outreach. Now it’s ready for phase 2.

Pharmacists for Healthier Lives aims to inform and remind the public that pharmacists do more than fill bottles. Phase 1 was outreach through Facebook, including a video shared there and elsewhere.

Since its launch in October 2018, the campaign reached more than 4 million individuals on Facebook, with the campaign video achieving more than 8 million views and more than 10 million impressions.

Phase 1 begins in March with a nationwide advertising and research campaign.

You can help! Spread the word on your own website, blog, Facebook page, Twitter feed, and just using your mouth. Point your patients and colleagues to pharmacistsforhealthierlives.org and follow its Facebook page at facebook.com/PharmacistsForHealthierLives.

Do more than ask “Do you have any questions?”

Sure, there are always some people who just love taking a new medication, but most people, it turns out, are a little apprehensive.

What’s driving the concern? No one is taking the time to talk about the meds with ’em. Oh, and giving them instructions in writing doesn’t cut it — they at least prefer a video.

Learn about Medicaid “lock-in” programs

Check out this one-hour “quickinar” — a webinar on “Care Transitions: Innovative Practices to Combat the Opioid Epidemic.” It’s from Alliant Quality, the Georgia Hospital Association, and Magnolia Coastlands Area Health Education Center.

The program will describe the increasing utilization of “lock-in” programs for members served by a Georgia Medicaid Care Management Organization to address concerns for unsafe use of opioids.

Lock-in programs seek to improve coordination of patient care by restricting access to Medicaid benefits for a patient to one primary care provider and/or one pharmacy. Program attendees will learn about criteria used to determine member lock-in enrollment; additional care coordination services offered to enrolled members, and appeals processes for members, pharmacists and prescribers to change or end the lock-in enrollment.

February 6, 2019 from 1:00 – 2:00 p.m. from your favorite Web browser.

Click here to register.

More Americans now uninsured

The U.S. uninsured rate rose to its highest point since 2014 according to new data from Gallup. At the end of 2018, 13.7% of American adults did not have health coverage. That’s below the 18+ percent rate before the Affordable Care Act took effect, but still far above every other advanced nation. (At one point it was as low as 10.9% uninsured, but that was in 2016.)

The AMA would like more diabetes telehealth programs

“[D]igital options must be part of fight against prediabetes,” according to the organization. Which makes sense, especially as diabetes remains entrenched in rural areas with few healthcare providers.

What could go wrong?

Meet Kick: the Web-based store where you can “see” a physician and get a prescription for propranolol shipped to your door to curb your anxiety. $59 gets you 24 tablets “to block shaking hands, racing heartbeat, and symptoms of nerves.”

Why did the fried chicken cross the road?

TO KILL YOU.

A regular serving of fried chicken or fish is associated with a higher risk of death from any cause except cancer, according to a new study done in postmenopausal women in the United States.

Here it comes

The CDC expects us to hit the top of the flu-activity graph in the next month, and the end of February is expected to be the peak.

Walgreens pays feds

Walgreens will pay the feds $269 million to settle fraud claims. That’s $209.2 million for allegedly billing the government for insulin it gave to people who didn’t need it, and $60 million for not giving Medicaid price discounts it had offered.

Latest aspirin news

Pluses and minuses: A meta-analysis finds that, for people without cardiovascular disease, “the use of aspirin was associated with a lower risk of cardiovascular events and an increased risk of major bleeding.”

Electric Avenue … to pain treatment

One alternative to pain meds — neurostimulation (e.g., spinal cord stimulators) — is expected to be a $16 billion market within the next six years. That’s a growth of 15 percent per year, at least according to one research firm*.

* Bonus fact: The company that released the outlook is based in Selbyville, Del., home of the Mumford Sheet Metal Works, which in 1950 set the record for the world’s largest frying pan.

Artist’s conception

What the traffic will bear, right?

Insulin makers doubled their prices in just four years, from 2012 to 2016. There are no changes to the product, no R&D costs, no marketing.

Per the senior researcher of the report:

“Use is pretty flat, and the price changes are occurring in both older and newer products. That surprised me. The exact same products are costing double,” she said.

The Wild, The Innocent, and the K Street Shuffle

The pharmaceutical industry pumped a record $27.5 million into the Washington, D.C., economy in 2018.

Scarlet stickers

One of Florida’s potential answers to the opioid crisis: Require pharmacists to put red stickers on opioid bottles.

The warning stickers would be required to flag the addictive nature of opioids and the risks of overdoses. The stickers would have text large enough to be legible and would be placed on the caps of the bottles.

Elsewhere: “Portland is a total train wreck”

What happens when you live in a city where people don’t wanna vaccinate their kids? People get sick, people are hospitalized, an emergency is declared, and you make the news.

CVS paid rivals less

A report from the Columbus Dispatch explains that “CVS shorted some rivals.”

We’ll let the article’s lede do the talking:

“CVS used its role as a pharmacy middleman for the Ohio Medicaid program to pay some of its biggest retail competitors far less than it pays its own stores, according to a section in a state report that CVS is fighting in court to keep secret.”

Allergic to penicillin? Maybe not

People who think they’re allergic to penicillin may actually not be — or might not be any more. A mild reaction may have been mislabeled as an allergy, or they might simply have ‘outgrown’ the allergy.

Hey! Don’t forget! Nominate someone for an award!

