https://americanpaindisabilityfoundation.org/
fund raiser for Emmalyn’s Journey
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Emmalyn’s Journey funding raising
Posted on January 12, 2024 by Pharmaciststeve
Are you in a soon to become PHARMACY DESERT?
Posted on January 12, 2024 by Pharmaciststeve
Back in the day, in the typical chain pharmacy, 80%+ of the business was in the front end and the balance was in the pharmacy/prescriptions. Thanks to the likes of Amazon, the front end of most chain pharmacies is DYING and the gross profit margins are close to HALF of what they were back in the day in the pharmacy- mostly thanks to the PBM industry. The large chain pharmacies are closing stores because they are not as profitable as they want and some are going the route of CVS in acquiring $10.6B acquisition of Oak Street Health to expand their primary care footprint. Oak Street is a Medicare-focused primary care company. After all, CVS owns Aetna Insurance which provides Medicare-C (Advantage) and Medicare Part D programs. Eventually, all of these medical healthcare companies will end up creating many “healthcare deserts” and some “healthcare oases”. Depending on the population density of where the pt lives, getting access to healthcare could be 10-30 miles from their home.
CVS closing select Target pharmacies, with plans to close 300 total stores this year
CVS is continuing to shutter storefronts in the new year and plans to close select pharmacies inside Target locations in the coming months.
The closures are set to begin in February and should be completed by the end of April. Spokesperson Amy Thibault did not address questions on how many stores are set to close, but The Wall Street Journal reported that “dozens” would be affected.
The closures are part of CVS’s plan to shutter roughly 900 ‒ or 10% ‒ of its stores. The pharmacy chain has closed about 600 stores since 2022 and expects to close the remaining 300 this year.
Why is CVS shuttering pharmacies?
Thibault said the closures are part of CVS’s plan to reduce store and pharmacy density.
The closures “are based on our evaluation of changes in population, consumer buying patterns and future health needs to ensure we have the right pharmacy format in the right locations for patients,” she said in an emailed statement.
Other major pharmacy chains, including Rite Aid and Walgreens, have also been shuttering stores amid rising competition, pressure on prescription profits and waning foot traffic. (Rite Aid also faces pressure to cut costs as it faces a slew of opioid lawsuits. The company filed for bankruptcy last year.)
A sign on the front door of CVS Pharmacy,1535 W. 26th St, announced the storefront will close but the pharmacy will remain open. The storefront will become an Oak Street Health primary care clinic sometime in 2024.
Pharmacists at the three chains have staged walkouts in recent months to protest deteriorating working conditions stemming from a lack of staff and resources.
Which CVS pharmacies are closing?
Thibault declined to share a list of the affected locations.
What happens to CVS employees?
Impacted employees will be offered comparable roles within the company, Thibault said.
What about the customers?
Patient prescriptions will be transferred to a nearby CVS Pharmacy before the closures.
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THE STORY OF PHONEY ALGORITHMS, CIVIL ASSET FORFEITURES, EXPOSING DEA AS A CRIMINAL ENTERPRISE AND HOW GOVERNMENT PROTECTS THE CORRUPTION
Posted on January 12, 2024 by Norman Clement
Is this but just one of the faces that was part of the start of our opioid crisis?
Posted on January 12, 2024 by Pharmaciststeve
Is this but JUST ONE OF THE FACES… that contributed to the beginning of our illegal Fentanyl poisoning crisis? He tells Congress that addiction is a DISEASE… He just won:
Jelly Roll Wins New Artist at 2023 CMA Awards, Urges Fans to Keep Going in Rousing Speech
Personally, I am not a big COUNTRY MUSIC LISTENER, most all the musical artists that listen to are DEAD… my musical tastes are from the 1950s & 1960s and early ROCK & ROLL!
Is Jelly Roll the highly visible personality that could also be a valuable spokesperson for the chronic pain community?
https://www.congress.gov/bill/118th-congress/house-bill/3333/text
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Medical board publishes new guidelines on prescribing opioids for pain
Posted on January 11, 2024 by Pharmaciststeve
If you read the hyperlink below, it concerns a practitioner in Calf that back in Nov 2022, his office practice was raided and shut down by the DEA… NOT THE MEDICAL BOARD OF CALIFORNIA. One of this practice intractable chronic pain pts – 61 y/o – Danny Elliott, who was nearly electrocuted to death in 1991 that precipitated his intractable chronic pain. This physician’s office practice was the third pain clinic that Danny was a pt of since 2018 and shut down by the DEA.
Danny & Gretchen lived in Virginia and flew out to California every 90 days to see Dr Bockoff and they had just arrived in CALF for Danny’s quarterly office appt. Suggesting that he had maybe a few day’s worth of Fentanyl patches on hand. After contacting over 12 different pain clinics and being turned away, they BOTH COMMITTED SUICIDE!
