Cost Effectiveness of Mail Order Pharmacies

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The debate rages over which option provides the better experience: pharmacy filled-and-delivered prescription drugs, or mail-order systems. Generally, research has shown that more patients prefer to get their drugs through a retail pharmacy than by mail.

However, when it comes to who’s saving who more money, two new studies suggest that mail order wins that one hands down.

The thumbs up for mail order come from two analyses: One by Centers for Medicare & Medicaid Services, another by Kaiser Permanente and the Centers for Disease Control and Prevention.

The former analysis compares mail-service pharmacies and retail pharmacies in Medicare Part D claims, while the latter looks specifically at the experiences of patients with diabetes.

The Medicare Part D “finds that mail-service pharmacies have lower overall costs,” reported the Pharmaceutical Care Management Association.

“CMS’ data confirms what consumers have known for years: mail-service pharmacies offer a better deal than drugstores in Medicare Part D. This is unwelcome news for drugstore lobbyists who want new regulations on their more affordable competitors,” said PCMA President and CEO Mark Merritt.

CMS looked at 57 plan sponsors with prescription drug plans that included the option of mail-order delivery. In analyzing claims data for the top 25 brand and top 25 generic drugs that can be obtained through either mail order or retail pharmacies, CMS found that mail-service pharmacies cost 16 percent less than retail pharmacies.

When CMS looked at generic drugs only, the cost advantage via mail order was 13 percent compared to pharmacy prices.

The PCMA claimed that CMS’s summary report “ fails to note the central point: mail-service pharmacies typically charge much lower drug prices than drugstores,” thus referring to the ongoing who’s-better battle between mail order and retail.

To continue reading this article visit http://www.benefitspro.com/2013/12/04/mail-order-drug-systems-more-cost-effective-than-p

Steroid Abuse Isn't Just for Athletes

Abuse of performance-enhancing drugs (PEDs) isn't just a problem of top athletes -- it's a large-scale public health problem that affects some 3 million people who use them in the U.S., according to a new scientific statement from The Endocrine Society.

The majority of users are non-athlete weightlifters who are focused on looking leaner and more muscular, according to Shalender Bhasin, MD, director of the research program in men's health at Brigham & Women's Hospital in Boston, the lead author of the statement.

PED use can lead to infertility, gynecomastia, sexual dysfunction, hair loss, acne, and testicular atrophy, and it has also been linked to risks of death and other complications including cardiovascular, psychiatric, metabolic, renal, and musculoskeletal disorders, Bhasin said.

The statement, published in Endocrine Reviews, notes that the most frequently used PEDs are anabolic drugs that increase muscle mass and reduce fat mass. Anabolic-androgenic steroids are the most heavily abused, followed by human growth hormone, insulin-like growth factor, stimulants, erythropoietin, diuretics, and thyroid hormone.

Those who develop a dependence on PEDs – which happens in about a third of those who take anabolic steroids -- tend to have many years of exposure and are at the greatest risk of complications, Bhasin said.

To continue reading this article visit http://www.medpagetoday.com/Endocrinology/Steroids/43513

Pharmacists Say They Are Seeing a Huge Spike in Drug Costs

JACKSONVILE, Fla. -- Michael Harrell said he has noticed the cost of his prescription drugs. 

"It's not getting any better. It's getting worse. It's going up," he said.

Though he has health coverage, he said in the last 6 months, his prescription has risen from about $48 to $72. He said he's having to shop around in hopes of "finding what i really can use without spending too much."

"I am angry at the fact that legitimate patients cannot get their meds," Dr. Marc Raitt, outpatient pharmacy director at Memorial apothecary said.

"So, we're not seeing five percent to seven percent. We're seeing 500%, to 1000% to 2000% increases," he explained.

For example, Raitt said Digoxin, a drug that helps control your heart rate used to be $213 per 1000 pills

"If i had to buy this now," he said holding up a bottle of pills. "It would probably cost me about $1,400- $1,500"

Raitt said birth control pills used to cost $18 now cost $40-$60 bucks. He said Doxocycline, used to treat bacterial infections, used to be $30 per bottle of 500 pills. Now he said a bottle of 50 pills costs $276.

Michael Jackson, CEO of the Florida Pharmacy Association, told FCN prescription drug costs are rising across the nation , not only Florida. Jackson said there are already some cases where pharmacies in Florida have had to close for reasons including prescription drug costs.

Raitt said, "One of the reasons I thought that we had heard was that in January, drug companies are not going to be allowed to increase prices."

