PHARMACY

Maine law arouses concerns about security of drug supply chain

BY Alaric DeArment

A new law in Maine will allow the importation of drugs from abroad through mail-order from some pharmacies, formalizing a practice that has existed in many parts of the country for several years, and marking the first time a state government has, by law, gone against Food and Drug Administration regulations that bar importation of drugs.

Bloomberg columnist Megan McArdle said Maine was "going rogue" on drug importation, and that pretty much sums it up. The state, which has long had a close relationship with Canada — its governor, Paul LePage, is of French-Canadian descent and spoke Quebecois French as his first language — is openly defying federal law. And because federal law ultimately trumps state law, it’s likely the federal government will crack down at some point.

Already, the law is the subject of a suit in federal court. Last month, the Maine Pharmacy Association, the Retail Association of Maine, the Maine Society of Health System Pharmacists and several individual pharmacists joined the Pharmaceutical Research and Manufacturers of America in a lawsuit in the U.S. District Court in Bangor, Maine, to try and overturn the law. LePage and other supporters of the law have brushed off objections as drug companies attempting to protect their "turf."

But this isn’t all just about businesses attempting to protect their interests. There are also serious concerns about safety at play.

According to an analysis of a report from the Group of 8 about rogue online pharmacies by the Partnership for Save Medicines, 70,000 fake prescription pills were discovered in the United Kingdom’s secure supply chain last year, and another 30,000 pills remain unaccounted for by the Medicines and Healthcare Products Regulatory Agency, the country’s equivalent to the FDA. The trouble is, the United Kingdom is one of the countries from which the Maine law allows drug imports. The others are Australia, Canada and New Zealand.

As mentioned before, Maine’s law formalizes practices that are in existence. Since 2004, the city of Portland, Maine, has obtained drugs through CanaRx, a broker based in Canada. The company also supplies to public-sector health plans in Illinois, Rhode Island and Vermont.

To be fair, it’s hard not to see where Portland and LePage are coming from: The city saved $3.2 million between 2004 and 2012 through its CanaRx partnership. The United States is the only industrialized country that doesn’t control drug prices, and concerns about cost are a major factor in medication non-adherence. So it’s no surprise that many patients and payers have sought to go elsewhere to find bargains.

CanaRx has had its share of problems as well. In 2003, it received warning letters from the FDA that its practices violated U.S. law, and currently, its physical presence in the United States appears limited to a post office box in Detroit. A call to CanaRx was not returned.

According to the company’s website, "medications shipped from CanaRx meet the same strict manufacturing requirements as those sold in the U.S. and are government regulated. Although the drugs you receive may look slightly different or have a different name than the one you are used to, for all intents and purposes they are identical. For example, a drug may be a capsule in the U.S. but a tablet in another country."

But the FDA doesn’t buy these explanations. "Notwithstanding these assertions, Canadian and other foreign versions of FDA-approved drugs are generally considered unapproved in the United States," read a follow-up to the 2003 letter, addressed to CanaRx president G. Anthony Howard and Syracuse, Ind.-based regional manager Joseph Todd. "This is so because FDA approvals are manufacturer-specific, product-specific, and include many requirements relating to the product, such as manufacturing location, formulation, source and specifications of active ingredients, processing methods, manufacturing controls, container/closure system, and appearance … Frequently, drugs sold outside of the United States are not manufactured by a form that has FDA approval for that drug."

To be sure, there are few doubts about the safety of Canada’s legal drug supply chain or the legitimate drugs sold there, and the same can be said of most other developed countries. But the issue isn’t about whether a prescription picked up at a drug store in Toronto is safe. The issue is about counterfeit or adulterated drugs making it into the U.S. supply chain by coming into the country through channels the FDA can’t regulate.

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Walgreens has all the pieces in place to really advance retail pharmacy and retailing into the future

BY Michael Johnsen

By November, Walgreens will have completed fine-tuning its management structure for maximum effectiveness in realizing its three-pronged strategy. That strategy includes improving the front-end experience through retail theater. It includes establishing the pharmacist as the go-to source for healthcare, not just for the patient but for the payer, too. And it includes creating an unrivaled global economy of scale. 

Now with all of the pieces in place, Walgreens has shown it has both a knack for creating the optimal retail health experience and identifying the corporate talent who possess a proven track record of transforming good ideas into better realities.  

To recap, Walgreens tapped strategic partner Alliance Boots for Alex Gourlay, who as of Oct. 1 was named Walgreens EVP, president of customer experience and daily living. Together with Mark Wagner, president of operations and community management and Kermit Crawford, president of pharmacy, health and wellness, you have a trifecta of top-notch talent who have been successfully redefining the retail pharmacy experience today. 

Tomorrow can only be better. 

Bryan Pugh had been named corporate VP of U.S. merchandising program development and execution. Reporting to Wagner, Pugh is the bridge between Walgreens’ merchandising and operations teams. He will oversee rollout of new merchandising initiatives to the field, including operating standards, cross-functional deployment and flagship rollout.

Shannon Curtin, Robert Tompkins and Moe Alkemade are the three general merchandising managers contributing to Walgreens’ front-end experience across beauty, health and wellness and seasonal, general merchandise and consumables, respecively. Alkemade was one of the architects behind Walgreens’ private label strategies. 

Linda Severin, formerly of Kroger, where she led the redevelopment of its private brand portfolio, in October joined Walgreens as divisional VP of private brands and is now responsible for the product development, brand management and program execution of Walgreens private brands. 

Throw in Walgreens’ focus on omnichannel retailing and you have a culture of executives who aren’t afraid to try new initiatives. "Everything we do for the customer, we are thinking about how to bring a digital experience along the way," commented Greg Wasson at the recent Shop.org Annual Summit 2013. "I’m the chief road-block remover and doubt remover. When you’re a brick-and-mortar organization, that’s my No. 1 responsibility."

There should be no doubt, however, that this team will realize many successes in the years to come.

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Pharmacy-accreditation group to develop program for specialty

BY Alaric DeArment

WASHINGTON — The Center for Pharmacy Practice Accreditation is developing an accreditation program for specialty pharmacy practices, the group said.

The CPPA said its accreditation would meet the public’s need for predictable and measurable pharmacy-based patient care services, noting that voluntary accreditation programs recognize pharmacy practices committed to quality, patient safety and improved care. Specialty pharmacy is focused on treatments for such difficult-to-treat, chronic conditions as cancers, autoimmune disorders, genetic diseases and chronic viral infections.

According to IMS Health, estimated costs for specialty drugs will be more than $260 billion by the end of this year, and according to a recent report by the Drug Channels Institute, eight of the top 10 best-selling drugs, by revenue, will be specialty drugs by 2016, with specialty accounting for 31% of pharmacy industry revenues in the United States.

 

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