PHARMACY

Medco breaks ground on world’s largest pharmacy

BY Amanda Baltazar

ANSON, Ind. —Medco Health Solutions has broken ground here on what will be the world’s largest automated pharmacy, scheduled to be operational by early next year.

This is Medco’s third automated pharmacy, and it will be the most advanced in terms of the efficiency of its technology and robotics, said Rich Jones, vice president and general manager of the facility.

The $140 million mail-order pharmacy also will boast a state-of-the-art research center for personalized medicine.

Located in AllPoints industrial complex, the pharmacy will be 318,000 square feet, or the size of six-and-a-half football fields, and will employ 1,300 people. Because of its scale, at peak capacity, which it’s expected to reach by 2012, the automated pharmacy will be able to process more than a million prescriptions per week.

This compares with Medco’s other facilities in Willingboro, N.J., which also processes about a million prescriptions per week, and the Las Vegas facility, which services about 700,000 prescriptions weekly.

Another advantage of the Indiana facility is its central geographic location, making it easy and cost-effective to send prescriptions anywhere in the country.

The advanced technology that Medco uses means that mistakes are rare. “In Las Vegas the only mistake has been through human intervention,” Jones pointed out.

The high level of technology also frees up the pharmacists to do the things they’re good at and allows them to use their knowledge to interact with patients and doctors, Jones said. “They can spend their time checking prescriptions and picking up potential errors.”

And because of the size of this new facility, pharmacists will each specialize in disease states, so that with this expertise, they can dig down a couple of layers deeper into patients’ medical history.

The new personalized medicine research center also will help with accuracy and is Medco’s latest move into the realm of personalized medicine.

The center will lead to active collaborations between Medco, universities and the local colleges of pharmacy to investigate how to deliver more precise pharmacy care through innovations in personalized medicine.

The PBM has partnered with clinical leaders to study the use of pharmacogenomics to advance pharmacy care. More attention is being focused on this field as more drug labels feature patients’ specific genetic information.

“Personalized medicine will really let us take patient care to another level,” Jones said.

Medco is backing pharmacogenomics because it promises to improve the safety, quality and efficiency of health care. Genetic testing can prevent adverse drug events that lead to hospitalizations, disability and even death. And because not all patients respond to medication the same way, personalized medicine can prevent patients being given ineffective medications.

Jones pointed to the example of breast cancer patients, 10 percent of whom do not respond to tamoxifen. Reactions to this drug can be tested with a simple cheek swab, which can be mailed to patients, and ensure they are put on a medication that will help their condition.

As time passes, and more data is collected, individual prescriptions will become more specific as the pharmacy knows what works for each patient and builds data profiles.

“We envision that the center will help bring personalized medicine into the mainstream of health care,” said Robert Epstein, Medco’s chief medical officer. “The science in this area is ‘popping,’ and Medco is leading the charge on translating this new science into clinical solutions on a national scale.”

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Analysis shows pain reduction for fibromyalgia patients using Lyrica

BY Diana Alickaj

CHICAGO A pooled analysis presented at the annual Academy of Neurology meeting reports that Pfizer’s Lyrica reduced pain in patients with fibromyalgia, whether or not they experienced symptoms of anxiety or depression.

The results were determined by analysis of data from three clinical trials that used a placebo as a control ranging from eight weeks, to 13 weeks and finally 14 weeks in more than 2,000 patients that had fibromyalgia. According to published reports, they also studied different dosages given to patients and where asked to measure their pain from a scale of zero to 10. The analysis confirmed that pain reduction was the greatest change in patients who used the drug regardless of whether they still had feelings of depression or anxiety.

According to published reports, Fibromyalgia is the most common, chronic pain condition in the United States, and patients who have it usually experience symptoms of poor sleep, stiffness and fatigue.

According to Dr. Lesly Arnold, one the authors of the study and associate professor in the department of psychiatry at the University of Cincinnati Medical Center, “The data showed that Lyrica reduced fibromyalgia pain, and alleviating that pain was associated with patients’ overall feeling of well-being. Understandably, many patients with a chronic pain condition, such as fibromyalgia, also experience depression and anxiety, and importantly we found that Lyrica helped reduce pain in patients regardless of the presence of symptoms of these co-morbid conditions.”

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NACDS urges Congress to refrain from adopting e-pedigree mandate

BY Jim Frederick

ALEXANDRIA, Va. New federal legislation to require that pharmacies and drug wholesalers establish electronic pedigrees for every drug they sell or distribute would throw both industries into turmoil and add “extraordinary” costs to their operations, the head of the National Association of Chain Drug Stores warned Thursday.

The Safeguarding America’s Pharmaceuticals Act of 2008 was introduced Thursday by Reps. Steve Buyer, (R-Ind., and Jim Matheson, D-Utah. If passed and signed into law, the bill would mandate electronic pedigree requirements to assist in the tracking and tracing of prescription drugs in the domestic supply chain.

NACDS president and chief executive officer Steve Anderson responded quickly to the proposal. “While instances of drug counterfeiting may occur,” he said, a federal e-pedigree mandate is the wrong approach.

“Despite the perception that e-pedigree and track and trace mandates are quick solutions, their adoption and implementation would be extremely complex and costly for retail pharmacies and others in the supply chain, and without the desired benefit,” Anderson asserted. “These systems are many years away from full development, have not been fully tested and lack uniform standards and patient privacy safeguards.”

There are alternatives to assure a safer drug supply as the industry gears up for e-pedigrees, Anderson added. Among them: adopting tougher uniform federal licensing standards for drug distribution and using the Food and Drug Administration to certify that manufacturers, distributors and pharmacies follow secure supply-chain guidelines.

“These steps would go a long way in improving safety and further protecting the supply chain by building on effective systems currently in place,” Anderson said.

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