Hidden fees at the pharmacy: Why it may be cheaper not to use your insurance

Posted on December 14, 2017 by Pharmaciststeve

http://wric.com/2017/12/14/hidden-fees-at-the-pharmacy-why-it-may-be-cheaper-not-to-use-your-insurance/

RICHMOND, Va. (WRIC) — A woman uses her insurance to purchase the drug Sprintec. Her copay was $50.

However, if she didn’t use her insurance and paid cash for the drug, it would only have cost her $11.65. That’s a difference of $38.35.

This is called a copay clawback. It’s a little-known secret driving up the price of your prescriptions.

Douglas Hoey, CEO of the National Community of Pharmacists Association explains to 8News how it works.

“The insurance company tells the pharmacy what to charge. The insurance company overcharges the consumer and then the insurance company takes the extra money back from the pharmacy that the pharmacy was forced to collect,” Hoey said.

It’s carried out through a middleman known know as a pharmacy benefit manager or PBM.

PBM’s negotiate drug prices with drug companies on behalf of your insurer.

 

Some PBM’s then charge a co-pay that exceeds the cash price.

Your pharmacist is expected to charge whatever price insurers set, and that middleman pockets or clawbacks the profit.

“The insurer sends back a message that says this is how much to charge the patient. That is the first time the pharmacy knows how much a patient is going to pay,” Hoey explained.

Many pharmacists can’t tell you that if you just paid with cash it would be cheaper. They’re sworn into secrecy with a sort of contract gag clause.

“The pharmacist is restricted or actually threatened by the PBM to tell the patient that they can maybe get the drug cheaper if they use cash,” Hoey said.

 

There is a language in the contract that implies if the pharmacist shares information with the consumer … the insurance plan can terminate the pharmacist contract,” Hoey said.

Federal lawsuits filed against United Healthcare, OptumRx and CVS Health allege these clawbacks impact a wide range of drugs and tend to target mostly those on high deductible health plans.

In one suit filed in Minnesota, the plaintiff, Megan Schultz alleges she got ripped off. She says she paid $165.68 for a generic drug with her insurance. Yet, if she paid cash, it would have only cost $92.00.

“We definitely do not want to be in that position as being the bad guy. Our goal is to get the safest medicine, the best medicine for the patient at the lowest cost,” Hoey said.

So what can you do? Medliminal, a medical billing advocacy group says just ask.

If you ask, “What’s cheaper, paying with my insurance or cash?” then the pharmacists can tell you.

Medliminal also tipped us off to the website GoodRX.com. It lets you type in your zip code to find the lowest price near you. Then you’ll know what you should be paying for that prescription before you get to the pharmacy. It also offers coupons for certain drugs.

Some states like Texas are trying to outlaw these clawbacks.

We reached out to United Healthcare, OptumRx and CVS health. CVS responded saying:

“Our PBM, CVS Caremark’s long-standing practice is not to engage in copay clawbacks, and we have no plans to implement clawbacks. If a PBM plan member’s copay for a drug is greater than the dispensing pharmacy’s contracted rate, it is not CVS Caremark’s practice to collect that difference from the pharmacy. If the pharmacy’s cash price is lower than the co-pay, the patient would be charged the lower price.”

 

United Healthcare issued this statement:

“Pharmacies should always charge our members the lowest amount available under their benefit plans. The ‘clawbacks’ referenced in the class action suit had no impact on what members agreed to pay for prescription drugs per their benefit plans. We continue to believe this case has no merit and should be dismissed by the court.”

 

 

 

 

 

 

OptumRX did not respond to our inquiries.

 

 

 

 

 

 

 

 

 

 

I recently got a call from a person on Medicare and has Silver Scripts Part D .. which is part of CVS HEALTH.  This person had a certain medication that requires a prior authorization to be covered and even though the pt has been on this particular medication for several years… it was a “fight” every year with Silver Scripts over the prior authorization.. they wanted to have the pt’s prescriber to fill out a new PA form EVERY YEAR…

Recently filling this prescription … before the end of the year and the PA ran out… the COPAY … with using the Part D insurance was $500 and change for a 90 day supply

The pharmacist called the pt and stated that the pharmacy had a “discount card” and in running it thru the discount card program.. the TOTAL PRICE was just UNDER $200.00.. and NO MORE PRIOR AUTHORIZATIONS to screw with…

Here is the website of the pharmacy discount card  https://www.communitycaresrx.com/clients/communitycares/Home.aspx

 

You can check the price of your prescriptions on their website and find participating pharmacies.  I am sure that not every pt will experience this great of a discount in out of pocket costs, but isn’t it worth at least checking it out ?

