I heard it through the GRAPEVINE

Posted on April 27, 2022 by Pharmaciststeve

It is a pretty accepted fact that the chronic pain community is – and has been – very divided… It seem that a small group of people who claim to be chronic pain pts and/or chronic pain advocates have been very busy at work trying to be more than just the “usual stuff” starting late summer – early fall last year. First it my blog getting labeled as a SPAMMER by FACE BOOK… some even made up stories about another chronic painer being the reason behind my blog being labeled as a SPAMMER.  Then there was the APDF protest in DC  last fall and one of the BOD members had done a TV interview with all three station in DC…  and some people called the station the day before the protest and told the newsroom that the protest was actually a PLANNED MASS SUICIDE and the interviews done…. were never aired…

During that same time frame, these same people, started calling and email one of the highly visible chronic pain pt’s pain doctor and apparently fabricating so many lies about the pt… that the pt was discharged from the pain practice that the pt had been going to for 27 yrs.

The question has to be asked, are these people who are putting themselves forward as pain pts and/or pain advocates or are they really just shills. What legit chronic pain pt goes out their way and fabricate lies/stories to try and get a chronic pain pts toss out of their pain clinic… knowing how difficult it is for a intractable chronic  pain pt to get into a new clinic. IMO… that has to done only by some people with a very depraved mind set.

IMO… it may get worse from here… have you noticed that there are a few “pain advocates” have been in hyper-mode…  talking about pts getting some severe side effects from using certain medications, or promoting some products for chronic painers to get/take when they have had their pain meds taking away…

Just be careful who you give your personal information to…  if someone is pushing a product, or you get a phone call from some law firm about physical damages you have experienced from taking one or more particular prescription medication(s) or you are “hooked-up ” with some entity selling some supplement that some claim helps with pts dealing with chronic pain or you are contacted by some entity – like a university – that is starting a new “pain study”…  because someone has gotten PAID to share your name/personal information or if you have purchased some product that they were pushing.

You may think that is perfectly OK for someone to monetize the selling of your personal information without your permission, but some of these individuals may be more interested in advocating for the money in their bank account.

Full disclosure: In the ten+ years I have had a active blog and advocating for chronic pain pts, my goal has always been to educate and motivate the chronic pain pt to advocate for themselves. I have NEVER requested money from pts that have sought out my advice, I have even turn down some of who have offered to pay me, I have never shared nor sold any personal pt information to any entity for my personal financial gain.  After this post is published, I expect that some of these “chronic pain advocates” to come after me…  I went to pharmacy school to help people and even though I am retired, I follow what I believe is my true advocacy.

 

 

 

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21st century healthcare: Medical McCarthyism, when errors become crimes

Posted on April 26, 2022 by Pharmaciststeve

Until COVID-19 became a issue, historically… medical errors was the third largest cause of death. After Cancer and cardiovascular. Has the DOJ and our judicial system got a “taste of blood” as more and more prescribers are being taken to court over mostly fabricated violations of the Controlled Substance Act.  As more and more District Attorneys are refusing to charge many criminals, is those in our judicial system just looking for any case that they can justify their paycheck ?

Selective Outrage in Healthcare, RaDonda Vaught vs. William Husel

https://www.daily-remedy.com/selective-outrage-in-healthcare-radonda-vaught-rn-vs-william-husel-do/

We lie all the time.

We pretend to care about things we really do not and we pretend not to care about things that we really do. We have no consistent parameters guiding our behavior.

We watch identical acts of injustice or see similar tragedies unfolding and have vastly different perceptions. Behavioral economists call this the empathy gap.

We underestimate the influence of subjective beliefs on our own behavior and make decisions that only satisfy our current perceptions. It explains why the loss of European lives in Ukraine attracts greater media attention than the loss of lives of Central Asians in Afghanistan. This is not a new phenomenon.

But it appears in healthcare in uniquely unprecedented ways. The increasing government encroachment into healthcare has led to a slew of highly publicized criminal cases that were previously addressed more privately as regulatory concerns. Now medical errors are criminal acts.

This may be tragic enough, but our wavering response to these tragedies adds a veneer of shame to a dark time in healthcare, and will prove to be an indelible stain on our medical history.

Recently, a nurse in Tennessee named RaDonda Vaught was convicted for murder for what otherwise would be deemed a medical error. While a fatal error, it was an error nonetheless, that took place over the course of patient care. It should have been handled by the state’s medical licensing board and nurse oversight committees.

Instead, local prosecutors took it upon themselves to indict and inflict a vicious display of retaliatory justice in which Vaught found herself convicted by a jury for a medical error. The ramifications were quick and powerful.

