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Research: Aspirin may play role in fighting colon, prostate cancers

BY Michael Johnsen

BOSTON — New research published in the October 2011 issue of Harvard Men’s Health Watch suggested aspirin may play a role in fighting cancer, the publication announced Wednesday.

Aspirin inhibits the action of two enzymes in the body — cox-1 and cox-2. One of these, cox-2, triggers the production of chemicals that cause fever, create inflammation in joints and other tissues and aggravate pain. Research suggests that these same cox-2 enzymes may have a role in certain cancers. Cox-2 appears to promote the growth of new blood vessels to support the rapid growth of tumors, and also may interact with various growth factors to stimulate the multiplication of malignant cells. It also appears to inhibit apoptosis, a natural defense mechanism that helps prevent runaway tumor growth by triggering cell death by suicide.

The information about cox-2 inhibitors and human cancer still is under study, but scientists have discovered that many of the most aggressive colon cancers have unusually high levels of cox-2, as do many prostate cancers. In addition, randomized clinical trials have demonstrated that cox-2 inhibitors help prevent people at high risk of colon cancer from producing the benign polyps that give rise to nearly all colon cancers.

A British study analyzed fully completed, high-quality randomized trials of aspirin. When analyzed together, these trials showed that daily aspirin reduced the risk of dying from cancer by 21%. Seven-of-the-8 trials provided enough information to permit analysis of individual patients and specific cancers. Aspirin was most effective against gastrointestinal cancers, reducing the risk of death by 54%.

It’s too soon to recommend routine aspirin use to prevent cancer, stated Harvard Men’s Health Watch. But people at high risk of cancer, particularly colon cancer patients, people with colonic adenomas and individuals with a strong family history of colon cancer, should discuss the issue with their doctors.

Though not included in the Harvard Men’s Health Watch report, other over-the-counter medicines that also inhibit the cox-2 enzyme include ibuprofen (Advil, Motrin) and naproxen (Aleve). Prescription-only cox-2 inhibitors include Celebrex (celecoxib) and the older pain reliever Mobic (meloxicam).

 


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NCPA wraps up annual meeting with ‘glass half full’ outlook

BY Michael Johnsen

NASHVILLE, Tenn. — Wrapping up its 113th Annual Convention and Trade Exposition, the National Community Pharmacists Association on Tuesday outlined the association’s key initiatives and programs heading into 2012. Chief among the association’s concerns are threats to already-diminutive reimbursement rates for prescriptions filled, including the release of federal upper limits by the Centers for Medicare & Medicaid Services.

"Our analysis leads us to be very concerned with the initial release of this information and we will be talking more with CMS and sharing our strategy for asking them to reconsider how they calculated those figures," NCPA’s EVP and CEO Doug Hoey told reporters during a media conference call.

In a Sept. 2 newsletter, NCPA explained that the White House Office of Management and Budget has extended its review of the Medicaid AMP regulation, which will delay implementation of the AMP regulation. "However, NCPA continues to hear numerous complaints from pharmacists regarding state Maximum Allowable Costs for Medicaid generics that are much lower than their acquisition cost. That is because state MACs are based on the Federal Upper Limits for generics — which are set by CMS – but haven’t been updated in several years. … CMS is waiting for the new authority in this now delayed new AMP regulation – the final version of which may be many months away – before updating the FULs to reflect current market prices."

The proposed merger between Express Scripts and Medco is also expected to threaten reimbursement rates. Already one pharmacy in rural Colorado has been dispensing an ESI prescription for Humera (adalimumab) at a $43.40 deficit. According to Don Colcord of Nucla’s Apothecary Shoppe in Nucla, Colo., his acquisition cost for the rheumatoid arthritis treatment is $1,765.23 versus a reimbursement of $1,721.83. His patient, who doesn’t have another pharmacy option in a 100-mile radius, does not want to participate in mail order out of concern that the temperature-sensitive medication might go bad if not delivered in a timely fashion.

Beyond reimbursement challenges, the business of independent pharmacy looks positive, Hoey said. "We see the opportunities for community pharmacy to continue to expand their role in the healthcare system." Those opportunities include improved medication adherence — a major theme that resonated throughout the meeting, Hoey said. "We have a program that we released a couple of months ago called Simplify My Meds," he said. "We believe that adherence is one of those issues that aligns the interests of the healthcare system, patients, payers and pharmacists and that pharmacists are in an ideal position to be able to influence and improve patient outcomes through adherence."

Some of the announcements to come out of the meeting included an independent pharmacy hotline number that was established by SureScripts to address concerns and issues around e-prescribing. NCPA also established the NCPA Legal Resource Center, a legal library that community pharmacists considering legal action of any sort can consult. And NCPA expanded its marketing and merchandising support for independent pharmacists with the hiring of consultant Gabe Trahan, director of retail services for Burlington Drug Co., to help independents better monetize their front-end.

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West Coast University pharmacy school appoints founding dean

BY Alaric DeArment

IRVINE, Calif. — West Coast University’s new School of Pharmacy has picked a dean, the school said Wednesday.

The university announced the appointment of Naushad M. Khan Ghilzai as the founding dean of the school, which will be at the university’s Los Angeles campus. Ghilzai most recently served as associate dean for faculty at LECOM School of Pharmacy in Erie, Pa., and in Bradenton, Fla.

"We’re very pleased that the School of Pharmacy will be guided by someone of Dr. Naushad’s caliber and experience," West Coast University founder and chairman David Pyle said. "He is highly regarded by his peers and students alike. His teaching skills and research credentials, along with the respect he commands, will be invaluable in recruiting top-flight professors and students to our new School of Pharmacy."

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