“The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick and the needy, and the handicapped.” – Hubert Humphrey
passionate pachyderms
Pharmacist Steve steve@steveariens.com 502.938.2414
It’s a health problem that a Wisconsin lawmaker calls “staggering” and which is expected to get worse.
Two out of five people living in Wisconsin are expected to develop type 2 diabetes in their lifetime, a disease the Wisconsin Department of Health Services estimates costs $5.5 billion annually in health care and lost productivity.
“This is something that is going to be affecting us all and it is a train that has not been able to be slowed down,” Rene Walters, diabetes education supervisor for UW Health, told state lawmakers on Wednesday.
A bipartisan proposal which got a hearing before the Assembly Committee on Health would require the state’s Health Department to develop a “diabetes action plan” with data on prevalence and prevention compiled in a report for lawmakers every two years.
More than half the states in the U.S. have assess the burden of the disease and make policy recommendations under diabetes action plans, according to the American Diabetes Association.
“These issues are costly to our state and affect a lot of people and, for the most part, type 2 diabetes is preventable,” said state Rep. Tyler Vorpagel, R-Plymouth.
He said lawmakers should do “anything we can to saves the state money and makes their lives better.”
Rep. Melissa Sargent, D-Madison, called the costs “staggering” and noted that 1,300 people die from diabetes in the state every year.
Under the proposal, the state’s Health Department would receive $107,600 to gather and analyze data and prepare biennial reports for lawmakers.
Those testifying at the committee hearing had different views on why diabetes has been such a stubborn problem to solve.
Anand Iyer, who runs Welldoc, a company that produces health and wellness software, said the problem isn’t going away with traditional methods and needs to be addressed differently.
Walters said the nature of the problem leads to inaction. Common ways to combat diabetes — diet and exercise — are personal and require change, he said. That’s something many find hard to do.
WASHINGTON, D.C. — U.S. Senators Kamala D. Harris (D-CA), Dick Durbin (D-IL), Mike Lee (R-UT), Sheldon Whitehouse (D-RI), Amy Klobuchar (D-MN), Chris Coons (D-DE), Mazie Hirono (D-HI), and Cory Booker (D-NJ), all members of the Senate Judiciary Committee, sent a bipartisan letter to Department of Health and Human Services (HHS) Secretary Alex Azar about their concerns that the Drug Enforcement Agency (DEA) and Department of Justice (DOJ) have not adequately consulted with public health agencies in connection with the Trump Administration’s recent request that Congress legislatively place all “fentanyl-related” substances into Schedule 1 of the Controlled Substances Act (CSA).
“We are concerned that the failure to engage necessary health experts vests far too much authority to a law-enforcement agency and may result in action that will deter valid, critical medical research aimed at responses to the opioid crisis, including efforts to identify antidotes to fentanyl-analogue overdoses and improved treatment options. We are also concerned that by sweeping a broad set of substances onto Schedule 1, with no scientific consultation, we risk erecting unnecessary research barriers to drugs that may have great potential to society, and criminalizing substances that have no psychotropic effects,” the Senators wrote.
Walmart has terminated hundreds of pharmacists and technicians! But before addressing this action, let’s identify an extremely important event that has had a large influence on Walmart’s not being able to operate its pharmacies as profitably as it wants to. Walmart recently withdrew from the network of pharmacies participating in CVS-Caremark’s prescription plans because of its determination that the reimbursement it was being provided was too low. However, within just several days Walmart and CVS-Caremark reached an agreement. If Walmart insisted on appropriate compensation from CVS-Caremark and other health insurers and pharmacy benefit managers (PBMs), it would not have to be terminating pharmacists and technicians, and its customers would be much better served. If Walmart as the world’s largest retailer can’t successfully operate pharmacies because of the mandates/demands and inadequate compensation from PBMs and health insurers, can anybody?
Walmart caved in to CVS-Caremark, as did Target, another huge and otherwise successful retailer, several years ago when it sold its pharmacies to CVS. The PBMs and health insurance companies are destroying the quality and scope of health care, and by not challenging them, Walmart and Target are complicit in the responsibility for this debacle.
