Sauce for the TB gander

Tuberculosis is particularly good at evolving resistance to antibiotics, tweaking the receptor that those antibiotics (typically rifamycin) target. But now researchers have found a group of bacteria that produce similar antibiotics … but that are just different enough to beat TB at its own game.

Great news for AbbVie!

Thanks to the new tax law, the company has been able to cut its tax bill by 96 percent.
Here’s hoping to see some of those savings translate to more research and potentially lower drug prices in the future.

Great news for 200 people a year!

Researchers have found a potential antidote to botulism.

Potential Epi-Pen problem

Adding to Mylan and Pfizer’s ongoing Epi-Pen woes, now there’s a problem with the labels. The labels of some injectors may have been placed incorrectly, causing the injector to get stuck to the package.

“In some cases,” said the FDA, “the patient or caregiver may not be able to quickly remove the epinephrine auto-injector from the carrier tube.”

Use it or lose it, please

A new report finds that a lot of parents — we’re talking almost half — save unused antibiotics to give to their kids ‘next time,’ or to give to other people.

The issue isn’t “you should finish the entire course” (which is not necessarily true), but that the drugs are being given to others without dosage considerations or medical supervision.

Opioid deaths hit new high

In 2017, 49,060 Americans died from opioid-related drug overdoses — that’s up more than 16 percent over 2016 … and the news comes just a week after HHS Secretary Alex Azar claimed overdose deaths were beginning to level off. Awkward.

FDA approves new opioid, but with controversy

In the midst of the opioid crisis, the FDA just approved a new, more powerful opioid called Dsuvia (based on sufentanil, which has been around for a while) made by AcelRx in California. Why? Military use.

One factor that weighed heavily in the Dsuvia decision is military interest in the drug, [FDA commish Scott] Gottlieb said in his statement. The military wants to explore whether the pill can be used as a battlefield painkiller that is less cumbersome than liquid analgesics. The Pentagon has spent millions of dollars helping to fund AcelRx’s research, public documents show.

Dsuvia won’t be available in retail pharmacies — only in ERs and in battlefield testing in a single-dose form.

 

Correction: In the November 2 edition of Buzz, we implied that Hyrimoz is the first biosimilar version of Humira. It is the latest biosimilar. Sorry for any confusion.

It’s here!

Epidiolex — the first FDA-approved drug derived from the marijuana plant. (Approved for use in patients two years old and older with Dravet or Lennox-Gastaut syndrome.)

Llama-based flu vaccine?

The latest candidate for a universal flu vaccine requires llamas (the bigger, nastier cousins of alpacas). It creates a bigger, nastier antibody.

Hope for a better vaccine emerged when scientists discovered that people sometimes produce rare antibodies that work against a range of flu strains. […] The authors of the new study wondered if they could string together these broadly neutralizing antibodies into a sort of mega-antibody. They isolated four of them, and then they created a gene that manufactured all four as a single mega-antibody.

The Rolling Stones would probably like this moss

So you know marijuana’s two cannabidiol compounds — CBD and THC, right? Now there’s a new* kid on the block: PET, or perrottetinene. It comes from a relative of the liverwort moss of all things, and it seems to be a lot like THC.

Notably, though…

Although PET’s psychoactive effects were less potent, it reduced certain molecules associated with inflammation, says study author Michael Schafroth, currently a postdoctoral researcher at The Scripps Research Institute.

*Not really new, ’cause it’s been known since the mid-’90s, but it’s now that its relationship to THC is being examined

If you have $2 billion lying around…

…you could think about buying Pfizer’s women’s health business.

Stand and deliver

You probably have to worry more about sore feet, but think about your patients who sit a lot. Apparently "Dead Butt Syndrome" is now a thing.

Americans are sitting so long that their butts are literally falling asleep. “Dead butt syndrome,” or gluteal amnesia, is a condition that occurs when your gluteus medius gets inflamed and forgets to function normally.

