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Should Brilinta be FDA-Approved?

July 29th, 2010 by Kristina Michel | No Comments | Filed in Uncategorized

Should Brilinta be FDA-approved?This week, the FDA began its review of Brilinta, the blood thinner that has caused some controversy over its trial results, particularly in the United States.

Brilinta (ticagrelor), manufactured by AstraZeneca, is an antiplatelet drug that would be used to prevent heart attack and stroke in people with acute coronary syndrome. AstraZeneca submitted it for FDA approval based on the results of the phase III clinical trial PLATO (A Study of Platelet Inhibition and Patient Outcomes) from 2009, where the drug was compared with rival antiplatelet medication Plavix (clopidogrel), manufactured by Bristol Meyers Squibb and Sanofi-Aventis. The 18,624 participants in the trial took either Brilinta or Plavix with an aspirin. According to the trial results, Brilinta reduced the incidence of heart attack and stroke in patients by 11.7 percent compared to Plavix, which only reduced cardiovascular incidents by 9.8 percent.

However, this was not the case when only patients in North America were studied. Brilinta failed to beat Plavix in reducing the incidence of heart attack and stroke in the 1,400 North American trial participants. In fact, more patients experienced a cardiovascular event (3.8 percent with Brilinta compared to 3.2 percent with Plavix) on Brilinta than Plavix. The FDA organized an advisory committee to review Brilinta and the PLATO results and decide whether or not to recommend Brilinta for approval. On Wednesday, the panel recommended in a 7-1 vote that the FDA approve the drug.

Medical experts are not sure why the North American results were so different from the overall results. Some suspect that participants in North America were given higher doses of aspirin than participants in other parts of the world.  Since the panel could not find enough evidence to explain the conflicting North America results, and since Brilinta had favorable results overall, the panel voted to recommend Brilinta be approved.

The advisory panel’s decision is not binding, and the FDA is not scheduled to make a final decision on approving Brilinta until September. The one panelist who voted against approval believes that AstraZeneca should conduct another study to address the North American results before the drug can be approved. Panelists also discussed the possibility of conducting a postmarket trial that would focus specifically on patients in the United States.

NPTA wants to know what pharmacy technicians think. Should the FDA go with the panel’s recommendation and approve Brilinta? Or should there be further study to explain the results in North America? Take the NPTA poll and post your comments on Facebook, Twitter or the comments section of this blog!


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Personal Health Records and the Pharmacy

July 22nd, 2010 by Kristina Michel | 3 Comments | Filed in Uncategorized

Computer keyboardThroughout the medical industry, health and wellness professionals are trying to encourage patients to get more active and involved in managing their health. One of these ways is by encouraging patients to create their own personal health records.

Personal health records (PHRs) are records that patients create and maintain themselves. Although PHRs can be created and stored electronically, they are different from electronic records in that e-health records may not belong to the patient. PHRs belong specifically to the patient. The patient maintains them, and caregivers must get their approval to access them.

Though the number of Americans using PHRs is still quite low, it is growing rapidly. An article in InformationWeek reported that the number of Americans using PHRs has doubled in only two years. Insurance companies such as Independence Blue Cross (an independent license of Blue Cross Blue Shield) and Medicare programs provide patients with tools to create their own PHRs. Patients can also create PHRs on health information sites such as WebMD and Google Health for free.

Last year, the MD Anderson Cancer Center created myMDAnderson, a site tool that gives patients access to their personal medical records and lets them authorize community physicians’ access. Already, over half of MD Anderson’s listed patients and survivors have used myMDAnderson to access their records, and 40 percent of community physicians have used the tool to look up their patients’ medical history.

Pharmacy organizations are discussing applications for PHRs in pharmaceutical care. The American Pharmacists Association (APhA) supports the use of PHRs as part of Medication Therapy Management programs and a patients’ overall health care. Many health professionals see PHRs as a way to keep patients more involved and better educated about their illnesses and medications, which can help reduce medication error. Having a personal health record can also help keep track of medications a patient has taken as well as illnesses, allergies and medical procedures, which is especially important if the patient has a chronic illness that requires multiple care specialists.

So if health professionals and organizations are encouraging patients to use PHRs and if more hospitals, insurance companies and online health pages are making it easier for patients to create PHRs, why is the number of Americans using PHRs still relatively low? One answer is that most are concerned that PHR systems are not secure enough, and creating a PHR puts their health information at risk. Some patients may not have the time or the means to keep their own thorough health records. Others simply do not feel they need to create PHRs because they don’t get sick that often.

