PHARMACY

PSE’s Rx-only switch in Arkansas opens a new can of worms

BY Michael Johnsen

WHAT IT MEANS AND WHY IT’S IMPORTANT — The latest Arkansas proposition to control PSE sales may deliver the biggest blow to the over-the-counter accessibility argument, as it restricts sales to Arkansas residents who have a state-issued picture ID and who don’t look like they might be meth addicts. It also is no more fair or effective to have pharmacists decide who looks like a meth addict and who doesn’t. Worse, the bill includes a provision that would allow the Arkansas Board of Pharmacy to color any OTC medicine with the same brush as PSE.

(THE NEWS: Arkansas PSE bill could spark fresh debate. For the full story, click here)

And that really opens a can of worms, because now dextromethorphan is being lumped together with PSE as “the other” OTC ingredient with a high abuse profile. Never mind that the issues surrounding each of these ingredients couldn’t be more disparate. And never mind the fact that the OTC industry voluntarily has stepped to the plate with paid-for programs to address each of these issues. Creating a streamlined rulemaking process absent any public stake in the outcome could place a whole host of appropriate OTC medicines in jeopardy — acetaminophen, for example, or nicotine-replacement therapy — just because the local newscasters stress the sexier headlines outlining the high-risk profile as opposed to the “less-than-sexy greater-benefit-versus-that-risk” storyline.

That aside, out-of-towners who are a bit under the weather are still out of luck if they want to buy a PSE product in the great state of Arkansas, if this bill becomes law, because pharmacists can only sell to those with an Arkansas-issued photo ID. The sole exception to that are military IDs; pharmacists can take those, too.

And if you’re sick and in search of some ready congestion relief, you may want to consider taking a quick shower and fixing up your hair before you go cold-remedy shopping. Because if you go into a pharmacy in Arkansas with bed head and the pharmacist mistakes you for a drug addict, well, you won’t be able to buy PSE then, either.

The only good news to come out of this proposed legislation is for law enforcement — real-time tracking of PSE purchases is still in play, and that means law enforcement still has a tool to identify the real bad guys in all of this — the actual meth cooks.

Except not all law enforcement sees this as good news. And that’s unfortunate, because as Arkansas Baxter County Sheriff John Montgomery testified, real-time electronic tracking works. The problem for some in law enforcement may be it works too well — fingering highly-likely meth addicts means an increase in meth lab busts. And how exactly do you propose to show progress in the war on meth if the number of your meth lab busts is on the incline as opposed to on the decline?

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PHARMACY

Taking evolving healthcare roles to the streets

BY Antoinette Alexander

WHAT IT MEANS AND WHY IT’S IMPORTANT — The Doobie Brothers once recorded a song called "Taking It to the Streets," and that’s kind of what Walgreens did when two top executives took the message of the changing role of the community pharmacist on the road.

(THE NEWS: WAG VP talks to Chicago Tribune about changing role of pharmacist. For the full story, click here)

During the 11th annual Population Health and Care Coordination Colloquium on March 15 in Philadelphia, Walgreens chief medical officer Cheryl Pegus spoke to members of the medical community on the evolving role of pharmacists and the positive impact of face-to-face interactions at both community pharmacies and employer worksite health clinics.

Pegus, who was named Walgreens CMO in May 2010 and has more than 18 years of clinical practice and industry experience under her belt, not only highlighted the broader range of services offered by today’s pharmacists, but also discussed how extensive data has shown that face-to-face interactions between pharmacists and patients significantly improve medication adherence. Improved medication adherence, in turn, means reduced costs to the U.S. healthcare system and better health outcomes for patients.

Just two days after Pegus’ presentation, Richard Ashworth, Walgreens VP pharmacy services, spoke to the general public during a live online "Health Chat" hosted by Chicago Tribune reporter Bruce Jaspen. During the hour-long Web presentation, Ashworth and Jaspen discussed the expanding role of the pharmacist and other retail healthcare professionals, such as nurse practitioners, in today’s consumer medical care model.

And don’t forget about the relaunch earlier this month of NACDS’ ad campaign to lawmakers to educate new members of Congress of the value of community pharmacy and the role the industry could play in health reform. Last week, Walgreens took that message "to the street."

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PHARMACY

Congress should mull over options before implementing track-and-trace system

BY Rob Eder

WHAT IT MEANS AND WHY IT’S IMPORTANT — It’s about time lawmakers start to understand the real threats posed by drug reimportation and unlicensed Internet pharmacy sites. About 20% of the current members of Congress are newly elected, and there is this recurring, cyclical fascination among politicians that we can fix everything with drug reimportation. But mandating electronic track and trace right now is a bad idea.

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(THE NEWS: NACDS responds to report on integrity of pharmaceutical supply chain. For the full story, click here)

In all, many of the proposals that came out of the joint report delivered this week to Vice President Biden and Congress are good ones:

  • Drug manufacturers and wholesalers should share intelligence with FDA, Customs, the DEA and every other relevant agency involved in guarding the nation’s pharmaceutical supply chain. Such companies as Pfizer, which was featured in a "60 Minutes" segment that aired March 13, have created special global security teams to work with local law enforcement groups around the world to bust illegal drug counterfeiters. Those companies could save a lot of money if they could get the same kind of results from our own enforcement agencies — the "60 Minutes" segment included footage from an early morning raid of a Peruvian operation;

  • The definition of "valid prescription" should be extended to ensure that people can’t be diagnosed by imaginary doctors somewhere in cyberspace who are prescribing medications without ever having met the patient or seen a medical record;

  • Congress should grant Customs and Postal inspectors civil and criminal forfeiture authority under the Food and Drug Act. During the "60 Minutes" segment that appeared March 13, a package found in a U.S. postal facility to contain counterfeit drugs was simply shipped back to the sender; and

  • In general, the laws that prosecute manufacturers, distributors and marketers of counterfeit drugs should be more severe. Right now, drug counterfeiting is a low-risk/high-reward business. It might cost 40 cents to make a potentially lethal knock-off of a drug that you can sell for $20 a pill; and if you get caught, the worst thing that can happen is the post office will send your contraband back to you? They don’t even make you pay return-postage? No wonder so many drug traffickers are giving up coke and heroin for counterfeit Viagra, etc.

But mandating a federal track-and-trace system before the technology has been fully tested is a bad idea as it punishes legitimate pharmacies and wholesalers for having done the right thing all along. According to cost estimates conducted in recent years, implementing such a system could cost billions; potentially tens of thousands of dollars per pharmacy, to roll out a system that experts are not convinced is ready yet. Former Calif. governor Arnold Schwarzenegger was smart enough to see the need to push back electronic pedigree mandates in that state until the technology was ready, scalable and implementation no longer likely was to put hundreds of pharmacies in his state out of business.

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