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Everyone has learned a lot since Medicare Part D was started on Jan. 1. Pharmacists learned new processes, people on Medicare learned new terms and options. Insurers and the Centers for Medicaid & Medicare Services learned to respond quickly to misunderstandings, technical glitches, and personnel shortages.

To prepare for the seasonal onslaught of pollen, mostallergy-stricken patients will try to find relief throughnonsedating antihistamines and nasal inhalers. Many others willundergo allergen immunotherapy as a next step, receiving theestimated 60 to 90 injections necessary for each treatment period.Although allergy shots can be effective, treatment is often atime-consuming and costly process. Preliminary results for newtherapies show promise and may soon offer allergy sufferers moreoptions with fewer injections.

According to oncology experts, active cancer accounts for about 20%of all new venous thromboembolic events (VTE), and cancer patientshave a four-to sevenfold higher risk for VTE. Add to that the riskof being treated with chemotherapy drugs that may haveclot-producing properties of their own, and you are talking about aserious risk for a deadly condition. With this in mind, theNational Comprehensive Cancer Network (NCCN) recently released newguidelines to help oncology practitioners prevent, diagnose, andtreat VTE.

Despite an over-my-dead-body opposition in some states, the day israpidly approaching when pharmacists will be able to obtain anational license valid in multiple states, predicted CarmenCatizone, R.Ph., executive director of the National Association ofBoards of Pharmacy.

CMS has announced plans for a "stakeholder-led Pharmacy QualityAlliance" to improve pharmacy care and outcomes, "includingmeasurement approaches." In recent years, CMS has linkedperformance with pay for other healthcare providers, an examplebeing the Hospital Quality Initiative (HQI). One result of HQI is aWeb-based list of quality measures on which hospitals must reporttheir performance or they get less of an increase in their Medicarereimbursement. CMS plans to set up a similar system for R.Ph.s.

A gay-rights group has sued Kentucky Gov. Ernie Fletcher forfailing to veto $11 million for a pharmacy school to be built at aprivate Baptist university that recently expelled a gay student.

Standard Management Corp., Indianapolis-based provider ofpharmaceuticals to the long-term care and infusion therapyindustry, announced the signing of a definitive agreement for thepurchase of In-House Pharmacies of San Diego. In-House Pharmacies,with about $40 million in annual revenues specializes in long termcare and represents the largest in a series of acquisitions byStandard Management, adding to its national presence.

U.S. pharmacists filled more than 270 million prescriptions in thefirst three months of the Medicare Part D drug benefit, accordingto CMS. During March, R.Ph.s filled an average of three millionPart D scripts every day.

The Nevada pharmacy board unanimously approved regulations topermit residents to purchase drugs from Canadian mail-orderpharmacies. Board-approved Canadian pharmacies can fill and mailscripts for drugs that are approved by the FDA and Health Canadaand that are drawn from the pharmacy's on-site inventory system.

Proposed changes by CMS relating to payment rates for inpatientstays would base the weights assigned to diagnosis-related groups(DRGs) on hospital costs rather than on charges and adjust the DRGsfor patient severity. CMS issued a notice of proposed rulemakingthat would begin the transition to the first significant revisionof the Inpatient Prospective Payment System (IPPS) since itsimplementation in 1983.

Medco locked more than 500 pharmacy technicians out of its LasVegas mail-order pharmacy after they failed to ratify a newcontract, according to a spokeswoman. The giant PBM brought in 550registered techs to temporarily replace the locked-out workers, whohave been without a contract for eight months.

Medicare Part D needs moderate to major improvements to besuccessful, according to 88% of the 5,859 pharmacists who respondedto an on-line survey in late March by the National Council of StatePharmacy Association Executives. The poll also found that 60% ofthe respondents said Part D is having a negative impact on theirbusiness or could force them to close and more than 50% stillreported at least five Part D-related problems every day, half ofwhich required more than 20 minutes of R.Ph. time to resolve.

The Washington State Pharmacy Association has purchased shares tobecome the 17th shareholder organization in the Pace Alliancepharmacy buying group. The addition brings the number ofindependent pharmacies served by the Pace Alliance to more than2,000 nationwide.

New data released by the Substance Abuse & Mental HealthServices Administration (SAMHSA) show admissions to substance abusetreatment involving methamphetamine and narcotic pain medicationscontinued to rise in 2004. Methamphetamine admissions to treatmentrose 11% between 2003 and 2004 and 25% between 2002 and 2004.

