Remember, the camera adds 10 pounds....

First off, Stuart Speedie is Dean Speedie's husband, and is a researcher in health information technology. He's also quoted in this article on telemedicine. This is going to be a short post-but I just want to make one connection that you likely have made already-how could this affect pharmacy? A lot of pharmacist are consultants to nursing homes and review their charts once a month. Well, what if they could do it remotely and talk to patients through these means? Same with MTM-do people have to be in the same room in order to deliver pharmaceutical care? I guess we'll see where this change in compensation leads....

Ethical stuff

First, for dramatic interlude, listen to this song in the background while reading the next two posts. Just open it up in another window and enjoy. That's right, even though no one is looking at this, I'm demanding my own background music. I guess my ego knows no bounds....

Awhile back I threw out that the WSJ, and specifically the WSJ blog, were must reads for health news. Current and up-to-date reporting, good insight, you know, that stuff. And, of course Pharmalot is great for pharma related news too. Well, the New York Times is making a run at them. Last week they had a great piece on research being done on real patients, with real problems. Ever look at a journal article and check out the exclusion criteria? I'm pretty sure I'd be excluded for stepping on a nail as a kid. You would be excluded (yes, you!) for reading this blog (read this) But when used in real life patients, you can't exactly exclude everyone from using your drug. You'll miss out on market share. But then, how would a drug become approved-so many complications/adverse events would show up in the study it'd be laughed at. Now you see why I labeled this "Ethical Stuff."

Well, the New York Times wowed me yesterday with this article looking at the cost of a life. In the time of serious calls for health care reform and complaints of rising health care costs, you have to ask: At what point does it stop? At what point do payors, and possibly, if we go to a single-payor system, does the government, say that it is too much for a drug. For a great analysis, check out the Pharmalot blog, and read the comments, particularly from "Michael" on December 3rd at 9:39am. Obviously, he's an insider for Pharma, but still, it's a strong point.

Things to consider as we get ready for change. Also, be sure to respond to the APhA Call to Action to actually participate in health care reform. If pharmacists aren't at the table, pharmacists won't have a say. It's that simple.

'CCO giving pharmacy some love

Here's the link to the WCCO discussion about decreasing med costs. They mention the $4 generics and prescription assistance plans, but they also throw a shout out to MTM. If only threw out the phrase "The most expensive drug is the one taken incorrectly" they might have helped us out. Oh, and here's the link to the blog discussed as well. Hopefully patients are willing to pay for the money saved....

Why are Obama's cabinets so important?

I mean, really. When my parent's got new cabinets, no one cares. When I do, again: No media attention. But all of a sudden, you're elected Pres-elect, and everyone cares about your kitchen...wait, what? Oh...boy, is my face red.

So, this is kind of huge. Well, maybe not huge, but it's going to have an effect on pharmacy. How? Well, I don't know. Sorry. But, Daschle's reportedly been angling for this for awhile. He supported the failed Hilary Health Care plan from the 90's (first years may not remember that, so here's some info on it) and is up for health care changes. Include the fact that meds take a huge chunk of overall health care (according to this vid) and you can expect some changes to occur in...oh...say...the next four to eight years.

Why tell the real news when the fake news is so much funnier

I go to Comedy Central for news television, and I'm ok with that. I mean-who wouldn't?




Now, that's just plain good stuff. Plus, he hit the news right on the head. Let's run through the highlights.



I'll try and run through the topics he discusses in later posts, but I'll let you enjoy the video for right now.

Cuz I want you back for good...

So, no one read this before, and likely no one will read this now. But you know what, I had a lot of fun writing it last year. So guess what, the blog is back! (Dramatic interlude for cheers and adulation. Shout out to Barack for showing me how to be humbly be showered with praise.)

Why is the blog back? Because there is just too much happening out in the world of pharmacy and health care to not at least make some kind of commentary on it. Sure, you could go to news sites and read the actual journals, but what fun would that be? Here you get few if any pictures, poor wit and sarcasm, and really no value added to the links I post. But hey, if you visit, it makes me feel good. Enjoy the updates.

Pharmacist's in Primary Care?

