PHARMACY

Hawaiian legislature comes out in favor of drug dispensing machines

BY Drew Buono

LIHU’E, Hawaii The Hawaii state legislature last Tuesday unanimously passed a controversial bill that will allow pharmacists to use remote dispensing machines to help low-income residents in rural areas improve their access to prescription drugs. Senate Bill 2459 evolved through a mixed batch of criticism, including pages of testimony from several Kaua’i pharmacists.

Kalaheo Pharmacy Manager Catherine Shimabukuro in late March testified that the bill fails to meet the guidelines of the National Association of Boards of Pharmacy. “It is clear to me that the intention of the legislature is to provide prescription care to those who are without insurance,” she says.

State Rep. Roland Sagum, said access means more than physical locations. “The pricing of these subscription drugs is much cheaper than they can get at a pharmacy,” he said. “It’s for our people who are poor and the indigent.”

Ho’ola Lahui, a federally qualified health center and Native Hawaiian health care system with offices in Lihu’e, provides drugs to patients at Kaua’i Veterans Memorial Hospital in Waimea and Samuel Mahelona Memorial Hospital in Kapa’a.

“HLH provides these medications at a reduced cost to those who otherwise would not be able to afford these medications. The technology allows HLH to reduce costs further by having a central pharmacy location … dispense acute medication at each clinic,” Ho’ola Lahui board director Grace Kamai said in her testimony.

Ho’ola Lahui’s remote dispensing pharmacies were stopped in April 2007 after the state Board of Pharmacy clarified the rules that a pharmacist must be on-site to dispense medications from the machines, Kamai said.

The state pharmacy board chair, Elwin Goo, testified in favor of the bill with amendments to track the remote dispensing pharmacies.

“The board supports the practice of remote dispensing and believes it is a technology that should be afforded to all pharmacies so that all residents of this state can be afforded easier access to prescription medications to meet their health care needs,” he says. “The board understands and sympathizes with the concerns of the legislature of the financial impact on the small independent pharmacies; however, this bill is not about financial gain or the prosperity of a business, but of the safe dispensing of prescription medications.”

The patient will be in contact with a technician via two-way sound and video monitoring devices, while getting the prescription filled.

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Wal-Mart’s $4 generic program expanded again

BY Mike Troy

BENTONVILLE, Ark. Wal-Mart’s $4 generic drug program was expanded on Monday to include new elements such as a 90-day, $10 option, several new women’s medicines and 1,000 nonprescription medicines priced at $4 or less.

This is the third time the program has been expanded since it was introduced in the fall of 2006. Since then, Wal-Mart contends, it has saved customers more than $1.1 billion and up to 95 percent of the prescriptions written in the majority of therapeutic categories now are included in the $4 prescription program. In addition, customers now can purchase a 90-day supply of 350 medicines for $10, a change Wal-Mart said gives customers an additional choice and saves them time and money.

Other changes include the addition of medicines such as a generic version of the osteoporosis drug Fosamax for $9 for a 30-day supply or $24 for a 90-day supply. In addition, medications to treat breast cancer (tamoxifen), menopause and hormone deficiency were added to the list of $9 medicines, a pricing tier that was added to the program in September 2007.

The other notable change to the program involved the inclusion of branded and private-label nonprescription drugs. More than 1,000 products, roughly one-third of the OTC drugs available at Wal-Mart and Neighborhood Market stores are available for $4.

“We’re succeeding in our efforts to deliver simple, affordable, quality pharmacy solutions for families struggling with the rising costs of health care,” said John Agwunobi, president of Wal-Mart’s health and wellness division.

Wal-Mart has promoted the $4 program extensively since its introduction via television commercials, print ads and signage throughout its stores to encourage customers to visit the pharmacy. In addition, the $4 program is frequently held up by Wal-Mart senior executives as an example of the retailer’s marketing slogan adopted last summer to help customers save money so they can live better.

Click here for the full list of discounted drugs.

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IDSA agrees to re-examine chronic Lyme disease guidelines

BY Drew Buono

HARTFORD, Conn. The Infectious Diseases Society of America has agreed to review its guidelines, which say there’s no evidence long-term antibiotics can cure “chronic” Lyme disease—or even that such a condition exists, according to the Washington Post.

The agreement, announced Thursday, calls for the doctors group to form a new panel of experts to review standards for treating Lyme disease. The IDSA says it agreed to the deal in part because the panel must be made up of doctors and scientists.

Lyme disease can be hard to diagnose with its vague, flu-like symptoms; the most obvious sign is its trademark round red rash. Usually, it’s easily cured with a few weeks of antibiotics. Those not promptly treated can develop arthritis, meningitis and other serious illnesses.

The IDSA says it’s never been proven whether these patients still have Lyme disease or something else. The group continues to defend its standards, which say short-term antibiotics are effective for nearly all patients. Long-term antibiotics are unproven and potentially dangerous, because overuse of the drugs can lead to drug-resistant infections, the society says.

“We are confident that our guidelines for the diagnosis and treatment of Lyme disease represent the best advice that medicine currently has to offer … and we look forward to the opportunity to put to rest any questions about them,” said Donald Poretz, the society’s president.

The society will consider a variety of scientific evidence and determine whether the 2006 guidelines are justified or need revision.

The guidelines are important because they discourage adequate treatment, advocates of chronic Lyme sufferers say. Perhaps just as significant is that insurance companies refuse to pay for long-term antibiotics to treat chronic Lyme disease because they follow the panel’s guidelines.

The doctors group makes clear that current guidance for treating Lyme disease remains in place.

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