What a pain expert has to say

Posted on October 28, 2015 by Pharmaciststeve

stevemailbox

My position on the opioid controversy is quite simple and I ask all concerned to consider it:
 
1. We have a long-standing standard known as the World Health Organization 3 Step Analgesic Ladder (1982).  Only when non-opioid treatments fail are opioids used because about everyone knows they have complications;
 
2. there cannot be a cap on dosages as patients vary.  The government should certify or recognize the MDs who will prescribe high dose opioids so patients who need high dosages can get the help they need;
 
3. Patients who are currently on opioids and doing well should be left on them.
 
Please help spread my view.
 
 
 
Best wishes always,
Forest Tennant
 
Contact Information:
 
Forest Tennant M.D., Dr. P.H.
Veract Intractable Pain Clinic
338 S. Glendora Ave.
West Covina, CA 91790-3043
Clinic Ph: 626-919-0064
Clinic Fax: 626-919-0065
Office Ph: 626-919-7476
Office Fax: 626-919-7497
 

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Out of TWO MINUTES… addiction is mentioned multiple times…disease mentioned once

Posted on October 28, 2015 by Pharmaciststeve

Another attorney and parent that has lost a child to the mental health disease of an addictive personality and he shows  up at a “Heroin Symposium”  when his kid died from alcohol/drug abuse. During a two minute piece, only ONCE was there a mention of addiction being a disease… but not one mention of addiction being a mental health disease.

 

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Pts have to account for every control dose given since birth ?

Posted on October 28, 2015 by Pharmaciststeve

analRPH

This is a ADD/ADHD pt that according to “Pharmacist Bob” has failed to account for ONE DOSE every 10 weeks over the last FOUR YEARS.  It sounds like “Pharmacist Bob” has filled this person’s C-II Rx monthly over all those years.. and now he takes 45 minutes to tie out the tablet count over a FOUR YEAR time span.

I wonder if “Pharmacist Bob” takes this much time and is that critical of pts that don’t routinely take their medications ? After all, pts will be harmed if they don’t properly take their medications routinely.

I also wonder if you went back and totaled up the overage/shortages in the Pharmacy register over the last four years.. if it would “tie-out”… After all if there was a overall shortage.. that would mean that the company lost money and if it was over.. then pts lost money..

Those who expect “PERFECTION” from other human beings.. had better be PERFECT themselves.. unless they don’t mind being a hypocrite !

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Son dies after abusing substances for 10 yrs..

Posted on October 27, 2015 by Pharmaciststeve

Increase in Drug Overdose Deaths Leads to State Action Plan

The state is trying to stop a growing drug abuse epidemic with a new plan to monitor powerful prescription painkillers. The Drug and Opioid Abuse Task Force released several recommendations to the Governor on Monday.

The nearly 30 recommendations are aimed at preventing and treating drug abuse. According to the report, in just eight years the number of opiod prescriptions in Michigan has quadrupled to nearly 750 million.

One of the proposals is increased monitoring of pain killer prescriptions. The task force wants to overhaul the state’s Automated Prescription Service, which tracks painkillers that doctors prescribe.

“It needs to be fixed, it needs to be repaired,” said Michigan Attorney General Bill Scheutte. “Think of it as a search engine that’s decades old and it means it really can’t function in today’s world and it needs to operate 24/7 365 days which it doesn’t today.

Using the database is optional right now but the task force want it to be a requirement for every doctor. That would have track down people who are abusing the system, and let doctors see if a patient has already been prescribed a pain killer by another doctor.

“Sometimes its a small percentage of unscrupulous doctors who operate pill mills and over-prescribe,” Scheutte said. “What it does and it has resulted in this country and in Michigan an epidemic of crisis proportions.”

Dealing with doctors is just the start, the task force is also trying to get medications off the street by expanding drug take-back programs.

Another goal is to help addicts. The task force is proposing removing criminal penalties for reporting an overdose or seeking medical attention for one.

The task force also wants to make Narcan, the emergency drug that can reverse the effects of an overdose, more accessible. It’s proposing letting pharmacists dispense the injection, similar to current EpiPen policies.

