watch this man I loved die a bit everyday until nothing of the man I loved was left to a shell of pain

Yesterday at 3:18 am the man I spent the last 20 years with dies.So unexpectedly I’m blindsided.Our 10 year old daughter called 911 cause daddy stopped snoring and she couldn’t wake him up.I ran downstairs I knew the minute I saw his face. The paramedics were wonderful they worked for 45 min to get a faint pulse and they were packing up.I said no heroics measures please. The paramedics asked what we thought happened out of the mouth babes my 10 year said they underrated his pain.She continues to  say drs making these decisions should come to the homes of these Patients to see the damage they cause.My daddy begged every month for an increase in his pain medication 2 years ago he was taking 360mme he lost his dr of 21 years 1 month they cut his script by 50% then the following month cut his script again 50%then then sent him to UW pain Management a front for PROP they told him no more cuts from now on they would slow down the tapers and they lied he was immediately cut again by 50% now down 70mme.He tried to find another dr he couldn’t he filed a complaint last summer he was in so much pain and bed ridden no quality if life. He longer participated as a family he just stayed in bed until his next appointment.My 10 year told the paramedics we watched him die every day bit by bit it was a cruel thing for the dr to do ignore his pain he knew daddy had no life he said his hands are tied. I knew he was lying because he couldn’t look me in the eye.It has been a very painful last year to watch this man I loved die a bit everyday until nothing of the man I loved was left to a shell of pain.I can’t explain to my 10 year old why would they not help daddy.

Smartphones are not only addictive themselves; but exacerbate the problems of other substance/process addictions

Most people trying to “financially get by” on Medicare disability run out of “money” before they reach the end of the month.

Bureaucrats want every worker to get $15/hr that is abt $30,000/yr and they are typically at that level below the poverty level.

yet most people on Medicare disability are LUCKY if their Medicare check adds up to $10,000/yr.

 

https://en.wikipedia.org/wiki/Anna_Lembke

At Stanford University, Lembke runs a dual diagnosis clinic; which supports people with more than one addiction. These are typically patients who are depressed or anxious and also addicted to substances (drugs, alcohol) or processes (gambling, sex).[2] Their main treatment involves a four-week abstinence from the addictive behavior, which she has shown is the minimum amount of time to reset their brain pathways.[2]

Lembke was one of the first physicians to speak openly about the opioid epidemic.[3][4] She wrote the popular science book, Drug Dealer, MD, which resulted in Lembke travelling the United States and delivering expert testimony to legislators.[5] She delivered a TED talk on the opioid epidemic and pain management at TEDx Stanford.[6]

Alongside drugs and alcohol, Lembke has studied smartphone and technology addiction.[2] Smartphones are not only addictive themselves; but exacerbate the problems of other substance/process addictions, increasing access and social contagion.[2] Lembke appeared on the Netflix documentary The Social Dilemma, explaining that “social media is a drug”, which exploits the brain’s evolutionary need for interpersonal connection.[7] Not only did Lembke appear on the show, but her children did too, and together they identified that most people significantly underestimate their screen time.[8]

according to this  https://www.supportprop.org/BOARD-OF-DIRECTORS/   she is a member of P.R.O.P. (Physicians for Responsible Opioid Prescribing ) does her educational background, specialty and membership in this one particular group seems to validate the old saying “… when you think that you are a hammer…everything starts looking like a NAIL..”

 

Political Pharmacist PODCAST: A Paragon WINNER Leaves CVS

https://soundcloud.com/politicalpharmacist/episode-56-a-paragon-leaves-cvs

The Paragon Award at CVS recognizes it’s highest performing and best in class pharmacists. So why have a fair number of them left the company?

An anonymous pharmacist, that goes by Arthur, joins me to discuss some of the major issues he has seen with CVS and the chronic backlog of work that really puts patients and staff at risk, after a recent article made the round of stores that were 8+ days behind.

We also dive into some more deep thought on pharmacy policy and the idea of ownership and unintended consequences. I thoroughly enjoyed this real world and philosophical debate with Arthur and his insight into stores that he saw reach 2 weeks behind in work!

Article that we refer to in the podcast: patch.com/massachusetts/falmou…behind-prescriptions

Presidential debate – a take away ..

