Flu Activity Marks A Late Start to Season

Have you noticed that not many of your co-workers have been home sick with the flu this winter? Well it’s not your imagination…it’s a fact. According to a report from the Centers for Disease Control and Prevention, this flu season is off to one of the latest starts in nearly three decades.

The flu season is officially considered to have begun when more than 10% of respiratory specimens tested for flu turn up positive. That didn’t happen this year until the week ending Feb. 4, the CDC says. During the following week, 15% of specimens tested positive for flu.

Only once in the past 29 years (1987-88 season) did it take until February to hit that 10% threshold, the CDC says. The flu season generally runs from October through May, with the peak most commonly occurring in February.

As of Feb. 11, three flu-related pediatric deaths had been reported to the CDC for this season, the report says. For all of last season there were 122 such deaths reported, and during the H1N1 pandemic, there were 348 between April 2009 and October 2010.

In December, the CDC reported that despite the slow start to the flu season, vaccination rates were up compared to a year earlier. Higher vaccination rates may help to make this season mild, experts tell NPR’s Shots blog. And people may already have some leftover immunity to the strains of flu in circulation this season, since they are the same culprits as in the previous season, NPR says. Unseasonably warm weather may be another factor.

The CDC report says vaccination “remains the most effective method to prevent influenza and its complications” and adds that health-care workers should continue to offer immunizations to all unvaccinated people who are at least six months of age.

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Florida Pharmacist Caught Running Drug Mill

Earlier this week, a pharmacist in Volusia county was accused of reselling on the street prescription pills he had stolen from his work. On Tuesday morning, Michael Lomangio (41 years old) and Allina Kirkland Michaud (28 years old) were arrested by investigators.

Deputies said the pair was arrested when a sheriff’s deputy pulled over their pickup truck in DeLand and found 253 prescription pills, a trace amount of marijuana and drug paraphernalia inside. Lomangino’s home in Edgewater was also searched by narcotic agents and found what they described as “a veritable home pharmacy.” The house contained a variety of prescription drugs, including oxycodone, Xanax and Valium. More than 5,700 pills, a loaded handgun, and nearly $5,000 in cash were found in the home.

When asked by deputies, Lomangino did admit to stealing some of the pills from Steve’s Pharmacy in Daytona Beach, where he works as a licensed pharmacist. The owner of Steve's Pharmacy, Tim Jobson, said he has worked with Lomangino for 10 years and never doubted the honesty and integrity of him.
"You really don't know the nightmare I'm going through right at the moment," said Jobson. "I find it extremely hard to believe that this has occurred and to the extent that I just found out.” Jobson said he installed cameras in the store when pharmacies became targets for criminals. "No, I would just never in a million, trillion years think that Michael would have done something like this," said Jobson.
Investigators are still determining how Lomangino obtained the rest of the narcotics.

Officers said Lomangino told them that Kirkland-Michaud , his accomplice, has a drug addiction and that she fuels it by selling various prescription drugs on the street or trading them for Kirkland-Michaud's drug of choice, roxycodone. He said he stole other drugs to sell or trade for the roxycodone because his pharmacy on Mason Avenue doesn't keep much of it in stock, said investigators. Deputies confirmed that Kirkland-Michaud told them that Lomangino was a major drug kingpin in the New Smyrna Beach area and that she knew he was using his job at the pharmacy to feed her drug habit.

The pair faces charges of trafficking in hydrocodone, trafficking in oxycodone, possession of a Schedule III narcotic, possession of a Schedule IV narcotic and possession of drug paraphernalia. Currently both are in jail and bail for Lomangino is set at $552,500 and Kirkland-Michaud's bail is set at $527,500.
The case is still under investigation and additional charges are pending, deputies said.

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The Lastest Pharma Scandal

Imagine yourself in front of your computer, looking up information about a drug prescribed by your doctor. Your Internet search tells you that there is a cheaper, maybe even a generic version available, but you have just paid top dollar for the brand name drug. You also learn that another treatment may be safer than the prescription you just filled. Now imagine you discover that your doctor gets paid by the manufacturer to promote the drug to other doctors. I imagine that would get you very mad!

There are various words for this sort of financial transaction, when, say, a radio disk jockey is paid by a recording studio to play a song or a broker is paid to tout a stock…both of which are illegal. In medicine it’s called a financial conflict of interest, although “pharmapayola” is in some ways more accurate. It’s perfectly legal, and it’s rampant. In a survey published in the Archives of Internal Medicine in 2010, 28% of physicians reported that they received some kind of payment from a drug company to serve on a speaker’s board, as a consultant, or on an advisory board. Other bennies handed out by companies included free drug samples, tickets to sporting events, meals at five-star restaurants and all-expenses paid trips to medical meetings in nice locales.

As of this year, doctors who accept gifts and payments from drug and device makers will see their names on the web, the result of the 2010 Physician Payment Sunshine Act, one of the most controversial provisions in the health care reform law. Companies will be required to report any gift or payment to a doctor or academic researcher over $10, whether it’s in the form of stock options, speaking fees, box seat tickets, knickknacks for the doctor’s office or travel to a medical conference. Doctors will also be required to disclose payments and gifts.

Some critics complain that the Sunshine Act will stifle innovation — that money and time better spent on coming up with better treatments will be diverted to nitpicking bureaucracy. The “pharmascolds” who support the legislation, they say, are demeaning doctors. One such critic is Tom Stossel, a Harvard physician, who claimed in a recent op-ed in the Wall Street Journal that conflicts of interest don’t matter to patients and don’t harm them.

But evidence says otherwise. Studies have found that doctors who accept free gifts and payments are more likely than those who don’t to prescribe “irrationally.” They prescribe an expensive brand name drug when a cheaper generic will do or a less effective more dangerous version when there’s a better alternative. Even more troubling, medical research on devices (such as pace makers and hip replacements) and drugs is routinely biased when the researchers have conflicts of interest.

Other critics of the law worry that disclosure won’t do any good, that many doctors will continue taking the money even if their names are put up in lights on the web. They’re right: disclosure alone doesn’t discourage behavior, it’s the shame that goes along with it, and there are hints that even the prospect of being exposed for having a conflict of interest is starting to discourage doctors from taking the money. Between 2004 and 2009, the number of doctors with a financial relationship with industry declined from 94% to 84%.

Of course, drug and device manufacturers are not dumb. Drug companies spent at least $220 million last year just on speaking fees to doctors. They spread that kind of money around because it works, but more importantly it helps them sell more product. As doctors become more wary, companies have begun to target nurses and pharmacists, who can also influence the drugs you take. The Sunshine Act is just the first necessary step in cleaning up medicine.

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