Getting true change will take action, something the State Medical Society says it wants to see.

“Governor Snyder has done a great job bringing together the various stakeholders to deal with a difficult issue. Everyone involved has a shared interest in reducing drug overdoses and related deaths. MSMS has been working on this issue for many years and in our experience the key to the success is in getting the recommendations implemented.”

But for people who work with addicts like Mike Hirst, it’s going to take the community’s help to make a true change.

“Everybody has to be working on the same problem from different angles, there’s no magic bullet here,” Hirst said.

But Hirst says tackling the opioid abuse problem with also help the state tackle a growing heroin abuse problem. Hirst’s son, Andrew Hirst, was 24-years-old when he died of a heroin overdose. Hirst says his son’s addiction started with pain killers but ended with heroin, a cheaper and readily accessible option. Working with recovering addicts, Hirst says the majority of additions started with pills.

“They get a tooth pulled and they were prescribed Vicodin or Percocet and they felt great taking that drug,” Hirst said. “That set them on their way and they were searching that drug out after that.”

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When healthcare providers are more of the problem than the solution

Posted on October 27, 2015 by Pharmaciststeve

 Importance of Health Insurance

Health insurance is a health insurance risk hedged against the probability that if and when someone unexpectedly becomes sick, requires expensive treatments, or is at the mercy of a chronic condition that requires long-term care they will not fall into dire financial straits.

Who will pay for all of the medical expenses?™

High-quality health care affects health and wellness. A health insurance policy is a contract between an insurance company and a policy holder intended to safeguard against high and unexpected health care costs. Although policy-holders pay a monthly premium, co-payments, co-insurance, and deductibles, it is expected that the total is far less than that required if paid fully out-of-pocket.

Though everyone wants to live longer, the real focus should be on achieving and maintaining optimal wellness throughout life. To do this, seek healthcare services at a good place like clinic chiang mai, where medical professionals prioritize wellness and holistic medicine.

Health insurance is a benefit provided through a government agency, private business, or non-profit organization. To determine cost, a provider estimates collective medical expenses of a population, then divides that risk amongst the group of policy subscribers. In concept, insurers recognize that one person may incur large unexpected expenses, while another may incur none. The expense, then, is spread among a group of individuals to make health care more affordable for the common good of all. In addition, public health programs like Medicare, Medicaid, and SCHIP are federally-funded and state-run to provide additional medical coverage to those in vulnerable groups who qualify, such as seniors and those with disability. Try out meticore if you are looking to improve your dietary results.

An individual with Cerebral Palsy will likely require specialized medical services throughout his or her lifetime. The expense for a chronic disability can greatly exceed the expense for standard care an individual without the condition incurs. Cerebral Palsy results in a chronic, physical impairment, which typically involves routine doctor visits, extended hospital stays, a range of therapies, planned surgeries, drug therapy, and adaptive equipment. Depending on the level of impairment, Cerebral Palsy usually requires a comprehensive, multidisciplinary health care team that may include any combination of the following: pediatrician, neurologist, radiologist, orthopedic surgeon, physical therapist, occupational therapist, and vocational therapist. Some individuals also require the assistance of a registered dietician, a speech pathologist, ophthalmologist, urologist, and a cosmetic dentist, amongst others.

Coverage from a health insurance policy or a public health program can greatly relieve the financial burden of health care expenses due to Cerebral Palsy. Those who are uninsured or underinsured can experience financial strain and require assistance from alternative funding sources such as community groups, charity organizations, or local business establishments. When no health insurance exists, providers often request payment in advance of services, or a payment plan agreement. Resurge is one the most natural weight loss supplements.

Health insurance offers long-term protection and contributes to a family’s physical, emotional and financial well-being.