To continue reading this article visit http://www.firstcoastnews.com/topstories/article/338868/483/Prescription-drug-costs-go-up-for-local-man

Pharmacists Assess Risks and Benefits of Medical Marijuana

The landscape is rapidly evolving for medical marijuana laws, and the role of pharmacists in serving patients who use it is complex and changing.

Two experts spoke on what pharmacists should know to help their patients during a session at the American Society of Health-System Pharmacists Midyear Clinical Meeting in Orlando, Florida.

Since California first allowed use of medical marijuana in 1996, 19 other states and the District of Columbia have passed laws to allow it. Connecticut's legislature has gone a step further and reclassified marijuana from a schedule I drug, suggesting no medical benefit, to a schedule II drug.

However, because federal law considers marijuana a schedule I drug, doctors are prevented from prescribing it and pharmacies are prevented from dispensing it.

Pharmacists are left to decipher how they can help their patients legally and effectively. They also have to consider that marijuana can have adverse effects when taken in combination with other drugs, said Laura Borgelt, PharmD, associate professor in clinical pharmacy and family medicine at the University of Colorado in Denver. "Anytime you're using a CNS depressant, there can be additive depressant effects, so alcohol, benzodiazepines, antihistamines, and narcotics can cause varied interactions."

To continue reading this article visit http://www.medscape.com/viewarticle/817946?src=rss

Do You Need Motivation To Get Healthy With the New Year?

Researchers at Duke Medicine are giving people another reason to lose weight in the new year: obesity-related illnesses are expensive. According to a study published in the journal Obesity, health care costs increase in parallel with body mass measurements, even beginning at a recommended healthy weight.

The researchers found that costs associated with medical and drug claims rose gradually with each unit increase in body mass index (BMI). Notably, these increases began above a BMI of 19, which falls in the lower range of the healthy BMI category.

“Our findings suggest that excess fat is detrimental at any level,” said lead author Truls Ostbye, M.D., Ph.D., professor of community and family medicine at Duke and professor of health services and systems research at Duke-National University of Singapore.

A study published earlier this year in the Journal of the American Medical Association, using death data from several large population studies, concluded that while higher degrees of obesity were associated with higher mortality rates, being overweight or even slightly obese was actually linked with lower mortality. Since these findings questioned the general belief that high body mass leads to poor health outcomes, Østbye and his colleagues sought to better understand the rates of obesity-related disease, or morbidity, by measuring health care utilization and costs.

Using health insurance claims data for 17,703 Duke employees participating in annual health appraisals from 2001 to 2011, the researchers related costs of doctors’ visits and use of prescription drugs to employees’ BMIs.

BMI is a measurement of a person’s weight adjusted for his or her height, and can be used to screen for possible weight-related health problems. A healthy or normal BMI is 19-24, while overweight is 25-29 and obese is 30 and above. For example, a 5-foot-6-inch person who weighs 117.5 pounds has a BMI of 19, while a person of the same height weighing 279 pounds has a BMI of 45. Underweight individuals (who reported a BMI less than 19) were excluded from this analysis, as very low weight may be a result of existing illness.

Measuring costs related to doctors’ visits and prescriptions, the researchers observed that the prevalence of obesity-related diseases increased gradually across all BMI levels. In addition to diabetes and hypertension -- the two diseases most commonly associated with being overweight or obese -- the rates of nearly a dozen other disease categories also grew with increases in BMI. Cardiovascular disease was associated with the largest dollar increase per unit increase in BMI.

The average annual health care costs for a person with a BMI of 19 was found to be $2,368; this grew to $4,880 for a person with a BMI of 45 or greater. Women in the study had higher overall medical costs across all BMI categories, but men saw a sharper increase in medical costs the higher their BMIs rose.

To continue reading this article visit http://www.newswise.com/articles/health-care-costs-steadily-increase-with-body-mass?ret=/articles/list&category=medicine&page=1&search%5Bstatus%5D=3&search%5Bsort%5D=date+desc&search%5Bsection%5D=10&search%5Bhas_multimedia%5D=

How the Flu Works and the Push for Vaccines

http://www.youtube.com/watch?v=7Omi0IPkNpY

In observance of National Influenza Vaccination Week, the Centers for Disease Control and Prevention released a report on Thursday that highlighted the benefits of getting vaccinated against the influenza virus.

The CDC estimated that flu vaccinations prevented 6.6 million flu-related illnesses, 3.2 million medically attended illnesses and 79,000 flu-associated hospitalizations during the 2012-2013 flu season. The report, published in theMorbidity and Mortality Weekly Report, estimates that the benefits of getting vaccinated against the flu this season will be higher than they were last year.