Filed under: General Problems | 1 Comment »

PA Bureau of Narcotics: opiate EPIDEMIC …on the brink of a SUPER PANDEMIC

Posted on December 14, 2017 by Pharmaciststeve

Officials call opioid abuse a ‘pandemic

http://www.neshobademocrat.com/Content/NEWS/News/Article/Officials-call-opioid-abuse-a-pandemic-/2/297/42265

The growing impact of opioids in Philadelphia and other communities was discussed at a town hall meeting last week where an officer with the state Bureau of Narcotics told about 75 people in attendance that the nation was “on the brink of a super pandemic.”

Lt. Jon Harless of MBN was among officials speaking at the meeting in the Philadelphia High School auditorium.

Harless said a super pandemic may sound like overkill to some people, but noted that Mad Cow disease and Asian Flu were at one time described as a pandemic.

It costs $78.5 billion to treat and provide healthcare and/or incarcerate people nationwide who are addicted to opioids, he said.

MBN Director John Dowdy and Harless cited several statistics during the presentation which ended with a question and answer session with those in attendance.

In 2016 alone, 45,087 opioid prescriptions were written in Neshoba County, Dowdy said, noting that the county’s total population is 29,403.

“That tells you how drastic the problem is,” he said.

In many cases, those opioid prescriptions are the doorway to addiction, Harless said.

While some people may think the face of an opioid drug addict is a homeless man sleeping in a ditch, Harless said that was not the case.

“Look to your left, look to your right and look in the mirror,” he said. “The addict looks just like us. It does not discriminate on who becomes addicted.”

In 2015, there were 52,404 death from overdoses in the United States, 33,091 of those were from opioids.

For comparison, 37,757 individuals were killed in vehicle accidents and 36,252 were killed by firearms.

“The average Boeing 747 passenger jet carries 416 people,” Harless said. “Opioid overdoses kill the equivalent of one 747 crash ever 4.5 days.”

Accidental drug overdose is now the leading cause of death for persons under the age of 50 in the United States, he said.

While the United States accounts for about 5 percent of the world’s population, Harless said, “we consume about 80 percent of the opioids manufactured in the world.”

In 2016, Mississippi was ranked Number 5 in the nation per capita for annual opioid prescriptions.

“That is 1.07 prescriptions per citizen,” Harless said.

He also addressed the rise in heroin use, noting that MBN heroin cases increased by over 300 percent from 2012 to 2016.

“The path to heroin addiction begins with prescription opioid addiction,” he said. “Over 80 percent of heroin addicts begin with prescription drugs.”

From 2013 until 2016, deaths from heroin related overdoses rose 2,000 percent in Mississippi, he said.

He also noted statistics that opioid addiction has brought about an increase in crime across the state.

From Jan. 1, 2014, until Dec. 4, 2017, Mississippi has experienced 133 successful burglaries at pharmacies, 53 attempted burglaries and nine armed robberies.

“In 2016, 146,389 dosage units of opioids were stolen from pharmacies in Mississippi,” Harless said.

Dowdy told those in attendance that officials were seeing success with the drug Naloxone, sold under the brand name Narcan, which is used to block the effects of opioids, especially in overdoses.

He said there was an ongoing effort to distribute Narcan to EMTs, law enforcement and other first responders across the state.

Dowdy said Narcan was used on a 19-year-old college freshman recently who had overdosed on heroin.

When first responders arrived, Dowdy said the student was blue and had a faint heart beat.

“They saved his life,” he said. “Every life matters.”

Dowdy said that young man “15 years down the road may find a cure for cancer.  As long as I am director that will be the case. Every life matters.”

Dowdy also talked about regulations that are placed on doctors and pharmacists in an effort to identify people who “doctor shop” to obtain opioid prescriptions.

The Mississippi’s Prescription Monitoring Program is an electronic tracking program managed by the Mississippi Board of Pharmacy to aid practitioners and dispensers in providing proper pharmaceutical care relating to controlled substances.

It also serves as a tool for regulatory agencies and authorized law enforcement to identify potential inappropriate use of controlled substance prescription medication.

During the question and answer session, one Philadelphia physician said the regulations were causing him anxiety and required more and more his time.

He said many people come into his office in need of opioids to treat various conditions.