Walmart terminations
It is surprising that the Walmart terminations have not received more media attention. However, the coverage in Bloomberg News (Matthew Boyle; June 26, 2019 and updated on June 27) identifies pertinent information as well as the lack of transparency on the part of Walmart. The article quotes a Walmart spokeswoman as saying the company “is aligning our staffing with the demands of the business. I don’t have a lot to share right now, other than we are on a transformational journey on how we operate our pharmacies and serve our customers.” The spokeswoman would not specify the number of jobs being cut.
The Bloomberg News report identifies a source who is familiar with the decision as saying that the pharmacy cuts will represent less than 3% of all health and wellness staffers in the U.S. This statement appears highly deceptive. The number of “health and wellness staffers” at Walmart has to be much higher than the number of pharmacists and pharmacy technicians, thereby creating a larger denominator from which pharmacy cuts representing less than 3% is calculated. “Less than 3%” is seemingly intended to suggest that the number of individuals terminated is small. Walmart should reveal the percentage of pharmacy cuts based on the number of pharmacy staffers rather than health and wellness staffers. However, that would look bad and raise even more questions as to whether the significant reduction in pharmacy staff will increase the risk of errors and harm to customers.
The numbers of pharmacists and technicians who have been terminated or have had their hours reduced are more likely in the many hundreds and possibly thousands. Posts on social media and message boards suggest that the cuts may include as many as 40% of senior pharmacists.
The Bloomberg News report includes a comment of the Walmart CEO at a gathering of investors in October, at which he stated that the company wants to find ways to increase its “share of wallet” in the $3.5 trillion market for health spending in the U.S. My loose translation of that statement is: Get the money, even at the expense of our customers and employees.
Responses of Walmart pharmacists and technicians
Hundreds of comments from Walmart pharmacists and technicians have been posted on social media sites and message boards regarding the actions taken and the manner in which they were communicated. For understandable reasons, most are provided anonymously, and the following represent a very limited representation of the distress and anger experienced.
“I was called to the back by the district manager several hours into my shift He gave me the talking points, went back to the pharmacy, handed me my license, and I was on my way home in 10 minutes! I thought our store was doing well!”
“‘Accompanied’ out of the building in front of staff and customers, desperately trying to hang on to my dignity. Failed miserably.”
“I got laid off yesterday as a pharmacy tech after 25 years of loyal service.”
“My exit interview wasn’t honest. I was encouraged to reapply full well knowing no positions will be posted within the 2-month window so IF I ever went back to Walmart it would be at drastically reduced pay.”
“Has anyone got any kind of paperwork from being let go? I’m having a hard time trying to get any kind of paperwork with my name on it.”
“The corporate email sent out this week said all the layoffs and changes were done to benefit customers. Well, my pharmacy has no more cashiers, no more pharmacist overlap, and tech hour cuts, but the script counts aren’t going down. Customers used to 20 minute waits will start leaving when the minimum reaches 1 hour+. Benefits only the shareholders.”
“Now with all of the staffing shortages its only a matter of time when big mistakes will be made due to the rush and stress of vaccinations, 90-day adherence, and pushing to get scripts out fast! With no cashiers at our busy store, we have techs trying to be both techs and cashiers and still get things done. One pharmacist per day at our store, long hours, no breaks, and his license on the line if a mistake is made.”
“Mr. Sam Walton (the founder of Walmart) said ‘There is only one boss – the customer. And he can fire everybody in the company from the chairman on down, simply by spending his money somewhere else.'”
“I bet Sam Walton would be rolling over in his grave if he could see what his company has become.”
“Walmart was the company who started the $4.00 prescriptions years ago. If they would have only raised it over time, they would be able to pay for adequate staffing and keep long-time, loyal employees.”
“Walmart just paid $282 million to settle and try to silence an international bribery scandal.”
“I am not a young pharmacist. I have been doing this for 20+ years. It has taken a toll on my body – standing for 12 hours a day, with less breaks than are legally mandated – all have contributed to knee/back/joint problems. . . I am a single parent with kids. And no job. In a saturated market. I think I’m going to have to sell my house, and most of the things in it. This has dramatically impacted me and my children. I have no illusions that I will find another job anytime soon, or that we will even have a home to live in. Devastated!”
These comments and the hundreds of others are all important. However, the last comment above has such an disturbing impact that I had to interrupt my reading, and resume reading more comments at a later point. Walmart executives must be made to recognize that the actions they take because of their mistakes have devastating consequences for individuals who have served their company well. However, they avoid personal responsibility to the point that a number of the individuals terminated observed that the manager who informed them of their firing said that the decisions were made by computers.