This Couple Died by Suicide After the DEA Shut Down Their Pain Doctor
Medical board publishes new guidelines on prescribing opioids for pain
The Medical Board of California recently published a long-awaited update to its opioid prescribing guidelines, which will make it easier for patients to get the care they need while maintaining appropriate safeguards. Importantly, the medical board has clarified that the guidelines are not intended to replace a physician’s clinical judgment and individualized, patient-centered decision-making.
The guidelines are consistent with recommendations from the California Medical Association (CMA), which had urged the medical board’s Opioid Prescribing Task Force “to use balancing between appropriate risk assessment and ensuring that patients receive individualized care as the guiding principle as you work on this latest update of the guidelines.”
In a letter to the taskforce, CMA noted that previous prescribing guidelines were acutely focused on reducing opioid prescribing to address opioid-related overdose. California already had one of the lowest opioid prescribing rates in the country when the previous guidelines were passed, and has continued to reduce prescribing. The current surge in overdose deaths is related to use of illicit drugs.
The chief of the Stanford University Division of Pain Medicine Sean Mackey, M.D., Ph.D., served as a senior advisor for the medical board’s taskforce and endorsed the revised guidelines.
“I’m a physician scientist, I care for people suffering from chronic pain, many who have intractable pain. Our motivation for revising this document was to learn from the lessons in the past and make it better,” Dr. Mackey said in a letter read at the May board meeting. “We recognize the need to ensure patient access to safe and effective pain management treatment, and at the same time, the need to support physicians providing treatment for people with chronic pain.”
CMA’s requested changes were largely incorporated into the guidelines, including a recognition that the medical board’s Prescription Reviewer Program (formerly known as the “Death Certificate Project”) contributed to physicians being less willing to treat patients with chronic pain.
“We think it is critical to ensure that guidelines recognize the nuance that treating pain requires and acknowledge the complex realities of treating these patients, which include systemic barriers for many patients to access nonopioid therapies or pain specialists and racial and ethnic disparities in care,” CMA wrote in the letter.
The new guidelines address many of CMA’s concerns and adopted CMA recommendations, including:
- Reinforcing the individualized nature of patient care and making clear that it is not intended to be applied as an inflexible standard by health care entities and is not a law, regulation and/or policy that dictates clinical practice.
- Clarifying that patients should not be required to sequentially “fail” nonpharmacologic and nonopioid pharmacologic therapy before proceeding to opioid therapy. The guidelines now state that the basis for initiating opioids should be whether the benefits are anticipated to outweigh the risks of the therapy, rather than by patients having attempted multiple therapies that have inadequately addressed their pain.
CMA also advocated for removing morphine milligram equivalent (MME) thresholds, because those included in the 2016 Centers for Disease Control and Prevention guidelines “established a ‘one-size-fits-all’ approach to opioid therapy that harmed patients” and perpetuated “the false idea that MME thresholds improve patient care.” The adopted guidelines provide a nuanced analysis of using MME, stressing the need for care being individualized and patient centered and for adequate medical recordkeeping that documents prescribing decisions. The final version removed originally proposed language that suggested an upper limit on opioid prescribing of 90 MMEs.
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Fighting rising prescription drug costs
Posted on January 9, 2024 by Pharmaciststeve
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Have You Been Overcharged for Prescription Drugs? We Want to Hear From You
Posted on January 9, 2024 by Pharmaciststeve
Have You Been Overcharged for Prescription Drugs? We Want to Hear From You
https://www.nytimes.com/2024/01/09/us/overcharged-drugs-pharmacy-benefit-manager.html
The New York Times is looking into pharmacy benefit managers, which play crucial roles in determining which medications your insurance covers and how much you pay.
Reed Abelson and
More voices, better journalism. The questionnaire you are reading is just one tool we use to help ensure our work reflects the world we cover. By inviting readers to share their experiences, we get a wide range of views that often lead to a more deeply reported article. We make every effort to contact you before publishing any part of your submission, and your information is secure.
Most prescriptions in the United States are handled by one of three companies: CVS Caremark, Express Scripts or Optum Rx. These pharmacy benefit managers serve as middlemen between the drug companies that make the medications and the insurance plans that pay for your prescriptions.
These relationships have been in the news because of the high cost of prescription drugs. We want to hear about your experiences with these companies, including whether your medications were covered and how much you paid for them.
We’re also interested in hearing from pharmacists and doctors about their experiences and those of their patients.
We read every questionnaire response, then reach out to a portion of respondents from whom we’d like to learn more. We will not publish any part of your response without communicating with you further. We don’t share your contact information outside the Times newsroom, and we use it only to contact you.
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Planning to Stop That Benzodiazepine? Think Twice
Posted on January 5, 2024 by Pharmaciststeve
Planning to Stop That Benzodiazepine? Think Twice
Patients who discontinued long-term benzodiazepines had a higher risk of death
https://www.medpagetoday.com/psychiatry/generalpsychiatry/107959
Stopping long-term benzodiazepine treatment was tied to a higher risk of death, according to a comparative effectiveness study using claims data.