“So many are doing it just right with no abuse,” he said.

Dowdy said many doctors share the same concerns and the legislature was looking to address some issues.

“There is a lot of misinformation in the medical field,” he said, noting that the legislature hasn’t finalized all the regulations.

“There are likely to be some tweaks,” he said.

Dowdy called the Prescription Monitoring Program a tool for doctors and pharmacists to identify doctor shoppers.

He said nurses or office managers could be trained to input data into the program.

“It’s not an unnecessary burden on doctors as others on staff can do it,” he said.

A former federal prosecutor, Dowdy described the program as a benefit to doctors.

“If my daughter died because a doctor kept writing prescriptions to her for opioids, I’m going to sue you if you did not check the PMP,” he said. “ I hope you did because if not you’re going to need a whole lot of money. It is there to protect you as well as the patient.”

He urged doctors and pharmacists to be patient until all the regulations are in place.

While he is 26 agents short because of funding, Dowdy said his agency continues to work all over the state.

When asked if they investigate pain clinics as well, Dowdy said, “we have our eye on some of those folks. I’m not afraid to arrest a doctor. It’s on our radar. Trust me.”

Chief of Police Grant Myers, who attended the town hall meeting, said his officers were certified to administer Narcan.

“I’ve seen those numbers and statistics about opioids before but this really put it into perspective when it is described as a 747 jet crashing every four-and-a-half days,” Myers said. “Anytime an airplane crashes it makes national news and is all over social media but you rarely hear about an opioid overdose.”

Myers said Philadelphia was fortunate, for now, that heroin “hasn’t made it here up to this point but we feel like it is coming. We have heard talk about it being here at times. We will continue to work with MBN and other state and federal agencies to combat this epidemic.”

Myers said if anyone has a relative or friend who is addicted, it is important to get them help before they end up in jail or deceased.

“If you don’t know where to turn you are welcome to come to the police department and I will try to point you in the right direction.

“ I will help get you in touch with someone who can assist them.”

The town hall meeting was hosted in partnership with several Mississippi agencies, including the Department of Mental Health, the Department of Public Safety, the Bureau of Narcotics, the Board of Pharmacy and the Mississippi offices of the FBI.

Let’s look at the numbers… there is 29,403 people in the county… we can presume that abt 2/3 are adults. I will take the low end figure that about 15% of the adult population suffers from chronic pain severe enough to require 24/7 opiate medication. What is now “best practices and standard of care” in treating pain 24/7 would entail both a long acting and short acting opiate… the first for “basal pain management” and the other for break thru pain.  Presuming that each pt is given a 30 days supply of each ..requiring 24 prescriptions for each pt every year.   Leaving abt 4,400 chronic pain pts in that county… and needing 105,600 opiate prescriptions for a full year.. NOT COUNTING opiates needed for pts suffering with acute pain… broken bones, surgery and the like.

45,087 opiate prescriptions were written during 2016. Suggesting that not all pts with mod-severe chronic pain got proper pain management nor did all pts dealing with acute pain.

Isn’t it amazing how they USE NUMBERS to prove their point and when you get “down into the weeds” they confirm what a lot of us already know.. chronic pain pts – and some acute pain pts – are not receiving adequate treatment… which some would consider a form of pt/senior abuse or torture.

Definition of a PANDEMIC:

A pandemic (from Greek πᾶν pan “all” and δῆμος demos “people”) is an epidemic of infectious disease that has spread through human populations across a large region; for instance multiple continents, or even worldwide.  https://en.wikipedia.org/wiki/Pandemic

Since our current and previous Surgeon Generals have clearly stated that ADDICTION is a MENTAL HEALTH issue and not a MORAL ISSUE… once again .. it would seem that non-medical trained professionals – mainly those in law enforcement – are calling mental health issues a CONTAGIOUS INFECTIOUS DISEASE…  Does this demonstrate their lack of understanding of what is going on, just pain stupidity on their part, or just their only known way to help create job security for them and others in law enforcement. ?

 

Filed under: General Problems | 8 Comments »

the Senate Judiciary Committee held a hearing to review the Ensuring Patient Access and Effective Drug Enforcement Act

Posted on December 14, 2017 by Pharmaciststeve

In Judiciary Hearing, Bipartisan Senators Set Record Straight on DEA/Opioid Legislation

Washington, DC—This morning, the Senate Judiciary Committee held a hearing to review the Ensuring Patient Access and Effective Drug Enforcement Act—a bill that was passed in the previous Congress to clarify the Drug Enforcement Administration’s enforcement authority with regard to the medicine supply chain.

