Category:

The government and private insurers have been trying for years to move away from the fee-for-service system that pays doctors and hospitals based on the volume of tests they perform and treatments they prescribe. They want to replace it with contracts that reward quality and better outcomes… changes in the reimbursement model are rippling out to manufacturers of drugs and devices…shift could help address a long-standing problem with medical advances:..benefits observed in carefully designed clinical trials don’t always materialize when a treatment is deployed in the real world…linking payment to performance, while appealing in theory, is tricky. "What metric are you going to select to measure performance?

Pharmacists should take some time to counsel patients on the pros and cons of each antidepressant to help them select the best regimen…Decision aids produced by the Mayo Clinic inform health care providers of the nuances between medications and how each drug may affect a patient…Here are 5 key facts about these antidepressants that warrant clarification for patients:

1. Weight Changes
2. Sexual Issues
3. Insomnia or Sleepiness
4. Cost
5. Stopping Treatment

Pharmacists can lead by example by promoting the FDA’s patient safety initiatives in their practice settings…FDA’s Safe Use Initiative involves a series of recommendations aimed at reducing preventable harm from medication errors…Pharmacies, hospitals, and other health care entities that regularly interact with patients and their medications are among the partners that the FDA hopes to actively engage in its comprehensive initiative…Here are a few current projects in the Safe Use Initiative that pertain to pharmacists:

1. Acetaminophen overuse
2. Atypical antipsychotic use in pediatric populations
3. Medication non-adherence
4. Non-steroidal anti-inflammatory drug use in elderly patients

…Endocrinologic and Metabolic Drugs Advisory Committee of the Food and Drug Administration…met to consider marketing applications for the new molecular entities alirocumab (Praluent) and evolocumab (Repatha)on the basis of their ability to lower low-density lipoprotein cholesterol levels…These first-in-class medications are fully humanized monoclonal antibodies that inactivate proprotein convertase subtilisin–kexin type 9…consequent lowering of LDL cholesterol levels…has led to optimism regarding the potential — but as yet unproven — cardiovascular benefits…LDL cholesterol reduction as the surrogate measure of clinical benefit. No efficacy data on cardiovascular outcomes were provided…Establishing evidence of improved cardiovascular outcomes is key to evaluating medications from any new drug class intended to reduce such risk….definitive evidence of reduced cardiovascular event rates is essential…to provide such evidence should elucidate the medications' true clinical benefits and possible risks.

..Hong Kong’s Nathan Road is a favorite destination for tourists from the mainland…Small, rainbow-lit drugstores have become a feature of some of Hong Kong’s most expensive neighborhoods…Their lineups include muscle rubs, painkillers, aphrodisiacs, and traditional Chinese medicines...if you ask discreetly, some will also sell you something else: cancer and hepatitis C drugs...Visitors from the mainland also prefer to buy their medicine in Hong Kong because they believe it’s less likely to be counterfeit…Cancer rates in China are soaring…Most Chinese lack prescription drug benefits and must pay out of pocket for premium medicines. The upshot: Prices for treatments from foreign drugmakers are some of the highest in the world…90 percent of cancer drug sales at pharmacies are to mainland tourists...

Nick Gentile, Director of State Grassroots Advocacy and Political Action for ASHP, discusses different legislative issues generating buzz on the state level, including biosimilars.

PCSK9 inhibitors…offer the promise of reductions in blood cholesterol levels…This broad indication sets the practice of cardiology on a collision course with specialty pharmaceutical pricing models…reserved for drugs that benefited relatively limited patient populations…these therapies may also lead to savings down the road, by reducing rates of cardiovascular events…There will surely be formal economic evaluations of these data, and there are long-term outcome studies under way to elucidate the potential effect of these therapies on cardiovascular event rates…it is apparent that the prices for these drugs will result in net costs to the health care system, even if they may eventually be found to offer good value for the money…expected total annual costs in the billions, it's important to ask who will bear these costs...Pricing pressure on innovative products would drive a fundamental restructuring of the industry and further increase the financial challenges of bringing scientific innovations to the market. It is important that we manage these downside risks carefully as we work toward a more sustainable pricing model in this market..

..Florida Board of Pharmacy approved a rule change…aimed at training pharmacists to change their mindset about prescriptions for controlled substances, in a reaction that followed pleas from desperate patients unable to get pain medications…change switches the rule from a focus on reasons to reject prescriptions for highly addictive narcotics to an emphasis on ensuring that legitimate patients get the medications…"Instead of starting out with trying to find a reason to doubt a prescription, you start off with an assumption that everything in the prescription is good…rule also includes requiring pharmacists to take a two-hour, "Validation of Prescriptions for Controlled Substances" course to educate pharmacists about ensuring access to pain medications for "all patients with a valid prescription."

Jennifer L. Costello, PharmD, BCPS, BC-ADM, ambulatory care clinical pharmacist at Saint Barnabas Medical Center

• Episode 1 New Pharmacological Agents for Treatment of Obesity
• Episode 2 Mechanisms of Action for New Weight-Loss Agents
• Episode 3 Risk and Benefit Profiles of Weight-Loss Medications
• Episode 4 What Pharmacists Should Prepare Patients for When Taking Weight-Loss Medications
• Episode 5 Key Takeaways from Recent Landmark Studies of Weight-Loss Drugs
• Episode 6 Counseling Points for Pharmacists with Patients on Weight-Loss Medications

…retail giant…will offer free blood glucose, blood pressure and vision screenings along with product samples and health insurance information at more than 4,400 stores nationwide on Oct. 10… "We expect to set record-breaking numbers during this single day because we will have hundreds of thousands of both screenings and immunizations,"…we believe that during this health fair more than 3,000 Americans will learn that they may have diabetes, and another 7,000 will find out that they have high blood pressure."…."This is a continuation of our commitment to helping our customers live healthier lives,"…"We have a long history of making health care more affordable and accessible…