The decrease in the number of physicians that pursue primary care has been noted over the past few years. The impact of this has contributed to increasing health care costs, and and a decrease in patients seeking primary and preventative care. This dearth of primary care physicians essentially created the market for nursing practitioners and physician assistants. However, this has still not solved the problem.

So, could pharmacists help out? We know that we are trained in disease management-particularly those that are often controlled primarily by medication therapy-diabetes, anti-coagulation, asthma, heart failure....ummm...there's probably more but I read too good. Well, the good folks at JAMA thought they would take a look at what pharmacists can do in the CHF. They have a spin-off mag called the Archives of Internal Medicine. It's pretty good, no People magazine or anything, but I like it.

Anyways, here's the article that they printed in Internal Medicine. I heard about it, where else, but on the Wall Street Journal Blog. Check out the links in the article too-they talk about the decrease in utilization of primary care and increase in specialty reimbursement mentioned above. They also discuss the 10 City Challenge sponsored by the APhA Foundation.

Short rant here: Stupid WSJ also is now making you pay for their Health page. At the least, they still give you access to their blog. But come on, Rupert Murdoch (who recently purchased the WSJ from the Hathaways) let me have access to the WSJ!!! I'm looking for some kind of online petition to make it all free, but I haven't found it yet. Let me know if you do, please.

Will drug companies write my papers?

No, really-will they. Cuz that'd be sweet. Now why do I say drug companies instead of, oh, English Majors? Well, according to JAMA it seems that they are more than willing to write them for academia studying their drugs. CNN has the shortened version of this and some discussion on it. One journal official who looked into it said: "The manipulation is just disgusting. I just didn't realize the extent." Merck counters that 5 of the 6 authors were involved in the Vioxx case against Merck. Slight bias. Great article. Less filling.

Students stepping up...and more

First off: Thanks to Kassy Bartelme and Colleen Flaherty for these next articles. Also, they tipped me off to Pharmacy Practice News. There are two things in life that make me happy: Spring and new pharmacy related news websites. I should probably say Laura too, but she doesn't read this anyways, so whatever.

Ok, back to real news. Medication Reconciliation is one of the goals within JCAHO. Goal 8 if you really want to know. If you work in a hospital, you've likely heard of "Med Rec" and 1) know it's important 2) know it's difficult to get accurate and 3) likely know that pharmacy isn't always involved. Last year at APhA2007, APhA-ASP brought this up and wanted to make it a priority for pharmacists and student pharmacist to the be the health care practitioner that provides this care.

Well, it looks like students CAN make a difference. Proof? Here. By the way, you have register with Pharmacy Practice News, but, ummm....we're entering pharmacy practice, so why not learn about the news within pharmacy practice. Plus, it's free.

Ok, lots of comments could be made on this. Let's do a pro/con debate. Against myself. Or for myself. I get confused. I'd go on Zyprexa, but I might get diabetes.

Pro: Students are learning about med rec. They are engaging patients in the role of a pharmacist, and are showing patients that we can do more than dispense. Patient outcomes are improving.

Con: Students shouldn't be used to do work pharmacists should be using. Hospitals should find a better way to do med rec. Interns should also be trained to do this (who are being paid) not students (who are paying)

Comment below-you can do that you know.

My greatest fear...

I always knew this blog was a bad idea....

What happens in Vegas, stays in Vegas

Ok, this has no connection at all to current events, in fact, it's probably from before many of you were born, but I'm going to post it anyways.

For Outcomes, one of our drug info questions dealt with the use of Cialis and nitrates. Through my research into the subject-I ran across this article on ED. Read the first paragraph in Editorial Comment 1. My only thought is, I guess urologists must be pretty used to displays like this.

Also, here's an article on Cookie Monster. Hey, I'm just trying to liven this place up. IS ANYONE OUT THERE!!!???

Pick your vices wisely

So...in college, we called this idea the buffalo effect, and it pretty much follows evolution: The weak brain cells die, and the strong survived. Yeah, turns out we were wrong back then, according to this article.

But, there is hope for using daily diuretics. Though alcohol is bad, caffeine might be good. According to this article, caffeine was neuroprotective. Well, in rabbits, no testing in humans yet. But whatever-I likes me my macchiatto.

