The Georgia Pharmacy Association
By Andrew Kantor

January 4, 2018

In the country of the blindness cure

In some cases, Spark Therapeutics can cure a rare form of blindness (retinal dystrophy) with a new gene therapy. But how much to charge?

Experts: One. Million. Dollars.

Spark: Nah. How about the bargain price of $850,000? (You can get one eye done for half that, if you like.)

Pundits: Such a deal!

We hope they only mean layoffs

Allergan plans to cull its workers.

Prepare to facepalm

A federal investigation found that just 10 misclassified drugs* cost Medicare $1.3 billion in just four years.

Worse, only four drug makers were responsible for more than half of those “errors,” and just two drugs accounted for 90 percent of those lost rebates.

What drug makers? What drugs? The HHS inspector general won’t say.

Wait wait, it gets better. The problem could be worse, but even if CMS thinks there’s some shenanigans going on, the agency has no power to compel drug makers to provide information. (Mylan got caught in 2016 because its competitor tipped off the government.)

The inspector general thinks this should change.

* When the drug maker tries to pay a lower rebate by claiming a drug is generic rather than a brand-name product

C. diff culprit nabbed

There’s been a quiet epidemic of C. difficile infections around the country over the past 20 years (“the most common microbial cause of healthcare-associated infections in U.S. hospitals,” per the CDC), and no one knew where it was coming from.

Until now. It turns out the culprit is a sweetener called trehalose, which started being added to a lot of food in the early 2000s when the manufacturing cost dropped. Two particular strains of C. diff have genes that let them metabolize it. Result: Infection City.

Pharmacists slow to dispense naloxone

This is pretty shocking: Some pharmacists are apparently reluctant to dispense naloxone to people in danger of overdosing on opioids, citing either the cost (they’re afraid of not being reimbursed) or simply the lack of desire to help addicts.

Yes, really; 29 percent of Kentucky pharmacists said they were simply unwilling to dispense it.

Remember: In Georgia (like most states) pharmacists do not need a prescription to dispense naloxone, nor any extra training. You only need a copy of the standing order of the commissioner of public health, available at GPhA.org/naloxone.

One months of ads

AbbVie was pharma’s biggest advertising spender in December 2017, shelling out $30.9 million on ads for Humira.

Pfizer wasn’t far behind, though, with a combined $26.6 million to promote Xeljanz XR and Lyrica during the month. (If you include the $16.7 million it and Bristol-Myers Squibb spent promoting Eliquis, Pfizer actually tops the list.)

Johnson & Johnson took the number-three spot with $23.5 million on Xarelto.

Bandwagon Watch™

Add Randolph County, N.C., and Rockford, Ill. (home of the Rockford Peaches!) to the list of places suing opioid manufacturers.

January 3, 2018

URGENT NEWS IF YOU’RE UNDER 40

It looks like chocolate will be gone in about 40 years as the cacao plant succumbs to global warming.

But there’s a ray of hope: Scientists from the University of California are teaming up with Mars (the company, not the god) to use — you guessed it — CRISPR to try to save the plant.

Cacao plants occupy a precarious position on the globe. They can only grow within a narrow strip of rainforested land roughly 20 degrees north and south of the equator, where temperature, rain, and humidity all stay relatively constant throughout the year. Over half of the world’s chocolate now comes from just two countries in West Africa — Côte d’Ivoire and Ghana.

As the climate changes, it pushes the growing area further up the mountains to the point it becomes inaccessible.

You look sick

Yes, humans can tell if one another are sick just by looking. So says a paper published in the Proceedings of the Royal Society B*. But why read a dry academic paper when you can read the plain English version from the Washington Post?

* You would think they could come up with a better name. That’s like naming your son “Steve” and your second son “Steve B.”

Patient co-pays and “accumulator” programs

Drug Channels’s Adam Fein writes about what he says are going to get a lot of attention this year: Co-pay accumulator programs.

In a nutshell:

  • Many people have a separate prescription deductible as part of their health insurance. Co-pays come out of this deductible.
  • When co-pays are high, drug makers often gives patients coupons to help cover them.
  • Those co-pays are between the patient and the drug maker, so patients still count their full co-pays against their deductibles. (It’s as if a friendly relative helped pay for their meds.)

But that, says Fein, is starting to change. Health plans are beginning to say, “If the drugmaker gives you a coupon, it doesn’t count against your deductible.”

And that will be a shock for a lot of patients, who suddenly have to bear a much larger share of their annual prescription costs because these coupons effectively count against them.

As Fein explains, adding insult to injury, PBMs give these policies names like “Out of Pocket Protection program.” And, he says, “Every word in those names is wrong.”

Moo

No, avoiding cow’s milk doesn’t prevent diabetes. So concludes a fairly large, long-term study that found “Cow’s Milk Doesn’t Play a Critical Role in Development of Type 1 Diabetes.” (That’s the news story, click here for the study in JAMA.)

Provider status hits a Senate milestone

APhA reports that 51 U.S. senators have now co-signed the big provider-status bill, the Pharmacy and Medically Underserved Areas Enhancement Act.

It would have Medicare pay for “certain pharmacist services that: (1) are furnished by a pharmacist in a health-professional shortage area, and (2) would otherwise be covered under Medicare if furnished by a physician.”

Contact your senators and ask them to support S. 109.

Johnny Isakson: Phone: (770) 661-0999; fax: (770) 661-0768

David Perdue: Phone: (404) 865-0087; fax (404) 865-0311

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