Actions Walmart should take
All of the comments posted by former and current Walmart employees should be compiled in a document titled, “How NOT to treat employees and run a business.” Every Walmart executive and manager should be required to read it in its entirety.
Walmart has attempted to operate pharmacies, and it has failed! It has placed its customers at risk, and treated its pharmacists and technicians horribly. Walmart, as a company should now get out of pharmacy before it makes things even worse for its customers, pharmacy staff, and the profession of pharmacy. Rather than doing what Target did in selling its pharmacies to CVS, Walmart should sell its pharmacies and first offer them for purchase to its current and former pharmacists.
North Dakota has it right!
North Dakota has a law that requires majority ownership of pharmacies to be held by licensed pharmacists. There have been numerous attempts to overturn or circumvent this law that have been led by Walmart, Walgreens and others (please see my editorial, “Voters in North Dakota Should Oppose the Challenge to the Pharmacy Ownership Law!” in the September, 2014 issue of The Pharmacist Activist). These challenges have failed, and residents of North Dakota are served well by this law.
Other states should enact similar laws for new pharmacies, and existing pharmacies when ownership is changed. To protect the safety of the public, state boards of Pharmacy should require Walmart and other chain pharmacies that are substantially reducing pharmacist and technician staffing to submit reports of errors that occur.
CARTERSVILLE, Ga. – A Cartersville mother has an important warning for others after she says a local CVS pharmacist filled her 13-year-old son’s prescription with the wrong medicine.
Susanne Epps Jones told Channel 2’s Alyssa Hyman that her son, Elijah, is on the autism spectrum and has been taking the same medicine for eight years.
“I was scared. I wanted to know how it was going to affect the other medications that he’s been taking, what were the side effects. I didn’t know anything about the drug,” Epps Jones said.
Epps Jones said the pharmacist filled her son’s prescription with medicine commonly used to treat Parkinson’s disease.
“I immediately took him to the emergency room,” Epps Jones said.
She told Hyman that fortunately, Elijah is OK and only had mild side effects.
Epps said when she picked up his prescription, she had no reason to think anything would be different
I do take my responsibility. I should have inspected it more, but they looked the same size, shape and color. I didn’t think anything of it,” Epps Jones said.
She told Hyman that the pills and the bottles were so similar, she didn’t notice that it was the wrong prescription until four days later.
The directions on the bottles are the same, and the names of the medicines look similar.
“I trust my pharmacist to be filling the right prescription,” Epps Jones said.
Hyman contacted CVS to ask about the medication mix-up. A corporate spokesperson sent her a statement that said:
“When Ms. Jones notified our pharmacy about her son’s prescription on Friday evening, our pharmacist apologized and attempted to contact the prescribing doctor, however the doctor’s office was closed for the weekend.
“Our district leader has been in touch with Ms. Jones multiple times since the incident occurred to apologize, follow up on her son’s health condition, and ensure that he receives the correct medication.
“Prescription errors are a very rare occurrence, but if one does happen, we do everything we can to learn from it in order to continuously improve quality and patient safety.”
As for Epps Jones, she wants to remind everyone to check their medication.
“You get into a pattern after eight years of taking the same medicine every single month. I will now, from this day on, and we’re changing pharmacies,” Epps Jones said.
David Lackey spent 40 years running his machine repair business, despite having a body wracked by arthritis, degenerative disc disease, bone spurs in his shoulders and fractures in his back and spine.
After the Drug Enforcement Administration raided his pain doctor’s offices in January, seized medical records and prohibited any more opioid prescribing, Lackey only lived 34 more days.
The Odessa, Texas man died of a heart attack in March, after a month-long withdrawal that left him in bed shaking or in the bathroom vomiting and with diarrhea, his daughter, Gina Bruton, said.
Facing a backlash from chronic pain sufferers nationwide, federal health officials are rethinking policies that led to abrupt cutbacks to those who legitimately need these painkillers to function.
Federal measures made a broad-based effort to cut opioid prescribing and slow an overdose epidemic that kills tens of thousands of Americans each year. However, the Centers for Disease Control and Prevention officials acknowledge the agency’s influential 2016 chronic pain guideline has been used incorrectly to justify harmful practices such as rapidly reducing pain pills or doctors abandoning patients.