Ziagen and Videx raise heart risk

A study in the Lancet found that the use of Ziagen (abacavir) and Videx (didanosine) raised heart risk. During the anti-viral section in Pharmacotherapy IV, some discusiong alluded to this: As people with HIV and AIDS live longer, the complications associated with long-term drug therapy will be a more significant risk than their actual AIDS. I'm obviously not an AIDS expert (no comment on my grade for the module...) but I think there will be a lot more information coming out on the issues of long-term AIDS therapy.

Just as a reminder, or to let you know for the first time, abacavir was developed right here at the University of Minnesota by Dr. Robert Vince. That's pretty cool.

Residency Talk

For those that attended APhA2008 or have heard other talk of this, one of the hottest topics within pharmacy is the expectation that by 2020, all pharmacists who wish to enter into patient care will have completed a one-year residency. This is a controversial topic for many reasons, not the least of which is whether or not there are enough residencies (commentary on that topic here) There are numerous articles discussing this-and I suggest you keep your eyes open for further discussion on it. For background, try googling "JCPP Future Vision of Pharmacy." I think this will lead you to many easily accessible discussion of what the future will hopefully be. Here's a copy of the original statement as well.

What reminded me of all of this was an article discussing nurses pushing for a doctorate in nursing to act as primary-care practitioners. I won't delve too much into this article-but one line caught my attention: By 2015, the American Association of Colleges of Nursing aims to make the doctoral degree the standard for all new advanced practice nurses, including nurse practitioners. Seeing all of the discussion that pharmacy is having, I felt this was a bold statement and prediction for them to make. Think of the impact that this would have on nursing education, and how closely this likely mimics the discussions that pharmacy is having right now.

I won't belabor this too much more, and I don't know how I feel on either way of advocating for residencies or not. But when we discuss, as a profession, what we want our future to look like, I think we need to remember that we need to find the best way for us to be the best medication experts for patients available and decide how we are going to get there, or other professions will decide for us.

Minnesota = Kind of a big deal

For those that went to APhA2008, you received the most recent copy of JAPhA, you may have seen this. You remember MTM? Well, apparently, it saves patients a lot of money on their medical expenses. Now, I'm no genius, but I did stay at a Holiday Inn Express last night. So I think that people may pay attention to the cost savings that can occur with MTM, and will help for it to be reimbursed. Good work to the good folks at Fairview Hospitals and Clinics and the good ol' University of Minnesota College of Pharmacy. I also think it may fall in line with the goals of Project Destiny, a collaboration between APhA, NACDS and NCPA.

Also, just a reminder of other cost savings programs, here's some info on the Asheville Project, which most of you have likely heard of by now.

TB Talk

I may or may not listen to NPR constantly. I won't comment on either side. But, one time, I happened upon a story that I found very interesting: On tuberculosis in Bangladesh. Two important things to note before going to the NPR piece: 1) Drug resistance to TB is a problem worldwide. The WHO checked this out recently, and I mentioned it a few weeks ago.
2) Bangladesh is a poor country and one of the most population-dense countries in the world. Bangladesh also just suffered a horrible hurricane last November.

So, judging by those two facts, one might say Bangladesh would have a horrible rate of MDR-TB. Meh, turns out-no. How'd they do it? Well, take 5 min, and listen to the NPR piece.

Some interesting points, and I'll just throw out two words: Alligned incentives. It's amazing what can be accomplished if an entire population believes in one goal.

Heparin Follow-up

Seriously-how many times will heparin come up in the news? Just seems strange to me. The recall of Baxter's heparin supply (oh, and Baxter supplies about half the heparin to the US) caused some ruffles, especially if you work on a hospital. Or, if you work in Germany. Also, they figured out what was in the heparin that caused nearly a thousand allergic reactions, and several deaths. Here's an article that has links to previous articles if you want more information about the recall.

So, now for the rest of the story. As this editorial from the Washington Post points out-there are some major problems in the drug approval and investigation process. According to this editorial-80% of active drugs are made outside of the US, and not all of those plants are inspected.

Now back to the heparin-Here's a little info on where some of the heparin in our supply comes from. Be sure to click on the slideshow to see more pics-as well as pics from a factory that is quite a bit cleaner and more advanced.