The legislation, sponsored by Senator Orrin Hatch (R-UT) and Sheldon Whitehouse (D-RI), addressed a flaw in the system that gave the Drug Enforcement Administration’s (DEA’s) Office of Diversion Control undefined authority cut off prescription supply chains without warning, thereby threatening access to lifesaving treatment.

 The benefits of this proposal were almost entirely overlooked in a one-sided Washington Post report that misrepresented the law’s intent and the process by which it was passed. The same report additionally downplayed the overwhelming bipartisan support for the bill, which passed Congress with unanimous support and was signed by President Obama on the advice of his own DEA.

In setting the record straight, Hatch noted that the very phrase that the news report claims “gutted DEA’s enforcement authority” actually came from agency lawyers. At today’s hearing, Hatch and other members of the panel had the opportunity to ask Demetra Ashley—the Acting Assistant Administrator for Diversion Control at DEA—about the bill’s impact and to rebut claims that the bill has impeded DEA’s ability to do its job. Senator Hatch also took the opportunity to explain the pressing need for the legislation, a key point that has been lost in the one-sided reporting on the bill.

Senators Hatch and Whitehouse Set the Record Straight on their Legislation Clarifying DEA Rules

In subsequent questions with Senators Hatch and Whitehouse, Acting Assistant Administrator Ashley made clear that Senator Hatch and Senator Whitehouse’s legislation had not caused a decline in DEA enforcement efforts. [VIDEO] Click here for copies of the two charts Senator Hatch referenced in his questions. [LINK]

  • Senator Hatch has previously addressed flaws in the reports about this legislation on the Senate floor. [VIDEO]
  • Numerous media outlets have likewise pointed out a number of omissions in the reporting on the bill. [LINK]
  • Patient groups have also written in to express support for the legislation. [LINK] [LINK]
  • In addition, a VCU medical professor has described some of the problems at DEA in the years leading up to the bill. [LINK]
  • Hatch wrote an op-ed in the Washington Post correcting a number of errors in reports about the bill and its impact on DEA’s enforcement capabilities. [LINK]
  • Representative Marino, the House sponsor of the bill, submitted a statement at the hearing explaining the need for the bill. [LINK]

Senator Hatch’s full remarks, as prepared for delivery, are below:

Thank you, Mr. Chairman, for holding this hearing and for allowing me to make a statement.

Too often in this town, narrative gets ahead of facts. A newspaper prints an explosive headline, and it’s off to the races. It doesn’t matter what the actual facts are. The bandwagon starts rolling, and everyone wants on, or off, as the case may be.

Indeed, Mr. Chairman, I was both surprised and disappointed by how quickly everyone seemed to start running from this bill the moment some negative news reports came out. From Senator McCaskill to Senator Manchin to Attorney General Sessions, it seems like everyone’s trying to wash their hands of it. But no one ever told me they were dubious about this bill when it was going through. No one entered a statement of opposition into the record or offered an amendment to change the bill. To the contrary, the bill passed this committee by voice vote and passed the full Senate by unanimous consent.

So these last two months have been deeply frustrating to me, Mr. Chairman. I wish some of my colleagues would stop trying to rewrite history or pretend this was some sort of shell game.

That’s why I’m glad we’re holding this hearing today. I want to talk about the facts. The facts of this law. The facts of my involvement and of this committee’s involvement. And the facts of the law’s impact.

Let’s start with the impetus for this law. This law came about, not because I or anyone else got some giant check, but because of very real concerns that the way DEA was operating was threatening patient access.

Representative Marino has said that he became involved after meeting with a community pharmacist in his district who was “having so much trouble obtaining prescription opioids that he had to turn away legitimate patients.” I heard similar concerns from constituents, one of whom will be testifying today.

And it wasn’t just Utah and Pennsylvania. Across the nation, pharmacies were facing supply chain problems. A January 2014 survey by the National Community Pharmacists Association found that 75 percent of respondents had experienced three or more problems with stopped shipments in the previous 18 months and that a majority had had to turn patients away as a result. News reports from Indiana to Florida detailed stories of legitimate patients who were having significant difficulty obtaining needed medication.