An intention-to-treat analysis showed that among people who weren’t simultaneously taking an opioid, the adjusted cumulative incidence of death over 1 year was 5.5% for those who stopped benzodiazepine treatment compared with 3.5% for those who didn’t, according to Donovan Maust, MD, MS, of the University of Michigan in Ann Arbor, and colleagues.
Those who were on concomitant opioids also had a higher incidence of death over 1 year if they stopped benzodiazepines compared with those who continued treatment (6.3% versus 3.9%), they reported in JAMA Network
Mortality risk for those who stopped benzodiazepines was 1.6 times higher than for those who stayed on treatment, with or without concomitant opioid use (95% CI 1.5-1.7 and 95% CI 1.6-1.7, respectively), they reported, noting that all of these risks held in a per-protocol analysis, and were slightly higher.
“Decades of research have demonstrated harms associated with benzodiazepine use, such as fall-related injury and increased risk of overdose — so the assumption has been that less benzodiazepine use would mean fewer harms,” Maust told MedPage Today in an email. “Our analysis suggests that, at least in those who have been receiving stable long-term treatment, risk of mortality appears to be higher in those individuals who have the benzodiazepine prescription stopped.”
“I think the findings speak to the importance of carefully considering the risk/benefit balance of continuing a benzodiazepine prescription,” he added.
Clinicians should be careful about letting their patients become long-term benzodiazepine users, especially if they plan to follow the standard of tapering those patients at some point, Maust added.
“I think it is important to revisit the assumption that tapering stable long-term users should be the default and instead, perhaps, focus on those with clearly elevated risk of harms,” he said.
Philip Muskin, MD, of Columbia University, who was not involved in the study, agreed that the results suggest clinicians should be even more deliberate about starting patients on benzodiazepines.
While the absolute risk shown in the study is small, Muskin said, “it’s real, and I think we need to respect that.”
Some people need and benefit from benzodiazepines, and they appear to be better off remaining on these drugs long-term, Muskin said. Based on these results, clinicians also likely need to diligently monitor any patient who begins to taper off benzodiazepines, even long after they discontinue the treatment, he added.
Increases in overdose deaths involving benzodiazepines have risen over the past several years, leading to a number of FDA actions including a 2016 warning related to co-prescribing with opioids and a 2020 class-wide boxed warning about the risks of abuse, misuse, addiction, physical dependence, and withdrawal reactions.
The FDA is also developing an evidence-based clinical practice guideline for the safe tapering of benzodiazepines, Maust and colleagues wrote. However, no studies have looked at the risks of discontinuation, they said. Stopping benzodiazepines may be “particularly fraught” as it can have both physiological and psychological implications, they added.
For their study, Maust and colleagues assessed claims data from Optum on patients with a benzodiazepine prescription from 2013 through 2019, totaling 213,011 without concomitant opioids and 140,565 with opioids. Mean age was about 62 and nearly two-thirds in each group were women.
Discontinuation was defined as having no benzodiazepine prescription for 31 consecutive days during a 6-month period after baseline. Patients were followed for about 1 year after baseline benzodiazepine prescriptions.
The researchers also found the risks of secondary outcomes including nonfatal overdose, suicidal ideation, and emergency department use were higher among those who stopped benzodiazepines, whether or not they also used opioids (relative risk 1.2, 1.4, and 1.2, respectively).
The study was limited in that it wasn’t a randomized controlled trial and couldn’t account for all possible confounders. Also, risks may vary by the speed of tapering, which the researchers did not investigate, Maust said. Finally, his team used a strict definition for stable long-term use of benzodiazepines, so this population may have been more likely to experience discontinuation-related distress and adverse effects.
Still, the researchers concluded that the findings are “at odds with the assumption underlying ongoing policy efforts that reducing benzodiazepine prescribing to long-term users will decrease harms,” adding that future work should examine possible mechanisms underlying these findings.
“It is possible that, having become physiologically dependent on benzodiazepines, patients experience adverse outcomes from withdrawal,” they wrote. “Alternatively, patients may experience adverse consequences if they seek alternative sedating substances (e.g., cannabis or alcohol) following benzodiazepine discontinuation.”
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Evidence-Based Policymaking: What’s Absent from the Opioid Crisis
Posted on January 3, 2024 by Pharmaciststeve
How Connecticut is going to resolve the opioid crisis – with an ORANGE STICKER
Posted on January 2, 2024 by Pharmaciststeve
How Connecticut is going to resolve the opioid crisis – with an ORANGE STICKER
As of January 1, 2024, Connecticut state law requires that all controlled substance and opioid prescriptions have a fluorescent warning label attached. Click here to see the regulations, policies and procedures.
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