Bermudan Pharmacists Assure Customers: "Your Prescription Drugs are Safe"

Over the last month, pharmacists in Bermuda have become increasingly aware of customers’ concerns over the drugs that they are receiving from the pharmacies. This could be because of recent changes in Bermuda regulations, which allow medicines to be imported to Bermuda from a wider variety of countries. Many customers were expressing concerns over generic drugs that were being brought in from India, and whether or not they were safe. Pharmacists attempted to allay the fears of their customers, explaining that it is not important where a drug is made, but rather how it is made, and that it has been tested and approved for sale in a reputable country. Stephanie Simons, president of the Bermuda Pharmaceutical Association, also spoke out, saying that the pharmacists have their patients’ interests at heart and will only sell them drugs that are safe and authentic. Health Minister Zane DeSilva went on to say that there are talks to amend the legislation to ensure that any drugs being sold there meet the regulatory standards of Canada, the UK, and the US.

This amendment should help to quell the fears of the Bermudian patients, who are worried about the drugs coming from India and other such non-regulated countries. There have been serious issues of counterfeit medication in India, and customers want to make sure that the generic drugs they are receiving are not actually these counterfeit medications. Often, the word “cheaper” that is associated with the generic drugs is misinterpreted, and people think that it means they are of a lower quality. A combination of the use of the amendment for regulatory standards in conjunction with patient education should solve these fears, though. Pharmacists are able to explain that even those drugs coming from manufacturers in Canada, the UK, and the US are significantly cheaper in generic form. For example, the stomach drug Losec wads retailing for $209.25 for a three-month supply in Bermuda, while its generic counterpart, Omeprazole, was only $62.95.

Lyanne Bolton, a Government pharmacy inspector, is satisfied to see that the amendments are taking place in order to stop what could have been a “dangerous situation” if the minister allowed drugs to be brought in from unregulated countries – not only India, as many feared, but Israel and Brazil as well. She feels confident that with the regulations and education that people will eventually be happy to receive the generic drugs at a cheaper price and therefore receive more reliable health care.

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Program Would Reduce Prescription Drug Abuse

Over the past few years, the term “drug abuse” has been reframed. Originally referring only to those drugs that could be found on the streets, drug abuse now also includes drugs found everyday in your medicine cabinet. Because of this, pharmacies and doctors offices are becoming more prominent sources of the problem.

Between 2007 and 2010, the rate of admissions into treatment programs for addiction to prescription drugs or prescription drug abuse increased by 45 percent, making it the second most prevalent illegal drug problem in our country. In order to curb this issue, it is important that laws or programs are put into place to help prevent prescription drugs from falling into the wrong hands.

Legislation for one such program is being proposed by Eric Schneiderman, the Attorney General of New York. The Internet System for Tracking Over-Prescribing Act, or I-STOP, would be an internet monitoring system allowing doctors and pharmacists to connect in real-time over databases that track the prescription and distribution of those drugs that are most frequently abused, such as Oxycodone, Vicodin, and Xanax. With access to the I-STOP database, a doctor would be able to check for previous outstanding prescriptions for these drugs before giving them to a patient complaining to them. If they see that they have received the drug multiple times, they will be better equipped to deny the patient the prescription and to also discuss with them drug abuse treatment options.

The I-STOP database would also help to deter those unscrupulous doctors or pharmacists who help fuel the prescription drug abuse problem by providing prescriptions with little background information, as they would be unable to plead ignorance to the patient’s past history (as they have access to all of it in the database) and also would allow doctors to report on those doctors or pharmacists who seemed to be distributing prescriptions too liberally.

Besides these advantages, I-STOP would also invalidate the use of stolen prescription pads, as there would be no record of the prescription in the internet database. Overall, it seems like a good plan, and it will be interesting to see what Schneiderman does in the future to get this legislation approved.

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Pharmacy Data-Mining

Recently, the Supreme Court struck down a case that would have made it illegal for data-mining companies to sell physician’s prescribing information to pharmaceutical manufactures for use in marketing. While you would think this would be considered a win for the majority of the pharmaceutical industry, some independent pharmacists say they are against the use of physician data mining.