CHECKLIST
Health insurance

Many choices must be made when choosing a health insurance option. Some recommended steps to follow during the selection process include:

  • Review helpful health insurance terminology. Understanding health insurance lingo assists with understanding the benefits each plan truly delivers.
  • Create a checklist of family health insurance needs. Make a list of health insurance coverage preferences you know your family will require. For example, should prevention or major medical coverage be the priority? Will dental, vision, and prescription coverage be necessary? Once complete, the checklist is used to evaluate and compare health insurance providers, plan choices, and coverage offered.
  • Research available health insurance providers. Does a parent’s employer offer insurance plans? If so, when is enrollment and what are the options? Does the parent belong to any clubs, special interest groups, or organizations that offer health insurance? Are they eligible and approved for any government insurance plans? Do they want to pursue an independent provider?
  • Decide between an indemnity plan or a managed care plan. If considering a managed care plan, determine which type of coverage best suits the family’s needs–indemnity, HMO, PPO or POS.
  • Request a quote for one or two appealing plan options.
  • Review policy provisions against checklist of family health insurance needs.
  • Decide whether the quote is within the family’s financial means.
  • Apply for the plan of choice.

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100,000 die every year from hospital/nursing home acquired infection

Posted on October 27, 2015 by Pharmaciststeve

Bacterial infection suspected in deaths of four at Pennsylvania hospital

http://www.cnn.com/2015/10/27/health/bacteria-york-hospital/

(CNN)A Pennsylvania hospital said Monday that it’s telling about 1,300 open-heart surgery patients they could have been exposed to a bacterial infection after identifying eight patients who contracted nontuberculous mycobacterium, or NTM. Four of those patients died.

The Centers for Disease Control and Prevention stopped short of directly linking the deaths to the infection, as all four for of the patients had underlying medical conditions. But the hospital acknowledged that the infection probably was a contributing factor.

NTM is a naturally occurring bacterium found in soil and water, including, sometimes, tap water. People become infected by inhaling the bacteria, according to the American Lung Association. Most people do not become ill, although those with weakened immune systems are at risk. This can include someone recovering from an invasive procedure. The result is a pulmonary illness that can take more than a year of antibiotic treatment to cure.

WellSpan York Hospital in York, Pennsylvania, is contacting all patients who underwent open-heart surgery between October 1, 2011, and July 24, 2015.

“We know that the news of this potential risk of infection may be concerning to our open-heart patients, and we sincerely regret any distress that it may create for those patients and their families,” said Keith Noll, senior vice president of WellSpan Health and president of WellSpan York Hospital.

In July, a study published in the medical journal Clinical Infectious Diseases found a risk of bacteria escaping from heater-cooler devices used during open-heart surgeries. The devices heat or cool the patient during surgery and usually stand about 8 to 10 feet away, said Brett Marcy, a spokesman for WellSpan Health.

According to a news release, the infection risk is thought to be limited to the patients who underwent the surgery. No physicians, clinicians, staff or patients who had noninvasive heart procedures were at risk.

“The safety, health and well-being of our patients is always our highest priority,” Noll said. “That is why we took this very seriously and immediately notified state and federal health officials and requested their assistance and guidance.”

The hospital also replaced its heater-cooler devices with new equipment in late July after consulting with the Centers for Disease Control and Prevention and the Pennsylvania Department of Health. “The new equipment is being meticulously maintained according to the enhanced cleaning procedures,” Noll said.

He’s referring to steps recommended by the Food and Drug Administration that hospitals can implement when using these devices, including not using tap water; taking environmental, air and water samples; and directing the vent of the device away from the surgical field.

They were issued as part of a safety communication from the FDA this month because the problem may be more widespread. According to the FDA, there were 32 reports of patient infections associated with heater-cooler devices or bacterial heater-cooler device contamination between January 2010 and August 2015. Of those reports, eight were in the United States, and most of the other 24 were in Western Europe, the agency said. And 25 of the reports were made this year. Not all of the reports were among patients who had undergone cardiac surgery, but some reports don’t identify the procedure the patient had undergone, the safety communication states.

Last week, the CDC issued recommendations to health officials, health care providers and health care facilities to be on the lookout for any such cases and to take steps to prevent them. It is working with local and state health officials, as well as the FDA.

“The most important action to protect patients will be to remove contaminated heater-coolers from operating rooms, and ensure that those in service are correctly maintained,” the CDC says.

