PHARMACY

Support for doctor-filled scripts: a warning sign for retail pharmacy?

BY Jim Frederick

ST. LOUIS In what could be either a worrisome sign of an increasingly fickle pharmacy consumer or a tempest in a teapot, researchers acting at the behest of a company that caters to physicians have found what they describe as widespread support for the idea of doctor-dispensed prescriptions.

Three out of four Americans in a nationwide poll appeared to support the concept of having their prescriptions filled by their doctors at the point of care, according to Purkinje, a health care technology and services company that partners with physicians. The poll, conducted by Opinion Research, found that a majority of consumers appear willing to try doctor-dispensed prescriptions rather than going to their neighborhood pharmacies.

The biggest factor is convenience, according to pollsters. “Overall preference for office-based medication dispensing appears to be driven by the prospect of saving time and improving quality of care,” noted a report on the study.

An overwhelming majority of respondents, 84 percent, said such a service would be more convenient, and 62 percent said it would help them better manage their health, according to researchers.

According to Purkinje, the findings suggest that “physicians are missing an opportunity to improve patient satisfaction and enhance revenue by not dispensing medicine in their office.” But the study’s results are troublesome for chain and independent pharmacies, which are already under assault from mail-order pharmacy, mandatory mail-order prescription plans and Medicaid reimbursement cuts, among other threats.

For pharmacy leaders, however, the findings might come with a few grains of salt. Purkinje describes itself as a specialist in providing physicians with computer-driven solutions to “save time, maximize income and provide optimal care for their patients.” Its products include software for practice management, electronic health records, billing and what it calls “medication fulfillment.”

Reacting to the report, Mary Ann Wagner, senior vice president of policy and regulatory affairs for the National Association of Chain Drug Stores, cited the drawbacks for any patient who cuts pharmacists out of the health care equation.

“Pharmacists not only dispense medications,” Wagner told Drug Store News. “They play a critical role in their patients’ health by monitoring potential drug interactions and allergies. If a patient is being treated by more than one health care provider, it would be more difficult to detect harmful drug interactions if the patient is receiving multiple medications from different doctors or pharmacies.”

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PHARMACY

DEA statistics show painkiller sales up almost 90 percent since 1997

BY Adam Kraemer

WASHINGTON The amount of five major painkillers sold at retail establishments rose 90 percent in the eight years up to 2005, according to an Associated Press analysis of statistics from the Drug Enforcement Administration.

According to the DEA statistics more than 200,000 pounds of codeine, morphine, oxycodone, hydrocodone and meperidine were purchased at retail stores during 2005, the most recent year represented in the data.

Most of the increase can be attributed to oxycodone, the codeine derivative in Purdue Pharma’s OxyContin. Use of oxcodone jumped nearly six-fold between 1997 and 2005.

While the drug gained notoriety as “hillbilly heroin,” because of the large amount sold illegally in Appalachia, its highest rates of sale now occur in places such as suburban St. Louis, Columbus, Ohio, and Fort Lauderdale, Fla., the AP reported.

Legal sales of other pain killers are becoming more prevalent in rural and suburban areas alike. In Appalachia, retail sales of hydrocodone—sold mostly as Vicodin—are the highest in the nation. Nine of the 10 areas with the highest per-capita sales are in mostly rural parts of West Virginia, Kentucky or Tennessee. Sales of codeine, however, see some of their highest rates in communities around Kansas City, Mo., Nashville, Tenn. And throughout Long Island, N.Y.

Other findings from the Associated Press:

  • More people are abusing prescription painkillers because the medications are more available. Though the vast majority of people with prescriptions use the drugs safely, the number of emergency room visits from painkiller abuse has increased more than 160 percent since 1995, according to the government.
  • Many pain-management specialists now say they offer guidance and support to patients but will not write prescriptions, even for the sickest people. They cite high-profile arrests and prosecutions by state and federal authorities for their reluctance. The increase in painkiller retail sales continues to rise, but only barely. There was a 150 percent increase in volume in 2001. Four years later, the year-to-year increase was barely 2 percent.

The DEA cites more than 100 cases of physicians being prosecuted for illegally prescribing drugs to patients. Of those, 16 have been convicted while 83 pleaded guilty or no contest. Eight cases are still pending.

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Ranbaxy receives FDA approval for generic Vicodin

BY Adam Kraemer

PRINCETON, N.J. The Food and Drug Administration has granted approval to Ranbaxy Laboratories for the manufacture and market of hydrocodone bitartrate and acetaminophen tablets USP, 7.5 mg/750 mg, 10 mg/500 mg, 5 mg/500 mg and 10 mg/325 mg strengths, Ranbaxy Pharmaceuticals announced today.

The FDA’s Office of Generic Drugs determined the Ranbaxy formulations to be bioequivalent and have the same therapeutic effect as that of the reference listed drugs as follows: Watson Pharmaceuticals’ Norco, Abbott’s Vicodin and Vicodin ES tablets and UCB’s Lortab tablets.

Total annual market sales for hydrocodone bitartrate and acetaminophen tablets were $390.6 million, according to IMS data.

“Hydrocodone bitartrate and acetaminophen tablets are indicated for the relief of moderate to moderately severe pain, and Ranbaxy is pleased to receive final FDA approval for multiple strengths of this product,” stated Jim Meehan, vice president of sales and marketing for Ranbaxy. “These approvals further expand our product portfolio of affordable generic alternatives and will be launched in a November 2007 time period to all classes of trade.”

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