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Entries in Prescription Drugs (41)

Tuesday
Mar052013

Apps Could Mean Cheaper Prescription Drugs at Your Fingertips

iStockphoto/Thinkstock(NEW YORK) -- After ABC News' “Real Money” piece last week on saving thousands on prescription drugs, many of ABC News' viewers inquired about how easy it was to use the money-saving apps suggested by expert Michelle Katz.

So, Katz, a health care advocate, joined up with the ABC News team again and Doug Hirsch, the CEO of the popular app GoodRx.

Here’s how the app works: Type in the drug and your location and the app will look for coupons as well as the best price for the drug in your area. Download the coupons to your smartphone or print them out from the GoodRx website.

GoodRx.com also provides the pharmacy’s number and gives directions to get there.

Using the GoodRx app, the “Real Money” team found that in the Santa Monica area, where California retiree Lynda Bezdek lives, prices ranged from nearly $15 to almost $150 for a 30-day supply of 40 mg of the generic brand of Lipitor.

“It’s shocking,” Bezdek said.

The “Real Money” team learned that medication prices depended on numerous variables, such as a pharmacy’s contract with each drug supplier, discounts and coupons.

Although the Food and Drug Administration monitors the products, Hirsch said the agency does not regulate price, so consumers have to pay whatever the pharmacy charges — at times a 20 percent to 80 percent price difference for the same drug.

Thanks to GoodRx, though, Bezdek was able to cut her prescription bills in half, saving $2,280 on her medication.

“I am not tech savvy and I think this [the app] is very easy to use,” she said. “That’s real money.”

Copyright 2013 ABC News Radio

Monday
Feb252013

Saving Money on Prescription Drugs

Comstock/Jupiterimages/Thinkstock(NEW YORK) -- Of the 47.9 percent of Americans who take prescription drugs, according to the U.S. Centers for Disease Control and Prevention, most would like to save on their monthly medication bill.

Cari and Andrew of Lake Worth, Fla., who asked that their last names not be used to protect their privacy, certainly fall into that category.

Cari has Crohn’s disease and requires monthly infusions. Additionally, her son Jared is on a growth hormone, and other members of the family take medicine for high cholesterol and high blood pressure. When the couple’s insurance company recently pulled the plug on some of their prescription drug coverage, they were facing a $20,000 monthly bill.

To help Cari and Andrew save money on their prescriptions, ABC News brought in Michelle Katz.  Katz is a health care advocate, nurse and author of Healthcare for Less: Getting the Care You Need Without Breaking the Bank and Life Tips: 101 Health Insurance Tips.

Want to learn how to slash those prescription drug bills? Katz suggests these tips:

1.   Check your bill, like you would at a restaurant.


Believe it or not, there are codes for your drugs, and billing departments often get them wrong. In seconds, ABC News found one of those wrong codes on Cari and Andrew’s bill. The couple was being charged for a higher-priced drug. Fixing the code immediately saved them $1,200.

2.   Arm yourself with the Low RX App.

Did you know that drug prices fluctuate like gas prices? The app tells you what the average cost is for a particular drug and its generic, and arms you with the phone numbers of every pharmacy in your area. You can call other pharmacies to comparison shop. The app also shows discounts.

“You can get up to 75 percent off in some cases,” said Katz.

3.   Go to big wholesalers, even if you’re not a member.


The Low RX app told ABC News to go to Costco, and as it turned out, by law you could buy your prescription drugs there even if you weren’t a member. ABC News found one of Cari’s drugs at Costco for $100 less than elsewhere.

4.   Negotiate.

If you do go to smaller mom-and-pop pharmacies, you can wheel and deal to bring the price down. Bringing cash can increase your bargaining power. Instead of paying $30 for a prescription at a local pharmacy, Cari secured the same prescription for $12 -- an $18 savings.

5.   You can go directly to the big drug companies.


Katz called and emailed large drug companies on behalf of Cari and Andrew. She kept at it for weeks, providing proof of the family’s financial situation and even suggested that Cari might have to stop buying its particular drug altogether.

6.   Visit Needymeds.com.


Needymeds is a nonprofit group that offers grants, vouchers and patient assistance through its website.

7.   Use an RX Access discount card.


Together Rx Access offers savings on brand-name and generic prescription products to individuals and families without prescription drug coverage, according to its website.

