Good Press

The New York Times has a good article on the expanded role and opportunity for pharmacists to take in patients' health care. Not only is this good press for the pharmacy profession, but it can serve to inspire you to start or expand new areas in your practice. For example,

The idea of using pharmacists in this way began to gain popularity in 2006 when someMedicare plans started covering medication therapy management programs, paying $1 to $2 a minute to pharmacists to review patients’ medicines with them; this year, about one in four people covered by Medicare Part D prescription drug plans will be eligible, according to agency estimates. For example, a Medicare Part D plan covered Ms. Gelinas’s medication management session at Barney’s pharmacy.

More employers and insurers also pay for pharmacists to advise patients, a role that the new health care law encourages with potential grants for such programs. In Wisconsin, for example, community pharmacists and some health plans have banded together to create a joint program, the Wisconsin Pharmacy Quality Collaborative, to standardize medication therapy management and ensure quality care.

Meanwhile Humana, which first paid for pharmacists to work with Medicare patients, expanded its coverage a few years ago. About a third of the 62,000 pharmacies in its network offer these services, and the insurer says it is studying whether a pharmacist seeing a patient in person has more impact than a phone call.

Time for Change for Performance Enhancing Drugs?

Is it time for a new look at performance enhancing drugs? Should we make the drugs legal through prescription?

Look at any bodybuilding forum online and it is clear that their availability is widespread. If an athlete wants to use the drugs, he/she can. Their level of knowledge is quite impressive. Users combine multiple drugs to achieve the benefits while counteracting the side effects. Yet the manufacturing of the drugs can be suspect and their safety should be questioned.

But this knowledge comes from others’ trial and error and locker room talk. It would be safer for knowledgeable physicians to prescribe performance enhancing drugs. Physicians and pharmacists can monitor the long-term effects and ensure a safer supply of drugs.

I see performance enhancing drugs being especially important for motivating people to exercise. Why should we prescribe drugs like Lipitor to lower cholesterol but not prescribe drugs that will help and encourage people to exercise? The drugs can help people achieve and see results faster and encourage them to continue exercising.

Atypical Antipsychotics MOA

Do any of the physicians or pharmacists out there know the mechanism of action that causes weight gain in patients taking atypical antipsychotics?

Please let me know.

I would be interested in looking at the MOA and what suggestions this might hold for weight gain. Conversely, can we learn anything more about weight loss from the MOA?

Ohio Prescription Database Fight

According to the Cleveland Plain Dealer, the Buckeye State Sheriffs' Association is working with the Ohio State Board of Pharmacy to write a law requiring doctors, nurses, dentists and others who write prescriptions for narcotic pain killers to consult a database. This is meant to prevent patient drug abuse.

According to the paper, Ohio would be the second state after Nevada to have this requirement.

However, doctor groups are expected to oppose this law because it adds another requirement.

Jeff Smith, director of government relations at the Ohio State Medical Association, said the group would likely oppose any mandate on doctors forcing them to check a database for prescriptions.

"We're not ready to agree to that kind of administrative burden on the Ohio physicians," Smith said, adding that it would hit doctors at a time when they are seeing more patients and implementing their own electronic medical records.

Doctors receive training on what to look for and how to evaluate potential patients who are doctor shopping for dangerous pain medications, Smith said.

However, he said, the statewide doctor's association is willing to work with the pharmacy board to understand why physicians aren't already voluntarily participating.

What are your thoughts on this? It often is the pharmacist who is required to verify that patients are not doctor shopping and abusing prescriptions. This bill attacks the problem from another angle. Is it more effective this way or through pharmacies?

High Regard

Gallup does annual polling on Honesty and Ethics of Professions.

Can you guess the top three spots?

Nurses, Pharmacists and Medical Doctors are the top professions believed to have high ethics.

Great news for health care professions and a sign that your opinion is valued. Use it wisely.

Underutilized Role of Pharmacists

The LA Times has an article describing the important, if underutilized, role that pharmacists can and should play in healthcare.

Physicians wholeheartedly agree about the importance of the pharmacist's role. "Pharmacists know more about medications than anybody else in the healthcare system," Gregerson says. "That's what they went to school for. . . . They're like walking encyclopedias."

The Solution

If you are like me, you have become disillusioned with the inability of pharmacy organizations and PACs to persuade the Michigan legislature to act in the interest of pharmacy and our own state economy.

Michigan State employees continue to receive their prescription medications from out-of-state mail order pharmacies. Our taxes pay for those prescriptions. Even more, it would be an economic boom to have Michigan pharmacies dispense those prescriptions to the Michigan State employees. You would be able to retain or hire new employees to process the flood of prescriptions. Your Michigan based pharmacy would pay taxes back into the system and this would create a cycle of self-perpetuating income.

There still is no law in the State of Michigan requiring mandatory lunch breaks for pharmacists who work incredibly long hours. There is ample empirical evidence to suggest that physically fatigued pharmacists are more likely to commit errors and this puts the public health at risk. This is a sufficient constitutional ground to enact such working condition legislation protection for pharmacists and the people of Michigan.

There are even more ideas I have that will advance pharmacists quality of life, prosperity, and to create more good jobs in Michigan.

As many of you are aware I have explored working within the MPA, forming a new pharmacy organization and other initiatives.

I am tired of waiting. We want change now. Do you realize that the only reason PACs ask for your money is simply to purchase time with our state legislators? That’s right, we are paying hundreds of thousands of dollars for a mere audience with people we elect that are supposed to serve the State’s interest and not their own. Yet, even as you write the check to the PAC, you know deep down inside, that the drug manufacturers and insurance companies and large employers write checks that dwarf your contribution into insignificance.

