I-Team: Online pharmacy shutting down after selling fake cancer drugs

http://abc11.com/health/i-team-online-pharmacy-shuts-down-after-selling-fake-cancer-drugs/3733321/

There are fresh warnings from both state and federal health officials about the risks of buying prescription drugs online.

According to the Food and Drug Administration, 97 percent of online pharmacies are “illegitimate and unsafe,” involving “highly sophisticated criminal enterprises” that sell medicine that “does not work, or worse, is dangerous to your health.”

Elaine Marshall, North Carolina’s Secretary of State, explained to the ABC11 I-Team that online pharmacy schemes also target consumers’ credit card numbers and identities.

“It is a fallacy that they’re in Canada,” Marshall said, referring to the popular notion that cheaper prescription drugs are available north of the border. “You can have all kinds of websites, and put up nice pictures, storefront locations and what have you, and they just don’t exist. They’re made up things.”

Jonathan Harward, Pharmacy Manager at Josef’s Pharmacy in Raleigh, said counterfeit drugs pose significant health risks to consumers because it’s possible the drugs are not the proper dosage, not stored correctly, or may have unknown ingredients.

“If you were to get a counterfeit drug and you were to take it, and you had a side effect – even a life-threatening side effect – we don’t know what that was,” Harward warns. “So it’s going to take more time for the doctor to reverse the effects or treat the effects of what happened to you.

The recent case of CanadaDrugs.com further exemplifies the many risks involved with online pharmacies. The company, which boasts that it has filled more than 7,000,000 prescriptions since its founding in 2001, will shut down on July 13 as part of a plea agreement with federal prosecutors. The indictment, obtained by the I-Team, highlights how investigators found pill bottles with no instructions and labels only in foreign languages; further investigation found CanadaDrugs.com selling two counterfeit cancer drugs with no active ingredients.

Under the terms of the plea, the company must forfeit $29,000,000 of the proceeds of their illegal scheme and pay a fine of $5,000,000. The court also sentenced CanadaDrugs.com’s Chief Executive Officer individually to pay a fine of $250,000 and five years of probation with the first six months in home confinement.

“FDA regulations are in place to protect patients and help ensure the medicines they receive are safe and effective,” said Catherine A. Hermsen, acting director of the FDA’s Office of Criminal Investigations. “The U.S. drug supply is among the safest in the world, but when drugs from outside the FDA’s closed supply chain enter the U.S., patients are put at risk. For the protection of consumers, the FDA will continue to pursue and bring to justice those who attempt to evade FDA’s regulations.”

For consumers wishing to purchase their medicine online, both the FDA and the Federal Trade Commission identify the following signs of a safe online pharmacy:

*Require a valid prescription from a doctor or another licensed health care professional.

*Are licensed by your state board of pharmacy or equivalent state agency. (To verify the licensing status of a pharmacy check your state board of pharmacy.)

*Do not appear on the National Association of Boards of Pharmacy’s “List of Not Recommended Websites.” (Just because the online pharmacy does not appear on this list does not mean it is safe.)

*Have a U.S. state-licensed pharmacist available to answer your questions.

*Are in the United States and provide a street address.

Additionally, the N.C. Secretary of State’s Office is promoting the website VerifyBeforeYouBuy.org, which enables users to simply enter a web address into a search bar and the tool will quickly determine whether the online pharmacy is certified and from a safe source.

“This is directed to help individual citizens,” Secretary Marshall insisted. “It is intended for consumers, it is health and safety issues by the medical community.”

All medications – both OTC and Rx – have a mandatory storage temperature … typically 55F – 85F for most.  Manufacturer, wholesaler and pharmacies are required to maintain those storage temperature.  But… once a pharmacy hands a filled prescription over to a delivery carrier… they are not obligated to maintain that storage temperature.  It is my understanding that there is a 24 hr “grace period” for medications to be outside of the required temperature and any outside of that range for > 24 hrs… is considered adulterated/contaminated and should be destroyed.

Many years ago, I read a report where some entity did a test on a inhaled medication ( I think) that was shipped/mailed to a address in the SW of the USA in the summer and when the contents were analyzed – after being in the heat of summer – LOST HALF OF ITS POTENCY !

I wonder how many deaths, these sort of things have caused and the person’s death was determined to be the deterioration of their health issue as the cause of death and never considered the possibility that the pt was getting their medication via mail order and they could have been sub-potent and contributed to the pt’s death ?

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Florida Attorney General Candidate Ashley Moody Stops in Bay County

https://www.mypanhandle.com/news/florida-attorney-general-candidate-ashley-moody-stops-in-bay-county/1287678156

BAY COUNTY, Fla. – Ashley Moody, a republican candidate for for Florida Attorney General made a stop in Bay County.

The Plant City native is familiar with Bay County, her mother born and raised in Panama City. Moody is a former federal prosecutor and judge married to a DEA agent. She plans to fight opioid epidemic by continuing the conversation and focusing on synthetic drugs like fentanyl.

She said she doesn’t believe in the separation of families at the border but said the administration is doing their best to correct it, and still follow the law.