With the help of Michelle Katz, Cari and Andrew lowered their monthly prescription drug bill from $20,000.19  to $1,252.28, saving them $18,747.91. And that’s real money.

 

Copyright 2013 ABC News Radio

Friday
Feb012013

Thieves Target Open Houses for Prescription Drugs

iStockphoto/Thinkstock(SAN DIEGO) -- During an open house, sellers typically secure valuables like jewelry, electronics and personal information, but locking up medicine cabinets may be next on the list.

Thieves posing as potential home buyers have targeted prescription drugs while attending open houses in San Diego, according to a local realtors’ group -- and the federal Drug Enforcement Administration confirms drugs appear to be entering the black market in that way.

“A lot of times the realtor is alone in the house and the bad guys will go in pairs,” said Kevin Burke, who is on the board of directors of the Greater San Diego Association of Realtors.  “One will engage with the agent as the other goes through the house.”

The bandits will then make their way into the master bedroom bathrooms, getting into the medicine cabinets, said Burke.

“Stealing drugs from open houses is indeed a technique drug thieves use to obtain controlled substance prescription drugs,” said Barbara Carreno of the Drug Enforcement Administration.

Opioid painkillers, ADHD drugs, anti-anxiety drugs and muscle relaxants such as Xanax and Valium are among those stolen during these kinds of thefts, said Carreno.

The DEA has enforcement groups called “tactical diversion squads” (TDS) that include special agents, diversion investigators, intelligence analysts, and state and local task force officers who work to investigate prescription drug trafficking.

Carreno said the open house thefts of prescription drugs have been found by the TDS on the black market.

Realtors in San Diego are warning homeowners looking to sell homes about such thefts, encouraging them to be cautious and avoid becoming a target.

“The take away here is common sense,” said Anthony Manolatos of the Greater San Diego Association of Realtors.  “When an agent is showing your home and you’re not there, take your valuables with you or lock them in a safe.”

Copyright 2013 ABC News Radio

Thursday
Oct252012

A Doctor's Take on Painkiller Abuse

A Doctor's Take on Painkiller AbuseDoctor's Notebook by NORLEENA GULLETT, M.D.

(NEW YORK) -- Some doctors knowingly prescribe powerful painkillers to patients who abuse them, according to a new editorial in the New England Journal of Medicine.

And as upsetting as it is, I'm one of those doctors.

As a resident physician in radiation oncology, I prescribe narcotics daily. All my patients have cancer. And with cancer comes cancer treatments, some of the most painful procedures medicine has to offer.

One of my patients, a young woman, had lingering pain from surgery, chemo and radiation. Both the attending physician and I were very sympathetic, and continued to prescribe daily Percocet.

Then I got a call from Medicaid telling me the refill prescription I wrote was too soon -- that the patient didn't qualify for a refill yet as she had already received 90 tablets. My sympathy dissolved as, confused, I called the pharmacy to confirm the prescription.

Our clinic still uses handwritten prescription pads, and my patient had changed the number of tablets from 30 to 90 -- a simple alteration, and a misdemeanor or felony, depending on the state.

My patient had also changed a Percocet prescription from her chemotherapy doctor. She spent four days in jail and missed four radiation treatments.

Prescription forging happens. And while doctors are aware of the problem, we don't often consider it at the point of care -- the moment patients tell us they're in pain. A 2011 survey from Yale University found nearly a third of patients who abused narcotic painkillers reported obtaining them from a doctor.

Do I think my patient was abusing Percocet? Maybe, but the answer isn't quite that easy. Maybe she had more pain and was afraid to tell us. Maybe we had unconsciously communicated that her pain should have been well-controlled with the drugs we gave her. Or maybe she was selling the extra pills to help pay for her treatment.

So what was I to do when she returned for radiation treatment after her release from jail? She still had cancer, still had pain from her operation and was still undergoing daily treatment. Most important, she was still my patient.

My attending physician took over the patient's pain management and drafted a pain contract -- a document that detailed what medication would be prescribed, who would prescribe it, along with rules that the patient agreed to follow. We also kept close contact with the patient's other providers.

I keep hoping that our clinic will switch to electronic prescribing, which would make it harder for patients to alter prescriptions.

But while prescription drug abuse is a problem and needs to be recognized, the reasons doctors prescribe painkillers should not be forgotten.

Dr. Norleena Gullett is a resident physician in the Department of Radiation Oncology at Indiana University, The Simon Cancer Center
.

