Trumm Drug

February 2009 Drug News

Prescribing By Internet Helps Patients and Doctors

Starting this month, physicians throughout Western New York and nationally are eligible to receive bonuses from the federal government for “writing” electronic prescriptions. The use of e- prescribing has the potential to provide considerable cost savings in our health system.
First and foremost, e-prescribing can enhance patient safety by reducing and hopefully someday eliminating dangerous and costly medication errors because of illegible handwriting. Secondly, an e- prescribing system can also identify potential drug interactions at the time of prescribing, thus minimizing this serious problem area. According to the Institute of Medicine, at least 1.5 million preventable adverse drug reactions occur annually throughout the United States. The cost to the health system ranges in the billions of dollars because adverse events often result in emergency care and hospitalizations.
There are other benefits of e-prescribing. Patients, especially the elderly and disabled who are taking multiple medications, can be monitored by their physicians to better ensure they are taking their medications. There are also alerts inherent in e-prescribing systems, including notifications about allergic reactions to medications or contraindications to use, such as in pregnancy.
Unfortunately, too few physicians nationally are utilizing e- prescribing and related technology. As such, the Centers for Medicare and Medicaid services is awarding incentives to Medicare physicians based on their e-prescribing compliance. It won’t last long. In 2012, physicians will begin to be penalized for hand- writing prescriptions.
The biggest challenge for physicians is cost. While most doctors offices have high speed Internet capabilities, there is still a cost to exchange information with pharmacies, between physician offices and, especially, hospitals and diagnostic laboratories. In rural communities, high speed Internet access may not be readily available.
In Western New York, there is a program through HEALTHeLINK, the clinical information exchange that serves various physicians and which includes an e-prescribing component. The program, which has been running since November 2007, is close to being rolled out to the region’s broader physician community. The potential benefits related to e-prescribing are very encouraging. As an added benefit to the physician, there is no cost for using the HEALTHeLINK program. It is enhancing communications among the physician office and the pharmacy and, most importantly, benefiting the patient.
However, e-prescribing is just one component of a larger information sharing and exchange network that has great potential to transform our health care system. There are challenges, but continued collaboration among a wide range of health care entities throughout Western New York will lead to positive results for all of us.
John Rodgers is chief marketing officer at Independent Health and chairman of the HEALTHeLINK Pharmacy Sub-Committee. He is also a licensed pharmacist.
Source: Buffalo News
Publication date: 2009-01-24

Stimulus Boosts Electronic Health Records

Jan. 29—Tucked inside the $819 billion economic stimulus package that passed the House yesterday are provisions to spur the adoption of electronic medical records.
The relatively modest $20 billion for health information technology would be, by far, the biggest government infusion to enable medical information to follow patients back and forth among doctors’ offices, hospitals and other providers.
If successful, experts say, electronic medical records would improve quality, reduce duplication of services, and limit errors — ultimately saving the nation hundreds of billions of dollars each year.
The federal money is likely to boost regional efforts in New Jersey, Pennsylvania and other states, such as a public-private project now ongoing to improve chronic care given by primary-care doctors in Philadelphia and its western suburbs.
“We are not tinkering around the edges here,” said Rep. Allyson Y. Schwartz (D., Pa.). “The investment of these kinds of dollars means we are looking to a goal of getting 90 percent of physicians in this country using secure, confidential electronic medical records [that other providers can also access] within the next 10 years.”
Schwartz said federal leadership was needed to push for quick implementation. That is especially true in areas such as the Philadelphia region with a large number of competing hospital systems and doctor practices that don’t share information, she said.
But some key advocates of electronic medical records expressed concern that the House bill, while injecting needed cash into the process, contains provisions that could erase progress already made.
“I am really elated that Congress . . . finally appears to understand the value of health information,” said David J. Brailer, the first national coordinator of health information technology under President George W. Bush.
But Brailer, a physician who has a Wharton School doctorate in health economics, said the House bill went so overboard on privacy that it may inhibit the flow of information. He also faults the measure for having the government develop the infrastructure for medical records rather than nonprofit groups.
The bill would make available $2 billion — it’s $5 billion in the Senate version, expected to be voted on next week — to states in grants and loans to help put electronic records systems in place.
Starting in October 2010, hospitals, doctors and others would be able to get increased payments from Medicare and Medicaid for using such systems.
Doctors would be eligible for $40,000 to $65,000 for “showing that they are meaningfully using health information technology.” Hospitals could qualify for several million dollars, and money would also go to federally qualified health centers, rural clinics and others.
Some South Jersey health systems have already begun to join in a regional health information exchange led by AtlantiCare. Nearer Philadelphia, Virtua Health will soon have a medical record system in Burlington, Camden and Gloucester Counties that will also tie into the AtlantiCare-led effort.
Last March, Gov. Rendell established a statewide health information exchange to encourage the sharing of information.
And in north-central Pennsylvania, the Geisinger Health System is on the verge of implementing electronic health records across its three hospitals and more than 700 doctors. That system took a decade to build, and Geisinger chief technology officer Ronald A. Paulus, while applauding the federal effort, cautioned against moving too quickly.
“I love the enthusiasm, I love the excitement, I love the funding,” Paulus said, “but it needs to be linked to a process that allows this to be done with a reasonable degree of care.”
Contact staff writer Josh Goldstein at 215-854-4733 or (JavaScript must be enabled to view this email address).
Source: The Philadelphia Inquirer
Publication date: 2009-01-29