No doubt these supply chain problems had multiple causes, but DEA’s activities were a contributing factor. According to a 2015 GAO report, the lack of clear guidance from DEA to distributors on what constitutes a suspicious order and what can trigger an enforcement action was leading many distributors to place quotas on drug shipments to pharmacies, a practice that the report found can “negatively impact . . . patients’ access.” The report detailed how fear of enforcement actions, coupled with lack of agency guidance, was leading distributors to decline to fill orders even in cases where a distributor had no evidence that a pharmacy or doctor was engaging in diversion.

And it wasn’t just lack of guidance. I’ve had a number of individuals tell me that DEA’s attitude toward registrants during this period was downright antagonistic. I have a letter here from a VCU Professor that describes some really troubling conduct by diversion control agents and that explains how difficult he found it to try to work with the agency in good faith.

And it wasn’t just the private sector that was having difficulty dealing with DEA, either. In a separate 2015 report about drug shortages, GAO described the great difficulty it had getting information from DEA’s Office of Diversion Control. According to the report, completion of GAO’s work “was delayed significantly because of DEA’s refusal to comply with [GAO’s] requests for information . . . for over a year.” Only after the intervention of “senior DOJ management officials” was GAO able to obtain the data it was seeking.

The Ensuring Patient Access and Effective Drug Enforcement Act was an effort to respond to these problems, to provide clearer guidance for supply chain members, and to encourage greater cooperation between DEA and the regulated community. That’s why it defined the agency’s immediate suspension order authority. That’s why it provided for corrective action plans. This wasn’t some effort to help drug companies kill people. Give me a break. This was an effort to ensure that DEA’s praiseworthy efforts to stem abuse don’t end up hurting legitimate patients.

Now, I’d like to say a word about how this law came together. I want to be clear right at the outset that this was not a pharma bill. Don’t tell me I did this bill because pharma donated however much money to me.

Prior to introduction, Senator Whitehouse and I negotiated with DEA, distributors, and patient advocacy groups. We may have talked to a pharma company at one point or another, but they were not key players.

And you know what? The bill Senator Whitehouse and I introduced? DOJ was okay with it. They said so in writing to this committee.

Of course, legislating is a process, and after introduction I found it was necessary to make changes in order to move the bill forward. I would have preferred not to, but we all know that legislation requires compromise. And so I had to accommodate some requests from industry stakeholders at the request of other members of this committee.

I negotiated these changes with DEA and DOJ. In fact, DOJ gave me the substantial likelihood language that critics now seem so fixated on.

And once DEA and I came to a point where we agreed on a path forward, I asked the Chairman to put the bill on a markup. And I kept my end of the bargain. I told other members what DEA had asked me to tell them, and I made the floor and record statements I’d promised DEA I would make. I did all of this in good faith.

I later came to find out that notwithstanding our agreement, DEA and DOJ were telling other offices they still had some concerns with the bill. For reasons I don’t understand, they never shared these concerns directly with me. But evidently the concerns weren’t that significant, as DEA didn’t try to stop the bill. As all of us on this committee know, any bill can be stopped by agency opposition. All it takes is one hold.

So that’s how we got here. This bill addressed a very real problem, and it did so in a carefully crafted, carefully negotiated way. If DEA has concerns with the bill, I’m happy to hear them. But I’d also ask DEA to explain why those concerns didn’t cause it to stop the bill 18 months ago, before it became law.

Thank you, Mr. Chairman.

Filed under: General Problems | 1 Comment »

Kentucky’s top agriculture official: DEA wrong to call hemp products illegal

Posted on December 14, 2017 by Pharmaciststeve

Kentucky’s top agriculture official: DEA wrong to call hemp products illegal

https://www.courier-journal.com/story/news/crime/2017/12/14/hemp-oil-hemp-seeds-legal-kentucky-dea/951836001/

Ryan Quarles, Kentucky’s Agriculture Commissioner, fired a letter to the head of the U.S. Drug Enforcement Administration this week asking to meet to discuss “federal overreach” with industrial hemp.

“I was dumbfounded when I read a Louisville Courier-Journal article that was titled, ‘Are you breaking the law when you buy hemp products?'” Quarles said, according to a copy of the letter.

He referenced statements from DEA spokesman Melvin Patterson calling all hemp products — even chocolate hemp bark — illegal if the product can be consumed. Even though federal law limits the THC amount to a non-intoxicating level.

Hemp vs marijuana: Can you get high off hemp? We’ll help clear the fog about marijuana’s ‘kissing cousin’

“Consumable hemp products are legal to buy,” Quarles said.

Duane Sinning, who oversees the industrial hemp program in Colorado, also views hemp products as legal.