Copyright 2012 ABC News Radio

Thursday
Oct042012

FDA Asks for Voluntary Recall of Popular Generic Antidepressant

J B Reed/Bloomberg News(NEW YORK) -- The FDA's reversal earlier this week of its approval of a generic equivalent of the popular antidepressant Wellbutrin XL 300 ends a five-year saga that began with consumer complaints and a crusade by Joe Graedon, the co-founder of the consumer advocacy group the People's Pharmacy.

In 2007, Graedon began receiving disturbing complaints on his website from patients who had been taking the 300 mg dose of Wellbutrin and had recently switched over to the generic equivalent Budeprion XL 300. Budeprion products are sold by Teva Pharmaceuticals and made by Impax Laboratories, both headquartered in Philadelphia.

"People were saying, 'I've been on Wellbutrin for several years and things were fine and dandy, but once I was switched I started experiencing headaches, anxiety, depression and sleeplessness,'" he said. "People who had never been suicidal were all of a sudden reporting suicidal thoughts."

At first Graedon said he was skeptical. But after he had received a few dozen messages, he decided to write about it in his syndicated newspaper column. That's when the floodgates opened: Soon more than a thousand messages poured into the People's Pharmacy website describing the same symptoms, in intimate detail.

Alarmed, Graedon contacted Consumer Lab, an independent testing group based in White Plains, N.Y, and asked them to evaluate the 300 mg dose of the generic pill. The findings of the Consumer Lab tests suggested that while the active ingredient in the generic Budeprion XL 300 mg and brand-name Wellbutrin XL 300 mg products was identical, the rate at which it was released differed.

"In the first two hours of a dissolution test, we found Budeprion released 34 percent of the drug, while Wellbutrin released eight percent. At four hours, the Teva product released nearly half of its ingredients, while original Wellbutrin released 25 percent. The generic did not act like a once-a-day formula but more like an immediate release formula," Dr. Todd Cooperman, Consumer Lab's president, stated.

Cooperman said the problems arose because of an unusual circumstance where the patent on the drug itself had expired, making it available in generic form, but the time-release mechanism used in the original did not. The original pill has a membrane so that the drug seeps out over time. The Teva pill simply breaks apart.

Consumer Labs and the People's Pharmacy took their concerns to the Food and Drug Administration and requested information on the human drug trials that companies are typically required to submit for drug approval. After what Graedon described as "a lot of back and forth," the FDA revealed that the 300 mg product had never undergone bioequivalence testing even though this is typical agency protocol. Instead, their approval was based on tests of a 150 mg version of the drug.

Graedon said although it's well understood that different dosages of drugs frequently don't have the same results and can produce varied side effects, the agency stood by its approval of the 300 mg dose of the generic. However, they asked Teva to voluntarily perform its own trials involving people who had reported problems.

Citing difficulty recruiting subjects, the company never performed the tests. Then in 2010, the FDA took the unusual step of conducting its own independent trial of 24 subjects. It found that the maximum concentration of Budeprion XL 300 in the blood reached only 75 percent of the amount Wellbutrin XL 300 released.

"This discrepancy in dosage could render the drug less effective in treating depression and could explain the side effects we were hearing about," Graedon said.

When results of the trials became available recently, the agency sent both Teva and Impax communications asking them to voluntarily withdraw the drug from the market. Both companies have complied with the request.

FDA spokesperson Sandy Walsh stressed that this is not a recall, which is typically done when a drug is unsafe.

"This is a voluntary market withdraw by the company for a drug that may not work well for some people. It is one type of generic Wellbutrin XL in the 300 mg strength only, made by Teva. This does not impact the other manufacturers or the 150 mg strength pills," Wash said.

The agency estimates that only about two percent of people taking a 300 mg dose of a generic version of the antidepressant take the Teva pill. They have asked other manufacturers of generic 300 mg dose versions of Wellbutrin to conduct their own studies and submit their data no later than March 2013.

But is this voluntary recall just the tip of the iceberg? Does it mean there could be other generics in wide use that are either unsafe or ineffective? Dr. Harold Koenig, associate professor of psychiatry and medicine at Duke University said he doesn't believe this is the case.

"Most generics work just fine and are as effective as the name brand. And they are a lot cheaper. So you cannot say, based on what happened with this one drug, that we should throw out all generics," he said.

