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The Medicare Modernization Act (MMA) that established the system's first outpatient drug benefit gives pharmacists more questions than answers. The reason is clear: politics. "The entire process is driven by politics," said Dan Mendelson, president of the Health Strategies Consultancy, a Washington, D.C., health policy firm. "Medicare is a political act, and the changes you will see to it will be politically driven."

Consultant pharmacists (CPs) can breathe a sigh of relief. Other professionals in long-term care value and appreciate pharmacists and pharmacy services. That is the conclusion of the 2004 Senior Care Source, an interdisciplinary survey of long-term care health professionals. The annual survey, sponsored by Novartis, includes pharmacists, medical directors, nursing directors, and nurse practitioners (NPs) in long-term care. The survey was released at the American Society of Consultant Pharmacists Annual Meeting & Exhibition held in San Francisco last month.

Community Care Rx (CCRx), the discount card created by the National Community Pharmacists Association, will pay pharmacists for medication therapy management services (MTMS) to help position the profession as a player when the Medicare prescription drug benefit comes on line in 2006.

In the belief that transparency creates competition and lowers costs, several states have created Web sites that post comparative retail drug prices. Consumer groups say this is a step in the right direction to make drugs more affordable, especially for the elderly and uninsured. But many pharmacists say it's a fool's errand by the states-prices change quickly and postings are rarely up to date. That leads to confusion and consumer anger more than to increased competition, say pharmacists.

Amylin Pharmaceuticals' pramlintide acetate (Symlin) is a synthetic version of amylin, the hormone secreted with insulin by the beta cells in the pancreas. It is the first member of a new class of medications known as amylinomimetic agents, or amylin receptor agonists. Amylinomimetic agents mimic the actions of amylin and have demonstrated activity in blood glucose regulation. The company recently submitted a complete response to the Food & Drug Administration's December 2003 approvable letter for pramlintide and is anticipating a six-month review.

Norditropin Nordiflex (Novo Nordisk) treats problems caused by insufficient natural growth hormone.

The remarkable advances in the treatment of cancer allow us to use terms like remission and cure, but, regrettably, some of these most effective therapies tend to wipe out the patient along with the disease. And so, researchers scramble to fill the great unmet need of developing the "wonder" drug-one that holds the promise of both efficacy and tolerability. For non-small-cell lung cancer (NSCLC), many have placed their hopes on a new class of agents that inhibit various growth factors. Iressa (gefitinib/AstraZeneca) was the first from the class to be approved, and Tarceva (erlotinib) is the latest.

Expanding its reviews of products, such as cars and appliances, Consumer Reports will compare the effectiveness and costs of a few types of widely used prescription drugs. Beginning Dec. 9, the free service was made available on the Consumer Reports Best Buy Drugs Web site at www.crbestbuydrugs.org.

Duloxetine approved for maintenance of MDD

The inclusion of medication therapy management services (MTMS) as part of the new Medicare outpatient prescription drug benefit (Part D) was one of the American College of Clinical Pharmacy's priorities during the past year, said C. Edwin Webb, Pharm.D., M.P.H., ACCP's director for government and professional affairs. He told attendees at the ACCP annual meeting in Dallas last month that the Part D benefit, to be implemented in 2006, is focused on "high-risk" patients. Those considered to be high-risk require multiple medications, have multiple chronic conditions, and are likely to incur substantial medication costs, he explained.

With the 2006 deadline looming to deliver useful patient drug information at the counter, the pharmacy profession has failed to meet the legal challenge laid down by the U.S. Congress, according to the Pharmaceutical Printed Literature Association (PPLA).

Patients with end-stage renal disease (ESRD) tend to develop hyperphosphatemia, which, if left untreated, can lead to calcification of the heart and blood vessels. Dietary phosphate restriction is the first line of therapy for reducing phosphorus levels in these patients. However, it is often unsuccessful, thereby creating quite a challenge for the more than 300,000 Americans with ESRD.