The CDC estimates that 40 percent of Americans six months of age and older have been vaccinated against influenza since early November. Health professionals are asking anyone that has not been vaccinated to do so immediately, before the peak of the season.

“We are happy that annual flu vaccination is becoming a habit for many people, but there is still much room for improvement,” The CDC’s Anne Schuchat said. “The bottom-line is that influenza can cause a tremendous amount of illness and can be severe.  Even when our flu vaccines are not as effective as we want them to be, they can reduce flu illnesses, doctors’ visits, and flu-related hospitalizations and deaths.”

The most vulnerable populations to influenza include children between six months of age and four years of age and persons older than 65 years of age. Health professionals are recommending everyone get vaccinated against influenza, especially if they belong to a vulnerable group.

http://vaccinenewsdaily.com/cdc/328879-cdc-pushes-for-increase-in-vaccination-rate-against-influenza/

Medication Adherence

Orange bottles and white pills. Maybe they’re two-color capsules. Maybe they are shaped like circles or ovals. They might have powder or pellets in them. Maybe your medication isn’t a pill at all. It could be a needle. In whatever form they are prescribed, we all know about prescription medicines and doctors’ orders to take them. Despite doctors’ instructions, the Centers for Disease Control and Prevention (CDC) states 20 percent to 30 percent of prescriptions are never filled. About 50 percent of people who do get their medicines stop taking them after 6 months. Are you in either of these groups?

Not taking your medicine as prescribed is called “medication non-adherence.” Doing this can have a bad impact on your long-term health. It can make you sicker. It can even land you in the hospital.

Whether you are asked to take 1 medicine or 11, it is understandable that you may not want to. Drugs can be expensive, and sometimes we just forget to take them. But we have to do better. Following the doctor’s advice can save time, money and energy. One trip to an emergency room can take up a whole day or longer for you and your family. Plus, it can cost you in gas money and cause you stress.

To Continue reading this article visit: http://washingtoninformer.com/news/2013/dec/11/wasted-prescriptions-tough-pill-swallow/

Is There a Link Between Cold Temperatures and Illness?

Cold weather has dumped snow, freezing rain and ice across the U.S., from the Southwest  to the Mid-Atlantic to the Northeast. Does that mean this week will be filled with more sniffles, colds and flu cases across the country?

Ice storm freezes Texas, South

Despite the popular perception that serious temperature drops make you sick, one expert who sees a lot of patients with flu says science doesn’t support such a link.

“It’s really inconclusive,” Dr. Leonardo Huertas, chairman of the emergency department at Glen Cove Hospital in N.Y., told CBS News.

A popular idea is that cold weather diverts energy away from the immune system to warm up the body, but Huertas says the scientific evidence doesn’t support this idea. 

What cold weather does is it tends to make people more likely to stay indoors, Huertas explained. More people inside may mean more disease-causing microbes inside, which in turn may raise risk for a person to get sick.

Deep freeze: Storm brings snow, sleet & freezing rain

If anything, the cold itself is not causing these microbes to flourish, said Huertas. More evidence suggests the humidity level might be the culprit behind flu and cold illness spikes.

“Cold and flu viruses tend to do better in lower humidity,” he said. Survival rates are higher for the viruses thriving in low humidity, and one Feb. 2013 study found increasing humidity levels indoors may reduce flu transmission, according to LiveScience.

But even that theory has some limitations. A March study found that while flu is more common in temperate areas where the humidity drops, the disease peaks in tropical areas like the Philippines and Vietnam when its hot and rainy, NPR reported.

To Continue reading this article visit: http://www.cbsnews.com/news/will-colder-temperatures-make-people-sick/

Will You Be Able to Keep Your Doctors or Medications Under Obamacare?

First some consumers found they couldn't keep their existing health insurance plans. Then others learned they couldn't keep their doctors. First some consumers found they couldn’t keep their existing health insurance plans. Then others learned they couldn’t keep their doctors. Now it’s possible that under Obamacare, some people won’t be able to keep their medications, or at least not afford them, under the complex formulary structure of the plans on the health exchanges and because of the rising costs.

Can You Even Keep or Afford Your Medicine Under Obamacare?

Health and Human Services Secretary Kathleen Sebelius addresses an audience at the Progressive Community Health Center in Milwaukee, Friday, Nov. 15, 2013. (AP/Milwaukee Journal Sentinel, Michael Sears)

“If you like your medicines, you may not be able to keep them under Obamacare,” health policy analyst Scott Gottlieb wrote in a Forbes column. “Health plans are cheapening their drug formularies – just like they cheapened their networks of doctors. That’s how their paying for the benefits that President Obama promised, everything from free contraception to a leveling of premiums between older (and typically costlier) beneficiaries, and younger consumers.”