Does this mean we should quit the good fight? No, it means we have to do something different and effective. What is the plan?

My plan is to elect a Michigan Congressman who is incorruptible, highly intelligent with an excellent education and a thorough understanding of the issues holding back pharmacy and the economy in Michigan. A young man who recently graduated from the University of Michigan who majored in Political Science and minored in Philosophy and studied Arabic and German. A young man who as a child, read so many advanced books on the American Revolution, the Federalist Papers and our Constitutional system of government that he soon knew more than most college students about the principles of American Government. A young man who was taught by his father that the great strength of America is the strength of its middle class. His father taught him that the rich will always be able to protect themselves in any form of government but the middle class is always at risk.

It is with great pride that I introduce you to the man I hope will be the next Michigan Representative for the 81^st District, my son Brent Pencak. If pharmacists help Brent Pencak, you will not need to pay PACs to voice your needs. Brent already knows. Brent needs to win the primary in August

With your help, Brent Pencak will be your state representative with the power to introduce the legislation we have dreamed of for decades.

- Christopher Pencak

My name is Brent Pencak and I am running as a Democratic Candidate for State Representative of the 81^st District. A map of the 81^st District can be found here, and includes areas such as Marysville, St. Clair, Yale, Port Huron Township, Algonac, Marine City, and Clyde Township. My website is under construction, but I have a blog which can be found here- http://pencak4mihouse.blogspot.com/

I recently graduated from the University of Michigan with a degree in Political Science and I also studied courses in Philosophy, Arabic, and German. I was inspired to pursue public office because of my membership with a student-think tank, the Roosevelt Institution. We wrote and tried to implement our policy ideas, including hosting a regional conference addressing ways to reenergize the Midwest economy.

As the son of a pharmacist and lawyer, I recognize the unique challenges faced by pharmacists. Although I will be elected by members of my district, I will work to represent the interests of pharmacists across the state. As your representative, I will work as an advocate for the rights of pharmacists.

Some of the issues that I wish to focus on during my time in office:

Pharmacists, as professionals, should receive a mandatory, paid 30-minute minimum lunch break when working shifts of eight hours or longer. This policy will help ensure public safety through less fatigued and more focused pharmacists on the job. It will also increase retention rates, preventing mental and physical breakdown among overworked pharmacists.

Michigan state employees will be mandated to have their prescriptions filled in-state rather than through mail. To help ensure fair pricing, Michigan pharmacies will be allowed to price match out-of-state prices. This plan will keep businesses and employees in the state and result in more tax dollars staying in our state.

An embarrassing burden for pharmacists who have had their license sanctioned is having their name posted on a publicly viewable list on the Internet. This unnecessary shame should be resolved with a sunset provision requiring names be removed after 3 years.

I intend to work with the Board of Pharmacy to address these needs and future needs of pharmacists. For example, working with the Board, I want to encourage them to issue more declaratory rulings. A declaratory ruling is a binding decision to clarify issues. For example, many pharmacists invested in Internet pharmacies before knowing the legality. Wouldn’t it be great to receive judgments on legality before investing time and money? Increased cooperation between the Board and pharmacists can only help clarify rules and prevent future problems.

I recognize the needs of pharmacists not only as professionals, but as community leaders and economic anchors. In my Congressional district are many small towns and cities where often times the pharmacy is the economic center of town, serving the needs of the community year-round. Pharmacists still serve the traditional role as a respected community leader. Not only are consumers’ needs met, but pharmacies offer jobs for many in the community. The experience of working at a pharmacy encourages many to pursue a career in pharmacy.

Another focus of mine is protection of drinking water and the environment through mandated proper disposal of prescription drugs. Adverse affects on animals have been proven. Can adverse affects on humans be far behind? As the Great Lakes State, we have an increased reason for concern. Properly mandated disposal of prescription drugs can prevent further contamination of water.

Michigan’s primary will be on August 5, 2008 and the general election is November 4, 2008. Here is a link to the Michigan Voter Information Center with voter registration information.

I know that you might think that you cannot help or benefit from my campaign because you are not in my district. However, if I am elected, I will be representing the State of Michigan and will introduce bills to improve the entire state. Remember to spread the word to friends, other pharmacists, and pharmacist groups. This is the opportunity to create change for the entire state.

I will be grateful for any contribution that you can make for my campaign. Please make checks out to the “Committee to Elect Brent Pencak”. My address is:

PO Box 515
Richmond, MI 48062

Include your full name and address. Contributions are limited to $500.00. If you are making a contribution more than $100.0, please include your profession, employer, and business address. I apologize for the inconvenience, but it is required election law.

If you are interested in volunteering for the campaign, please email me at the address below.

If you have any questions or comments, please email at pencak4mihouse@gmail.com

Big Money for Pharmacists

A settlement between CVS Caremark Corporation, the United States, and several states was approved by a Federal District Court in Northern Illinois. Between 1999 and 2006, CVS was alleged to substitute capsule of Ranitidine for tablets for Medicaid prescriptions, allowing them to evade the Federal Upper Limit pricing for Ranitidine tablets. This caused over-billing.

The settlement allowed CVS to deny wrongdoing or violation of state or federal law. The settlement sent $21 million to the federal government, $15.6 million to state plaintiffs, and $4.3 million to the qui tam relator, a part-time pharmacist of CVS.

I have experience in these cases and they can be very lucrative for persons who are aware of overbilling or other corporate fraud.

Expect a big announcement in the coming days.