Nurses all over the country shouted in protest. Nurses quit. The American Nurses Association issued a statement of concern:

“The nursing profession is already extremely short-staffed, strained and facing immense pressure – an unfortunate multi-year trend that was further exacerbated by the effects of the pandemic. This ruling will have a long-lasting negative impact on the profession.”

The outrage in support for Vaught was commendable. It shows a strong sense of solidarity in support of one healthcare worker. Such displays of support are sorely needed. And have strong reason to believe the government encroachment that led to Vaught’s conviction will be challenged. We likely have not heard the last of this case.

What we have not heard of is another ruling, that of an acquittal, for a physician who was indicted for prescribing fentanyl as a form of palliative care for hospice patients under his care. Dr. William Husel was indicted on fourteen counts of murder for treating patients with fentanyl to relieve their pain in the last days of their lives.

He violated no protocol. He adhered to clinical standards of care. He simply prescribed fentanyl at a dose that a non-medically trained prosecutor somehow believed to be excessive and therefore criminal. There was no clinical or legal basis for the charges. Yet he was made to endure a two month trial for what amounts to practicing clinical medicine.

Yet there is no outrage against the prosecutors in this case. No congratulatory support for the physician who risked life imprisonment to challenge bogus claims of criminality.

Why the glaring difference in response from the public?

At least in the cause of Vaught, an error took place. But Dr. Husel committed no error and ensured a pain-free quality of life for patients at the end of their lives. We clamor for justice in one case, and remain silent for the other.

This is what the empathy gap looks like in healthcare. And it is why little has been done to reign in government encroachment in healthcare. We have no consistent response to individual acts of injustice and therefore no consistent means of challenging government misconduct. Shakespeare recognized as much centuries ago when he wrote the following lines in The Merchant of Venice:

If you prick us, do we not bleed?

If you tickle us, do we not laugh?

If you poison us, do we not die?

The lines allude to the lack of compassion we hold for some but carry in abundance for others. It shows how empathy waxes and wanes and leads to different reactions to similar events. It is why Vaught’s conviction led to national outrage and why Husel’s acquittal hardly registered a blip on the national radar.

Healthcare is facing unprecedented pressure from a government encroaching more and more into healthcare. It has induced a state of fear and artificial conformity – a veritable state of Medical McCarthyism.

It manifests when we see errors become crimes. Yet, our inconsistent responses have allowed this to go on. We feign selective outrage when we see someone we can relate to being attacked. We ignore or show disdain when we see someone we cannot relate to being attacked.

Accordingly, our perceptions flutter. Of course, the physician deserved to be indicted. Of course, the physician got away with it. But the poor nurse, she must be a victim. Even if she made an error, she should not be criminalized for an error that could have happened to anyone.

We attribute systemic errors to the individual when convenient. And we remember the nuance in systemic problems when we can identify with the individual. There are no consistent parameters in our response.

It all depends on the perceptions we hold, fluttering amidst the winds of outrage, emerging out of the void of the unknown, where we find the empathy gap.

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East Brady woman sues CVS over face mask dispute

Posted on April 25, 2022 by Pharmaciststeve


East Brady woman sues CVS over face mask dispute

https://www.butlereagle.com/20220425/east-brady-woman-sues-cvs-over-face-mask-dispute/

An East Brady woman has filed a lawsuit against CVS alleging she had no alternative but to resign because the company would not allow her to wear a face shield instead of a face mask that caused her to faint.

Through her attorney, Brittany Beham filed the suit in Butler County Common Pleas Court against Pennsylvania CVS Pharmacy, LLC, which operates the CVS inside the Target in Butler Commons in Butler Township where she worked as a pharmacy intern from March 2016 to September 2020, according to the suit.

Beham suffers from panic disorder with syncopal, or fainting episodes, and experienced several episodes from March through June of 2020 as a result of wearing a face mask, according to the suit.

During that time, she claims that she told her supervisor on several occasions that wearing a mask was causing the episodes. While on short-term disability leave from June 18 to July 21, 2020, she was treated by a therapist, but could not take anti-anxiety medicine because she was pregnant, according to the suit.

She completed and submitted a reasonable accommodation questionnaire, asking for permission to wear a face shield instead of a mask to prevent further episodes, and submitted a note from a nurse at Butler Health System Women’s Care Associates, saying she cannot wear a mask due to the episodes, but she can wear a shield.

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Pfizer recalls some batches of blood pressure drug over carcinogen presence

Posted on April 24, 2022 by Pharmaciststeve

Pfizer recalls some batches of blood pressure drug over carcinogen presence

Pfizer has yet to receive any reports of adverse effects related to the recalled batches

https://www.foxbusiness.com/healthcare/pfizer-recalls-batches-blood-pressure-drug-carcinogen

Pfizer said Friday it was voluntarily recalling five batches of its Accupril blood pressure tablets after finding elevated levels of a potential cancer-causing agent in the medicine.