Follow up to Emily Jerry and Techs

We first heard the tragic tale of Emily Jerry back in October. A reminder: Due to a mistake with her chemo drug that was not caught by the pharmacist, Emily passed away. The family, after investigating, filed manslaughter charges against the pharmacist. The family are also proponents of a law in Ohio called Emily's Law. The purpose of this bill is to require pharmacy technicians to be trained, tested and certified, which is also what MPhA is promoting. They are also very prominent in a group called FLAAME-Families Launching Action Against Medication Errors.

One of the supporters of FLAAME is Dr. J. Lyle Bootman, who has won the Remington this year.

Anti-depressant's getting you down?

Well, according to this article, they aren't helping you feel better. Well, a bit of an overstatement: They found, through evaluating 50 trials on paroxetine, sertraline, venlafaxine and fluoxetine, that there was not much improvement found in patients who were put on meds versus those that were only put on a placebo pill. For (the few) third-years in Ethics on Thursday, I guess docs may be prescribing placebos even when they don't realize it. Here's the article on the always reliable Pharmalot as well as the article from the University of Hull where the study was conducted. Also, the UK (where this study originated) has decided to pour more money into training therapists to help out those that are depressed.

It should be noted that there was a difference noted in severely depressed patients, and that anti-depressants did work in quite a bit of the population, just not in an appreciable amount more than in placebo-so if it works for you or your patients-keep 'em on the meds! Thanks to Sarah Mallak for making me aware of this one.

Also, this should not stop you from prescribing meds for your pets (there's even Reconcile-literally Prozac for your dog) Also, the FDA just approved Pristiq or desvenlafaxine for use as well-the advantage over Effexor-XR is there is no ramp up period when initiating therapy. Not to ruin there marketing campaign too much, but I'll quote Conway and say "Scam." Hopefully I don't get hit with a slander lawsuit for that one.

E-prescribing

Thanks to Adele Reichel and Rachel Root, "Guest Bloggers" for submitting some info on e-prescribing:

E-prescribing is definitely something we will all hear more about. Here are some questions for thought:
• How will this impact your practice?
• What would you say to a physician in order to convince her/him of the important role e-prescribing can play in healthcare?
• Do you think this method would work for controlled substances?
• What will you do with the time you were formerly using to process prescription claims?
• The Fox News article states, “Doctors received an annual bonus for prescribing more generics.”Are pharmacists rewarded for dispensing generics, why/why not?

For further consideration, here's the letter from APhA to President Bush. Also, for further information on some examples of e-prescribing companies, check out RxHub and SureScript (p.s. checkout the RxHub ePrescribing 101 Overview as well.)

Scratch your trip to Azerbaijan...

Bummer, I know. According to the WHO, the incidence of Multi-drug resistant TB is at the highest level, and is also at it's highest level ever. What is MDR-TB? Well, I would tell you, but I haven't started studying for my therapy test. As always, Wikipedia has the answer (from now on, I'm going to abbreviate that statement as AAWHTA) The WHO also has a great site on tuberculosis as well. MDR-TB is also highest, oddly enough, in eastern Europe and the countries of the former Soviet Union. Why? Poor funding for TB drugs, slow diagnoses of MDR-TB and stopping treatment before cure. However, Africa only provided info on 6 countries which may skew the results. Now, geography wasn't my strong point, but I'm pretty sure there's at least 8 countries in Africa, possibly as many as 10 (no really, look at a map. Also, they also have the highest incidence of TB, so take the info in the report with a grain of salt. If you really want to get into the report-go to the actual report. But, you better have some serious spare time.

Easing prostate cancer

There's been a few prostate cancer pieces brewing, so I'll combine the two topics into an enlarged (prostate) posting. Okay, that was uncalled for, especially for such a serious disease, but I couldn't resist.

A venture capital company, Dendreon, that develops biotech drugs that target cancer, is currently conducting Phase III trials into a vaccine for the disease. As this article details, an advisory panel to the FDA recommended approval, but afterwards two panel members suggested a go slow approach. Here's where it gets interesting: These two panel members then came under fire for possible conflicts of interest. Congress was asked to investigate, they refused, and now there is a bit of a storm-Read the bottom of the Pharmalot blog for the comments from organizations that say that 20,000 people have died due to a few doctors that have financial interests in competitor companies.