The CDC plans to update and expand the guideline with new research and is coordinating with public safety officials to ensure patients such as Lackey aren’t discarded when a doctor’s office is raided or closed.
In April, the Food and Drug Administrationwarned about reports of serious harm from slashing or discontinuing medication for opioid-dependent patients, including withdrawal, pain, psychological distress and suicide.
This fall, the FDA is expected to finalize plans to add warning labels to opioid medications about the risks of abruptly stopping the drugs. The FDA also proposed in May that drugmakers be required to offer limited-count blister packs of pills as an option to patients. These packs could be in low, medium or high-dose packs or be tailored to different procedures, such as hernia operations or appendectomies.
And a Department of Health and Human Services advisory task force in May reported on how to weigh the needs of 50 million chronic pain sufferers while tightening prescribing to prevent opioid addiction. The Pain Management Best Practices Inter-Agency Task Force recommended ways to allow pain sufferers to function and improve their quality of life.
Total U.S. opioid prescriptions have declined each year since 2012, a trend that accelerated after the CDC guideline issued in March 2016. Still, overdose deaths have continued to climb as pharmacies dispensed fewer pain pills, largely driven by illegal drugs such as heroin and fentanyl.
Vanila Singh, who chaired the HHS task force, says it could take time for state medical boards, doctors and others to bring nuance to prescribing opioids.
“I am not advocating we go and mindlessly prescribe,” says Singh, chief medical officer of the HHS office of the assistant secretary of health. “It has to be where the stigma of being the patient or the doctor or clinician who is prescribing is lessened. It is still a hard ship to turn.”
‘Doctors are afraid of the DEA’
Bruton believes pain patients and doctors have been unfairly targeted.
“Sure, the warning labels should be there,” says Bruton. “But in my opinion, they are fighting the wrong war.”
The CDC’s clarification is that its guideline was intended for primary care doctors, who increasingly are turning away pain patients.
“Doctors are afraid of the DEA and worry their livelihood will be lost, so they are trying to protect themselves,” says Bruton.
Like her father, Bruton’s husband, Vernon, works in heavy machinery repair and was a patient of Carl D’Agostino, a pain doctor who was disciplined by the Texas Medical Board in June 2018 for failing to maintain paperwork that showed he monitored patients through urine drug screens, pill counts and medical histories. D’Agostino did not return calls from USA TODAY.
Vernon Bruton now has to travel 700 miles round-trip to a new pain doctor in San Antonio, Texas. She says there are only four or five pain management doctors in an area of about 200,000 people.
He takes a small dosage of opioids to treat his degenerative disc disease and neuropathy, some of which stems from a car crash when he was young and drove off a bridge, landing in a creek bed upside down in his truck. He was found six hours later.
“Every day he worries his will be the next doctor raided,” says Bruton.
Because he couldn’t get copies of his medical records from the FBI, no new doctor would take Lackey on as a patient. The 74-year-old was still working part-time for his business and needed his 60 milligrams of hydrocodone a day to “be functional,” says Bruton.
“He was never completely out of pain,” says Bruton. “He just wanted to be able to participate in life.”
‘At the end of my rope’
The CDC acknowledged that there may have been unintended consequences from its 2016 guideline. Officials emphasized that the CDC is not a regulatory agency and its guideline is voluntary. Nevertheless, state health departments, insurers and other cited the guideline as reason for implementing opioid limits.
A common restriction: Limiting daily opioid intake at 90 morphine milligram equivalents per day – equal to two 30-milligram oxycodone pills.
“A lot of groups have taken that number and said, ‘We need to either taper [patients] down to that amount or we need to stop them,’” says Sharon Tsay, a medical officer with the CDC’s division of unintentional injury prevention. “That was not the intention. Some individuals need higher levels. People have physical dependence, whether or not they have addiction. So it’s actually very unsafe.”
Along with the federal Agency for Healthcare Research and Quality, the CDC is collecting new data to update and expand its pain guideline. The agency described the research as a priority but would not say when it expects to publicly release the information.
41% refuse new pain patients
Other research shows one consequence of the prescribing crackdown is that doctors are reluctant to take on new pain patients. A University of Michigan study published Friday in the Journal of the American Medical Association found that 41% of 194 primary clinics surveyed refused to take new pain patients.