The CDC also asks patients who have undergone cardiac procedures to tell their doctor if they were exposed to this device or if they are experiencing a combination of symptoms, including fever, pain, redness, heat or pus around their surgical incision, night sweats, joint or muscle pain, and fatigue.

WellSpan York is the second hospital in Pennsylvania associated with a potentially deadly infection in recent months. In September, the University of Pittsburgh Medical Center voluntarily suspended organ transplants after three transplant patients died after contracting a fungal infection.

Marcy stressed the situations at the two hospitals are unrelated.

“No connection between Pittsburgh and here; this is different scenario,” he said.

CNN’s AnneClaire Stapleton and Debra Goldschmidt contributed to this report.

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IT’S OFFICIAL: Walgreens is buying Rite Aid

Posted on October 27, 2015 by Pharmaciststeve

IT’S OFFICIAL: Walgreens is buying Rite Aid

http://www.businessinsider.com/its-official-walgreens-is-buying-rite-aid-2015-10

If the FTC allows this merger to happen that means that abt 60% of all chain pharmacy outlets will be controlled by TWO NAMES ! and abt 25% of all community pharmacies.  The possible real TROJAN HORSE is that both of these mega players will have  PBM’s (Prescription Benefit Managers) that controls what/how much  and when other pharmacies – their competitors – get paid for prescriptions filled at their competitors. The various PBM’s have been notorious on “dragging their feet” on reimbursing pharmacies at current cost of the medication that the pharmacy has to pay from the wholesaler. Ultimately being able to highly influence if a competitor is capable of making a profit and even just staying in business.  Just during 2015 the two major PBM’s ( Express Scripts & CVS Health) stopped paying for specialized compounded medications and new expensive LIFE SAVING MEDICATIONS. While all of these mergers talk about economy of scale… the result will could be poorer service at the store level and more denial of assess to certain medications or categories of medications.

Walgreens Boots Alliance just announced plans to buy Rite Aid Corp. for $9 per share.

That values Rite Aid at $9.4 billion. The deal is valued at $17.2 billion, including debt.

That’s a 48% premium to the closing price per share the day before the agreement was signed.

Rite Aid shares were up as much as 40% earlier Tuesday after news broke of a potential deal. In after-hours trading, shares were down about 6.92%.

“Our complementary retail-pharmacy footprints in the US will create an even better network, with more health and wellness solutions available in stores and online,” Walgreens CEO Stefano Pessina said in a statement.

He added: “Walgreens Boots Alliance will provide to Rite Aid its global expertise and resources to accelerate the delivery of integrated frontline care, and to offer innovative solutions for providers, payers, and other entities in the US healthcare system.”

He also said they would realize “synergies over time.”

Once they’re combined, the companies expect to cut over $1 billion in annual expenses.

Walgreens plans to finance the deal with cash by issuing new debt and assuming existing debt.

Citigroup is the sole adviser to Rite Aid. UBS is advising and arranging bridge financing for Walgreens.

Here’s the press release:

DEERFIELD, Ill. & CAMP HILL, Pa.–(BUSINESS WIRE)–Walgreens Boots Alliance, Inc. (Nasdaq: WBA) and Rite Aid Corporation (NYSE: RAD) today announced that they have entered into a definitive agreement under which Walgreens Boots Alliance will acquire all outstanding shares of Rite Aid, a U.S. retail pharmacy chain, for $9.00 per share in cash, for a total enterprise value of approximately $17.2 billion, including acquired net debt. The purchase price represents a premium of 48 percent to the closing price per share on 26 October 2015, the day before the agreement was signed. The combination of Walgreens Boots Alliance and Rite Aid creates a further opportunity to deliver a high-quality retail pharmacy choice for U.S. consumers in an evolving and increasingly personalized healthcare environment.

Walgreens Boots Alliance is highly focused on building a differentiated in-store experience for health, wellness and beauty, and this combination will help accelerate Rite Aid’s own efforts toward that end. Once the acquisition closes, Walgreens Boots Alliance plans to further transform Rite Aid’s stores to better meet consumer needs.