A couple of weeks ago, Dendreon had a press release that they hope will change the FDA's mind and fasttrack the vaccine-again a report from Pharmalot (gotta love that blog.)

Another development in prostate cancer care looks to reverse the side effects to androgen-deprivation therapy that is used to treat prostate cancer (One good thing about writing this blog-it makes me really interested to learn more about what I write about-I guess it's a good thing that "Learner" is one of my strengths according to this book.) The drug, toremifene, has previously been marketed and used under the brand name Fareston. However, according to a Phase III trial from the company, GTx, there is a possibility that it can also be used to lower the incidence of fractures. More info is also on the WSJ blog.

More bad news for Vytorin

I think this news shows you need to make sure your studies are a) well designed b) you don't make suspicious moves to secondary endpoints and bring in new investigators during the study and c) if you do all of those bad things-don't try and hide it. Though the study didn't show that Vytorin was superior or inferior-one always has to ask "What are they hiding?" and the effects of that decision are starting play out. The American College of Cardiology is meeting in March, and will release a statement on the trial then. But, will it be too late?

"Imagine there's no drug ads, it isn't hard to do"

Could it be possible? According to a blog post from the magazine DTC Perspectives (yes, there actually is a magazine dedicated to DTC, but it looks like the only perspective they take is their own. They even have a national DTC convention. It's in April if you want to go, but I don't think MPSA will be reimbursing for it.) Here's some articles from WSJ and Pharmalot on it too. I would take some time and check out the DTC Perspectives website too and just look a bit more at the market that has emerged for drug marketers. Though I imagine most pharmacy students are against DTCA, I think it's interesting to look at what they consider when they market, trends they watch, and, of course, how much they spend (one study put it at more than what they spend on R&D, but it wasn't the best study.) One thought-get some DTC out there about MTM and pharmacists. We just need a mascot as cute as the Nasonex bee or Rozerem beaver.

Another napping article? Really?

Apparently sleeping during the day is big for the Brits, because this is the second article on the topic in as many days. (See below for the other note.) Now, I'm all for napping, but I guess I need to make sure it's on my schedule. I also don't know if this study accounted for students in a pharmacology lecture or not...

Mirror, mirror, on the wall...

...which flu bug will we see this fall... Sounds like choosing the bugs for next year's flu season is going to be pretty tough-they will be changing all three strains for the first time ever this year. It's kind of shocking that they have to develop it this far off. I suppose I'll forgive them for missing on it a bit this year.

And now for something completely different

So, I saw a couple of things that weren't exactly drug related, but still pertinent, so I'll just throw them all into one post.

Cat-naps=good according to this article. Of course, I'll still take a longer nap whenever I wants to. Something to remember when you are cramming late at night for those dang therapy exams. Just remember to wake up after 6 minutes.

Your patients won't care how much you know until they know how much you care. Sometimes overused, but still an important idea. This article from CNN/Oprah.com was passed on to me by someone who doesn't think I am empathetic enough-I won't say who. Anways, a lot of what it talks about is very pertinent to think about when we talk with our patients and being more empathetic and better caregivers.

Google: The saviour of EMR? So this topic raises so many questions and concerns that I won't even get into, but Google is looking at storing health records online. Good? Bad? To be decided...

Drug prices rising

It's not really news that drug costs are raising, but more that the rate that they are increasing is increasing. I think this is called something in calculus, but due to my pump and dump studying strategies, I don't remember what it's called. Anyways, here's the WSJ article on it.

Pharmacy's "Dirty little secret"

Last night (Feb 18) Henri R. Manasse spoke about "Leadership with Integrity" and how pharmacy needs to continue to push the profession forward, admit its mistakes and understand how to improve them. One thing he mentioned, that others have also noted is the area of errors in pharmacy. For third years, this is especially noted as many of our lectures lately have dwelled on this topic, and Dr. Hadsall sent out similar articles (we'll get to them below.)

The way that Dr. Manasse brought up the issue was in the context of technicians who are not adequately trained, both in the community and in hospitals and health-systems, calling this the profession's "dirty little secret." Obviously, errors can not be blamed on a particular person-we are all to blame. But well trained technicians and certified technicians can greatly help minimize errors. Also, the Pharmacy Technician Certification Board conducted a survey and found that the general public overwhelmingly supports technician certification, and most thought that training and certification was done anyways.

