Author: Peter

...Valeant Pharmaceuticals finally explained its complex interactions with Philidor RX Services, a so-called “specialty pharmacy” that has a previously-undisclosed financial relationship with Valeant...Valeant has been labeled the “Enron of the pharmaceutical industry,” although I don’t know if any of the alleged shenanigans are true…the controversy has tarred the entire specialty pharmacy industry along with manufacturers’ legitimate specialty pharmacy relationships…Philidor RX is not a specialty pharmacy. I also suggest what the Valeant-Philidor relationship could mean for payer surveillance of manufacturers’ copay offset programs…I believe (hope?) that over time, everyone will recognize the differences between a true specialty pharmacy and a company such as Philidor...expect greater scrutiny of manufacturers’ specialty channel strategies. Smaller independent specialty pharmacies should also expect greater oversight, as manufacturers and payers work to validate the business operations of their trading partners.

Visual and video content is surging online, already making up more than half of all consumer web traffic… pharma marketers in general have lagged behind in adopting traditional consumer strategies, one digital agency is lobbying its drugmakers to consider visual content…When it comes to video use...we want them to put their budgets behind behavior…Stop putting money behind what people don't do and create strategies around what people are actually doing…pharma needs to follow its potential consumers' behavior. Today that means watching videos or looking at visual content online and in social media…that means getting attention more quickly, better engagement and (people) watching longer…

Embattled Valeant Pharmaceuticals International…that its accounting related to its relationship with a specialty pharmacy was legal and appropriate, but added that its board was nonetheless forming a special committee to investigate the relationship…disclosed for the first time last week that it had acquired an option to buy the specialty pharmacy, Philidor Rx Services, which dispenses some of Valeant’s dermatology drugs… If doctors send prescriptions to Philidor, rather than having their patients go to a retail pharmacy, it makes it harder for the pharmacies or insurers to switch the patient to a cheaper generic alternative…Philidor negotiates for reimbursement with insurers, relieving doctors of the hurdles that might otherwise discourage them from prescribing a high-priced drug. Patient co-payments are also reduced or eliminated, removing another barrier to use of Valeant’s drugs.

Victorian pharmacists will play a pivotal role under proposals announced by the Victorian Government to make medicinal cannabis available to some patients under exceptional circumstances…pharmacists will dispense medicinal cannabis after authorisation is provided by medical specialists…“Having pharmacists acknowledged as best-placed to dispense medicinal cannabis is welcomed as it ensures that medicines experts are available to advise and counsel patients using these products,”…there were specific eligibility requirements for the scheme based on conditions and corresponding symptoms. These were:

• Severe muscle spasms or severe pain resulting from multiple sclerosis
• Severe pain, nausea, vomiting or wasting arising from cancer, HIV/AIDS
• Severe seizures resulting from epileptic conditions where other treatment options have failed or have intolerable side effects
• Severe chronic pain with the approval of two specialists

Americans want more medications to treat obesity and depression, among other conditions…
Obesity, which affects more than one-third of Americans, ranked highest among US physicians who were asked which conditions they wished had more pharmacological remedies…More than 6000 US physicians participated in the "PatientsMap" survey, which was conducted by the Social Survey Research Information Co, M3 Inc, and M3 Global Research and took place between December 2013 and February 2014…According to the US survey results, the following are the 15 conditions that most warrant new medications, with some information on how pharmacists can help these patients:

1. Obesity (27.4%)
2. Depression (24.7%)
3. Diabetes (22.1%)
4. Dementia (20.5%)
5. Migraine (19.5%)
6. Anxiety (18.8%)
7. Hypertension (17.8%)
8. Chronic pulmonary obstructive disorder (16%)
9. Lower back pain (15.7%)
10. Dyslipidemia (15.6%)
11. Osteoarthritis (15.1%)
12. Fibromyalgia (14.8%)
13. Headache (14.8%)
14. Gastroesophageal reflux disease/nonerosive reflux disease (14.3%)
15. Diabetic neuropathy (13.9%)

About half of all surgeries involve some kind of medication error or unintended drug side effects…There is a substantial potential for medication-related harm and a number of opportunities to improve safety…Drugs delivered during an operation don’t have the same safeguards that other medication orders do. In most parts of a hospital, prescriptions are typically double-checked by pharmacists and nurses before they reach the patient. Operating wards are riskier…some kind of error was made in about one in every 20 drug administrations. Several medications are typically used in each operation, from anesthesia to antibiotics, so that rate translated into some kind of error or adverse reaction in every other surgery...

Ronna B. Hauser, PharmD, vice president of pharmacy affairs for the National Community Pharmacists Association, provides an overview of some of the most important aspects of the Drug Quality and Security Act.

Recent comments by the editor of The Lancet, Richard Horton, have stirred the ire of Indian health officials who called them derogatory and not borne out by evidence…the country's government…failed to make the health sector a priority…a joint secretary in the Ministry of Health, said in a letter to Horton…the country has made great strides in reducing infant and maternal mortality through its immunization programs…as well as increased efforts to control drug-resistant tuberculosis and HIV…government has spent more than $4 billion at 10 centers for medical science and at 58 district hospitals that will be converted to medical schools…Indian officials...said the respected journal (The Lancet)…must not become a tool in the hands of people with their own agenda for generating political controversies…

Nothing sends a shock of fear through a hospital C-suite quite like the word audit. And the second phase of HIPAA audits is slated to being in early 2016…Those CIOs, CISOs, CEOs, General Counsel and privacy officers unfortunate enough to receive notification of an impending HIPAA audit from the Health and Human Services Department's Office for Civil Rights will invariably feel that pressure…While security is a crucial aspect to any health organization, it's another thing entirely to plan accordingly for an OCR audit.

…tips for healthcare organizations potentially facing an audit:

1. OCR is moving forward with HIPAA compliance audit program
2. Compliance audits expected to be in hundreds; not thousands
3. OCR has been transparent on topics it will target
4. Prepare now in case your organization is selected
5. Educate staff and leadership on how your organization is preparing for an OCR audit

OCR will look into security, privacy and breach notification rules to analyze risk, safeguards and implementations, especially those associated with electronic health information and device encryption.

James Schiffer, RPh, associate at Allegaert Berger & Vogel LLC, discusses some red flags related to prescriptions that can lead to administrative action from the DEA. (video)