The affordability of prescriptions could hinge on whether a consumer is enrolled in a platinum, gold, silver or bronze plan.

Under the Patient Protection and Affordable Care Act, those earning up to 250 percent of the poverty level will qualify for cost-sharing reductions on prescriptions. That applies to those earning less than $60,000 for a family of four and $30,000 for an individual. That’s only if they are enrolled in the silver plan on the exchange.

In some cases, to be covered at all, the drug will have to be included in the plan – similar to how doctors must be part of a network covered by insurance, he wrote.r doctors. Now it’s possible that under Obamacare, some people won’t be able to keep their medications, or at least not afford them, under the complex formulary structure of the plans on the health exchanges and because of the rising costs.

Health and Human Services Secretary Kathleen Sebelius addresses an audience at the Progressive Community Health Center in Milwaukee, Friday, Nov. 15, 2013. (AP/Milwaukee Journal Sentinel, Michael Sears)

“If you like your medicines, you may not be able to keep them under Obamacare,” health policy analyst Scott Gottlieb wrote in a Forbes column. “Health plans are cheapening their drug formularies – just like they cheapened their networks of doctors. That’s how their paying for the benefits that President Obama promised, everything from free contraception to a leveling of premiums between older (and typically costlier) beneficiaries, and younger consumers.”

The affordability of prescriptions could hinge on whether a consumer is enrolled in a platinum, gold, silver or bronze plan.

Under the Patient Protection and Affordable Care Act, those earning up to 250 percent of the poverty level will qualify for cost-sharing reductions on prescriptions. That applies to those earning less than $60,000 for a family of four and $30,000 for an individual. That’s only if they are enrolled in the silver plan on the exchange.

In some cases, to be covered at all, the drug will have to be included in the plan – similar to how doctors must be part of a network covered by insurance, he wrote.

To continue reading this visit http://www.theblaze.com/stories/2013/12/09/can-you-even-keep-or-afford-your-medicine-under-obamacare/

How to Effectively Save on Prescription Drugs

Many Americans, even those who have insurance coverage, spend more than they need to on prescription medications, says Consumer Reports. Those who regularly take a prescription drug spent an average of $758 a year, according to its 2012 Consumer Reports Best Buy Drugs annual prescription-drug poll.

Here’s how to keep more money in your pocket and still get effective and safe treatments for what ails you.

Try an over-the-counter drug for some problems. For certain common conditions — heartburn, insomnia, seasonal allergies, migraine headaches, joint pain — a treatment you already have in your medicine cabinet might work as well as a prescription drug. Why? Many over-the-counter drugs were once prescription only. Those OTC drugs might be less expensive than prescription drugs for the same condition, and many are now available as low-cost generic store brands.

Skip OTCs for others. Some over-the-counter remedies should be used only after a trip to the doctor. Others don’t work well enough to justify the risk of side effects. Two examples:

The Oxytrol patch, previously a prescription-only drug, will become available this fall as an over-the-counter product for women with overactive bladders. As with all drugs in its class, Oxytrol (oxybutynin) is only moderately effective at relieving symptoms and can cause dry mouth and constipation. Consumer Reports’ medical advisers caution against treating yourself for an overactive bladder without first seeing a physician for a diagnosis.

A multi-symptom cold reliever might not provide the relief you seek and could cause side effects. You are better off listening to mom about getting rest and drinking plenty of fluids.

To continue reading this article visit http://www.bostonglobe.com/business/2013/11/17/surprising-ways-cut-your-drug-costs/6SqjMFE1BuUQ3RBdV3IkBK/story.html

So You're Sick...Is it a Cold or the Flu?

Its winter, the most popular time of the year for everyone to be sick. You can't walk into a public place without hearing someone sniffle or cough. So, how do you know if you have the flu or the cold? Many people believe that the symptoms are very similar--when in fact the symptoms and treatments can be VERY different.