Both Pres Trump & candidate Biden seemed to state that PRE-EXISTING HEALTH ISSUES WOULD BE COVERED… by whatever health insurance system that either one will bring to the market place.

For the chronic pain community.. this pay provide a path for some law firms to find a way to take various parts of our healthcare system to task for failing to provide treatment for the various subjective diseases that impact those within the community.

Take for example,  According to https://www.medicare.gov/plan-compare/#/?lang=en&year=2021 Humana Part D policy in 2021 will NO LONGER COVER Benzodiazepines.  I did not investigate what other meds are not going to be covered during 2021.

If it is going to be stated that all insurance programs are to cover pre-existing health issues… should that give the insurance company to NOT COVER a particular med or category/class of meds ?  Could this dove-tail into civil rights/discrimination issue under the Americans with Disability and Civil Rights Act ?

 

Walmart sues government in pre-emptive move ahead of expected opioid lawsuit

Walmart sues government in pre-emptive move ahead of expected opioid lawsuit

https://www.marketwatch.com/story/walmart-sues-government-in-pre-emptive-move-ahead-of-expected-opioid-lawsuit-11603402626

Retail giant says U.S. government is trying to use it as a scapegoat

Walmart Inc.  sued the federal government in an attempt to strike a pre-emptive blow against what it said is an impending opioid-related civil lawsuit from the Justice Department.

The retail giant said in a lawsuit filed Thursday that the Justice Department and Drug Enforcement Administration are seeking to scapegoat the company for the federal government’s own regulatory and enforcement shortcomings in combating the opioid crisis. Walmart WMT, -0.58% said the government is seeking steep financial penalties against the retailer for allegedly contributing to the opioid crisis by filling questionable prescriptions.

The suit names the department and Attorney General William Barr as defendants, as well as the DEA and its acting administrator, Timothy Shea. It is seeking a declaration from a federal judge that the government has no lawful basis for seeking civil damages from the company based on claims pharmacists filled valid prescriptions that they should have known raised red flags.

Walmart, which operates more than 5,000 in-store pharmacies in the U.S., said the government’s “threatened action would be unprecedented.” It said the government hasn’t alleged that the company was filling altered prescriptions, or that its pharmacists had inappropriate relationships with patients or doctors.

An expanded version of this report appears on WSJ.com.

 

Prescription Drugs From Canada? Not So Fast

Prescription Drugs From Canada? Not So Fast

https://www.medicaldaily.com/prescription-drugs-canada-not-so-fast-456815

Almost a month after President Donald Trump announced that states could begin importing drugs from Canada, pharmacists on both sides of the border don’t like what he’s prescribing.

Importing medications from Canada is part of the president’s America First Healthcare Plan to lower drug costs for Americans, especially older adults. The order, however, excludes some expensive biological drugs, including insulin.

“This will be a game-changer for American seniors,” the president said, according to Kaiser Family News. “We’re doing it very, very quickly.”

The new U.S. Department Health and Human Services’ (HHS) rule takes effect in 60 days.

Medications are cheaper in Canada

Prescription medicines are cheaper in Canada because the government limits what drug manufacturers can charge.  And for years, Americans have crossed the border to buy medications from Canadian-regulated pharmacies.

In fact, roughly 4 million Americans already buy their medications from abroad, even though it is illegal. Kaiser Family News also reported that another 20 million say they or someone they know has imported medications from foreign countries because the cost is substantially less. The government generally looks the other way for personal use purchases.

The President’s plan

Under the president’s plan, a Canadian-licensed wholesaler would buy medications approved for sale in Canada from a pharmaceutical company, then export the drugs to a U.S. importer. The importer would contract with a state, which would then dispense the drugs to pharmacies.

The fly in the ointment, however, is that the Canadian government has said it doesn’t have the drugs to spare. And many Canadian pharmacists and distributors have pledged not to participate. Daniel Chiasson, president and CEO of the Canadian Association for Pharmacy Distribution Management, told Reuters that job one for his members is to ensure a safe and stable supply of medications for Canadians.