The drugmaker said it was not aware of any reports of adverse events related to the recalled batches, which were distributed in the United States and Puerto Rico from December 2019 to April 2022.

Pfizer Canada also recalled all lots of three doses of Accupril Thursday after finding the same impurity to be above acceptable levels.

Pfizer said there was no immediate risk to patients taking this medication, in which the agent, a nitrosamine, was found.

 Exterior view of a Pfizer building in Berlin.  (Ulrich Baumgarten via Getty Images / Getty Images)

Nitrosamines are common in water and foods, but exposure above acceptable levels over long periods of time could increase the risk of cancer.

Pfizer last month also recalled some batches of another blood pressure drug, Accuretic, and two authorized cheaper versions due to the presence of the possible carcinogen.

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Japan’s Shionogi says COVID-19 pill shows rapid clearance of virus

Posted on April 24, 2022 by Pharmaciststeve

Japan’s Shionogi says COVID-19 pill shows rapid clearance of virus

The company has global aspirations for the antiviral pill

https://www.foxbusiness.com/healthcare/japans-shionogi-says-covid-19-pill-shows-rapid-clearance-virus

An experimental treatment from Shionogi & Co. Ltd. has shown rapid clearance of the virus that causes COVID-19, according to new data, the Japanese drugmaker said Sunday.

The pill, S-217622, “demonstrated rapid clearance of the infectious SARS-CoV-2 virus,” Shionogi said in a statement, citing results from a clinical trial of the drug.

The company has global aspirations for the antiviral pill, which is now being evaluated by Japanese regulators.

The findings released Sunday also showed “there was no significant difference in total score of 12 COVID-19 symptoms between treatment arms,” although the drug showed improvement in a composite score of five “respiratory and feverish” symptoms, Shionogi said.

 A ground crew member moves pallets of a shipment of Pfizer’s antiviral COVID-19 pills, Paxlovid, as they arrive at an Incheon International Airport cargo terminal Jan. 13, 2022, in Incheon, South Korea. ( Jung Yeon-Je, Pool/Getty Images / Getty Images)

The drugmaker said in March it would launch a global trial for the drug with U.S. government support, and Chief Executive Isao Teshirogi has said production could reach 10 million doses a year.

Shionogi’s shares have been on a roller coaster on speculation about success of the treatment. The stock climbed Friday after a report the U.S. government is in talks to acquire supplies of the drug.

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Biologics for JIA? Not So Fast, Say Insurers

Posted on April 24, 2022 by Pharmaciststeve

Biologics for JIA? Not So Fast, Say Insurers

— Nearly all required prior authorization in a small study, and requests often rejected at first

https://www.medpagetoday.com/rheumatology/arthritis/98368

A photo of a young girl holding her painful hand.

It’s not a simple matter to prescribe tumor necrosis factor (TNF) inhibitors for patients with juvenile idiopathic arthritis (JIA), at least those with insurance, a single-center study found.

Among 54 patients seen at Boston Children’s Hospital for newly diagnosed JIA in 2018-2019, their insurers required prior authorization for all but one, according to researchers there led by Jordan E. Roberts, MD.

And for 14 of those, the initial requests were denied, the group reported in JAMA Network Open. Four of the patients ended up taking another type of medication because of the denials, although TNF inhibitors were eventually approved for all 54.

That latter finding indicates that insurers’ policies “present barriers to care despite appropriate specialty medication requests,” Roberts and colleagues argued — a situation also faced by adults with rheumatoid arthritis and similar conditions for which TNF inhibitors are a standard of care.

In many cases, insurers insisted on particular forms of “step therapy” with either (or both) nonsteroidal anti-inflammatory drugs (NSAIDs) or nonbiologic disease-modifying anti-rheumatic drugs (DMARDs) before they would authorize TNF inhibitors.

For some patients, insurers demanded that patients receive a different TNF inhibitor from that prescribed by clinicians. Four such patients, for example, were required to take adalimumab (Humira) instead of etanercept (Enbrel) or infliximab (Remicade). “Infliximab’s intravenous formulation allows for more precise weight-based dosing than subcutaneously administered [TNF inhibitors],” Roberts and colleagues pointed out.

In other cases the insurer simply decreed that TNF inhibitors were not a “medical necessity,” even though clinicians judged that their patients were not responding adequately to nonbiologic therapy. TNF inhibitors are “strongly recommended” in the most recently published guidelines, and were already central to treatment as far back as 2011.

In fact, 91% of the patients in the Boston Children’s study had previously received conventional DMARDs and 61% had taken NSAIDs. Mean patient age was 10 and just over half were girls; no particular JIA subtype was predominant.