“If i’m given the chance to be attorney general I will do so in a way they can be proud of their support, and will be a strong, effective attorney general for Florida,” said Moody.

Moody will face fellow republican Frank White in the primary election in August. If she wins there she will face the winner of the democratic candidates in November.

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Kasich team’s CVS ties questioned amid pharmacy benefit manager inquiry

http://www.dispatch.com/news/20180708/kasich-teams-cvs-ties-questioned-amid-pharmacy-benefit-manager-inquiry

The administration of Ohio Gov. John Kasich has been less than forthcoming about critical aspects of CVS’s business with the state as the pharmacy giant faces scrutiny over its Medicaid-related operations.

Possible conflicts of interest between the Kasich administration and CVS are fueling skepticism over whether Ohioans will see changes in a Medicaid setup that gives the national pharmacy company up to six times its actual cost of providing prescription drugs to Ohio’s poor and disabled.

The relationships are shrouded in secrecy — in part because of confidentiality laws and in part because the administration of Gov. John Kasich has been less than forthcoming about critical aspects of CVS’s business with the state.

The concerns are heightened because Medicaid officials withheld key information from state legislators about CVS costs and displayed a reluctance to make substantive changes to a system that many lawmakers and pharmacists say is a ripoff of taxpayers.

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https://video.vice.com/en_us/embed/5b3e30aebe40770821623321

5 minute video… making healthcare AFFORDABLE

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But I’m about to do a live feed  ( https://www.facebook.com/iamafibrowarrior ) I need all chronic pain patients to make these signs and post them in fact maybe even put it as their profile picture so we let the legislators know that we’re damn voters and we count

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https://www.civilized.life/articles/jeff-sessions-sabotage-medical-marijuana-research/

Attorney General Jeff Sessions hasn’t been able to institute any marijuana crackdowns due to political pressures in Congress, but he has found one area where he can stymie marijuana growth: research.

It’s been nearly two years since the Drug Enforcement Agency (DEA) announced it would open up the process for producing marijuana for research by the federal government. The DEA contracts outside companies to grow or manufacture illegal drugs so they can study them further. And yet despite opening up the process, the DEA still hasn’t picked any companies to provide marijuana for the process, and that’s exactly what Sessions wants.

Historically, while the Attorney General does oversee the DEA, they usually stay out of the process of researching marijuana. And yet Sessions inserted himself fully two years ago, and he’s refused to authorize anyone to begin growing marijuana for research.

Several members of Congress have questioned Sessions about the situation, and he’s given no indication as to when (or possibly if) he will make a decision. In April, Senators Orrin Hatch and Kamala Harris gave Sessions a deadline of May 15th to give them a timeline. That deadline was ignored.

Sessions claims that the DEA cannot handle overseeing more applications for marijuana growers, which is why he needed to get involved. And yet, the DEA has approved 26 applications for manufacturing other illegal drugs to study in 2018 alone. 

Unfortunately it doesn’t seem Congress is to intent on forcing Sessions to make a choice as all they’ve done is send a few letters to him. 

But why is Sessions so reluctant to allow this marijuana research to continue? If marijuana has no benefits, as he claims, wouldn’t the research simply prove him right? Or does he know that the research proves his antiquated ideas about cannabis are wrong, and he knows if he allows more research it will only become more apparent how wrong he is?

Pres Trump has had such a dramatic turnover in his Cabinet and yet this BOZO… is still around…

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@CVS Health/Caremark/Silver Scripts screwing pts on Medicare Part D ?

I called Senator Donnelly’s DC office about the issue that I had made in the above blog post earlier in the week… and you can read the letter that I got back from his office.  Being overcharged by CVS Health/Caremark/Silver Scripts has NOTHING to do with the donut hole with Medicare Part D.

The fact that over a ONE YEAR period… Silver Scripts was going to OVER CHARGE us enough on ONE PRESCRIPTIONS that would pay for ONE YEAR’S cost of property tax and insurance on our home. – NO SMALL SUM…

Early this week both Sen Warren (Mass) and Smith (Minn) has a press release about PBM’s and their role of high prices.. I attempted to contact their DC offices as well… but.. since I am not one of their constituents… not interested… I guess only FACTS from their constituents or those lobbyists with contribution to their re-election campaign are worth talking to.

You can read Sen Donnelly’s letter… Sen Donnelly is up for reelection in Indiana this Nov.. a Democrat in a normally very politically RED STATE…

I fully realize that Sen Donnelly didn’t himself generate this email, but if this is representative of the quality and training of his staff… IMO.. he has a problem…

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Opioid stigma is keeping many cancer patients from getting the pain control they need

www.statnews.com/2018/07/06/cancer-patients-pain-opioid-stigma/

History is repeating itself. Twenty years ago, a pain management crisis existed. As many as 70 percent of cancer patients in treatment at that time, or in end-of-life care, experienced unalleviated pain. Identified as a major medical problem, poor pain management became synonymous with poor medical care. In fact, prescribing adequate pain medication became mandatory for hospital accreditation.