Drugstore-based promotions of pharmaceutical products are gainingwide industry acceptance, according to data recently presented atthe DTC National Conference. Panelist Gary Norman, executive VP andgeneral manager for Rx EDGE, a pharmacy-based, direct-to-consumermarketing firm, reported in-store promotions are an emerging trendin which pharmaceutical marketers are boosting their emphasis onpatient information and education, and shifting from TV to moretargeted, measurable media.

A gay-rights group has sued Kentucky Gov. Ernie Fletcher forfailing to veto $11 million for a pharmacy school to be built at aprivate Baptist university that recently expelled a gay student.

The University of California, San Diego, will dedicate the new $45million building housing the Skaggs School of Pharmacy on May 2.The four-story, 110,000-sq. ft. building will accommodate 330Pharm.D. students, 60 Ph.D. candidates, and 30 residents, as wellas research facilities.

CMS has selected Bioscrip as the first national vendor for the newCompetitive Acquisition Program (CAP) for certain Medicare Part Bdrugs and biologicals beginning July 1. Participating physicianswill acquire the drugs from Bioscrip and administer them tobeneficiaries instead of purchasing them from distributors andbeing reimbursed by Medicare.

The Nevada pharmacy board has ruled that pharmacists can refuse tofill scripts based on professional judgment but not on theirreligious or personal beliefs. The regulation permits pharmaciststo refuse to dispense if a script is unlawful, potentially harmfulto the patient, or not for legitimate medical purposes.

A coalition of large Florida employers launched a campaign to makedoctors write legible scripts. The Florida Health Care Coalitionprinted one million stickers that state, "I won't accept aprescription if I can't read the writing."

MedVantx is introducing OTC Advantage, a program aimed atbroadening patient access to cost-effective OTCs. The programenables physicians participating in the nationwide MedVantx Networkto easily dispense and track free, full-course samples of OTCmedications for use as first-line therapy.

Three contact lens care solutions made by Ciba Vision are in shortsupply at retailers nationwide, following a temporary shutdown of aCiba manufacturing plant in Ontario. The shortage of Clear Care,Aosept, and AQuify, which clean and disinfect contact lenses, comesat the same time that Bausch & Lomb asked retailers to pull itsReNu with MoistureLoc contact lens solution, which is underinvestigation as a possible cause of a rare eye infection.

Merck is offering a free Guide to Affordable Medicine, a resourceto help people learn about the various programs available forreceiving medications at a discount or for free. The guide providesan overview of Medicare, Medicaid, prescription discount programs,and patient assistance programs.

An FDA alert has been issued to warn practitioners that allproducts containing promethazine HCl are now contraindicated inchildren younger than two years of age. The labeling change comesafter the agency received reports of respiratory depression anddeath following use of the drug by children in this age group.

The prolonged-release formulation of ciprofloxacin-ProQuinXR-is now available in three-tablet blister packs in additionto the already-existing 50-count bottles. According to themanufacturers Depomed Inc. and Esprit Pharma, the blister pack willprovide a convenient alternative for patients who have beenprescribed a three-day course of the fluoroquinolone to a treaturinary tract infection. Each tablet of the antibiotic contains 500mg of ciprofloxacin and should be taken once daily.

Following two federal appeals court rulings last year that rejectedFTC actions that had prevented brand-name companies from payingtheir rivals to drop patent challenges, an FTC analysis has foundat least seven agreements made in fiscal 2006 and three in 2005between brand-name drug companies and generic companies. Speakingto the In-House Counsel's Forum on Pharmaceutical Antitrust, FTCcommissioner Jon Leibowitz said that if the appeals court decisionsremain in force, rival drugmakers will have "carte blanche to avoidcompetition and share resulting profits.

A new study by AHRQ shows that physicians and pharmacists fail tocorrectly identify the tablets of three common medications morethan a third of the time. The research suggests that the lack of astandardized system for marking prescription tablets withidentifying codes and symbols can lead to confusion and perhapsmedication errors.

The launch of many brand-name drugs and an increased volume ofprescriptions written for Medicaid enrollees between 1997 and 2002were responsible for a doubling of Medicaid expenditures duringthis time period, according to a new report from the Agency forHealthcare Research & Quality (AHRQ). At the same time, the useof generics fell from 47% to 44%.

Following a six-month trial on corruption charges, former IllinoisGovernor George Ryan was found guilty on all counts related toracketeering, mail fraud, obstructing the IRS, tax fraud, and lyingto the FBI. Ryan, a Republican, was a pharmacist in Kankakee beforehe entered politics.

Accredo Health Group, a subsidiary of Medco, won a five-yearcontract as the sole specialty pharmacy for Flolan (epoprostenolsodium, Myogen) for pulmonary arterial hypertension (PAH). Terms ofthe deal were not announced.