PHARMACY

Uninsured, young adults less likely to take medications as prescribed, CDC study finds

BY Alaric DeArment

NEW YORK — A desire to save money is driving younger and older adults to request cheaper drugs from their doctors, but it’s also driving younger adults not to take their drugs as prescribed, according to a new study.

The study, by the Centers for Disease Control and Prevention, found that about one-fifth of adults between 18 and 64 years and one-fifth of those 65 years and older were equally likely to request lower-cost drugs, but 12.6% of those ages 18 to 64 years were likely not to take drugs as prescribed, compared with 5.8% of those 65 years and older. Meanwhile, elderly adults with only Medicare coverage were more likely to ask their doctors for lower-cost drugs to save money. Overall, Americans spent $45 million out of pocket on prescription drugs in 2011, according to the Centers for Medicare and Medicaid Services.

Lack of insurance — whether Medicaid or private insurance — was also driving medication nonadherence, with 23.1% of uninsured adults not taking their drugs properly, compared with 13.6% of those with Medicaid and 8.7% of those with private insurance.

While a number of factors drive medication nonadherence, the study — conducted by researchers at the CDC’s National Center for Health Statistics — sheds light on the prevalence of nonadherence as a cost-cutting strategy, as well as the risks involved, such as higher probability of emergency room visits and hospitalizations.

The study also found that about 2% of adults bought drugs from another country to save money, while 6% of those ages 18 to 64 years used alternative therapies, compared with 2.3% of those ages 65 years and older.

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Pharmaceutical balance tipping to specialty side

BY Jim Frederick

The new world of targeted, specialized medicines — many of them bioengineered and many of them aimed at smaller and smaller segments of the population — isn’t just on its way. It’s here. And it’s going to radically change the practice of pharmacy.

Here’s an eye-opener: Specialty drugs will likely account for 50% of all drug costs by 2018, up from 28.7% of total prescription drug costs in 2012.

That’s according to two new studies from pharmacy benefit manager Prime Therapeutics and Blue Cross and Blue Shield of Minnesota. As reported in Drug Store News, April 2, the studies were based on pharmacy and medical claims from 1.2 million commercially insured and continuously enrolled members receiving a drug for hepatitis C or rheumatoid arthritis, and looked at cost-of-care trends for the two disease states.

Specialty drugs, said Sumit Dutta, SVP and chief medical officer for pharmacy benefit manager Catamaran Corp., are now “the primary driver of new product development, where you’ve got new therapies for narrower and narrower diseases.” As opposed to old-line drugs like broad-spectrum antibiotics or statins, he added, many of the new medicines are aimed at “a much smaller group of people in a targeted way.”

Still to come, said the physician, is “the promise of individualized therapies and personalized medicine."

“We’re not there yet but we’re moving toward that,” he predicted recently in an interview.

What will that mean for community, institutional and hospital pharmacy? Will pharmacies of the future be like therapeutic boutiques, where individual patients, pharmacists, physicians, nurse practitioners and other clinicians work in a virtual side-by-side setting, connected electronically and applying genomic research and molecular tinkering as they constantly fine-tune dosages and expensive drug formulations for maximum patient benefit?

One thing seems certain: pharmacists will be called on, more and more, to manage expensive and time-consuming specialty drug therapies for patients with serious, complex and chronic conditions. And in the process, they’ll be making a huge beneficial impact on millions of patients whose lives will depend on those medicines and pharmacist interventions.

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FDA approves first new morning sickness pill in 30 years

BY Alaric DeArment

ROSEMONT, Pa. — The Food and Drug Administration has approved a drug for treating nausea and vomiting during pregnancy.

Drug maker Duchesnay USA said the FDA approved Diclegis (doxylamine succinate and pyridoxine hydrochloride) delayed-release tablets in the 10 mg/10 mg strength for NVP, more commonly known as morning sickness, in women who don’t respond to conservative treatment. NVP is estimated to affect 70-85% of pregnant women, and symptoms range from nausea to severe vomiting and retching that can last throughout the day.

The company said Diclegis was the first FDA-approved treatment for morning sickness in more than 30 years.

"The FDA approval of Diclegis provides an important new treatment to the millions of women suffering from nausea and vomiting of pregnancy and fills a 30-year void in the treatment of NVP," Duchesnay CEO Gilbert Godin said. "Duchesnay USA is honored to bring the only FDA-approved treatment to help control symptoms of morning sickness to market."


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