But the best comment:

“If you imagine making a panini sandwich where you take high pressure and high temperature and make a grilled cheese, sitting on your glutes all day is a little like this.”

Obligatory reminder that Daylight Savings Time ends Sunday morning

Fall back.

Three pieces of Humira news

1. The FDA approved the first biosimilar (i.e., generic) version of AbbVie’s Humira for the U.S. market: Novartis’s Hyrimoz (which is “Zomiryh” backwards).
2. Hyrimoz won’t be sold here until 2023.
3. Humira biosimilars were already announced in Europe, but AbbVie is fighting back by offering an 80 percent (!) discount to the EU government.

Looking at you, Steve Jobs

A poll from the American Society of Clinical Oncology found that 40 percent of Americans “believe cancer can be cured with the use of alternative therapies alone.” We’re talking “enzyme and oxygen therapy, certain diets, and vitamins and minerals.”

Keep it in your genes

Yeah, genetic tests are cool for finding out that you’re 75 percent Golden Horde or whatever, but the FDA would like to remind you that no, they can’t predict your response to a particular medication. (Probably. We just don’t know yet.)

NCPA turns up the heat on PBMs

Our friends at NCPA have been working hard, and they’ve had some success to show for it. In fact, they made a short video to tell you about it : https://youtu.be/C6iX-k2vlNs

CVS tests next weapon in its war with Amazon

CVS is testing an Amazon-Prime-like membership program called CarePass. The test is in Boston, the fee is $48 a year, and it includes free delivery, “access to a pharmacist helpline, a 20 percent discount on all CVS-branded products and a monthly $10 coupon.”

Looking for patients affected by BCBS policy

Blue Cross Blue Shield has a new, retroactive policy that might deny payments to people who use the ER if the insurer doesn’t think it was an emergency.

If you know of any patients affected by this policy, would you drop a quick note to Greg Reybold at greybold@gpha.org (or simply reply to this message)?

Just let him burp

Got a patient who’s giving her kids acid suppressants? Offer a warning: It could lead to obesity later. (How? By messing with gut microbes, of course.)

I bet they like the pharmacist just fine

Half of little kids are afraid of the doctor.

Maybe news, maybe not

New York-based Schrödinger announced it is forming a new drug discovery venture with a Chinese company. It may or may not have results soon.

Patients will walk away

Almost half, in fact, if the out-of-pocket cost of a med is too high. And almost three-quarters would switch pharmacies because of cost. (Obviously this doesn’t apply to consumers whose insurance has a set co-pay.)

The takeaway: Don’t be a commodity. Educate patients on cost-saving options (coupons, paying out of pocket, etc.), and on the other services you can provide.

Irbesartan recall

Be aware: Some lots of irbesartan made by ScieGen — labeled as Westminster Pharmaceuticals or as GSMS Incorporate — have been recalled.

Open enrollment begins today

Remind your patients: If they get their health insurance through the federal ACA exchange, open enrollment begins today, November 1. And remember that the enrollment period has been shortened to only six weeks. Enrollment ends December 15.

“We price to the marketplace”

Remember when Donald Trump said drug makers were going to be voluntarily lowering their prices? Not many did, but many — including Pfizer — held off on price hikes. Now Pfizer has announced that it will return to “business as normal.” Per the CEO:

“[W]hat I’m trying to indicate is that we did voluntarily agree to defer price increases until the (Trump administration) blueprint (on pricing) was implemented over the end of this year. We’ve been working with the president on parts of the blueprint. And I expect our approach by the end of year will be, what I would characterize as business as normal. We price to the marketplace.”

Small hospitals woo drug trials

Some smaller hospitals are joining together to offer their facilities to drug makers for clinical trials. Why? How about $10,000 per patient (or more)?

I, for one, welcome our new microbiota overlords

Gut bacteria, is there anything you don’t do? (tl;dr: Gut bacteria can control the neurons responsible for movement.)