COLD:

Symptoms:

• Sore throat (first 1-2 days)
• Nasal symptoms (runny nose followed by stuffy nose)
• Cough (usually around the 4th or 5th day)
• Slight fever is possible (more likely in children, less than 100 degrees)

Treatment: 

• Sore Throat: throat lozenges containing benzocaine work well 
• Nasal Symtoms: 
• Runny nose: Chlorpheniramine or Diphenhydramine (will cause drowsiness)
• Stuffy nose: pseudophedrine, phenylephrine or oxymetolazone (Afrin Spray)--caution if high blood pressure
• Sneezing
• Hacking Cough: dextromethorphan for dry cough, guaifenesin for productive cough
• Fever: Acetaminophen, ibuprofen, or naproxen 
• See a doctor if you have not improved within a week, you may have a bacterial infection and need an antibiotic

Duration: 

• Symptoms usually last around 5 days
• You are contagious the first 2-3 days

FLU:

Symptoms:

• Often more severe and come on rapidly
• Sore throat
• Fever (Often as high as 102 or higher and can last 3-4 days)
• Headache
• Body aches/Muscle aches
• Fatigue (can linger for 2-3 weeks)
• Cough/Chest Pain 

Treatment: 

• Sore Throat: cough drops or throat lozenges containing benzocaine work well 
• Fever/Heachace/Body Aches/Muscle Aches: Acetaminophen, ibuprofen, or naproxen 
• Cough: dextromethorphan for dry cough
• Plenty of rest and relaxation is the key to recovery! 

Duration: 

• Contagious for first 2-3 days--hand washing and proper hygiene can help reduce transmission
• Transmitted from all mucous membranes (eyes, nose, mouth) 
• Symptoms will begin to improve within 3-5 days, though some strains can last more than 7-10 days

What Does the FDA Have to Say About Drug Shortages?

Q. What is the major reason for these shortages?

A: A major reason for these shortages has been quality/manufacturing issues. However there have been other reasons such as production delays at the manufacturer and delays companies have experienced receiving raw materials and components from suppliers. Discontinuations are another factor contributing to shortages. FDA can't require a firm to keep making a drug it wants to discontinue. Sometimes these older drugs are discontinued by companies in favor of newer, more profitable drugs.

With fewer firms making older sterile injectable drugs, there are a limited number of production lines that can make these drugs. The raw material suppliers the firms use are also limited in the amount they can make due to capacity issues at their facilities. This small number of manufacturers and limited production capacity for older sterile injectables, combined with the long lead times and complexity of the manufacturing process for injectable drugs, results in these drugs being vulnerable to shortage. When one company has a problem or discontinues, it is difficult for the remaining firms to increase production quickly and a shortage occurs.

Q. What can FDA do to address drug shortages?

A: FDA responds to potential drug shortages by taking actions to address their underlying causes and to enhance product availability. FDA determines how best to address each shortage situation based on its cause and the public health risk associated with the shortage.

For manufacturing/quality problems, FDA works with the firm to address the issues. Problems may involve very low risk (e.g. wrong expiration date on package) to high risk (particulate in product or sterility issues). Regulatory discretion may be employed to address shortages to mitigate any significant risk to patients.

FDA also works with other firms making the drugs that are in shortage to help them ramp up production if they are willing to do so. Often they need new production lines approved or need new raw material sources approved to help increase supplies. FDA can and does expedite review of these to help resolve shortages of medically necessary drugs. FDA can't require the other firms to increase production.

When a shortage occurs and a firm has inventory that is close to expiry or already expired, if the company has data to support extension of the expiration dating for that inventory, FDA is able to review this and approve the extended dating to help increase supplies until new production is available.

When the US manufacturers are not able to resolve a shortage immediately and the shortage involves a critical drug needed for US patients, FDA may look for a firm that is willing and able to redirect product into the U.S. market to address a shortage. FDA considers a list of criteria to evaluate the product to ensure efficacy and safety. These criteria include the formulation and other attributes of the drug as well as the quality of the manufacturing site where the drug is made.

FDA works to find ways to mitigate drugs shortages; however, there are a number of factors that can cause or contribute to drugs shortages that are outside of the control of FDA.

Also, FDA issued a long-term strategic plan to outline the agency’s priority actions, as well as actions drug manufacturers and others can take, to prevent drug shortages by promoting and sustaining quality manufacturing.

Q. How does FDA communicate to the public about drug shortages?

A: Early notification from manufacturers of any issue that could lead to a potential disruption in product supply has been, and will continue to be, critical to preventing or mitigating drug shortages.

FDA works to communicate information about shortages on the FDA website, based on information provided by the manufacturers. FDA appreciates all information that manufacturers provide for posting on the FDA website since we realize how necessary this is for patients and healthcare professionals to be informed when shortages occur and how long they may last. Manufacturers can report any information for posting todrugshortages@fda.hhs.gov.

Q. Where can I obtain additional information on drug shortages?

A. The American Society of Health System Pharmacists (ASHP) lists drug shortages and additional information.

To read more FAQs about drug shortages from the FDA visit http://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm050796.htm

Obamacare is Supposed to Address Doughnut Hole

Written by

Susan Bloom

For the Asbury Park Press

• FILED UNDER

• Living

After suffering a stroke in 2003 and retiring from his job as an employee of the Social Security Office, Nathaniel Lawrence was grateful that Medicare covered his many medical expenses.

