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