However, Koenig said he thought the FDA's actions were significant. "It might open up a can of worms if this is the first time the FDA took their own look at the effectiveness of generic versus name brand. It could lead to a lot of other drugs being studied," he said.

For his part, Graedon said he is happy with the result even if it was a long time in coming.

"It took us five years and an awful lot of arm wrestling to help the FDA make this decision, but this is really a historic moment. If you think of prescription drug use in America, generics account for about 75 percent of them, and until yesterday the FDA has maintained they are identical to brand names."

Copyright 2012 ABC News Radio

Friday
Sep282012

FDA: Beware Buying Prescription Drugs Online

iStockphoto/Thinkstock(WASHINGTON) -- A moving target of as many as 40,000 active online pharmacies, a huge majority of them fly-by-night start-ups, may sell products at a cut-rate price but they may also deliver expired, contaminated and fake drugs that can harm consumers, the FDA said Friday.

"You have no guarantee of the safety, efficacy or quality of those products," Dr. Margaret Hamburg, commissioner of the Food and Drug Administration, told ABC News. "You want to go to an online pharmacy that is licensed, located in the United States, [and] importantly, that will ask for a prescription from a doctor."

On Friday, the FDA launched BeSafeRx, a national campaign to alert consumers to the possible dangers of buying pharmaceuticals online.

"This a real problem. In fact, it is a growing problem, it is a problem that we are doing everything we can ... to try and protect the safety and security of the drug supply chain," Hamburg said. "The consumers have a role to play, as well, and that's why we want them to be informed about how to recognize a safe and legal online pharmacy so they can get those drugs that they really do need."

In May, the FDA surveyed more than 6,000 adults and found that almost a quarter of Internet shoppers bought prescription drugs online, and three in 10 said they weren't confident they could do so safely.

What many consumers don't realize is they are more likely online to get fake drugs that are contaminated or past their expiration date, or contain no active ingredient, the wrong amount of active ingredient or even toxic substances such as arsenic and rat poison.

They could sicken or kill people, cause them to develop a resistance to their real medicine, cause new side effects or trigger harmful interactions with other medications being taken.

Just how easy is it to set up an online pharmacy?

Two University of California, San Diego medical researchers showed ABC News how they set up their own fake drug store using search engines, Facebook and Twitter to draw potential buyers, and no pharmaceutical degree or any medical license, is required to set up any of these websites.

Timothy Mackey, a doctoral student in the joint doctoral program between San Diego State University and the University of California, San Diego created a fake pharmacy in less than 15 minutes and for less than $80.

"We basically created a Web app which is very descriptive and has a medical professional, a picture of a person that we just purchased, and we were able to post it online without any verification or requirements at all," Mackey said.

A hit-and-run pharmacy is lightning fast to start and even faster to disappear -- all before authorities can catch up.

"The bad guys know when they're getting chased, so they just shut down with a minute, and then literally within another hour they've set themselves right back up again," said Brian Liang, head of the Center for Patient Safety at the University of California, San Diego School of Medicine. "What it's telling us is that there's clearly no enforcement, and Facebook and others in this space are making money off of illicit drug sales."

Liang and Mackey said their mock sites saw more than 1,000 unique users in the 10 months they were active. The outgoing links they included went to a "dead page," and they did not actually sell any pharmaceuticals.

While there are some legitimate online pharmacies, about two percent according to the Alliance for Safe Online Pharmacies, how can you tell which are legitimate and which are fake?

According to the FDA, watch out for sites that ...

1. ... allow you to buy drugs without a prescription;
2. ... offer deep discounts that seem too good to be true;
3. ... send unsolicited emails offering cheap drugs;
4. ... are located outside of the United States, beyond the reach of regulators.

"If you find out about the website because of spam or unsolicited email, be very, very careful," Hamburg said. "If the price is bedrock cheap and it seems too good to be true, it probably is too good to be true. And if it is not located in the United States and it's offering to ship drugs worldwide, another red flag; don't go there."

Liang added that when they were searching for online pharmacies, the first 10 pages of hits was comprised entirely of fake pharmacies, and they did not come to a legitimate site until page 10 in the Google search results.

The new "BeSafeRx" website allows consumers to check a pharmacy's license through state boards of pharmacy, as well as providing tips for shopping online and seeing the signs of a fake pharmacy.

