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.