If you haven’t already, time’s running out — time for you to nominate a pharmacy professional for one of GPhA’s prestigious awards:

• The Distinguished Young Pharmacist Award
• The Excellence in Innovation Award
• The Generation Rx Champions Award
• The Larry Braden Meritorious Service Award
• The Bowl of Hygeia

Get more information on what each of these awards represents, then nominate someone to receive one — all at GPhA.org/awards!

The beginning of the end for DTC drug ads?

Only the U.S. and New Zealand allow drugmakers to target consumers with their ads — and only the U.S. gives pharmaceutical companies a tax break for doing so.

But that might change. The Senate has had its eye on that deduction for some time but didn’t have the votes to pass a bill. With the new Congress, though, eliminating the deduction has some high-powered support.l;p

Diabetes and fractures: This must make sense somehow

People with Type 1 diabetes are more at risk for fractures than average — but (oddly) the same isn’t true for Type 2 diabetes… unless the patients are taking rosiglitazone and pioglitazone.

Going with their guts

There are potential “super donors” out there whose gut bacteria — if transplanted — could help treat a wide range of conditions and diseases, from cancer and obesity to depression and even PTSD.

The long read: Organ transplants

Instead of a lifetime of anti-rejection drugs, what if scientists could retrain transplant recipients’ immune systems?

Study: Gifts lead to opioid deaths

A study published Friday in JAMA Network Open found a direct correlation between gifts given to doctors and the number of opioid deaths.

From the New York Times:

It found that counties where opioid manufacturers offered a large number of gifts and payments to doctors had more overdose deaths involving the drugs than counties where direct-to-physician marketing was less aggressive.

Anti-vaxxers are a health threat: WHO

The World Health Organization has added the misguided anti-vaccination movement — what it calls “vaccine hesitancy” — to its list of the top 10 health threats facing the world.

Amid the latest U.S. measles outbreak (in Washington State), Forbes explains why “Measles Outbreaks Show Why Anti Vaxxers Made WHO’s 10 Global Health Threats.”

Alzheimer’s + epilepsy drugs = hospital

Alzheimer’s patients who take anti-epileptic drugs tend to spend more time in the hospital, at least according to a new study out of Finland (and published in the Journal of American Medical Directors Association).

Gut bacteria turn meds into dopamine

A common gut bacteria might make Parkinson’s meds ineffective, finds a new study.

Gut bacteria metabolizes levodopa, a common Parkinson’s medication, into dopamine, a neurotransmitter in the brain. Since dopamine can’t pass through the blood-brain barrier, it saps the levodopa of its effectiveness

Solution: Use a a decarboxylase inhibitor, obviously.

Tiny Swiss swimmers might deliver meds

A Swiss team has created a “microswimmer robot” that could someday be able to deliver drugs directly to specific locations in the body.

“[It] is a few millimeters in length and made using a folding technique similar to the Japanese art of origami, helping it adapt to the environment around it” and can be controlled from the outside of the body. Science, baby!

The long read: Fax machines in medicine

Why, in 2019, do American medical practices still use fax machines? The basic answer is that the laws that digitized medicine considered storing information but didn’t take into account the need to share it. But there’s plenty more to the story.

Elsewhere: Across the pond

Could be worse, could be in Britain where people are stockpiling medication in fear of a chaotic, no-deal Brexit in March. (The government there says ‘Don’t worry!’ because “Plans have been drawn up for the use of alternative transport routes and prioritisation of medicines.”)

Drug prices hitting hospital staffing

Why should employee pharmacists care about pharmacy laws and regs? Because of stories like this: “A quarter of US hospitals cut staff to cope with rising drug costs.”

It’s not just your patients who are being affected by these issues — it’s your job.

The FDA wants naloxone to go OTC

So for the first time it’s developed and tested “consumer-friendly” drug facts labels that are required on an OTC medication. It’s posted the results for manufacturers to use. “These efforts,” wrote FDA Commissioner Scott Gottlieb, “should jumpstart the development of OTC naloxone products to promote wider access to this medicine.”

Grocers fight opioids

From pharmacist training to drug-takeback programs, working with law enforcement to partnering with schools, “Top Grocers Take Aim Against Opioid Epidemic” — Progressive Grocer reports.

How PBMs keep the cost of insulin high

KHN calls it the “rebate trap.”

Makers of established brands give volume-based rebates to insurers or intermediaries called pharmacy benefit managers. In return, those middlemen often leave competing generics off the menu of drugs they cover, called a formulary, or they jack up the price for patients. The result is that many can’t get the cheaper drugs unless they shoulder a bigger copay or buy them with no help from insurance.

What do drugmakers do when there’s a shortage of valsartan?

Raise the price, according to the Wall Street Journal.

At least three sellers of a widely used blood-pressure medication, valsartan, have raised prices since a series of safety-related recalls of the drug by other manufacturers began in the summer of 2018.

Support your team … and avoid mosquitoes at the same time

Researchers from Sweden and Hungary were curious about why indigenous peoples might wear body paint. What they discovered: It can ward off mosquitoes.

Here’s the plastic model they used:

Relax, it’s plastic

History-minded folks might make the connection with the “dazzle camouflage” used in WWI:

The modern equivalent might not be as effective, though, at least at Georgia Tech:

ICYMI

CVS and Walmart have patched things up, meeting after math class in the third-floor hallway and promising each other to keep dating for at least a few years.

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