Median active joint count was 2 (interquartile range 1-4) when TNF inhibitors were first recommended, and medians for patient/parent and clinician global assessments stood at 3 on a 10-point scale, with 10 representing the most burdensome disease.

Both figures suggest that most patients were experiencing some degree of difficulty that TNF inhibitor therapy could help relieve.

Public insurance (n=10) was no better than private in terms of the barriers erected, the admittedly limited data indicated. Denials of initial requests ensued in 30% of these cases, compared with 25% of patients covered by private insurance, and median times to approve prior authorization and to start TNF inhibitor treatment after the requests were made were similar (2.5 vs 3 days and 20 vs 24 days, respectively).

While a 3-week wait to begin recommended therapy may not seem long, Roberts and colleagues observed that early aggressive treatment has been tied to improved outcomes.

Limitations to the study were the small number of patients and its location in Massachusetts, where Medicaid is “relatively comprehensive”; formularies differ considerably among state Medicaid programs as well as among private insurers.

In this small study – mean aged of pt was 10 y/o – and bodily damage caused by juvenile idiopathic arthritis (JIA) is NON-REVERSIBLE so the denial by these insurance companies – per this survey … the time between first being prescribed and receiving the TNF inhibitor … Initially the joint damage on a 1-10 scale was a TWO and by the time that the insurance companies stopped playing around – THREE WEEKS – with prior authorizations… the joint damage had progress ONE WHOLE POINT.

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ALL HAT AND NO CATTLE

Posted on April 23, 2022 by Pharmaciststeve


Isn’t there someone in Rhode Island that professes to be a strong advocate for chronic pain pts ?  I know when people reach out to me, I try to get back with them the same day and no later than the next day. I have been watching the TV show YELLOWSTONE and they have a phrase they use that may be appropriate here ” “they” must be ALL HAT AND NO CATTLE”  To make sure that I was correct about the definition.  I found this on the web https://wordhistories.net/2020/12/07/all-hat-no-cattle/  to have or cultivate a particular image or reputation which has no basis in reality

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Why employees of major pharmacy chains are quitting their jobs

Posted on April 22, 2022 by Pharmaciststeve


It’s my last day at the WAG and this is my final (i think) draft of the email that I‘ll send to upper management as I end my shift. I held back many unprofessional words but also wanted them to hear my frustration for not just myself but all other pharmacists and techs.

This is a final “goodbye letter” to Walgreen after 7 yrs working up to being a pharmacy manager. All the things/tasks that this tech is referencing in this letter is in the industry as “metrics”.  Generally this is something that your local independent pharmacy doesn’t worry about. When I had my own independent pharmacy… the “metrics” that I looked at… was the number of prescriptions filled and $$ generated this month compared to the previous month or the same month one year ago..  Once a month that took – MAYBE – 10-15 minutes of my time.  If my pharmacy was filling more prescriptions and generated more revenue – it was easy to come to the conclusion that we were doing something right…  if those numbers did not increase, we were doing something wrong and we need to find out what it is and how we make adjustments.  These pharmacy chains seem to want to over analyzes even minute details. Often they waste all of these staff hours trying to figure out how they could cut staff hours and generate more profits for the corporation. When work feels more like a battlefield, it’s essential to take steps to cope and improve your experience.

If you patronize a chain pharmacy and you wonder why you have to wait too damn long to get your prescriptions filled… or the pharmacy doesn’t have your meds in stock or why the Rx dept staff looks like they are running on a tread mill all the time… or why you can’t get them to answer the phone when you call.

If you are tired of being treated just like another number when you are trying to get your necessary medication filled… here is a hyperlink to find a independent pharmacy by zip code https://ncpa.org/pharmacy-locator

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APDF runs on donations – please use these apps to donate

Posted on April 22, 2022 by Pharmaciststeve

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I’m looking for someone from Michigan affected by the high costs of insulin for a reporter

Posted on April 22, 2022 by Pharmaciststeve


I’m looking for someone from Michigan affected by the high costs of insulin for a reporter. Here’s the info. You can call. Today, I’m wrapping up a story on drug prices, and that includes the Afford Insulin Now Act that would cap insulin cost-sharing at $35 — at least for some people.
. Unfortunately, I’m on a tight deadline. Might you know anyone in Michigan who can help? The best way to reach me is 734-725-1155. Please feel free to share that number.
Many thanks for all the help. Unfortunately, I’m on a tight deadline. Might you know anyone in Michigan who can help? The best way to reach me is 734-725-1155. Please feel free to share that number.
Many thanks,
Robin Erb
Michigan Health Watch
Read my latest.
Bridge Michigan
(734) 725-1155

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