The medications used to treat moderate to severe pain among people with cancer are the same opioids helping fuel today’s opioid crisis. Though it has turned a much-needed spotlight on the overprescription of these medications, it is overshadowing their underprescription among people who really need them, especially those with cancer. Two-thirds of individuals with metastatic cancer and more than half of those being treated for cancer report experiencing chronic pain, and 1 in 3 cancer patients do not receive medication appropriate for the intensity of their pain.

To get a sense of how people living with cancer are being treated for pain at a time when there is a growing stigma associated with opioid use, we reviewed 140 public posts on Inspire, the health social network we work for, written by 100 people with cancer and their caregivers. Although the writers spanned many cancer types, they primarily represented lung, bladder, and advanced breast cancer. In general, they described facing stigma from both health care providers and society in general.

Some writers said their doctors now hesitate to prescribe opioids due to concerns over addiction. Restrictions on refills and their timing are barriers to consistent use of medications to treat pain. Many of the writers said they felt they were being treated like drug seekers when their pain needs are real and management is necessary. Their experiences with access were described as: “makes me feel like a druggie,” “I use a very low dose,” “treated like a pill seeker,” and “I am not part of the oxycodone EPIDEMIC.”

One individual wrote, “I have been made to feel like a criminal – from my doctor’s office…to the pharmacy worker who said very loudly to other patients in line that I was sure taking a lot of opioids. I was humiliated. I have been afraid to ask for pain relief as it seems like I am doing something wrong. During my cancer journey, I had to have a hysterectomy without pain relief…Hospitals feel they are opening the door to opiate abuses and my surgeon would not authorize pain medicine. I am terrified right now to ask for a refill on my pain medication.”

While the stigma from health care providers can affect cancer patients’ access to pain medications, it is the stigma from society that affects their use. Many writers indicated that they feared becoming addicts and worried about withdrawal symptoms. They also offered concerns about what use of high doses or multiple daily pain pills says about them.

These misperceptions aren’t alleviated by what patients are learning about opioids. Varied messaging about addiction and dependence from the media, government, and even health care providers seems to be leading to confusion and misunderstanding among cancer patients. Some of the Inspire writers said that health care providers had told them that cancer patients who need increasing doses are addicted; others wrote that their providers said they cannot become addicted because they “don’t get high.” Some providers say those who need increasing doses are addicted, while others say it means they are becoming tolerant or dependent on drugs. These contradictory views leave patients unsure, with many of them opting to live with pain rather than risk addiction.

We read several posts indicating that fear of addiction is causing family caregivers to withhold prescribed pain medications from those they are caring for. Responses to these posts advised against doing that, offering the opinion that managing pain is more important than addiction. While caregivers take this advice seriously and often follow up with a physician, we don’t know what they finally decide to do.

Some of the posts advocated for proper, controlled pain management, arguing that stigma should not interfere with care decisions. Their basic message to other group members is: “Don’t feel guilty for taking pain medication.” They recommend seeking out clinics and teams with expertise in pain management, cautioning that oncologists may excel in their treatment of cancer but are not necessarily knowledgeable about treating cancer-related pain.

Inspire members who wrote that they are not feeling stigmatized expressed confidence in their opioid use, derived from having knowledgeable pain management physicians who are not only experts in the field but who take time to explain pain management strategies and who include patients in decision making. These patients feel they are part of a team that is both instructive and supportive, and experience fewer struggles with access or worries about how to take their medications.

Two decades ago, the medical community woke up to the fact that far too many people with cancer weren’t being properly treated for their pain, sparking a movement to improve pain control that may have helped give rise to the epidemic of opioid misuse now affecting the country. In addressing this problem, the pendulum has swung too far, attaching a stigma to using opioids for legitimate reasons. While individuals treated in pain management clinics or by physicians specializing in pain management may be inoculated against or protected from this stigma, not everyone with cancer has access to these professionals.

What can be done? Education and clear messaging seem to be key. Pharmacists, oncologists, family practitioners, and other clinicians who care for people with cancer need better education about pain management. So do patients with cancer and their caregivers. Pain management awareness campaigns aimed at both patients and physicians could help counteract the stigma and encourage practices that do not hinder legitimate access or use.

People with cancer who need medication to control their pain are getting lost in the middle. They need support, not stigma.

Sara Ray is senior director of research at Inspire, where Kathleen Hoffman is senior health researcher and writer.

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Pay attention to cost of prescription at CVS/Caremark

http://www.dispatch.com/opinion/20180706/letter-pay-attention-to-cost-of-prescription

I want to share my recent experience with CVS Caremark. I called my doctor’s office to refill my 30-day prescription at their local dispensary. My two previous orders were 54 cents each, with help from my insurance company. When I asked for another refill, I was informed by the dispensary that CVS Caremark had taken over this prescription.

After going through numerous telephone menus, I was told that this would be fulfilled with a 90-day supply. I received my order yesterday and was billed $12. That is nearly a 750 percent increase from my original price. I am trying to find out the reason for such an increase.

I am thankful that The Dispatch has been doing its investigation into CVS Caremark pricing and suggest other people pay attention to the company’s billing practices.

Joe Erion, Columbus

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