Loblaw Companies, Ltd, which owns Shoppers Drug Mart, one of Canada’s largest pharmacy chains, told Reuters it had not been contacted about participating and had no plans to.

Safety Not Guaranteed

South of the border, the American Pharmacist Association (APhA) has said that it opposes the president’s order for several reasons, safety being first and foremost.

“Nothing in the final regulation and other supporting documents that the FDA [Food and Drug Administration] published demonstrates that this can be done safely and will result in savings for patients,” Ilisa Bernstein, APhA’s senior vice president for pharmacy practice and government affairs, told Medical Daily.

The supply chain from Canadian wholesaler to the American pharmacy counter, Ms. Bernstein said, is fraught with opportunities for mischief. Drugs will change hands several times and may be relabeled and added to the importer’s supply chain, which includes drugs from other countries. It is possible, she said, that when you pick up your prescription, you won’t get the FDA-approved version, but a counterfeit drug.

The final HHS rule also mentions a second plan “in the future” that would allow pharmacists to import drugs directly from Canada.

“There is very little information HHS has given about that, and that poses even more significant risks,” Ms. Bernstein said. “You don’t know what you’re getting from the global supply chain. Most online drug sellers that present themselves as pharmacies are really rogue and buying drugs from the unregulated global market.”

It’s a complex issue

Ms. Bernstein said that lowering the cost of medication in the U.S. is a complex issue that will take a multipronged approach to resolve. In the meantime, the APhA will focus on working with states to mitigate risks as each state develops its proposals for buying drugs from Canada.

“Pharmacists want to protect our patients,” she said. “Whether the patient is in the U.S. or Canada, as pharmacists we are the last step before the patient can get that drug. It is really important that we are giving a high-quality product.”

The Feds are getting into the pharma business – what could go wrong ?

OxyContin maker to plead guilty to federal criminal charges, pay $8 billion, and will close the company

https://www.cnn.com/2020/10/21/business/purdue-pharma-guilty-plea/index.html

Purdue Pharma, the maker of OxyContin, has agreed to plead guilty to three federal criminal charges for its role in creating the nation’s opioid crisis and will pay more than $8 billion and close down the company.

The money will go to opioid treatment and abatement programs. The privately held company has agreed to pay a $3.5 billion fine as well as forfeit an additional $2 billion in past profits, in addition to the $2.8 billion it agreed to pay in civil liability.

The company will be dissolved as part of the criminal charges, and its assets will be used to create a new government-controlled company.

That new company will continue to produce painkillers such as OxyContin, as well as drugs to deal with opioid overdose. The money that the new company makes will now go to combat the opioid crisis.
“Purdue Pharma actively thwarted the United States’ efforts to ensure compliance and prevent diversion,” said Drug Enforcement Administration Assistant Administrator Tim McDermott. “The devastating ripple effect of Purdue’s actions left lives lost and others addicted.”
The company, which filed for bankruptcy in 2019, pleaded guilty to violating federal anti-kickback laws, as it paid doctors ostensibly to write more opioid prescriptions.
Abuse of prescription painkillers is a major cause of the nation’s opioid crisis. According to the Centers for Disease Control, 450,000 people died in the United States in the 10 years starting in 1999 from overdoses involving any opioid, including prescription and illicit opioids. And about a third of those deaths in 2018 involved prescription opioids.
But while the more than $8 billion in fines and penalties in the agreement is a record to be paid by a pharmaceutical company, it is only a fraction of what it has cost federal, state and local governments to combat the opioid crisis. States across the country have filed claims topping $2 trillion in the Purdue Pharma bankruptcy case.
“Purdue deeply regrets and accepts responsibility for the misconduct detailed by the Department of Justice,” said Purdue Chairman Steve Miller, who joined Purdue’s board in July 2018. “Purdue today is a very different company. We have made significant changes to our leadership, operations, governance, and oversight.”
The Justice Department also reached a separate $225 million civil settlement with the former owners of Purdue Pharma, the Sackler family. Still, the Sackler family — as well as other current and former employees and owners of the the company — face the possibility that federal criminal charges will be filed against them.