“Agriculture laws are not really that hard, unless you get the DEA involved and they want to make it hard,” he said.

 

Hemp products in Louisville: From beer to bedding, hemp products are easily found at some stores that may surprise you

Hemp for headaches, arthritis, pain?: Hemp is ‘the next big thing’ in pain management as growth and research expand in Kentucky

The 2014 Farm Bill allowed states to pass laws to grow and market industrial hemp, but the law is brief and interpreted in conflicting ways.

Quarles requested a meeting with DEA Acting Administrator Robert Patterson during Quarles’ trip to Washington, D.C., at the end of January to meet with agriculture officials from other states. 

“We enforce the Controlled Substances Act,” Melvin Patterson said Thursday in response to Quarles’ letter. “He’s knocking on the wrong door.

“Unless Congress changes it, we’re going to continue to do our jobs.”

Quarles said he believes Congress should — and eventually will — remove hemp from the federal Controlled Substances Act list.

Reporter Beth Warren: bwarren@courier-journal.com; 502-582-7164; Twitter @BethWarrenCJ. Support strong local journalism by subscribing today: www.courier-journal.com/bethw.

Filed under: General Problems | 1 Comment »

DEA Leads Massive Drug Confiscation In War On Opioids

Posted on December 14, 2017 by Pharmaciststeve

The “fishing” operation went on to target a total of 4,500 to 5,000 drugstores present in the area. The DEA officers accumulated all the drug tracking that they had gathered, and combined it with the data that was received from insurance and billing, provided by the Department of Health and Human Services, the state-level prescription drug monitoring programs, and the tax information provided by these pharmacists to the IRS.

www.libertynewsnow.com/dea-leads-massive-drug-confiscation-war-opioids/article8362

Results for the Operation Faux Pharmacy were declared on Wednesday by the Drug Enforcement Agency (DEA). The operation targeted 26 pharmacies that were suspected for illegal distribution of prescription drugs and medications. This resulted in the confiscation of a total of 494,000 pills, valued at $2.8 million.

Led by the DEA’s Los Angeles Field Division, the operation included different busts taking place simultaneously in southern California and the state of Nevada, and another set of raids in Hawaii. These raids also included the efforts of 60 people, who were out of the state.

These raids resulted in four of these pharmacists to willingly surrender their licenses; whereas the others would now face civil and criminal proceedings in the months to come.

The basic mission of the operation was to crack down on all of the illicit distribution of prescribed drugs. According to the search warrants that were issued before the operation against pharmacies, these seized drugs include all kinds of opioids, along with other non-specific forms of prescribed medications, like Xanax. As per an estimate, four out of every five heroin addicts on the west coast start their addictions with such prescription pills.

“DEA is fighting the opioid crisis on multiple levels, using every resource available to identify reckless doctors and rogue businesses that fuel addiction in our neighborhoods and communities,” said the Acting DEA Administrator – Robert W. Patterson. “We will continue to identify and hold accountable the most significant drug threats, using every tool at our disposal—administrative, civil, and criminal—to fight the diversion of controlled substances.”

 Deputy special agent and the officer in charge with L.A. Field Division – William Bodner, told the reporters that Faux Pharmacy was a project that took more than a year in strategizing and devising. The project’s very initial goals, he went on to explain, were to go past these small busts of doctors to target the original source of illegal prescription drugs.

“We decided to look at the root of the prescription drug problem,” Bodner had said in a statement. “Where are the prescription drugs coming from?”

The operation went on to target a total of 4,500 to 5,000 drugstores present in the area. The DEA officers accumulated all the drug tracking that they had gathered, and combined it with the data that was received from insurance and billing, provided by the Department of Health and Human Services, the state-level prescription drug monitoring programs, and the tax information provided by these pharmacists to the IRS.

Agents looked for more common identifiers of an illegal drug sale, including pharmacies that had filled remarkably high numbers of oxycodone prescriptions, high or rapid opioid sales, multiple customers with identical addresses, or customers who have to travel long distances to specific pharmacies despite having access to more convenient options. Using these patterns, DEA officers went on to narrow down nearly 5,000 pharmacies, first to 90, and then down to only 26 with unusual patterns of behavior.

The year’s worth of work has led to seizing of more than 600,000 pills, the majority of which were picked up on Wednesday.

Bodner further said that this data-driven approach would be served as the basic framework for similar stings in other states in the upcoming future raids.