Pfizer to buy Wyeth for $68 billion, cut jobs

Pfizer Inc. is buying rival drugmaker Wyeth in a $68 billion cash-and-stock deal that will increase its revenue by 50 percent, solidfy its No. 1 rank in the troubled industry and transform it from a pure pharmaceutical company into a broadly diversified health care giant.
At the same time, Pfizer announced cost cuts that include slashing more than 8,000 jobs.
The deal comes as Pfizer’s profit takes a brutal hit from a $2.3 billion legal settlement over allegations it marketed certain products for indications they have not been approved. The New York-based company is also cutting 10 percent of its work force of 83,400, slashing its dividend, and reducing the number of manufacturing sites.
Early Monday, Pfizer, the maker of cholesterol treatment Lipitor, the world’s top-selling drug, and impotence pill Viagra, said it will pay $50.19 per share under for Wyeth, valuing Madison, N.J.-based Wyeth at a 14.7 percent premium to the company’s closing price of $43.74 Friday.
Both companies’ boards of directors approved the deal but Wyeth shareholders must do so, antitrust regulators must review the deal and a consortium of banks lending the companies $22.5 billion must complete the financing.
Pfizer has been under pressure from Wall Street to make a bold move as it faces what is referred to as a patent cliff in the coming years. As key drugs lose patent protection they will face generic competition and declining sales. Lipitor is expected to face generic competition starting in November 2011. It brings in nearly $13 billion per year for the company.
Acquiring Wyeth helps Pfizer diversify and become less-dependent on individual drugs – Lipitor now provides about one-fourth of all Pfizer revenue – while adding strength in biotech drugs, vaccines and consumer products. Wyeth makes the world’s top-selling vaccines, Prevnar for meningitis and pneumococcal disease, and co-markets with Amgen Inc. the world’s No. 1 biotech drug, Enbrel for rheumatoid arthritis.
“The combination of Pfizer and Wyeth provides a powerful opportunity to transform our industry,” Pfizer Chairman and Chief Executive Jeffery B. Kindler said in a statement. “It will produce the world’s premier biopharmaceutical company whose distinct blend of diversification, flexibility, and scale positions it for success in a dynamic global health care environment.”
Together, and the two companies will have 17 different products with annual sales of $1 billion or more, including top antidepressant Effexor, Lyrica for fibromyalgia and nerve pain, Detrol for overactive bladder and blood pressure drug Norvasc.
Shortly after announcing the Wyeth deal, Pfizer said fourth-quarter profit plunged on a charge to settle investigations into off-label marketing practices. The company earned $268 million, or 4 cents per share, compared with profit of $2.72 billion, or 40 cents per share, a year prior. Revenue fell 4 percent to $12.35 billion from $12.87 billion.
Excluding about $2.3 billion in legal charges, the company says profit rose to 65 cents per share.
Analysts polled by Thomson Reuters expected profit of 59 cents per share on revenue of $12.54 billion.
Looking ahead, New York-based Pfizer expects earnings per share between $1.85 and $1.95 in 2009, below forecasts for $2.49.
Source: Associated Press/AP Online
Publication date: 2009-01-26

