Letters: February 2009

Key Points

"The largest challenge we are facing in rural America is the shortage of quality, affordable healthcare. Shortages range from pharmacists, physicians, and nurses to specialty practitioners such as neonatologists and pathologists. Affordability and access are rough here. Many factors influencing patients' decisions for treatment are often not addressed. For instance, traveling two to five hours for appointments is not only time consuming, but costly.

Treatment that would normally be addressed immediately in larger urban areas is often put off for weeks or months, or not even given at all, which is very detrimental to the outcomes of treatment and will likely lead to more expensive and extensive treatments later. The pharmacy that I own and operate in Madison, Neb., had no prescribing practitioner for nearly two years! In October 2007, Dr. Keith Vrbicky and AET presented an idea for telemedicine in my pharmacy. This innovative idea addressed the problem in an affordable manner.

Nebraska recently passed legislation that authorizes the use of telepharmacy. This will open a door to underserved areas of rural Nebraska that are in dire need of quality, affordable healthcare".

Generics are not the same

I am an NP in pediatrics - old school, you could say - practicing for close to 20 years. I have a real problem with generics for my patients, family, and myself. I was taught and have read that certain generics such as those used in warfarin and cardiac therapy should not be used.

Even the slightest difference could prove harmful. An oncologist here in town will only use brand Coumadin for her patients. I witnessed my father's blood pressure soar after only a few days on a generic and quickly return to normal after he took an extra dose and then went back to brand. I find various generic antidepressants have little to no therapeutic effects on the majority of my patients.

Brand drug prices are soaring. No one really talks about this subject, and consumers, our patients, should know or have a choice!

Jeanne Monaco, BM, BSN, MSN, ARN, CPNP

Plagakis conveys emotion and sensitivity

[Jim Plagakis] is my favorite part of Drug Topics. He has the ability to convey emotion and sensitivity. Thanks for relating to everyday retail pharmacists. Regarding your article from the Dec. 15th issue ["Caring should extend beyond pharmacy counter"], don't beat yourself up about what happened in 1972. Sometimes we do what we feel is best at the time and then, if it doesn't work out, we realize there was something else that could have been done. It happens to everybody, and it is not your fault. Take care and keep up the quality pieces.

Jeffrey Roeder, PharmD
BETHLEHEM, PENNSYLVANIA

Tobacco bans are hypocritical

Let's make one thing clear: As a pharmacist, I don't like pharmacies selling cigarettes. It is contrary to their purpose. Might as well get rid of the alcohol as well. However, I'm also not in favor of government telling retailers they can't sell an item while someone else down the street or next door can. If you're going to ban cigarette sales for one retailer, ban them for all. Otherwise you're just being hypocritical. Government has no place in trying to protect citizens from themselves if they walk into a pharmacy and want to buy something that is unhealthy. What's next? I imagine they'll ban the sales of shortening, eggs, whole milk, and half-and-half at pharmacies because it may affect customers' cholesterol levels.

Keith Gillette, RPh
SCOTTSDALE, ARIZONA