There are two main arguments opposing physician data-mining. The first is that it drives up costs of prescription drugs. Physician data-mining gives pharmaceutical companies information on what individual doctors are prescribing, allowing them to link the specific drugs being sold to different doctors offices, refining the drugs that they market. Because of this, data mining allows pharmaceutical companies to increase the sales of costly branded drugs over generic alternatives by marketing them more frequently. Retail pharmacies, data-mining companies, drug manufacturers, and the American Medical Association all profit from the use of these data-mining and marketing techniques, and inevitably the costs are passed along to the physicians’ prescribing the drugs and eventually the patients themselves.

The second argument opposing physician data-mining looks at the undue influence that pharmaceutical companies can put on doctors. By looking at the data-mined records, pharmaceutical representatives can ask the doctors why they are not prescribing certain drugs, possibly swaying them or making them feel pressured to prescribe it more often. Pharmacists and doctors alike have spoken out against these practices, saying that the pharmaceutical companies should be marketing their drugs based on their merits and not on buying patterns.

In the end, though, this case was not just about data-mining but also about the fine line between protected speech and privacy in general. Currently, data-mining companies are able to sell this information without a physician signing off on it, which could be a concern to the patients that the information is based off of.

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Protecting the Neighborhood Pharmacist

Across the seas in Tel Aviv, a debate is heating up over pharmacists’ rights. The Ministry of Health recently claimed that a private pharmacy in the Israeli city was providing customers with drugs that did not meet the ministry standards, shocking its customers. The story of the pharmacy in Tel Aviv brings up questions about pharmacists, family physicians, and drug companies that span not only that city but also the entire globe.

On average, family physicians can spend seven minutes per patient, diagnosing only their most acute symptoms in order to get a picture of what illness they have and what can be done to cure it. This is not the case with many pharmacists. Often, when visiting a local pharmacy (especially a smaller or privately owned one), the pharmacist has a longer amount of time to sit and speak to the customer, receiving a far more comprehensive and detailed picture of their current state of health. Pharmacists also have access to the customer’s medical history, allowing them to better assess what type of medication will be the best to prescribe to the patient. The one drawback to patients relying more heavily on the pharmacists than family practitioners to diagnose their diseases, though, is that pharmacists receive a lot less training and have less knowledge of diseases. There can be things that they miss simply because they did not know to look for them.

Still, overall, local pharmacies do a proficient job working with their customers in order to give them the medication and attention that they need. This begs us to raise the question of whether bigger groups were involved in the harsh crackdown on private pharmacies in Tel Aviv. Specifically, there is speculation that the crackdown on small pharmacies is being used to strengthen the larger pharmaceutical industry as a whole. Larger pharmaceutical chains want to create a monopoly over the drug industry. Smaller, privately owned companies, while they do not carry a large market share, prevent them from doing this. The smaller companies often offer the one on one care as well as homeopathic medications that the larger companies do not. I predict there will be an ongoing struggle between large and small business to assert dominance in the industry while still providing patients with care.

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Proposed Pharmacy Bill Could be Big Win for Small Pharmacies

Recently, US Representative Tom Marino held a press conference in order to introduce legislation that could be considered a big victory for small, independent pharmacies. The HR-1946 bill empowers independent pharmacies in negotiations with pharmacy benefit managers so that they can negotiate the most important terms that affect prescription drug prices that most consumers and insurers are unaware of. The bill would allow independent pharmacies to collectively combine in order to negotiate better deal so that buying in less volume would no longer be a deterrent. Marino has six co-sponsors and continues to seek more as of June 20. He plans on talking with GOP leadership in order to get the bill to move forward and hopes that it will come to the House floor for a vote this year.

Marino views this legislation as a win for everyone. It would not cost the government any money, and would greatly benefit the more than 23,000 independent community pharmacies in the United States that currently account for 300,000 American jobs. By allowing the community pharmacies to work together as a collective unit, they are able to better negotiate prices with pharmacy benefit managers instead of just receiving take it or leave it contracts. This would allow the community pharmacies to pass down the benefits and savings to the consumers, as they would no longer have to base their pharmacy preferences on a financial reason but rather where they feel the best about going for their prescription drug needs.

It will be interesting to follow this legislation through the House and see if it is approved, and also how if does effect the drug prices at local pharmacies around the country in the future.

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