Rebekah Leonard knows the difficulty of finding a pain doctor. A bulging disc, nerve damage and a botched back surgery have put the Reidville, South Carolina woman in constant pain since the late 1980s.
She says a fentanyl skin patch provided steady relief for years. But when her primary-care doctor retired five years ago, it took six months to find a pain specialist who put her on a strict, tapering regimen. When Leonard failed to take off one pain patch before putting on another, the pain doctor refused to continue to treat her, she said.
She’s been without pain medication for more than three years and spends 23 hours a day on her bed or sofa. She rarely leaves the house.
“I’m at the end of my rope,” Leonard says. “There are many people in this situation. You don’t seek any solutions. After awhile, you don’t have the energy for it.”
From Vicodin to kratom
Tucson, Arizona resident Jacqui Gerschefske still has lingering back pain from an auto accident six years ago caused by a drunk driver. Her primary care doctor prescribed 5 milligram dosages of Vicodin and oxycodone, which allowed her to stand for 8-hour shifts as a convenience store clerk.
“She knew I was stable and she knew I was not abusing,” Gerschefske says.
Her doctor retired and her new doctor refused to prescribe her the same regimen, so Gerschefske began taking a herbal product, kratom. The FDA has warned consumers to avoid kratom because of risk of addiction, abuse and dependence.
The CDC says kratom, an herbal supplement, was a cause of deaths in 91 fatal overdoses in the United States from July 2016 to December 2017. USA TODAY
Gerschefske says because she no longer has access to a doctor willing to prescribe opioids, she will stick with kratom despite the FDA warnings.
“My new doctor doesn’t prescribe pain pills,” Gerschefske says. “This was my solution, and I’m thankful that I have it.”
Feds want to prevent new cases of addiction
Public comments on the FDA’s blister pack proposal have been largely negative so far, with suggestions that regulators focus on illegal drugs and look for solutions that don’t make it harder for people with painful conditions to open their pill packs.
Dr. Yngvild Olsen, a Baltimore addiction medicine physician, notes the proposed blister pack rules are targeted at patients with acute pain, such as after injuries or surgery. She doesn’t expect it will help or hurt chronic pain patients much. But it could help prevent some addictions from starting.
“Certainly there is a percentage of people who get started on opiods for acute pain and continue to use and may go on to misuse,” she says.
Olsen, co-author of “The Opioid Epidemic: What Everyone Needs to Know,” said the CDC guideline was applied in ways it was never intended.
It “was really never meant for people already on opioids,” she said. “Unfortunately, that’s what happened.”
Dr. Douglas Throckmorton, deputy director for regulatory programs in FDA’s Center for Drug Evaluation and Research, says the agency has “never lost sight of the needs of pain patients.”
“We know that every action we take could have a big impact,” he said.
Although doctors still routinely give 30-day prescriptions to opioids for procedures that rarely require more than a couple days, Throckmorton says he believes they can “change in response to conditions and education.”
“The goals that the CDC has mirror our goals – education and to reduce inappropriate prescribing of opioids,” said Throckmorton. “As we work to educate prescribers, we will continue to keep the pain patient in mind.”
Two U.S. Senators introduced a piece of legislation Thursday which would prohibit the Food and Drug Administration (FDA) from allowing opioids to be labeled for intended use of “around-the clock, long-term opioid treatment.”
The FDA Opioid Labeling Accuracy Act, introduced by U.S. Sens. Joe Manchin, D-W.Va., and Mike Braun, R-Ind., would prohibit such labeling until a study can be completed on the long-term usage of opioids.
“In the United States, we consume 80 percent of the world’s opioid production and in 2017, one single year, over 70,000 people died due to drug overdoses,” Manchin said in the release. “These statistics are unacceptable. As one of the hardest hit states, West Virginia has been on the front lines of the opioid epidemic, which is why I have introduced this bill today with Senator Braun to address how the FDA approves opioid prescriptions for treating different types of pain.”
In 2001, the release said the FDA updated opioid labels to indicate use from “moderate to severe pain where use of an opioid painkiller is used for more than a few days” to “management of moderate to severe pain when opioids are needed for an extended period of time.”
With this change, opioids began to be prescribed as a first line of treatment for long-term chronic pain that surpassed the original intended use for cancer pain or short term post-surgical pain and definitively contributing to the heightening of the opioid epidemic.
