PHARMACY

Study: Mild asthma patients may be overusing drug combinations

BY Alaric DeArment

PHOENIX — Most patients with mild persistent asthma overuse a drug combination despite an apparent lack of added medical benefit, according to a new study by pharmacy benefit manager Medco.

Medco released results of the study Monday showing that nearly two-thirds of those patients are combining inhaled corticosteroids with long-acting beta agonists, even though national guidelines recommend that they use the ICS therapies alone. The company’s research arm, the Medco Research Institute, conducted the study and presented the data during the weekend at the annual scientific meeting of the American College of Allergy, Asthma and Immunology.

The company based the study on pharmacy and medical claims from 8,424 patients treated for mild asthma, finding that 5,523 were using the combination of an ICS and a LABA, while the remainder used an ICS alone. The researchers did not find a significant difference between the two groups in terms of use of acute asthma medications, emergency room visits or hospitalizations, meaning that the combination of an ICS and a LABA probably did not provide any clinical benefit compared with an ICS alone.

“This study confirms that, based on pharmacy and medical claims, patients with mild asthma using only an inhaled corticosteroid seem to control their asthma just as well as those who take a combined ICS [and] LABA treatment, such as Advair or Symbicort,” lead study researcher Luis Salmun said in a statement. “While these combination therapies are important treatments for patients with more severe asthma, it’s concerning that they are being used by a majority of patients with milder asthmatic symptoms given that these medications are more costly and that clinical guidelines prefer ICS therapy alone for these patients.”

Advair (fluticasone propionate and salmeterol) and Symbicort (budesonide and formoterol fumarate dihydrate) are made by GlaxoSmithKline and AstraZeneca, respectively.

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NACDS, NCPA claim pharmacy victory after withdrawal of Medicaid program provisions

BY Alaric DeArment

ALEXANDRIA, Va. The National Association of Chain Drug Stores and the National Community Pharmacists Association heralded the withdrawal of two provisions from the Medicaid program that would have had retail pharmacies selling generic drugs at a loss.

 

The Centers for Medicare and Medicaid Services cut provisions that defined average manufacturer price and determined calculation of federal upper limits. The NACDS and NCPA sued CMS in the U.S. District Court for the District of Columbia in November 2007 to obtain an injunction against the provisions, which the court granted. In response, CMS revised its definition of multiple source drugs in October 2008, though the pharmacy lobby groups amended their lawsuit to block that as well, saying it was still against the law. CMS’ new rule removes that provision as well.

 

 

In a joint statement, NACDS president and CEO Steve Anderson and NCPA EVP and CEO Kathleen Jaeger heralded the decision, saying the rule would have reduced patients’ access to pharmacies by cutting reimbursements, thus forcing retail pharmacies to sell generic drugs at a loss.

 

 

“We insisted that this policy was not appropriate,” the statement read. “Separately, we also have urged that policy-makers should recognize the ability of pharmacies and pharmacists to help improve health and reduce healthcare costs. We are gratified that this sense is reflected in the pharmacy provisions of the new healthcare-reform law. The new law contains provisions ranging from dramatically reducing the [accelerated manufacturing of pharmaceutical] cuts to advancing medication therapy management, through which pharmacists can help patients take their medications correctly, which is referred to as ‘medication adherence.’”

 

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Roadside announces partnership to further ‘drive’ wellness programs

BY Alaric DeArment

BOSTON Two companies have formed a partnership to provide services for long-haul truck drivers.

 

Sleep HealthCenters and Roadside Medical Clinic + Lab announced a partnership Wednesday to provide sleep medicine services as part of Roadside’s driver-wellness programs.

 

 

Roadside provides medical services, such as Department of Transportation-compliant physicals, drug testing, driver-wellness programs and sleep services for professional drivers on the highway and at company terminals. Sleep HealthCenters will support Roadside’s programs by providing education, professional diagnosis and treatment support, which will be incorporated into the driver-wellness program.

 

 

“You cannot effectively screen, test and treat sleep apnea without addressing and improving drivers’ overall health condition, such as weight, [body-mass index], stress and cardiac strength,” Roadside COO Rob Scheschareg said. “By providing continuous care for drivers for sleep, fitness, health and [Department of Transportation] compliance from the terminal to the highways, Roadside Medical is able to move the needle toward better driver health.”

 

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