“Today’s announcement is another step in Walgreens Boots Alliance’s global development and continues our profitable growth strategy. In both mature and newer markets across the world, our approach is to advance and broaden the delivery of retail health, wellbeing and beauty products and services,” said Walgreens Boots Alliance Executive Vice Chairman and CEO Stefano Pessina. “This combination will further strengthen our commitment to making quality healthcare accessible to more customers and patients. Our complementary retail pharmacy footprints in the U.S. will create an even better network, with more health and wellness solutions available in stores and online. Walgreens Boots Alliance will provide to Rite Aid its global expertise and resources to accelerate the delivery of integrated frontline care, and to offer innovative solutions for providers, payers and other entities in the U.S. healthcare system. Finally, this combination will generate a stronger base for sustainable growth and investment into Rite Aid stores, while realizing synergies over time.”

“Joining together with Walgreens Boots Alliance will enhance our ability to meet the health and wellness needs of Rite Aid’s customers while also delivering significant value to our shareholders,” said Rite Aid Chairman and CEO John Standley. “This transaction is a testament to the hard work of all our associates to deliver a higher level of care to the patients and communities we serve. Together with Walgreens Boots Alliance, the Rite Aid team can continue to build upon this great work through access to increased capital that will enhance our store base and expand opportunities as part of the first global pharmacy-led, health and wellbeing enterprise.”

The boards of directors of both companies have approved the transaction, which is subject to approval by the holders of Rite Aid’s common stock, the expiration or termination of applicable waiting periods under the Hart-Scott-Rodino Antitrust Improvements Act of 1976, as amended, and other customary closing conditions. The transaction is expected to close in the second half of calendar 2016.

The transaction is expected to be accretive to Walgreens Boots Alliance’s adjusted earnings per share in its first full year after completion. Additionally, Walgreens Boots Alliance expects to realize synergies in excess of $1 billion.

Upon completion of the merger, Rite Aid will be a wholly owned subsidiary of Walgreens Boots Alliance, and is expected to initially operate under its existing brand name. Working together, decisions will be made over time regarding the integration of the two companies, ultimately creating a fully harmonized portfolio of stores and infrastructure.

Walgreens Boots Alliance expects to finance the transaction through a combination of existing cash, assumption of existing Rite Aid debt and issuance of new debt.

Citi acted as Rite Aid’s exclusive financial adviser, with Skadden, Arps, Slate, Meagher & Flom LLP acting as its legal counsel on transaction legal matters and Jones Day acting as its legal counsel on antitrust regulatory matters.

UBS Investment Bank acted as Walgreens Boots Alliance’s financial adviser and provided a fairness opinion to the board of directors of Walgreens Boots Alliance, with Simpson Thacher & Bartlett LLP acting as its legal counsel on transaction legal matters and Weil, Gotshal & Manges LLP acting as its legal counsel on antitrust regulatory matters. UBS Investment Bank will be the sole arranger on the bridge financing to Walgreens Boots Alliance.

Walgreens Boots Alliance will hold a one-hour conference call to discuss its fourth quarter results and today’s acquisition announcement beginning at 8:30 a.m. Eastern time tomorrow, 28 October 2015. The conference call will be simulcast through the Walgreens Boots Alliance investor relations website at: http://investor.walgreensbootsalliance.com. A replay of the conference call will be archived on the website for 12 months after the call.

The replay also will be available from 11:30 a.m. Eastern time, 28 October 2015 through 4 November 2015, by calling 855-859-2056 within the USA and Canada, or 404-537-3406 outside the USA and Canada, using replay code 42212047.

 

Filed under: General Problems | 3 Comments »

Another Pharmacist’s point of view…

Posted on October 27, 2015 by Pharmaciststeve

This is a comment on this blog by another Pharmacist/reader on this post https://www.pharmaciststeve.com/?p=12316  and points out the legal requirements of a Pharmacist in processing a prescription. A lot of things that are REQUIRED are based on facts. In dealing with subjective diseases many “facts” are not black/white but subjective and often fuzzy. 