The FDA Opioid Labeling Accuracy Act would prohibit opioids from being labeled for intended use to treat long-term chronic pain, except for cancer pain, end-of-life care or when a prescriber has determined that all non-opioid treatments are inadequate or inappropriate.
This past Monday, Senator Braun had a “town hall meeting” in Corydon IN. At one point he was talking about “Medicare for all”.. which apparently he was not in favor of. I tried to point out to him that what “they” are talking about is “MEDICAID FOR ALL” because it would seem that they are talking about paying for FIRST DOLLAR for everyone’s medical care.. I pointed out that Medicare required premiums, deductibles, co-pays and it was MEDICAID that may have minimal copays … mostly on prescriptions… otherwise the pt has “no skin in the game” … He went right back to talking about “MEDICARE FOR ALL”
Senator Manchin, in the last Congressional session, proposed a “opiate prescription tax” to get money from group of pts (chronic painers ) to pay for the treatment for another group of pts (substance abusers).
Agents with the Florida Department of Law Enforcement, who have been investigating Wester for more than nine months, arrested him in Crawfordville and took him to the Wakulla County Jail, where he is being held without bail. Wester, expected to make his first court appearance on Thursday, invoked his right to remain silent and declined to speak with investigators.
He was arrested on 52 counts in all. Aside from the racketeering count, he was charged with a number of other felonies, including official misconduct, false imprisonment, fabricating evidence and possession of a controlled substance. He was also charged with misdemeanor charges of perjury, possession of a controlled substance and possession of drug paraphernalia, FDLE said.
Jackson County Sheriff Lou Roberts, State Attorney William “Bill” Eddins of the 1st Judicial Circuit and Chris Williams, special agent in charge of the FDLE’s Pensacola office, discussed the case in an afternoon news conference. One of Wester’s alleged victims, Teresa Odom, wept as they discussed details of the case.
“I’m overwhelmed,” she said afterward, adding she was proud of one of the FDLE agents who worked with her during the investigation.
‘Something we’re not proud of’
Roberts, who had been silent about the Wester allegations since the Tallahassee Democrat broke the story last year, said Wester’s alleged crimes were “disheartening.” He thanked the community for its patience during the investigation, which got sidetracked after Hurricane Michael hit Oct. 10.
“This is something we’re not proud of,” said Roberts, who plans to retire and not seek re-election next year. “No agency wants to go through this kind of situation and face the embarrassment of the public. This is a very serious matter. We’re supposed to set higher standards, and the allegations that were made in this case will be tried.”
Eddins and Williams offered new details in the case, including a large amount of drugs found in Wester’s vehicle during an internal affairs probe that began last August. But investigators declined to give a possible motive for Wester’s alleged actions.
“You’re never certain of the ways of the heart of man,” Eddins said. “We have some ideas and some theories, and we’ve talked about that a lot. But I do not feel that it would be appropriate to go into it in any detail at this time.”
Williams emphasized that the case was still open, and he asked the public to call FDLE’s Pensacola office if they have any information about Wester.
“A significant investigation has been and is being conducted,” Williams said. “FDLE has assigned a team of 10 special agents and two crime analysts who have logged over 1,400 hours on this case already. And it’s still ongoing today.”
Eddins, who was assigned the case after Glenn Hess, state attorney for the 14th Judicial Circuit recused himself, said he was prepared to go to trial now if Wester demands a speedy trial. And he said he will not allow a plea bargain in the case in part because it involves a public employee. He added that so far, no evidence has been found that any other deputies or other Sheriff’s Office personnel worked in concert with Wester.
“It’s been my experience in monitoring this investigation that the law enforcement community in Jackson County is honest, professional and they do not condone or support illegal activity,” Eddins said. “I cannot overstate how complete and how well (the Sheriff’s Office) cooperated with us.”
‘His actions put innocent people in jail’
FDLE began its investigation last August at the request of the Sheriff’s Office after whispers of misconduct by Wester began to surface around the courthouse. He was suspended Aug. 1 and fired a month later. During the internal investigation, deputies searching his patrol car found 42 pieces of drug paraphernalia, ten baggies of methamphetamine and five baggies of marijuana concealed in an unmarked and unsecured evidence bag in the trunk.