NPTA would like to know what pharmacy technicians think. Should pharmacies be doing more to encourage patients to create personal health records? Are you concerned about the security of PHRs as well? Do you think PHRs can help patients keep better track of their medications and reduce medication error? Take our poll below, and post your thoughts on Facebook, Twitter or the comments section of this blog!


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Could Cutting Saturday Delivery Affect Mail-Order Pharmacy?

July 13th, 2010 by Kristina Michel | 3 Comments | Filed in Uncategorized

800px-United_States_Postal_Service_TruckAn interesting article appeared recently in the Houston Business Journal about the effects of cutting Saturday postal services on mail-order pharmacy benefits. According to the article, the Pharmaceutical Care Management Association (PCMA), a national organization representing pharmacy benefits managers, is concerned that the U.S. Postal Service’s proposal to cut Saturday delivery services by 2011 will have a negative impact on Americans with chronic conditions who rely on mail-order pharmacy services for their medications.

According to the PCMA, one in six prescriptions that are delivered by mail arrive on Saturday. Cutting Saturday services could force people with chronic conditions to wait days for their medications to arrive.

The difficult economy has forced budget cutbacks in businesses and government agencies in all industries, not the least of which is the U.S. Postal Service. According to an article in the LA Times, the USPS will be facing a $238 billion deficit over the next decade. To offset some of this deficit, the USPS released a proposal in March to end Saturday services by 2011, which the agency says would save $5.1 billion a year by 2020.

Congress will ultimately have to approve the proposal to cut Saturday services, but NPTA would like to know what pharmacy technicians think. Should the USPS cut Saturday delivery services? What, if any, impact do you think cutting Saturday deliveries would have on mail-order pharmaceutical services? Take our polls below and post your comments on Facebook, Twitter or the comments section of this blog!


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Questions after the Walgreens/CVS Standoff

June 25th, 2010 by Kristina Michel | 3 Comments | Filed in Uncategorized

Walgreens CVS logosAs abruptly as the pharmacy benefit management (PBM) feud between Walgreens and CVS Caremark began, it ended. Both companies reached an agreement that lets Walgreens remain in CVS Caremark’s network. The feud only lasted for 11 days, yet it was enough to lower both companies’ stocks, raise questions about current PBM business practices and have analysts in a frenzy trying to figure out what either company would do next and the impact it would have on consumers. And while both companies seem to have returned to business as usual, here we are in the aftermath wondering what in the world happened.

The dispute started when Walgreens announced on June 7 that it would no longer participate in CVS Caremark’s pharmacy benefit network. The company said that CVS was limiting patient choice by requiring patients  to use pharmacies owned by CVS for their prescriptions instead of Walgreens under certain prescription drug plans. Walgreens also said CVS was keeping them out of the loop when participating in a new or altered CVS pharmacy network and that CVS was being flimsy about its reimbursement rates to Walgreens.

CVS Caremark responded with a statement dismissing Walgreens’ decision as nothing more than a stunt to raise its reimbursement rates. Two days later, CVS made its own announcement that it planned to remove Walgreens completely from its pharmacy benefit management network and that it would terminate Walgreens’ participation in its Medicare Part D retail pharmacy networks by 2011. The feud continued for a week until June 18, when CVS and Walgreens announced they had reached an agreement that let Walgreens stay in CVS Caremark’s PBM network.

Every working pharmacy technician has handled prescriptions through a pharmacy benefit management program. Millions of Americans currently receive prescription drug benefits through PBMs either through their employer or through a government health program like Medicare. According to an article from the Chicago Tribune,  Americans spend about $250 billion a year on prescription drugs. CVS became the largest pharmacy health care provider in the U.S. when it acquired Caremark in 2007, now providing access to a network of over 64,000 pharmacies through its drugstores, health clinics, online pharmacies and mail-order pharmacies. Walgreens is the nation’s largest drugstore chain with over 7,500 drugstores in the U.S. and 2009 fiscal sales of $63 billion.

Neither Walgreens nor CVS has said much about the agreement they have reached. A quote from CVS Caremark’s PBM president Per Lofberg in a joint-issued press release hints that the deal will address some of Walgreens’ initial concerns about CVS Caremark’s PBM business practices at least by a small margin. NPTA would like to know what pharmacy technicians think. What impact would either company’s decision have had on pharmacies and pharmacy workers? Does the feud say something to you about current state of pharmacy benefit management networks? Or was it simply much ado about nothing? Discuss your thoughts on Facebook, Twitter or the comments section of this blog!