"We want consumers to be able to get safe, effective, high-quality drugs," Hamburg said. "And if they want to order them online that is terrific, but use a safe and legal online pharmacy."

"The important messages," Hamburg added, "are have a prescription, know your online pharmacy, make sure it is safe and take your medication as directed."

The National Association of Boards of Pharmacy also recommends only using Internet pharmacies accredited through Verified Internet Pharmacy Practice Sites or Vet-VIPPS program. It also provides a listing of "Not Recommended Sites."

Copyright 2012 ABC News Radio

Thursday
Jul262012

Petition Combating Opioid Addiction Could Hurt Patients

iStockphoto/Thinkstock(WASHINGTON) -- Thirty-seven health care workers signed and submitted a petition to the Food and Drug Administration on Wednesday, urging officials to change labels on prescription opioids, such as OxyContin, morphine or Vicodin -- all part of an effort to curb prescription drug abuse.

"If the requested changes were adopted, drug companies would not be able to claim that the pain medications are safe and effective for long-term use by noncancer patients," read a statement from Public Citizen, the nonprofit advocacy group spearheading the petition.

The petition follows a wave of reports of increased addiction to opioid pain drugs.  Although pain management and addiction specialists agreed with the sentiment behind the petition, several doctors told ABC News it takes a step too far by limiting opioid access to noncancer patients with chronic pain.

"I believe this is not an appropriate way to address the disease of addiction," said Pam Kedziera, the clinical director of Fox Chase Cancer Center's pain program.  "Pain is a significant problem in the United States, and those who suffer deserve treatment."

The proposal suggests striking the word "moderate" from opioid labels to reserve it only for patients with severe pain; limiting the maximum daily dose to the equivalent of 100 milligrams of morphine; and limiting the maximum prescription duration to 90 days.

Dr. Joshua Prager, who directs the Center for Rehabilitation of Pain Syndromes at the University of California at Los Angeles, told ABC News he's treated chronic pain patients for nearly 30 years and believes a regulation that would make it harder for doctors to treat these "legitimate patients" would be "extremely regressive."

Prager's patients have included people who've had a failed back surgery or severe osteoarthritis.

Other chronic pain patients could have shingles, multiple sclerosis or pain from a nerve injury.

"We've seen the pendulum go from it being extremely difficult for physicians to prescribe opioids to patients who didn't have cancer… to where it was clearly being overprescribed," Prager said.  "What I would argue for is that there really has to be balance that doesn't have the pendulum swing back too fast and too far beyond what is reasonable."

Prager called the 90-day limit "draconian," and Kedziera called it "unbelievable."  After all, the definition of chronic is that it is long-lasting, and Kedziera said she's worried about arbitrarily taking chronic pain patients off medication just because time runs out.

An FDA spokesperson said the agency would respond to Public Citizen.  In the meantime, it will allow interested parties to provide input on the issue before it is approved or denied.

Copyright 2012 ABC News Radio

Wednesday
Apr182012

'OFF LABEL': Tribeca Film Captures Our Insatiable Appetite for Prescription Drugs

Andy Duffy(NEW YORK) -- Andy Duffy's first encounter with the world of drugs was as an Army medic at the notorious Abu Ghraib prison in Iraq, where he forced resistant prisoners to endure excruciating pain.

Sgt. Duffy says superior officers ordered him to inject the veins of prisoners with 14-gauge needles to hydrate -- and to intimidate -- them during hunger strikes.

"These needles are used for really massive trauma…not in the veins but to put a hole through the chest to relieve pressure," he said.

The Iowa City boy had signed up just days after his 17th birthday -- March 19, 2003 -- in the midst of war lust after 9/11.

Then in a 2006 attack by rebels, shrapnel tore apart his lower right flank and back as Americans readied to hand the prison over to Iraqi authorities. "They mortared us instead," said Duffy.

Many of his fellow soldiers never made it back. Duffy did in October of 2006, but with a diagnosis of post-traumatic stress disorder (PTSD) and a mountain of prescription drugs that he says only made him worse.

"It was obvious altering the chemicals in my brain was not the answer," he said. "My [PTSD] was not an imbalance, but from an experience."

Now, Duffy's journey is told in a quirky but powerful documentary about eight Americans whose lives are ruled by pharmaceutical drugs.

In the film OFF LABEL, directors Michael Palmieri and Donal Mosher investigate the epidemic of skyrocketing use of medication, following such disparate characters as human guinea pigs in drug testing, a former pharmaceutical rep and a mother who blames a drug study for her son's suicide.