Medicare's Outpatient Prospective Payment System (OPPS) took a hit recently. A report from the Government Accountability Office detailed problems in the way OPPS rates are set.

Medication therapy management services (MTMS), as outlined in the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA 2003), is likely to have a significant impact on pharmacy practice, Jannet Carmichael, Pharm.D., told attendees at the American College of Clinical Pharmacy annual meeting, held last month in Dallas. She is PBM manager at VISN 21 Health Care Services at the VA Sierra Pacific Network in Reno.

A severe shortage of pharmacy directors and assistant directors could put a damper on progress made by pharmacists at a time when they are poised to take commanding ownership of medication and patient-safety leadership positions in hospitals.

A workforce shortage combined with federal government funding cutbacks may complicate the lives of an incoming generation of pharmacists. So claimed two of the profession's topsiders at an ASHP leadership conference, held recently in Chicago.

Anesthesia awareness-the unexpected cognizance that occurs when anesthesia lightens during surgery-is the subject of a recent Sentinel Event Alert issued by the Joint Commission on Accreditation of Healthcare Organizations. Forty-eight percent of patients who experience awareness report auditory recollections, 48% report being unable to breathe, and 28% report pain-without being able to communicate this to the surgical team.

With a click of a mouse, chain and independent pharmacies can find out which short-dated pharmaceutical are available from drug manufacturers, thanks to St. Louis, Mo.-based ShortMeds.

The technical safeguards focus on adopting appropriate technology (hardware and software) to guard electronic protected health information (PHI) and policies and procedures to control access to the technology.

The American Academy of Dermatology estimates that five million to six million Americans will at some point experience a skin pigmentation condition. Of all these disorders, vitiligo has the most devastating effects on the patient's psychosocial and emotional well-being. Other conditions, such as melasma and solar lentigines, may have less disabling psychological effects, but they are not inconsequential. Raising awareness of these skin disorders was recently discussed at a Galderma-sponsored luncheon in New York City.

Remember when one of the first drugs used to stimulate fertility was obtained from the urine of postmenopausal nuns, actually in the Vatican? The drug, if you recall, was Pergonal, and it was a mixture of follicle-stimulating hormone (FSH) and luteinizing hormone (LH).

Used with follitropin alfa to treat female infertility. This medicine is a hormone.

Two New Jersey pharmacists were among 17 suspects arrested in three states for allegedly running an OxyContin drug ring. The operation, which allegedly moved the painkiller from the mob in New Jersey to college kids in Boston, involved members of the Lucchese and Bonanno organized crime families and the Bloods street gang.

Complying with the physical safeguards under the Health Insurance Portability & Accountability Act may be the easiest to achieve, since you may already fulfill several of the requirements through adherence to state and federal pharmacy and drug laws.

There are many strategies that retailers can implement to better serve women shoppers, particularly in the sanitary protection, skin care, and cosmetics categories. This recommendation comes from the recently released Merchandising for Success study by the General Merchandise Distributors Council (GMDC) Educational Foundation.

Labeling revised to show orlistat reduces Type 2 diabetes risk

Busy behind the pharmacy counter, many pharmacists may think they can't enlist in the fight against increasingly bold and sophisticated counterfeiters, but there are ways they can make it tougher for fake medications to reach their patients, according to industry experts.

Instead of merely complaining about the tactics of pharmacy benefit managers, the National Community Pharmacists Association is working on a game plan to take the Rx drug benefit play away from their arch enemies.

For the estimated 70 million people in the United States suffering from insomnia the availability of a novel treatment option would be welcome relief. Takeda, which recently submitted an NDA to the FDA, hopes its compound, ramelteon (TAK-375), will meet that challenge. Ramelteon is a novel selective melatonin (ML-1) receptor antagonist developed by Takeda for the treatment of insomnia. According to the firm, this is the first new mechanism of action to be developed in 35 years in the area of sleep research.