Elsewhere: Mother Necessity™ edition

What happens when you only allow medical exemptions for children’s vaccines? As California is learning, it means physicians pop up offering to write them for your kids without even an examination.

In fact, California has seen a 250 percent increase in medical exemptions for required vaccinations since it outlawed “philosophical” exemptions.

Health officials are onto the game, though. It’s kind of obvious when the exemptions come from cardiologists, dermatologists, surgeons, and in at least one case a marijuana dispenser.

In one case, a study participant said a doctor charged patients to watch a video in exchange for signing an exemption. Another told of a physician who charged for medical tests before vouching for an exemption. In some cases, doctors openly advertised their willingness to sign exemptions for a fee.

AFM in Georgia, concerns

At least four Georgia kids have been hit with acute flaccid myelitis — the ‘mysterious, polio-like illness’ that’s been popping up all over the country. And now the CDC’s own medical advisors are criticizing the agency’s handling of the issue.

[CDC advisor and neurology professor] Dr. Keith Van Haren and other doctors who care for these children say the agency has been slow to gather data and to guide pediatricians and emergency room physicians on how to diagnose and treat the children struck with the disease.

Please stand by

The Trump administration is waiting until after the mid-terms to announce its next proposal for cutting drug pricing. Read into that what you will.

Meanwhile, with House control still a toss-up, Nancy Pelosi’s come-to-Jesus moment may be coming for drug makers.

PBMs blamed for Epi-Pen prices

A lawsuit says they didn’t do their duty to protect patients, and that allowed Mylan jack up the price of Epi-Pens. (A judge just ruled that yes, the class-action suit can continue.)

You’re a social creature

A major factor in dementia risk: loneliness.

A new Florida State University College of Medicine study involving data from 12,000 participants collected over 10 years confirms the heavy toll that loneliness can take on your health: It increases your risk of dementia by 40 percent.

Babies, bathwater, and the throwing out of both*

Suboxone helps opioid addicts fight withdrawal, but it can also be abused. And that means cracking down on it might end up hurting more than helping.

*I’ll take ‘Obtuse Headlines’ for $400, Alex

At some point food labels are gonna look like laundry-care tags

The FDA is considering requiring allergy warnings for foods containing sesame.

Can we bring up the hygiene hypothesis now?

Dogs can sniff out malaria

It’s actually important — early treatment means a much higher survival rate.

Don’t give these out tonight

We need to find some story with a pharmacy/Halloween twist, and we got it. There’s this discussion out there: “What Are Your Favorite CBD Gummies?“

The Georgia pharmacists who need your help

When’s the last time you had to hand-write your labels? Or run your practice without Internet — or without power or even a working phone?

That’s what’s facing your colleagues in South Georgia in the wake of Hurricane Michael. It may be out of the headlines, but the devastation is still on the ground.

The Georgia Pharmacy Foundation has set up a fund to help GPhA members in South Georgia who are trying to keep their practices open while they wait for help — and for the towns around them to be repaired. Many of them have suffered damage to both their homes and pharmacies.

Yet they are standing by their patients.

Please help by donating the the Georgia Pharmacy Foundation Hurricane Michael Relief Fund. 100 percent of your (tax-deductible) donation will go to help Georgia pharmacists affected by the hurricane.

GPhA’s Rhonda Bonner visited the area last week and saw the damage. Donalsonville, especially, was hit hard.

Scott Hartzog’s Seminole Hartzog Pharmacy lost its roof — adding insult to injury, it’s lying in the road next to the pharmacy. Electricity and phone service was out. Scott’s home was also severely damaged, but he’s at the pharmacy, running a generator and filling scripts as best he can.

That means handwriting prescription labels — there aren’t any typewriters around any more — and saving the paperwork (emphasis on paper) to submit to insurance companies. Community comes first.

“I need to take care of my patients,” he said. “I really haven’t had time to absorb everything that’s happened.”

He went on, “I’m so overwhelmed. I have have no Internet, phone, or fax. I lost my roof. It’s lying in the road outside the store. I lost so much personal property, but need to take care of my patients. I really haven’t had time to absorb everything that’s happened.”