Media coverage on errors, like what recently was posted on USA Today in an ongoing series called "Rx for errors." (Check out the graphic on how prescriptions are filled as well.) The series also has suggestions on how to safeguard against errors like consulting with your pharmacist as well (Brilliant!)

Dr. Manasse said that errors will still occur, but taking a defensive stance on the issue helps no one-realizing that the system isn't perfect and looking to improve it is what will help things. The USP also issued a statement on the most commonly confused drugs, and technology can help as well. Understanding that errors occur is one step to move the profession forward, and lead with integrity.

Flu shot a little bit off....

So...this kind of sucks. According to the CDC, their prediction of which B virus was going to be popular this flu season was a bit off. Confused by that report, me too-Here's a better one from CIDRAP-the Center for Infectious Disease-Research and Policy that is at the University of Minnesota and an article on it from the Wall Street Journal blog.

Also, here's a little FAQ on how they select the viruses they put into the vaccine, and some other info as well in case you need a refresher...like me.

Another recall....

Note to self-Don't have surgery this week. In addition to half of the heparin across the country being pulled, Duragesic patches made by Johnson and Johnson are also being recalled as well due to accidental overdose when the patches fail.

This article had a lot of interesting points (how much Johnson and Johnson grossed on the patches even though it's generic, new drug-Ionsys-that's having problems) but there was a statistic that really jumped out at me: They estimate that 2 patches per million have failed-around 64 total. But one patch failing could kill someone-so at what point did they decide to recall the patches? Perhaps a case for an Ethics case analysis....

More trouble for Baxter

You may recall that Baxter was sued earlier by Dennis Quaid over confusing packaging-there is a post earlier on this. Well, looks like Baxter is in a bit more trouble now as well due to allergic reactions to their meds. Here's a link to FiercePharma with an article on it.

Retail Clinics the next step?

A bit of a follow-up to the discussion on healthcare from the WSJ blog. Is it possible that Wal-Mart (and other similar models) could save healthcare? Important notes: Average cost-$50, and over half of the customers are uninsured. I think this indicates two things: A normal doctor's visit or ER is too expensive or takes too long and that people are willing to pay for health care...as long as it's affordable.

New clopidogrel study

A new clopidogrel study was just released in JAMA that found that patient's risk of heart attack after ceasing use of clopidogrel doubled when they stopped using Plavix nine to twelve months after a stent was placed. (Bloomberg article here) The study was carried out in VA's around the country (120 or so) and wasn't funded by the drug company. It also raises the question of where the benefit of stents was coming from-from the stent itself, which has come under scrutiny as of late due to build-up of clots around the metal tubes.

For your edification and reminder, as well as a chance for me to showcase the hyperlinking capability of blogs, here are links to previous clopidogrel studies that show the possible benefit of this highly touted (and prescribed) drug, here are a couple of commentaries and dissection of the trial that set the standard of prescribing for clopidogrel prior to this study, the CURE trial. Here's one in the ol' favorite JAMA and one from respected heart hospital Cleveland Clinic's journal.

Debate on National Health Care

Universal health care. Generally, that phrase is used as rhetoric to guide voters to support that particular candidate. Michael Moore used his documentary Sicko to play with the idea, and also pointed out the many flaws in our current system. Our own Quynh Nguyen commented on this movie and topic as well in Student Pharmacist.

This past month, the New England Journal of Medicine had a great commentary on our broken system, or non-system. It also brings up the safety-net, part of which our HRSA-PSCC grant helps to support. This commentary points out that any major shift in policy has to come from our leadership responding to public opinion as it did with the FDR's New Deal in 1932 and with LBJ's Great Society in 1964. Recently, the Clinton health care reform proposal was brought forth by then First Lady Hilary Clinton. (I like Wikipedia.)

There is no end of commentary, research, opinions and examples from other countries of the pros and cons of universal health care. It's a tough concept for us to imagine here since we our current system has essentially lasted for the past two generations. Whether it's right or wrong to pursue universal health care, I think we can all agree that something must change. What that change will look like, will, for better or worse, come from our elected officials. The more we make our voices heard, the better chance we have of having an influence.