“The items located within Deputy Wester’s patrol car were not maintained as required of legitimate evidence, items for safe keeping or items for destruction,” the arrest affidavit says. “The multiple items located were consistent with, and similar in appearance to, items believed to have been used to fabricate evidence during (his) traffic stops and arrests.”
The investigation found Wester routinely pulled over citizens for alleged minor traffic infractions, planted drugs inside their vehicles and arrested them on fabricated charges. It also found that Wester misused his body camera, sometimes turning it off before drugs were located or turning it on just after they were found.
“There is no question that Wester’s crimes were deliberate and that his actions put innocent people in jail,” Williams said in a news release. “I am proud of the hard work and dedication shown by our agents and analysts on this case to ensure justice is served.”
Christina Pumphrey, a former assistant state attorney in Marianna who helped bring Wester’s alleged misdeeds to light, said she was “incredibly surprised” to learn of his arrest because she didn’t think he’d ever get charged.
The last I read, the Supreme Court has determined that a police office can’t required a person stopped for a traffic stop.. they cannot make a person wait for a “drug dog” and handler to show up to “sniff the car” if the person declines for the officer to search the car. The Supreme Court declared that the detaining of a person was consider a unreasonable SEARCH AND SEIZURE… violation of the 4th Amendment.
I once saw a video before this Supreme Court ruling where the person allowed his car to be “searched by a dog” . little did the police know that the person they have pulled over .. was a trainer of these dogs and he pointed out in the video where the dog was responding to the officer’s signal to react as if there was contraband in the person’s car.
Needless to say that this person, got the charges dropped… what happened to the canine officer… after this case was thrown out… I don’t remember.
A big part of the Trump administration’s plan to lower drug prices is now dead, White House spokesman Judd Deere confirmed to Axios.
Why it matters: The administration is backing away from an effort to change the way money flows through federal health care programs — one of the most sweeping elements of its drug-pricing blueprint. That’s bad news for pharma, and the move will put pressure on other parts of the administration’s plan, which is also bad news for pharma.
How it works: The now-dead proposal would have overhauled the rebates collected by pharmacy benefit managers — the middlemen between insurance plans and drug companies.
They negotiate discounted prices in the form of a rebate, but keep some of those rebates for themselves as profit.
Trump’s proposal would have banned that arrangement in Medicare and Medicaid, requiring PBMs to pass the rebates on to patients at the pharmacy counter and find a different way to bring in their own revenues.
What they’re saying: “Based on careful analysis and thorough consideration, the President has decided to withdraw the rebate rule,” Deere said.
“The Trump administration is encouraged by continuing bipartisan conversations about legislation to reduce outrageous drug costs imposed on the American people, and President Trump will consider using any and all tools to ensure that prescription drug costs will continue to decline,” he added.
Between the lines: This is very bad news for the pharmaceutical industry, which blames middlemen for high drug prices and vocally supported the proposed rebate overhaul. It’s very good news for insurers and PBMs.
Independent critics of the proposal argued it did nothing to require drugmakers to lower their prices and would’ve cost taxpayers hundreds of billions of dollars.
What’s next: This will increase the pressure for the administration to finalize its other major drug-pricing push — which the pharmaceutical industry loathes.
That proposal would set Medicare’s prices for certain drugs based on the prices other countries pay. It likely “will be the executive order of choice,” a source close to the administration said.
The plan is also controversial among Republicans, who are hesitant to set drug prices.
What we’re watching: The administration is also open to a controversial proposal being discussed in the Senate that would limit how much drug companies can increase their prices within Medicare’s drug benefit.
“Driving down outrageous price hikes in prescription drug prices is a priority for the President, and a policy like an inflation cap for Part D drugs is something the Trump administration is seriously considering,” a senior administration official said.
The government just has to open up the VA medication purchasing contract to all community pharmacies.. The get some of the lowest prescription medication prices in the country. Reimburse the pharmacy for the cost of the medication and let the pharmacies determine what the copay is for the pt. Let the free market determine which community pharmacies prosper or fall by the wayside.. Let the pt decide if they are comfortable – or willing – to pay a higher copay for better, more convenient service or prefers to wait in line and pay a few dollars less out of pocket for their prescriptions. The PBM’s can still be in the process – back to their original design – a processor of payments… the government will negotiate with them to how much the feds will pay over the cost of the medication – based on the VA contract – to cover their overhead. Will it happen – NOPE – too easy and too transparent for the insurance/PBM industry.