“I had more than $70,000 in bills after the stroke, including hospital stays and rehabilitation at a nursing home, but everything was covered by Medicare,” the 73-year-old Howell resident and member of the Howell Senior Center said.

“I don’t think Obamacare affects me at all,” he said. “There should be no change.”

While many of the more than 40 million American seniors on Medicare may share that belief with Lawrence, experts say the Affordable Care Act has, in fact, expanded care for seniors and promoted Medicare reform in several subtle and not-so-subtle ways.

“While seniors on Medicare won’t see a whole lot of impact, there are several things they should be aware of as it relates to their health care and the ACA,” said Dr. Mary Campagnolo, a board-certified family physician in Burlington County and the immediate past president of the Medical Society of New Jersey. The MSNJ represents more than 8,500 physician members statewide

To Continue reading this article visit http://www.app.com/article/20131203/NJLIFE/312030003/Obamacare-will-address-doughnut-hole-costs-people-Medicare?nclick_check=1

Over 50 Americans Die From Drug Overdoses Daily

Current Drug Shortages

Have you ever gone to a pharmacy to pick up your prescription just to be told that it is unavailable? How about noticing that blood pressure medication that you have taken for years is suddenly blue, then white, then green? All of this is due to national drug shortages. 

A full list of prescription drugs on shortage currently can be found  at:  http://www.fda.gov/drugs/drugsafety/drugshortages/ucm050792.htm and they are updated frequently. 

A few of the more notable shortages that you may notice from your neighborhood pharmacy are:

1. Cyanocobalamin Injection (Vitamin B12 shots)--listed as an increased in demand for the drug
2. Hydromorphone Tablets (Generic for Dilaudid)--listed as unknown reason 
3. Methylphenidate IR and ER Tablets (Generic for Ritalin)--listed as an increased in demand for the drug
4. Tetracycline Capsule--listed as shortage of active ingredient 

The list of drugs on national shortage is very long, though it mostly contains medications that affect you while you are in the hospital (such as IVs and injections). To check if any of your medications may be on the list, visit the link to the FDA website above. 

Common Questions on Medicare Part D

Q. What is Medicare Part D?

A. Congress approved the Medicare Modernization Act in 2003 to provide affordable prescription drugs to seniors and the disabled. It took effect in 2006. Some 36 million people are now enrolled in private insurance plans that pay most of the cost of their drugs. Medicare spent $62 billion subsidizing the program last year.

Q. Where does this data come from?

A. When pharmacies dispense prescriptions to Medicare patients, they transmit information to Part D plans about the patient, the prescriber, the drug, its strength and retail cost. The plans pay the claims and then submit the data to the Centers for Medicare and Medicaid Services, which oversees Medicare. ProPublica obtained and analyzed data for 2007-2011 for this project. We are currently displaying data for 2011 -- covering more than 1.1 billion prescriptions and refills. (We had previously displayed data for 2010; that information is no longer available.)

Q. Why is my health provider not in here?

A.  Medications administered to Medicare enrollees during an office visit or in a hospital are covered by another part of Medicare, not Part D. That means they will not show up in our data. In addition, providers who did not write at least 50 prescriptions (including refills) of at least one drug under Medicare Part D will not show up. Nearly 364,000 providers are reported on Prescriber Checkup.

To continue reading this article visit: http://www.dailymail.com/News/201311240074

The Truth About Flu Vaccines

Lately there has been a lot of talk about the safety and necessity of flu vaccines. I find myself reading articles on social media such as "11 Reasons Why Flu Shots Are More Dangerous Than The Flu Itself" posted on realfarmacy.com and cannot help but get frustrated. This article along with others suggest, without out reliable sources, that flu shots are in fact dangerous for the public--especially the elderly and young children Many parents are refusing to vaccinate their young children, who often end up suffering for days with the flu the picked up from daycare or school.

According to the Center for Disease Control (CDC), there have been 22,048 cases of the flu reported in the  2011-2012 flu season, which is a dramatic increase from the year before. This flu season is expected to follow that trend. Children and the elderly are at a particularly higher risk for contracting the flu, and are at an especially high risk for hospital admittance and death, due to the fact  that they have weakened immune systems.