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Honoring Our Fathers

June 16th, 2010 by Kristina Michel | No Comments | Filed in Uncategorized
Father and daughter on the beach

Photo by Bobby Mikul from Public Domain Pictures.net.

Father’s Day is an important holiday and celebration in America, but it wasn’t always recognized as such. While Mother’s Day took only six years to become a permanent national holiday, Father’s Day had to wait six decades. Father’s Day in the United States originated in 1909 when Sonora Smart Dodd of Spokane, Washington was listening to a Mother’s Day sermon in church. The sermon got her thinking about her father, a civil war veteran who was left to raise a family of six alone after his wife died in childbirth. Dodd wanted a day to honor her father and all fathers who had worked hard to become symbols of courage and leadership to their children.

On June 19, 1910, her father’s birthday, with the help of the Spokane Ministerial Association and the YMCA, Dodd hosted the first Father’s Day celebration. Young members of the YMCA went to church wearing roses—a red rose to honor a living father and a white rose to honor a deceased one—and Dodd traveled through the city carrying gifts to shut-in fathers.

Though support of a national holiday honoring fathers was growing, it faced resistance and criticism from newspapers, politicians and other critics. The fear was that Father’s Day was the first step toward purely commercialist holidays,  filling the calendar with meaningless days of merchandising and mindless promotions. Attempts to formalize the day were resisted and defeated in Congress. Though President Woodrow Wilson visited Spokane to speak in a Father’s Day celebration in 1919 and recommended that the day be observed by the nation in 1924, even he fell short of issuing a national proclamation.

The day finally found a new voice in Maine Senator Margaret Chase Smith, who openly advocated for the holiday and in 1957 wrote a strongly-worded proposal in Congress that accused the legislative body of ignoring fathers by honoring mothers on Mother’s Day yet doing nothing for fathers. Finally in 1966, President Lyndon Johnson issued a national proclamation that the United States would observe Father’s Day every year on the third Sunday in June. Father’s Day finally became a permanent national holiday when President Richard Nixon signed it into law in 1972.

Though it may not have received the same attention as Mother’s Day, Father’s Day has evolved into an important national holiday. It is a time where we can honor our fathers for the physical, emotional and financial support they work tirelessly to provide for their families. Mothers are viewed as symbols of love and kindness, and fathers are symbols of strength and courage. Father’s Day is also a day for father figures— uncles, grandfathers, teachers and mentors who step up and inspire their children and students to become strong, steadfast leaders.

So this Father’s Day weekend, NPTA would like to thank all the pharmacy technician fathers and father figures for their hard work, wisdom, encouragement and unconditional love. Use Facebook, Twitter and the comments section of this blog to send your father messages of love and support. Three cheers for Dad, and a happy Father’s Day to you all!

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U.S. News and World Report Picks Its Best Children’s Hospitals of 2010

June 9th, 2010 by Kristina Michel | No Comments | Filed in Uncategorized

usnews-logo-smU.S. News and World Report has released its list of the best children’s hospitals of 2010. The publication worked with the National Association of Children’s Hospitals and Related Institutions (NACHRI) to send out surveys to 170 different pediatric centers. The response pool included over 80 medical directors, department chairs, infection specialists and other specialty medical experts. The hospitals were chosen and ranked in 10 different specialties: cancer, gastroenterology, heart and heart surgery, neurology, neonatology, pulmonology, diabetes and endocrinology, kidney, orthopedics and urology. Of the 62 pediatric centers that made the rankings, only eight made the Honor Roll by placing in all 10 specialties.

Competition is a part of every industry in America, and the medical industry is no exception. Year round, both adult and children’s hospitals fight for research grants, world class rankings and, of course, bragging rights. At stake are the most talented medical professionals, patients seeking the best medical care and funding for the most cutting-edge medical treatments in the name of improving health and curing disease. And for those pharmacy technicians seeking employment in a hospital pharmacy, knowing about the honors and grants a hospital has received looks really impressive in a job interview.

Here are the eight pediatric hospitals that made the U.S. News and World Report Honor Roll this year. For more listings and rankings by specialty, visit the U.S. News and World Report Health website.

So here’s to all the pediatric hospitals that received top honors this year and to all pharmacists, pharmacy technicians and health and medical professionals who work tirelessly to provide our children with the best medical care possible!