“Part of the mindset here is they can take this model back and do it in other states, do a similar type of operation. It starts at the front end, a lot of statistical analysis, and then after that point, it gets into our standard investigative techniques,” Bodner had said.

Bodner also expects that these operations would allow to strongly clamp down the pharmacists who are planning on getting into the business of illegal drugs distribution.

“I think it’ll have a significant impact, because the pharmacists are now on notice because the federal government is looking at them to make sure that they are ethical and they are following the rules of dispensing,” he had said. “If they are, we applaud them, and we have no issue. It’s those that are not that we’re taking a close look at and will be coming after.”

Filed under: General Problems | 1 Comment »

Harris County Attorney Vince Ryan said the lawsuit is seeking to prevent the group named in the lawsuit from selling opioids

Posted on December 14, 2017 by Pharmaciststeve

Harris County sues drugmakers, doctors over opioid epidemic

https://www.click2houston.com/news/harris-county-to-sue-drug-makers-doctors-over-opioid-epidemic

Ryan said that the those named in the lawsuit put profits above the public good when advertising and prescribing the powerful painkillers. He said lies, half-truths and deception were used to foster the use of the drugs.

The doctors named in the lawsuit by Dallas defense attorneys have already had criminal charges filed against them, Ryan said.

DOCUMENT: View a copy of the lawsuit

Ryan said the lawsuit is seeking to prevent the group named in the lawsuit from selling opioids. He said it also seeks monetary damages and fines to be assessed.

Other defendants could be added as the county’s investigation continue, Ryan said.

Things to know about Harris County opioid lawsuit

  • 21 drug makers & distributors are named in the lawsuit by Law Office of Glenn C. McGovern.
  • Two of the national distributors named in the lawsuit have offices in the Houston area. The McKesson Corporation and Cardinal Health.
  • Harris County says it’s been forced to use all of its limited resources to address & deal with the opioid epidemic, across the board, from the criminal justice system side to the medical side. 
  • In Harris County, in 2015, 318 deaths were directly attributed to opioid overdoses. 
  • Harris County Attorney Vince Ryan or lawyers for wrongful death cases is asking all of the agencies within Harris County to look at the costs they’ve incurred as a result of the opioid epidemic. 
  • Additional defendants could be added to the lawsuit as the county’s investigation continues. 
  • The Harris County Attorney’s office is working closely with law enforcement and the District Attorney’s office who is prosecuting the results of criminal activity related to the opioid epidemic.  Help From David C. Hardaway criminal justice attorneys help will help in criminal cases.
  • Pharmaceutical companies make upwards of $10 billion a year on opioids, according to the county attorney. 

  It is estimated that the drug cartels generate 100 billion/yr in illegal drugs sales. So is this attorney going after the “smaller fish” – ones that provide FDA approved legal opiates thru legal channels –  in the opiate crisis… because they have better paper trails because of their DEA licenses and assets that the attorney can attach/seize more readily… unlike the cartels that are based outside of the USA ? Isn’t this the same methodology that bullies use… pick on the person that they can “readily beat up” with little chance of consequences ?

Filed under: General Problems | 3 Comments »

The First Count of Fentanyl Deaths in 2016: Up 540% in Three Years

Posted on December 14, 2017 by Pharmaciststeve

https://www.nytimes.com/interactive/2017/09/02/upshot/fentanyl-drug-overdose-deaths.html

 

The first governmental account of nationwide drug deaths in 2016 shows overdose deaths growing even faster than previously thought. Related Article

Drug overdoses killed roughly 64,000 people in the United States last year, according to the first governmental account of nationwide drug deaths to cover all of 2016. It’s a staggering rise of more than 22 percent over the 52,404 drug deaths recorded the previous year — and even higher than The New York Times’s estimate in June, which was based on earlier preliminary data.

Drug overdoses are expected to remain the leading cause of death for Americans under 50, as synthetic opioids — primarily fentanyl and its analogues — continue to push the death count higher. Drug deaths involving fentanyl more than doubled from 2015 to 2016, accompanied by an upturn in deaths involving cocaine and methamphetamine. Together they add up to an epidemic of drug overdoses that is killing people at a faster rate than the H.I.V. epidemic at its peak.

 
Note: Data for 2016 is provisional.

This is the first national data to break down the growth by drug and by state. We’ve known for a while that fentanyls were behind the growing count of drug deaths in some states and counties. But now we can see the extent to which this is true nationally, as deaths involving synthetic opioids, mostly fentanyls, have risen to more than 20,000 from 3,000 in just three years.