Articles such as "11 Reasons Why Flu Shots Are More Dangerous Than The Flu Itself" suggest that the flu vaccine is unsafe for many reasons. One reason that they suggest it is unsafe is the level of mercury in the vaccines. Thiomerosal, a preservative used in most of the influenza vaccines has been greatly reduced over the years. There is also a preservative free version that is available for children and pregnant women that contains only trace amounts of thiomerosal. These trace levels have been review by the Institute of Medicine Immunization Safety Review Committee and found to be safe.

There have also been suggestions that those pushing flu vaccines are those making millions of dollars. This is partially correct. While the drug manufactures and the CDC may benefit--healthcare professionals such as pharmacists, nurses, and doctors do get "bonuses" because you get a flu shot. Most of us are encouraging you to get a flu shot because it is beneficial for you and those around you.

I have also heard or read from many friends and family that they work at institutions or facilities that require them to get a flu vaccine before they can work there--or they must wear a mask every day during flu season. This is often true of nursing homes, long term care facilities and hospitals. While these individuals state it is "their right to put whatever they want in their body," what needs to be considered is who they may be affecting on a daily basis. Most places with these policies in place house elderly, young, or those with otherwise weakened immune systems. Germs can be brought from home and introduced into the institution, which can be detrimental for a patient that is not strong enough to fight off an infection that a health 25 year old may be able to. So while it is your right to get a flu vaccine or not, it is also the patients right to be housed in a healthy environment.

CVS Caremark Predicts Specialty Drug Spending to Increase Exponentially

Where a drug is administered can significantly impact specialty pharmacy costs 
 
Management of the whole patient critical to improving outcomes, managing costs 
 

WOONSOCKET, R.I., Nov. 20, 2013 /PRNewswire/ -- A new CVS Caremark (NYSE: CVS) report released today projects that specialty drug spend is expected to more than quadruple by 2020, reaching approximately $402 billion a year. The Insights report on specialty pharmacy prescribing trends and strategies for managing costs also reports that while only a very small percentage of patients (less than four percent) use specialty medications, they account for 25 percent of health care costs. Specialty drugs treat complex diseases such as multiple sclerosis, rheumatoid arthritis, hepatitis C and cancer and represent a rapidly growing area of spending in health care.

(Logo: http://photos.prnewswire.com/prnh/20090226/NE75914LOGO )

"Specialty pharmacy trend is driven by price, mix and utilization, just like traditional drug trend, but managing specialty drug trend is more complex," said Jon Roberts, president of CVS Caremark's pharmacy benefit management business. "While many payors already have basic strategies in place to manage costs and ensure safe and effective use of specialty drugs, we have found that every plan has the opportunity to improve upon their management of this category."

The report reviews foundational strategies for managing specialty drug trend and provides additional insights into key areas where CVS Caremark offers expanded services to improve cost savings for clients. These areas include: understanding the cost impact resulting from the location of drug administration for infused drugs (e.g., at the hospital, doctor's office or at home), gaining visibility to the portion of specialty pharmacy spend billed under the medical benefit, and providing a full range of services designed to provide comprehensive care for the patient that can improve outcomes and reduce overall medical costs.

"Clinical appropriateness is the primary consideration when managing specialty pharmacy patients, but there are a variety of other factors that can also affect the optimal therapy choice for an individual," said Alan Lotvin, MD., executive vice president of Specialty Pharmacy at CVS Caremark. "For example, the site of care where an infused drug is administered to the patient is one area that can significantly impact costs for the patient and payor without necessarily influencing the patient's outcomes."

Understanding the Cost Impact of Site of Care

Many specialty drugs for the treatment of conditions such as cancer, rheumatoid arthritis and multiple sclerosis are administered via infusion that can take place in a hospital, physician's office, infusion center or even the patient's home. Costs for both the drug and its administration can vary by thousands of dollars depending on where the patient receives the infusion. CVS Caremark offers programs that can help payors increase the utilization of more cost-effective sites of care for infused therapies.

To continue reading this article visit: http://online.wsj.com/article/PR-CO-20131120-905858.html?dsk=y

Telehealth Improves Patient Relationships As Well As Sales

As this video shows, telehealth can be very beneficial to patients and providers when communication is difficult due to various barriers. Telehealth provides the option for counseling when it would otherwise be turned down as well as the ability to form a closer pharmacist-patient relationship. Patients often feel more comfortable calling their pharmacist with questions about side effects and clarifications when they feel that they know their providers personally. Telehealth is a communication method that is growing in the rural pharmacy setting, the mail-order pharmacy setting and the long term care facility setting.

Generic Drugs No Longer the Bargains They Once Were

Generic drugs are often thought of as bargains.  But in the last year, the prices of many generic medicines have skyrocketed and pharmacists across Vermont say they and their customers are taking a hit. Jason Hochebert is one of the owners of Rutland Pharmacy, a family-owned business with four locations. 