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Deceptive Herbal and Dietary Product Marketing Practices Raise Concerns

May 28th, 2010 by Kristina Michel | No Comments | Filed in Uncategorized
Photo by Sage Ross (ragesoss.com), from Wikimedia Commons. Creative Commons Attribution-Share Alike 3.0 Unported.

Photo by Sage Ross (ragesoss.com), from Wikimedia Commons. Creative Commons Attribution-Share Alike 3.0 Unported.

A report issued by the Government Accountability Office (GAO) has raised questions about the safety of herbal and dietary supplements and how they are marketed.

According to the report, which was presented at a Congressional hearing on Wednesday, sellers of herbal/dietary supplements used deceptive practices and gave customers questionable and potentially dangerous advice to market their products. The GAO randomly selected 22 retailers of herbal/dietary supplements, both storefront and online. GAO staff contacted sales representatives in these locations either in person or by phone posing as elderly customers and recorded conversations with the representatives.

Some representatives claimed their herbal/dietary products could prevent or even cure conditions like diabetes and obesity. Some encouraged the customers to stop taking their prescription meds altogether and replace them with an herbal/dietary product without consulting a doctor or pharmacist. Federal Trade Commission (FTC) regulations prohibit marketers of herbal and dietary supplements from claiming that they treat or cure medical conditions. Any product that claims to treat, prevent or cure a disease is considered a drug and must go through strict reviews by the FDA.

The most dangerous advice came from sales reps who failed to warn customers that taking certain herbal products with certain medicines could cause adverse and even lethal side effects. One told a customer that it was safe to take gingko biloba and aspirin together contrary to FDA warnings that gingko biloba combined with aspirin can cause internal bleeding. When the undercover customer asked about ginseng and told him that he was a diabetic, the sales rep told him that ginseng would help treat his condition even though the National Institutes of Health (NIH) has warned diabetics that taking ginseng with certain treatments can cause an unsafe drop in blood sugar.

In addition to illegal marketing practices, the GAO found trace amounts of lead, arsenic, mercury and residues from at least one pesticide in 37 of the 40 products they tested. However, these amounts did not exceed any FDA or Environmental Protection Agency (EPA) regulations governing herbal and dietary supplements’ raw ingredients.

Most herbal/dietary supplements are safe when used properly. Knowledge is power when it comes to using any product, and pharmacy technicians can do things to help patients make informed decisions when it comes to purchasing herbal and dietary products. Refer the patient to their doctor, the pharmacist or non-biased information sources if they have a particular question about an herbal or dietary product. If they appear to be taking an herbal/dietary supplement with a medication that could cause adverse effects, have them speak to the pharmacist immediately. Have the pharmacist discuss any side effects or potential risks that can occur when using these products with any type of medication.

Since the GAO report was released, government officials have been discussing whether or not herbal/dietary supplements should be put under the same scrutiny as food and drugs. Unlike food products and drugs, these products are not required to apply for FDA approval before they are sold, and the FTC regulates the marketing of herbal and dietary supplements. NPTA wants to know what you think. What kinds of questions have patients asked you about herbal and dietary supplements? What’s your opinion about these types of products? Should they be regulated by the FDA? Take our poll below and post your thoughts on Facebook, Twitter or the comments section of this blog.


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Antibiotics: Too Much of a Good Thing?

May 21st, 2010 by Kristina Michel | No Comments | Filed in Uncategorized

Poster from the CDC Get Smart: Know When Antibiotics Work campaignMost patients who get sick will visit the doctor’s office, take a few tests, wait for the doctor’s diagnosis and then receive a prescription to be picked up at their nearest pharmacy.  Often included in that prescription is an antibiotic medication.

However, how often is too often when it comes to using antibiotics? According to a study published this week in the British Medical Journal, using antibiotics too often can cause patients to develop drug resistance that can last up to a year, putting them and the surrounding population at risk when a serious treatment is needed.

Antibiotics are an important line of defense against many life-threatening diseases such as tuberculosis, meningococcal diseases, strep throat and food-borne illnesses such as salmonella. However, using antibiotics too often or using them to treat the wrong illnesses can be dangerous. The more often antibiotics are used, the less effective they become. If used too often, bacteria will eventually grow into antibiotic-resistant “superbugs.” Some recent cases of antibiotic-resistant infections include MRSA, C. Difficile and multidrug-resistant tuberculosis. According to the CDC, a 2008 study of 188 patients in a single healthcare institution found that they spent between $13 and $18 million on medical expenses in the treatment of antibiotic resistant infections. Antibiotic-resistant infections are a growing problem particularly in hospitals and clinics, where antibiotics are often used on admitted patients to prevent the spread of infection.