Though the characters never interact, "they speak as one voice, coming up from the depths of the margins of American society," said Palmieri.

The documentary, which follows the directors' 2009 film October Country, premieres April 19 at the Tribeca Film Festival in New York City.

The directors owe much of their research and inspiration to Carl Elliott, associate professor at the Center for Bioethics at the University of Minnesota and author of Better Than Well: American Medicine Meets the American Dream.

"It is an astonishingly moving, lyrical film that also manages to be very funny," said Elliott, who has been critical of America's insatiable appetite for drugs. "I loved everything about it. There is more humanity in this film than anything I have ever seen or read about pharmaceuticals."

The film is dedicated to Mary Weiss of Minneapolis, whose son Dan Markingson was admitted in 2003 to a psychiatric hospital with delusions and was prescribed the antidepressant Seroquel by his attending physician, who was involved in the marketing study of that drug.

Weiss said she believed her son was going to hurt himself and begged doctors to take him out of the study.

"He was legal age, so we couldn't," says Weiss in the film. "But he was deteriorating and gaunt and believed he was plagued by devils. He was psychotic."

After five months in the trial, at age 27, Markingson slashed himself to death in a gruesome suicide. "They let him die," says his mother.

Today, because of her efforts, "Dan's Law" was passed in 2009 in Minnesota to protect patients from medical conflicts of interest in clinical trials.

Both Weiss's son and Duffy "speak to crisis side of the issue," said director Mosher. "There is real damage to people and these are the strongest examples. Both of them are the most harrowing examples of abuse of trust by doctors."

The documentary looks at the situation from the industry side, following Michael Oldani, a medical anthropologist who once worked as a drug rep for the pharmaceutical giant Pfizer.

"Ultimately, we are all implicated, not just the pharmaceutical companies or drug reps or doctors prescribing meds for people," said director Palmieri. "In the end we do need medicine, but the system we all participate in is kind of crazy, where the quick-fix approach is easier, but not necessarily better."

It was that approach at the Veterans Administration that victimizes people like Duffy, according to the documentary.

He was prescribed dozens of antidepressants, sleep aids and anti-anxiety drugs in place of psychological counseling to get over his flashbacks, nightmares and sleeplessness.

Today, at 26, Sgt. Andy Duffy finds psychological support working with fellow veterans.

Even a chimp in a zoo gets behavioral therapy when prescribed drugs for depression, according to the film.

"I was on four meds at a time," Duffy told ABC News. "The drugs were preventing me from moving forward. I basically was numbing myself to escape things."

He ballooned in weight from 140 to 196 pounds and was tired all the time. "I had much more suicidal thoughts with all this medication," said Duffy.

But the VA had contracts with certain drug companies that prevented doctors from adjusting his drugs and long waiting lists to see a psychologist.

"Literally, if there is a medicine that saves a life -- at the VA, if they don't have a contract, you probably are not going to get that drug."

"It was easier and cheaper for the government to dispense out meds," Duffy said.

In a moment of clarity, Duffy went off all medications and was able to quiet his demons by finding the support he needed from other war veterans.

Today, he is going to school to study social work and is active with Veterans for Peace and formed his own group, Veterans Relief.

"I realized that what I really needed was talk therapy," he said. "And it helped me so much. There were so many guys out there with the exact same problem who understood where I was coming from.

"They didn't just give me a sterile answer and shove me on the street with a bunch of pills in my pocket."

Copyright 2012 ABC News Radio

Thursday
Mar222012

Fake Pharmacies Create Drug Shortages

iStockphoto/Thinkstock(BALTIMORE) -- University of Maryland head women's basketball coach Brenda Frese is not afraid of challenging authority, especially off the court when it involves her 4-year-old son, Tyler, who has leukemia. Frese was shocked when she discovered that the treatment he required was threatened by a cancer drug shortage.

“Let’s wake up here,” Frese told ABC News. “How many people have to die....It makes me sick to my stomach to think about it.”

So Frese wrote to her congressman, Elijah Cummings, D-Md., and found out that fake pharmacies are one big reason for the shortage.

“What they do is, they horde the drugs and basically create the shortage,” Cummings said. “Not only is it insensitive, it’s criminal.”