He says generic prices have been all over the place lately. He picks up a bottle of Digoxin for instance, a popular heart medicine. “Yeah,” says Hochberg, “without warning it went from under $100 for a bottle to over a couple hundred dollars a bottle. Creams are another one - nystatin creams and triamcinolone creams which are your generic steroid or anti fungal creams - they’ve also skyrocketed in price.”  He says, “they used to be like $1.69 for a small tube and now it’s 12 bucks. That may not seem like a lot on the grand scale, but that’s 1000%.”

Ken Wilkins of Mount Tabor stops in Hochberg’s pharmacy to pick up his medicine. “As a newly diagnosed diabetic, I have to take more drugs,” says Wilkins. “And it seems like they’re changing them all the time.  And it is an issue for someone who’s retired and on a fixed income.”

For patients on Medicare or with low deductible insurance, the price hikes may be less noticeable. But Jim Godfrey, President of the Vermont Pharmacists Association, says the situation has hit those without insurance hard. “When you’ve been paying $30 cash a month for meds and then all of a sudden it goes up ten fold, you’ve got a $300 a month medication all of a sudden - this can be a significant issue.”

He and other pharmacists say it’s frustrating because the price hikes seem so random.

But Robert Jaffe says there's nothing random about it.  Jaffe is a spokesman for Lannett Company, which makes and sells close to 80 different generic drugs.  In an email to VPR, Jaffe wrote that drug prices are affected by numerous market forces including the increase in cost for hard to find raw materials, new steps in the Food and Drug Administration product development process, as well as what he described as a dramatic increase in fees for submitting a generic drug application.

Rutland Pharmacy’s Jason Hochberg understands the economics, but he and other pharmacists complain that insurance reimbursements aren’t keeping up with the price increases.

To continue reading this article visit: http://digital.vpr.net/post/generic-meds-no-longer-bargain-say-pharmacists

Prescription Drug Monitoring Program May Save Lives

Lisa was still recovering from a nasty fall down a flight of stairs when she walked into Eugene Decker's family practice office in December 2012.

X-rays showed the 34-year-old Phillipsburg woman had suffered fractures to her neck and back. Decker said the injuries were so significant, they could have left Lisa paralyzed.

So when she said she was looking for medication to help ease the pain, Decker had no reason to doubt her.

"She had all the right reasons to have pain meds and I prescribed pain meds to her," Decker said. "I didn't know she was going to other doctors."

In fact, Decker was one of more than two dozen doctors Lisa had visited in Pennsylvania and New Jersey between October and December 2012. According to documents obtained by her family members, those visits translated into 660 tablets of various prescription pills.

All in a period of 54 days.

With prescription drug abuse on the rise, many doctors now face a delicate balancing act of trying to decipher between patients in legitimate need of medication and those, like Lisa, who may have an addiction. 

Many advocates, including Decker, say the answer may lie in making improvements to states' prescription monitoring programs while encouraging, or mandating, increased participation by health care professionals. 

Unfortunately, for some, it is already too late.

To continue reading this article visit: http://www.lehighvalleylive.com/warren-county/express-times/index.ssf/2013/11/advocates_say_increased_use_of.html

Colorado Study: Healthcare Premiums Will Skyrocket Next Year

Colorado employers will pay an average of 10.9 percent more for health insurance in 2014 than 2013, a dramatic upward climb after two consecutive years of reduced cost increases, according to a study from insurance benefits consultant Lockton Cos.

The reason for the price escalation is twofold, said Bill Lindsay, president of Lockton Benefit Group in Denver and author of the survey. First, prices on services such as hospital and prescription-drug costs will continue to rise as they have in past year, though at greater rates than predicted elsewhere in the country.

But that will combine next year with a new slew of mandates on minimum insurance benefits required by the Affordable Care Act, as well as a 2.25 percent federal tax on self-insured plans. Those two alone will combine to increase employer costs by at least 5.25 percent, Lindsay said.

“Health care costs are going up for all of the above reasons — hospital construction, pharmaceutical costs, the aging population,” Lindsay said. “But we know the ACA by itself is going to add to the cost.”

Such double-digit-percentage price increases were common for the first 11 years of the 21st century, but the increases fell to 9.4 percent in 2012 and 7.4 percent in 2013 in the Lockton survey. Health reform advocates trumpeted a provision of the federal bill that triggered government reviews for all premium hikes of more than 10 percent as a primary reason for the decline.

To continue reading this article visit: http://www.bizjournals.com/denver/news/2013/11/13/employer-health-care-costs-will-soar.html