One thing that I will disagree with my colleague’s opinion, is that many general practitioners develop a special knowledge or expertise over the years of practice in dealing with a certain category of pts with often complex or high acuity issues. To point this out.. today Pharmacists after the option after receiving their PharmD degree.. can spend another year in a residency in http://www.pharmacist.com/residency 

Community Pharmacy Residency Programs

Myself on the other hand opened/built several successful businesses including a independent community pharmacy and Home Medical Equipment company..  but I have no piece of paper on the wall stating my academic credentials of completely a residency in as a specialists in “community pharmacy practice”.

My colleague’s final statement I totally agree with.. when a pharmacist sends a pt away without medication or plan of treatment, especially when they have not had any discussion with the prescriber and the decision was made unilaterally by the Pharmacist. The Pharmacist and the system has failed the pt and totally discounted the time/trouble/expertise the prescriber had expended in evaluating the needs of this particular pt.

As the old saying goes… if you are not part of the solution… you are probably part of the problem..

Maybe the pharmacy practice acts and rules need to be modified, or if not, clarified so as to not leave a pharmacist feeling as if she is open to malpractice for just going along with doctors. Doctors are not gods and they are not always right. But pharmacists need to know that duty to collaborate and document does not necessarily mean a pharmacist has a right to refuse any prescription.

Pharmacy, as defined in one state’s statutes, is “Pharmacy practice is a dynamic patient-oriented health service that applies a scientific body of knowledge to improve and promote patient health by means of appropriate drug use, drug-related therapy, and communication for clinical and consultative purposes. A pharmacist licensed to practice pharmacy by the Board has the duty to use that degree of care, skill, diligence and professional judgment that is exercised by an ordinarily careful pharmacist in the same or similar circumstances.”

Here is what one state’s Pharmacy Board rules say about what is called drug utilization review. It is a REQUIREMENT that pharmacists perform it in most states. What is it?

(17) Participation in Drug Selection and Drug Utilization Review:

(a) “Participation in drug selection” means the consultation with the practitioner in the selection of the best possible drug for a particular patient.

(b) “Drug utilization review” means evaluating prescription drug order in light of the information currently provided to the pharmacist by the patient or the patient’s agent and in light of the information contained in the patient’s record for the purpose of promoting therapeutic appropriateness by identifying potential problems and consulting with the prescriber, when appropriate. Problems subject to identification during drug utilization review include, but are not limited to:

(A) Over-utilization or under-utilization;

(B) Therapeutic duplication;

(C) Drug-disease contraindications;

(D) Drug-drug interactions;

(E) Incorrect drug dosage;

(F) Incorrect duration of treatment;

(G) Drug-allergy interactions; and

(H) Clinical drug abuse or misuse.

SOOOOOOOOO…. one can understand how a pharmacist might feel as if drug abuse or misuse is a concern, because their own rules say so.

It’s not as cut and dried as the pro-pain advocates would like it. The point of change is new laws that require any pharmacist who wishes to refuse a prescription first reach the prescriber and inform them of such denial. If the prescriber cannot be reached immediately, the pharmacist must actively find a pharmacist who will take over care of that patient so that the patient is served in a reasonable amount of time.

And RSDLady, pharmacists are well educated on classes of medications. But like any general practitioner, deference must be given to specialists such as pain management doctors. BUT often in daily practice, family practice doctors (who treat ear infections and thyroid conditions) are trying to manage complicated cases with too quickly increasing doses of narcotics. Or with no safety nets for patients whose case becomes even more complicated. Not to mention, nurse practitioners and naturopathic doctors can prescribe in many states, and because of DEA interference they have started whole practices of pain relief, but they also are not specialists and a reasonable pharmacist would at least consider the legitimacy vs. misuse equation. But again, collaborate with prescriber or complain to the naturopath board…don’t PUNISH patients. Pharmacists cannot allow anyone to leave hurting without a treatment plan of action or they have shirked their duty.