Then he went back to the line of patients who were waiting for their medication.

While Roberts Pharmacy, owned by Susan Mills, didn’t suffer the kind of structural damage that Seminole Hartzog did, Susan is just as overwhelmed. She’s also running a generator (as long as she can get fuel), and her daughter Mary, also a pharmacist, was able to hook up a label printer to their computer — even if it’s not hooked up to the Internet.

Still, she can’t fill prescriptions the way she normally would. Instead, she’s keeping a written record of what’s she’s filled and for whom. Patients, she said, need their medication — they can’t wait until she’s reconnected with the insurance companies. Instead, Susan’s hoping her records will be enough to be reimbursed by those insurers once they’re back online. (Nor is she charging patients any co-pays. She’s hoping they’ll come back and pay that part, but so many have lost their homes she’ll understand if they can’t.)

“We are hoping we will be able to recoup some,” said Mary, “[We’re hoping] that the insurance will go through for the patients who have it.”

Adding to Susan and Mary’s workload is the fact that the Fred’s Pharmacy in town has not opened, so they’re filling scripts for those patients as well. “We’re dispensing meds to other stores’ patients because we know these folks need their medicine,” Susan said. “We are here to help our community, and this community needs a lot of help right now.”

“This community is in bad shape right now,” Mary said. “We feel blessed that we had no more damage than we did here at our store. We are doing what needs to be done and we’re praying for the best.”

These are two of the stories. There are others GPhA members in Southwest Georgia that we simply haven’t been able to reach yet.

Michael was an unprecedented storm for the state — the strongest hurricane to hit Georgia since record-keeping began and the first major hurricane to hit the state since the 1800s.

Pharmacists like Scott Hartzog and Susan Mills need your help. Please give to the Hurricane Michael Relief Fund. Help those pharmacists — and those communities — get back on their feet. 100% of your donation will go to GPhA/AIP members in the area.

 

It’s two, two, two epidemics in one

BuzzFeed News* explains how the ‘painkiller epidemic’ in the U.S. is actually two separate but equally important events: Prescription painkillers are hitting the middle-age and older crowd, while heroin is killing the young.

• Not to be confused with plain ol’ BuzzFeed, home of click-bait lists

There is no headline I can use here that the boss will approve

Remember Addyi, aka flibanserin, the “female Viagra” that never really caught on? It’s still out there — and now it’s appearing in those creepy OTC supplements we like to make fun of (e.g., LabidaMAX, Monkey Business).

Are you ready for the next pandemic?

The latest National Health Security Preparedness Index is out — it measures how well states (and the country) are prepared for a public health emergency.

It took into account factors such as detecting health threats early; communication between government, community, and individuals; and healthcare delivery.

The good news: “Consistent National Progress: The U.S. posted a fourth consecutive year of gains in health security for disease outbreaks, disasters and other large-scale health emergencies.”

The not-as-good news: We’re still behind the rest of the developed world.

The bad news: If something happens in Georgia, head to North Carolina. We’re below average, N.C. is above it.

Georgia hospitals and the economy

Georgia hospitals play a huge role in the state’s economy. How big? To the tune of bringing $47.8 billion each year in the form of healthcare spending and jobs.

Despite that, according to the latest DCH figures, almost half of all hospitals — and more than two-thirds of rural ones — lost money in 2015, mostly due to uncompensated care. And that’s expected to increase in the future.

Remember to check out our insurance products

The enrollment window for GPhA’s voluntary insurance — life, accident, and critical illness products, offered through UNUM — is open through April 28.

Look for your e-mail from Enroll VB or visit EnrollVB.com/GPhA.

These policies supplement your medical coverage — they take care of things your medical plan does not cover. Check ’em out!

Tomorrow, eye of newt

Yesterday it was an anti-viral from frog mucus. Today it’s an antibiotic from dragon’s blood. Really.