Millions Can’t Afford Their Meds, Study Says

When your doctor writes you a prescription, she expects you’ll get it filled.
But 36 million Americans didn’t fill a prescription they needed in 2007 because they couldn’t afford it, according to a study published this week by the Center for Studying Health System Change.
That’s an increase from the estimated 24.4 million people who didn’t fill prescriptions in 2003 because they couldn’t pay.
In Franklin County, about 112,000 people currently are not filling prescriptions or not taking medications because they can’t afford them, said Jeff Biehl, executive director of Access HealthColumbus.
“We’re heading into a period where this will continue to worsen, especially for those people with chronic diseases on multiple drugs,” he said.
Researchers who performed the national study blame rising prescription-drug costs and health-insurance plans that require consumers to pay more for medications.
“This would indicate that health insurance offers less financial protection against out-of-pocket costs than it did in the past,” said Laurie E. Felland, a senior health researcher at the center and co-author of the study.
The 2007 survey by the Washington-based nonprofit center covered 18,000 children and working adults.
Since 2007, the economy has worsened and more people have lost their jobs and health insurance. Felland said she expects an increase in the numbers.
Physicians say they are worried.
“You see it a little more frequently than you used to,” said Dr. Diana Donati, a North Side primary-care physician.
When patients tell her they can’t afford a medication, she tries to give them samples or find a generic.
“Most people can pay $4 and $10,” Donati said.
People also can use discount-drug-card programs or ask drug companies about free medication programs.
“Too many people are delaying needed care … and turn up for health care when they’re much sicker and more expensive to treat,” said Cathy Levine, executive director of the Universal Health Care Action Network of Ohio.
“We need to change from a sick-care system to a health-care system by making sure that people have preventive care.”
U.S. prescription-drug spending had its lowest growth rate — 1.6 percent — in 30 years in 2007, according to a study last month by the journal Health Affairs.
The decline in price increases is attributed to more drug patents expiring, an increased use of generic drugs and a drop in the number of new medicines approved by the Food and Drug Administration.
Source: The Columbus Dispatch, Ohio
Publication date: 2009-01-23

FDA Issues Rule on Labeling Require for Reporting Side Effects

The Food and Drug Administration has issued a final rule that will require the side effects labeling of certain drug products to include a toll-free number for reporting adverse events. The rule took effect late last year, but won’t be enforced until July 1, 2009.
The new labeling must state: “Call your doctor for medical advice about side effects. You may report side effects to FDA at 1800FDA1088.”

Drug Makers Halt Branded Gifts to Doctors

The U.S. drug industry has agreed to stop giving branded gifts like pens to doctors to counter the idea they unduly influence medicine, an industry group says.
“It’s not just the pens — it’s the paper on the exam table, the tongue depressor, the stethoscope tags, medical calipers that might be used to interpret an EKG, penlights,” Dr. Robert Goodman, an internal medicine physician at New York’s Montefiore Medical Center, told The New York Times.
“Practically anything you can put a name on is branded in a doctor’s office, short of branding, like a Nascar driver, on the doctor’s white coat,” said Goodman, founder of No Free Lunch, a non-profit group that encourages doctors to reject drug-company giveaways.
The voluntary moratorium, drawn up by Pharmaceutical Research and Manufacturers of America to start Jan. 1, still lets drug makers underwrite lunches for doctors and their staffs and sponsor restaurant dinners for doctors, as long as the meals are accompanied by educational presentations.
About 40 drug makers have signed on to the code, the industry group said.
Last year, besides giving doctors nearly $16 billion in free drug samples, drug companies spent more than $6 billion on sales activities such as doctor office visits, mealtime presentations and branded pens and other handouts, healthcare information company IMS Health Inc. said.
Source: United Press International
Publication date: 2008-12-31

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