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this lawsuit represents a blatant end-run around state law and the constitutional and jurisdiction limitations on executive officials, most notably the attorney general

Posted on October 26, 2015 by Pharmaciststeve

Drug firms want WV Supreme Court to halt ‘pill mill’ suit

http://www.wvgazettemail.com/article/20151026/GZ01/151029610

Legally licensed prescribers write prescriptions…. pharmacies fill these legal prescription… Pharmacies orders replacement stock from legally licensed wholesalers.. AG is suing wholesalers because they sold properly ordered controlled meds where ordered by legally licensed … and the AG is suing the wholesalers ?????

Eleven of the nation’s largest prescription drug distributors are asking the West Virginia Supreme Court to stop a state lawsuit that alleges the companies turned a blind eye to suspicious orders from “pill mill” pharmacies.

The drug wholesalers say Boone County Circuit Judge William Thompson “committed clear error” by refusing the companies’ repeated requests to dismiss the case.

The drug firms also assert the state Board of Pharmacy has the power to sanction prescription drug wholesalers, but not the Attorney General’s Office, Department of Health and Human Resources, and Department of Military Affairs and Public Safety — the three West Virginia agencies suing the companies. The pharmacy board isn’t taking part in the lawsuit.

The out-of-state drug wholesalers filed a “writ of prohibition” late Friday, arguing they can’t be held liable for West Virginia’s prescription drug epidemic.

“No one denies the devastating effect such abuse has had on our state,” wrote A.L. “Al” Emch, lead lawyer for the drug firms, in Friday’s filing. “At the same time, this lawsuit represents a blatant end-run around state law and the constitutional and jurisdiction limitations on executive officials, most notably the attorney general.”

The lawsuit — initially filed by former Attorney General Darrell McGraw in 2012 — alleges the 11 drug wholesalers helped to fuel West Virginia’s prescription drug problem by shipping an excessive number of pain pills to pharmacies across the state. The companies should have flagged the suspicious orders, according to the lawsuit.

President Barack Obama spotlighted West Virginia’s opioid abuse problem during a visit to Charleston’s East End last week. West Virginia has the highest prescription drug death rate in the nation.

In a revised complaint filed earlier this year, the state’s lawyers disclosed that the 11 drug wholesalers shipped nearly 60 million oxycodone pills and 140.6 million hydrocodone pills — both are powerful and addictive painkillers — to West Virginia between 2007 and 2012.

In their Supreme Court filing last week, the drug firms note that the state pharmacy board has never taken disciplinary action against them. The board recently renewed the companies’ permits to distribute prescription drugs in West Virginia.

The companies said they have sophisticated systems to monitor drugs they purchase from pharmaceutical manufacturers and ship to pharmacies. But they don’t track drugs any further.

“[Drug wholesalers] are isolated from the segment of the chain — transactions between pharmacies and physicians — from which diversion occurs,” Emch wrote to the Supreme Court.

The companies argue that the state has no right to force them to pay costs — law enforcement, jail, drug treatment and other expenses — caused by the prescription drug problem.

“West Virginia prohibits government entities from recovering amounts expended for public charges,” Emch wrote.

In the filing, the drug wholesalers also say the state can’t sue them for breaking pharmacy board rules under the West Virginia Consumer Credit and Protection Act. The drug shipments weren’t a “consumer transaction” — as required to prove a violation of the state’s consumer protection laws.

If the Supreme Court rejects the drug firms’ request to halt the lawsuit, the trial is scheduled to start in October 2016. Lawyers for the two sides also will try to settle the case through mediation in April.

Officials with DHHR, Military Affairs and the Attorney General’s Office have repeatedly declined to comment on the lawsuit.

The companies named in the lawsuit are: AmerisourceBergen Drug Corp., Miami-Luken Inc., J.M. Smith Corp., the Harvard Drug Group, Anda Inc., Associated Pharmacies, H.D. Smith Wholesale Drug, Keysource Medical, Masters Pharmaceutical, Quest Pharmaceuticals and Top Rx.

Reach Eric Eyre at ericeyre@wvgazettemail.com, 304-348-4869 or follow @ericeyre on Twitter.

Filed under: General Problems | 3 Comments »

Inside a Pharmacist’s mind concerning the filling of controlled meds ?

Posted on October 26, 2015 by Pharmaciststeve

emptyhead

Filed under: General Problems | 8 Comments »

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