Here’s how it works: The fake pharmacy, which is licensed, acts as a middleman. But rather than dispensing short-supply drugs to patients, as their licenses require, they buy drugs from the manufacturer, then sell the drugs to a wholesale company they also own. The wholesale company, which is often at the same address as the fake pharmacy, then offers the drugs to desperate hospitals, often at an even higher price.

Investigators say fake pharmacies sold a $15 vial of cancer-fighting fluorouracil to hospitals for $350.

Congress sent 19 letters to supposed pharmacies across the country this week and are working with state authorities to pull their licenses. North Carolina closed one that never actually saw any customers, and whose shelves had few drugs, only those that were in short supply.

“We’re paying a ridiculous price for many of these drugs, sometimes marked up 100, 200, 300 percent for a drug that we get for a couple of bucks,” said Dr. Jennifer Brandt, clinical specialist pharmacist at Washington Hospital Center.

It’s an illegal action that creates shortages, increases costs and threatens cancer treatments for patients like Tyler Frese.

Copyright 2012 ABC News Radio

Monday
Mar122012

Prescription Painkillers for Small Surgeries May Lead to Long-Term Use

iStockphoto/Thinkstock(TORONTO) -- Older adults who receive pain medications after surgery may be at higher risk of becoming addicted, according to a new study published in the journal Archives of Internal Medicine.

Physicians often prescribe opioids, including codeine and oxycodone, after outpatient surgeries.

While these drugs are proven to be effective for temporary pain relief, they are also associated with side effects including sedation, constipation and breathing problems, as well as addiction.

Researchers analyzed data from nearly 400,000 Canadian patients ages 66 and older who received an opioid prescription within seven days of undergoing surgery for cataracts, gallbladder removal, prostate tissue removal or varicose vein stripping.

What they found was that more than 10 percent of the patients who received an opioid after a surgery were identified as long-term opioid users one year after surgery. They also found patients were 3.7 times more likely to use non-steroidal anti-inflammatory drugs on a long-term basis if they received a prescription for the drug within seven days after surgery.

"We tried to look at what some of the events are that start people on the road to acute or chronic use of opioids," said Dr. Chaim Bell, associate professor of medicine at University of Toronto and co-author of the study. "It's much easier to prevent the initiation of the medication than wean people off it later. Everyone should get pain relief, but the painkiller and the dose should be tailored to the specific patient."

The findings align with the general experience of Dr. David Maine, director of the Center for Interventional Pain Medicine. He said the decision to start and prescribe an opioid at any time is a serious one. Treatment goals should be clearly defined when a prescription is first written, to ensure safety and effectiveness of the medication -- and to minimize the risk of addiction.

"Generally with older patients, if starting an opioid, we set up a short interval follow-up to ensure tolerability of the medication as well as efficacy," said Maine. "If either of those are an issue then we make a change. Sometimes that change is discontinuing the medication entirely. Ultimately, I think the decision to stop an opioid analgesic is as important as the decision to start."

Dr. Timothy Collins of the Pain and Palliative Care Program at Duke University Medical Center said the results of the study are surprising since patients who undergo such small surgeries should be finished with their pain medications after 10 to 14 days.

"Changes in the way pain medications are prescribed such as linking the pain medication to a specific outcome would help," said Collins. "Patients would have to have better function, or significant improvement on a pain scale, in order to continue on the medication. Frequently patients just say 'I feel better' or 'it helps some' but do not have any other evidence that the medication is actually helping them function better."

One in five American adults received a painkiller prescription in 2006, totaling more than 230 million total prescription painkiller purchases.

And in 2010, the Centers for Disease Control and Prevention reported that the number of fatal opioid poisonings more than tripled from 4,000 in 1999, to 13,800 in 2006.

Lack of communication between surgeons and family physicians may contribute to excessive painkiller prescriptions, along with the potential addiction and abuse of them, Bell said. Communication barriers, such as hearing or cognition deficits in older patients, also may hinder patients' understanding of when it is appropriate to taper a pain medicine or take it only on an as needed basis, said Dr. Doris Cope, director of the Pain Medicine Program at University of Pittsburgh Medical Center.

The study emphasizes the importance of tailoring patient education on a case-by-case basis, as well as the need for careful coordination of medical care among a patient's surgeons, doctors and caregivers, said Cope. Hopefully, she added, "this can be better achieved in the offices of busy primary care physicians."

Copyright 2012 ABC News Radio







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