Medical associations, advocacy groups and the United States Department of Health and Human Services have launched numerous awareness campaigns and issued statements encouraging doctors and patients to use antibiotics wisely. In a blog entry, Dr. Alan Greene says that one of the reasons why antibiotics continue to be misused and over-prescribed is because patients, particularly parents with small children, go to the doctor wanting or expecting antibiotics to treat an illness regardless of whether or not the antibiotic is actually effective in treating the illness. Fortunately, there are things pharmacists and pharmacy technicians can do about this.

Pharmacy technicians can help by reminding their friends and loved ones that antibiotics do not treat all diseases. Antibiotics will not treat viral infections such as a cold and the flu. If a patient with an antibiotic prescription appears to be taking it for a viral illness, offer to have the patient speak with the pharmacist about their prescription. Emphasize the importance of taking all antibiotics that are prescribed even if the patient starts to feel better. When patients stop taking antibiotics too early, leftover bacteria inside the patient can adapt and return as a stronger, drug-resistant infection. If a patient has questions about their antibiotic prescription, refer them to the pharmacist.

Do you see a lot of patients misusing or overusing antibiotics? Do you think antibiotics are prescribed too often? Take our poll below, and discuss with us on Facebook, Twitter or in the comments section of this blog.


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Honor Our Troops for National Military Appreciation Month

May 13th, 2010 by Kristina Michel | 1 Comment | Filed in Uncategorized

Honoring our service men and women for National Military Appreciation MonthMost of you know Memorial Day as the day when we honor our brave military heroes  who have fallen in the line of duty. However, Memorial Day is just one of many special days held throughout the month of May as part of National Military Appreciation Month.

National Military Appreciation Month (NMAM) started in 1999 as an initiative by U.S. congressmen and over 50 veteran service organizations to honor, remember and recognize all the men and women who have dedicated their lives to protecting our citizens and our country. In 2004, Congress unanimously voted to officially designate May as National Military Appreciation Month. Important dates in NMAM include Loyalty Day (May 1), VE Day (May 8), Military Spouse Appreciation Day (May 7), Armed Forces Day (May 15) and finally Memorial Day (May 30).

This Friday is Armed Forces Day and the halfway mark of National Military Appreciation Month. NPTA would like to recognize those pharmacy technicians serving or who have served in the military and thank them for the sacrifices they have made on behalf of our beloved country. We would also like to acknowledge those pharmacy technicians with friends and relatives in the military.

We encourage our friends, fans and followers to use Facebook, Twitter and the comments section of this blog to show your appreciation for those on active duty in all branches of military service, the National Guard and Reserves as well as for retirees, veterans and all their families. Post your messages thanking them for their service. We also encourage you to visit the NMAM official website to learn more about National Military Appreciation Month and about events honoring our troops going on in your area.

And the next time you see a service member, no matter what day it is, thank them for their service.

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Celebrating Mother’s Day

May 7th, 2010 by Kristina Michel | No Comments | Filed in Uncategorized

mothersdayNo one is a better symbol of kindness, generosity and empathy than our mother. When we are sick, her kisses and hugs always make us better. When we’re lost, she gives us guidance. When we’re sad, she always knows just how to cheer us up. She is our loudest cheerleader. At our most frustrating moments, she is that voice inside our heads telling us to never give up, never stop pursuing our dreams and that we can achieve anything.

This Mother’s Day weekend, we, at NPTA, would like to thank our mothers for all the love and kindness they have given us. To celebrate Mom, we are inviting pharmacy technicians, friends, fans and followers to post your own messages of love to your mothers. Tell her a joke. Tell her your favorite story. Tell her the best advice she ever gave you, or just send her a sweet thank you message for being there.

And for those pharmacy technicians who are mothers, post your messages too. Tell us what Mother’s Day means to you. Tell us what you love most about being a mother. Or you can just post a friendly reminder to your kids to not forget that gift you’ve been wanting or that restaurant you’ve been hoping eat at.

Post your messages on our Facebook page, on Twitter or on the comments section of this blog. This weekend, mom, we celebrate you! Happy Mother’s Day everyone!

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