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As the Oct. 31 deadline for Britain to leave the European Union approaches, health professionals are warning that shortages of some medicines could worsen in Europe in the event of a no-deal Brexit...Britain’s food and drink lobby warned last week that the country would experience shortages of some fresh foods if there is a disorderly no-deal Brexit. Pharmaceutical companies have expressed similar concerns about medicines, and some have reserved air freight capacity to fly in supplies if needed…But the impact on medical supplies will also be felt beyond Britain. About 45 million packs of medicines are shipped from Britain to the rest of the bloc every month...Experts say some disruption is inevitable if Britain leaves the EU without a deal. British Prime Minister Boris Johnson has said he will lead his country out of the EU...without a deal if the EU refuses to negotiate a new divorce agreement...READ MORE

Across the United States and Canada, people are buying cocaine only to discover too late that it contains potentially deadly fentanyl…In all cases, victims "reported thinking they were snorting cocaine," said a team led by Dr. Patil Armenian, of the University of California, San Francisco, in Fresno. Instead, they had ingested cocaine laced with fentanyl, a synthetic opioid...Overall, "death rates involving cocaine increased by approximately one-third during 2016-2017," the researchers added...READ MORE

A shortage of a versatile medicine used to treat immune disorders and other diseases has forced U.S. hospitals and infusion clinics to suspend treatment for many patients... many hospitals and infusion clinics have received less immune globulin, or IG, than they need. Some have started to ration it, prioritizing it for patients who need it to stay alive and canceling infusions for patients deemed to have non-life-threatening conditions. The shortage has gotten to an acute status...READ MORE

McKesson Corp., Cardinal Health Inc., and AmerisourceBergen Corp. have proposed paying $10 billion to settle claims they helped to fuel the U.S. opioid epidemic — the first sign of progress in resolving state lawsuits against the drug distributors…The companies, which deliver the majority of prescription medications to U.S. pharmacies, made the verbal proposal as part of talks with a group of state attorneys general...Whether the distributors and attorneys general can agree to a deal remains uncertain...READ MORE

Medicare and Medicaid will cover CAR-T cell therapies...a decision that helps address, but doesn't fully solve, the reimbursement challenges that have hampered uptake of the pricey cancer drugs...One major hang-up is reimbursement. Kymriah costs $475,000 for pediatric and young adult patients with leukemia and both therapies are priced at $373,000 to treat lymphoma in adults...Under regulations published this month, Medicare will reimburse at least 65% of the treatment's cost, or about $242,000, through Part B...That will give hospitals surety they will receive payment for the drug, yet doesn't necessarily make whole the full cost of treating a patient with CAR-T. The cell therapies are also still reimbursed via billing codes for bone marrow and stem cell transplants, rather than using a separate identifier...READ MORE

In honor of recent supply chain deficiencies, FDA recalls, as well as loss of manufacturing capabilities from recent environmental disasters in Puerto Rico and the Gulf Coast, St. Ann’s Lying-In Hospital and Orphanarium has been renamed “Our Lady of Perpetual Shortage.”...“We feel that this name change better actualizes the current reality of medicine, synergizing the relationship between the hospital, administrators, and supply vendors,” said hospital CEO Reid Roberts, simultaneously winning Corporate Buzzword Bingo and ignoring doctors and patients...Reactions from patients and doctors was mixed...READ MORE

New system could free bench chemists from time-consuming tasks, may help inspire new molecules...Guided by artificial intelligence and powered by a robotic platform, a system developed by MIT researchers moves a step closer to automating the production of small molecules that could be used in medicine, solar energy, and polymer chemistry…The researchers tested the full system by creating 15 different medicinal small molecules of different synthesis complexity, with processes taking anywhere between two hours for the simplest creations to about 68 hours for manufacturing multiple compounds…The team synthesized a variety of compounds: aspirin and the antibiotic secnidazole in back-to-back processes; the painkiller lidocaine and the antianxiety drug diazepam in back-to-back processes using a common feedstock of reagents; the blood thinner warfarin and the Parkinson’s disease drug safinamide, to show how the software could design compounds with similar molecular components but differing 3-D structures; and a family of five ACE inhibitor drugs and a family of four nonsteroidal anti-inflammatory drugs...READ MORE

Naloxone dispensing from retail pharmacies increased from 2012 to 2018, with substantial increases in recent years. Despite increases, in 2018, only one naloxone prescription was dispensed for every 69 high-dose opioid prescriptions. The lowest rates of naloxone dispensing were observed in the most rural counties...What are the implications for public health practice?...READ MORE

The Trump Administration's Department of Health and Human Services has officially proposed legalizing the importation of drugs from Canada...Canadians’ reactions provide an important perspective demonstrating why drug importation will harm the U.S...Despite assurances from Prime Minister Justin Trudeau, Canadians are worried that the U.S. proposal will impose severe costs on Canadians. Their concerns are well founded. Typical of their reaction, the Canadian Pharmacists Association has noted that...the Canadian medicine supply is not equipped to support both Canadian and U.S. consumers, and will make existing drug shortages in Canada even worse, disrupting patients’ access to their medications. Drug shortages have ‘greatly increased’ in the last 3-5 years according to a newly released survey of Canadian pharmacists...READ MORE

Laura Joszt, Managing Editor at The American Journal of Managed Care. Welcome to This Week in Managed Care from the Managed Markets News Network