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ADHD can be diagnosed in children from age 4, physician group says

BY Alaric DeArment

BOSTON — Children can be diagnosed with attention deficit hyperactivity disorder as soon as 4 years old, according to new guidelines released Sunday by the American Academy of Pediatrics.

In a new report, the children’s physician group said emerging evidence made it possible to diagnose and manage ADHD from the ages 4 to 18 years; previous guidelines, released in 2000 and 2001, included children ages 6 to 12 years. The AAP recommends behavioral interventions in children ages 4 and 5 years, while methylphenidate "may be considered" for preschool children with moderate to severe symptoms who do not experience significant improvement with behavior therapy. A mix of drug and behavior therapy is recommended for elementary school children and adolescents.

"Treating children at a young age is important because when we can identify them earlier and provide appropriate treatment we can increase their chances of succeeding in school," report lead author Mark Wolraich said. "Because of greater awareness about ADHD and better ways of diagnosing and treating this disorder, more children are being helped."

The AAP released the report, titled "ADHD: Clinical Practice Guidelines for the Diagnosis, Evaluation and Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder," at its National Conference & Exhibition in Boston Sunday. It will also be published in the November 2011 issue of the journal Pediatrics.


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Vivus resubmits application for Qnexa

BY Alaric DeArment

MOUNTAIN VIEW, Calif. — Vivus has reapplied to the Food and Drug Administration for approval of a drug to treat obesity, the company said Monday.

Vivus said it sent in its regulatory approval application for Qnexa (phentermine and topiramate), a drug designed to treat obese and overweight patients by inducing and maintaining weight loss.

The company originally sought approval for the drug in October 2010, though the FDA declined to approve it.


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NCPA ads feature community pharmacy proposals to trim federal deficit

BY Antoinette Alexander

ALEXANDRIA, Va. — With the congressional “super-committee” inching closer to making budget decisions to reduce the deficit, the National Community Pharmacists Association announced on Monday that it has developed two new advertisements reinforcing how local pharmacists can reduce federal healthcare costs.

“Community pharmacists can help reduce healthcare expenses by maximizing the appropriate utilization of lower-cost generic drugs and through face-to-face, expert counseling on the proper use of medications as prescribed for patients,” stated NCPA CEO B. Douglas Hoey. “Small-business community pharmacies are ready and willing to work constructively with policy-makers to address rising medical costs while maintaining patients’ access to the cost-cutting services of local pharmacists.”

NCPA first offered its recommendations in a Sept. 7 letter to “super-committee” members.

NCPA’s first ad focuses on overall deficit reduction. It offers policy-makers five recommendations to lower spending:

  • Utilize local pharmacists to increase the appropriate use of low-cost generic drugs in Medicare Part D, Medicaid and Tricare;

  • Reduce an estimated $290 billion in avoidable healthcare spending by empowering pharmacists to counsel patients face-to-face on proper medication use;

  • Collect billions of dollars in drug manufacturer rebates retained by middlemen pharmacy benefit managers in Medicare, Medicaid and Federal Employees Health Benefits Program;

  • Reduce costly waste in mail-order pharmacy, particularly “mandatory mail” plans; and

  • Allow community pharmacists to continue providing advice and testing supplies to keep Medicare patients with diabetes healthy.

The second ad highlights H.R. 1936, the Medicare Access to Diabetes Supplies Act, legislation introduced by Reps. Aaron Schock, R-Ill., and Peter Welch, D-Vt. The bipartisan bill would reduce the deficit and permanently exempt independent community pharmacies (defined as 10 or fewer pharmacies under common ownership) from competitive bidding prices in the Medicare Part B Durable Medical Equipment, Prosthetics, Orthotics and Supplies program. A recent survey of more than 800 community pharmacists found 84% of them would be forced to stop providing access to diabetes testing supplies if they had to competitively bid or accept prices set by that process.

In addition, NCPA has developed an analysis of the many cuts community pharmacies have already had to absorb in recent years. That document finds that community pharmacies have seen prescription drug reimbursement slashed by more than $15 billion. Between 2005 and 2010, the number of independent community pharmacies that are operating at an overall financial loss has increased by 64% and now accounts for 23% of independent community pharmacies.

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