Why it takes TOO DAMN LONG to get your Rx filled

Medicare open enrollment now thru Dec 7th

See the source image

https://www.medicare.gov/plan-compare/#/?lang=en&year=2021

Everyone needs to look at the Part D plan… many will not have to change their plan but others may be forced to change.

What I found was that some of the Part D policies is that they are currently not listing prices of individual medications.

When comparing prgms for us… I was offered one policy from Anthem and when comparing Barb’s … she was not offered that same Anthem Part D policy, but a different Anthem policy with a higher monthly premium, but lower copay… in reality looking at premium and deductible… she would be paying $100 more per year than would I.  I talked to a licensed agent for Anthem and he stated that Barb should have been offered the same policy as was offered me.

Some policies are stating that they are NO LONGER PAYING FOR  some Medication – like Alprazolam (Xanax), Methocarbamol (Robaxin ) and others.

Everyone need to pay attention to the prices listed for each medication. I saw a few where the price in the deductible period is the same as after the deductible is met… since suggests to me that the particular medication is basically the pt will be paying the “full rack rate” for the entire year for the particular medication.

There could be some software issues with this program – like no prices listed – or not offering a particular policy for some odd reason.

If you are not happy with your current Part D Policy… it is important to look at your options, but … given the errors that I ran into … it might be advisable to not commit to a specific policy until towards the end of the open enrollment period — and hopefully any software issues have been corrected.

Of course, if you want to keep the policy that you have now… you NEED TO DO NOTHING… you will automatically be re-enrolled into that policy

 

 

Court tosses $7M judgment awarded to patient paralyzed after spine injection at ASC

Court tosses $7M judgment awarded to patient paralyzed after spine injection at ASC

https://www.beckersasc.com/asc-news/court-tosses-7m-judgment-awarded-to-patient-paralyzed-after-spine-injection-at-asc.html

The Colorado Court of Appeals reversed a $7 million judgment against Surgery Center at Lone Tree (Colo.) on Oct. 15, saying the ASC should not have been held vicariously liable for a spine surgeon’s alleged malpractice.

Plaintiff Robbin Smith lost all feeling in her lower extremities after receiving “a bilateral S1 L1-L2 transforaminal steroid injection using the particulate corticosteroid Kenalog” at Surgery Center at Lone Tree, according to court documents. Ms. Smith was later diagnosed with bilateral lower extremity paraplegia secondary to spinal infarct/ischemia and is permanently paralyzed below the waist.

She and her husband, Doyle Edward Smith Jr., filed a lawsuit against three defendants: the spine surgeon who performed the epidural, SpineOne Spine & Sport Medical Clinic, and Surgery Center at Lone Tree, where the injection took place.

However, only the claims against the ASC proceeded to trial. Claims against the spine surgeon were settled before trial, and claims against Lone Tree-based SpineOne Spine & Sport Medical Clinic, which is the surgeon’s employer, were dismissed.

During trial, the plaintiffs alleged Surgery Center at Lone Tree had an obligation to either prevent its surgeon’s off-label use of Kenalog, which they believe contributed to Ms. Smith’s paralysis, or ensure Ms. Smith had given her informed consent to its off-label use.

After an eight-day trial, a jury ruled in favor of the Smiths and awarded them $14.9 million in damages. The trial court reduced the amount of the verdict to roughly $7 million. The ASC appealed the jury’s ruling, and the Smiths cross-appealed the reduction in damages.

Citing Colorado’s corporate practice of medicine doctrine, which “prohibits healthcare facilities from controlling a physician’s independent professional judgment regarding the practice of medicine, diagnosis or treatment,” the Colorado Court of Appeals reversed the trial court’s judgment and remanded the case for judgment in favor of Surgery Center at Lone Tree.

“We conclude that the trial court should have dismissed the corporate negligence and uninformed consent claims against [Surgery Center at Lone Tree] as a matter of law because, under the corporate practice of medicine doctrine, [Surgery Center at Lone Tree] was not vicariously liable for any malpractice” by the operating surgeon, nor was the ASC obligated to assume any medical responsibilities the surgeon failed to fulfill, the Colorado Court of Appeals said.

The court also dismissed the Smiths’ claim for negligence per se, on the grounds that state licensing and federal Medicare regulations weren’t enacted primarily for public safety reasons.