And one more study from JAMA looking at the approval ratings of health care in seven countries. Moral: I'm moving to the Netherlands.

Medicated creams and lotions

Laura Behm forwarded this CNN article on to me, and it's a good reminder that OTC meds can be dangerous as well. The story of Arielle Newman is especially notable for me-I remember hearing about it last year and warning the high school kids I was coaching to be aware that excess use of even OTC meds can be extremely dangerous.

I also received this article from Tom Welch. It reminds us of the importance of counseling patients and the effect meds can have. It has an 8-step reminder system for patients. With the untimely, and apparently drug-related, death of Heath Ledger, hopefully it will serve as yet another wake-up call for the importance of pharmacists. Here's the latest on Heath at WSJ.

New HIV drug

More HIV news: The FDA, just last week, approved a new drug, etravirine or Intelence. Here's the press release. A quick high point though: This non-nucleoside reverse transcriptase inhibitor is effective when other NNRTI's have established resistance and is the first drug in this class that accomplishes this.

Shopping for Health Care

This past weekend, I attended the MPhA Winter Clinical Conference-some meetings not great, some really good. One of the better ones highlighted a project that Drs. Schommer and Schondelmeyer (and others) have been working on for the past few months.

Drug companies, due to direct-to-consumer ads and other marketing (where they spent, just on direct-to-consumer ads, nearly $6 Billion in 2005!) have been great on getting their name out and information...on their new brand name drugs. To attempt to improve the information on non-marketed drugs, the U of M PRIME Institute began to develop information on drugs that were almost as effective as the brand name, but generic. More information on this project can be found at crbestbuydrugs.org. I encourage you to direct your patients to this website, and ask Drs. Schommer and Schondelmeyer for more information if you are interested.

In addition, a new website just started as well. You likely have heard the advertisements or seen the billboards on https://www.carol.com/ a new website that allows you to shop and compare health care. It will be interesting to see where this leads, and if this "shopping" for healthcare allows greater effectiveness in the use of health care flex spending accounts.

An option to an HIV vaccine

Hey, third years, do you remember your HIV drugs? Yeah, me neither. But maraviroc/Selzentry prevents the virus from binding to the cell, and then enter into it. According this WSJ article (which, by the way, I realize I need to pay much more attention to since it seems they have the most up-to-date information regardless of the fact that they are owned by Rupert Murdoch now) Pfizer is taking a different approach to preventing AIDS. If you remember back to last fall, Merck halted their research into the HIV/AIDS vaccine realm due to findings that more people were contracting HIV after the vaccine than those in the control group....yeah. But this takes a different route, namely, the vaginal route. Pfizer is even working with a non-profit to develop this, and hopefully release it to women in areas of high occurence. A very interesting approach to prevention....

Perceptions of drugs and Big Pharma

First off, I recently found out that "Big Pharma" is actually an organization, cleverly called PhRMA. Just an interesting factoid. Anyways, there was a recent study released by the New York Institute of Technology looked at the perceptions of people aged 18-26 and what they thought about medications, advertising and Big Pharma. Here's the link to the article on the study, as well as some actually pics. It's encouraging to see that most surveyed realized the importance of drugs, as well as the possibility of side effects. People also requested more information (see the top question on the second chart) And, who is better than drug information than us. Obviously, an opportunity to step in and offer information, and be a resource. I think we can also realize that advertising, thought totally biased, can stimulate conversation with patients.

Just for the taste of it!

A University of Minnesota study, published in Circulation, found that fast foods-including diet soda-were correlated with a higher risk of developing metabolic disease, which is strongly correlated with later development of diabetes. Here's the MPR article. This supports a study out of the University of Boston from last July that had similar findings. It is important to note that both studies acknowledged that the diet soda may just be indicative of other behaviors that are contributing to the higher risk, fast food likely being at the top of this list. Here's another good summary from the trusty ol' Star Trib as well.

Adults don't like shots either...

Or at least that is what this study says, well the CNN article says so. I couldn't find the actual CDC report-but I'll work on it. Anyways, opportunity for education by pharmacists, perhaps? I think, yes. Especially when you think about how cost-effective vaccines are in the long run.