Total U.S. drug deaths

Deaths involving prescription opioids continue to rise, but many of those deaths also involved heroin, fentanyl or a fentanyl analogue.

There is a downward trend in deaths from prescription opioids alone.

At the same time, there has been a resurgence in cocaine and methamphetamine deaths. Many of these also involve opioids, but a significant portion of drug deaths — roughly one-third in 2015 — do not.

The explosion in fentanyl deaths and the persistence of widespread opioid addiction have swamped local and state resources. Communities say their budgets are being strained by the additional needs — for increased police and medical care, for widespread naloxone distribution and for a stronger foster care system that can handle the swelling number of neglected or orphaned children.

Drug overdose deaths per 100,000 residents in 2015 and 2016

Of the 21 states that reported the highest quality data for 2016, the steepest rises were in Delaware, Florida and Maryland.

Note: Deaths were coded based on where the death occurred rather than residency.

It’s an epidemic hitting different parts of the country in different ways. People are accustomed to thinking of the opioid crisis as a rural white problem, with accounts of Appalachian despair and the plight of New England heroin addicts. But fentanyls are changing the equation: The death rate in Maryland last year outpaced that in both Kentucky and Maine.

This provisional data, compiled by the National Center for Health Statistics, was produced in response to requests from government officials after reporting from The Times in June. An early version of the report was posted online last month and will be formally published by the N.C.H.S. in the coming weeks. According to Robert Anderson, the agency’s chief of mortality statistics, the document is the first edition of what will be a monthly report on the latest provisional overdose death counts.

Because of delays in drug death reporting, the data is mostly but not entirely complete. The final numbers, released in December, could be even higher.

It’s too early to know what 2017 will hold, but anecdotal reports from state health departments and county coroners and medical examiners suggest that the overdose epidemic has continued to worsen. In March, President Trump created a commission to study the crisis. The commission’s interim report made a number of recommendations, but the administration has yet to take concrete action on any of them.

Data for 2016 is provisional and includes a small number of deaths from residents of other states (for the state data) or other countries. Some categories in the national chart include closely related drugs in addition to the named drug. (For example, “fentanyl” includes both fentanyl and fentanyl analogues as well as other synthetic opioids.) “Prescription opioids” excludes synthetic opioids. Categories are not mutually exclusive because deaths often involve multiple drugs. A small portion of the increase in deaths attributable to a specific drug may be due to improved cause-of-death reporting.

Source: National Center for Health Statistics, Centers for Disease Control and Prevention

It is amazing how they put out a sizeable article about DRUG OD DEATHS… and it focuses on opiates and then if you read a few chosen words and/or sentences

Many of these also involve opioids, but a significant portion of drug deaths — roughly one-third in 2015 — do not

so the 52,404 ALL DRUG OD DEATHS… abt 17,450 did not involve OPIATES

They also mention FENTANYL and analogs… no mention of all the analogs – about 17 of them –  being illegal drugs – not FDA approved for any use in humans and being illegally imported from China & Mexico.

There are several graphs on the article – that I could not cut/paste to this post – that clearly demonstrates how illegal opiates are the major problem in OD’s – about 75% of the total…and have increased dramatically over the last 3-5 yrs.

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malpractice lawyer in New Jersey

Posted on December 14, 2017 by Pharmaciststeve

If you need a malpractice lawyer in New Jersey, the man to call is Raymond Gill 655 Florida Grove Road, Woodbridge, NJ Phone:732-324-7600 He is WICKED ASS GOOD!

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Genetic Study Defies ‘One-size-fits-all’ Approach to Prescribing Opioids for Chronic Pain

Posted on December 13, 2017 by Pharmaciststeve

FAU Investigator Receives $4 Million NIH Grant for Novel Prescription Opioid Study

https://www.newswise.com/articles/view/686700/

Newswise — It impacts 100 million Americans, it is the number one reason that people go to see the doctor, and it is now a national crisis. The problem: chronic pain and prescription opioids. The dilemma: how to provide the most effective pain treatment for 80 percent of pain patients who are at least risk for addiction while causing the least harm to the remaining 20 percent who are at most risk. The solution: it’s very complicated, but it may be possible to address both problems without adversely affecting either.

Opioids (morphine, Oxycontin, Viocodin), which can lead to increased risk of addiction, have been the mainstay of treatment for moderate to severe pain for decades. The challenge is that their effects on patients vary tremendously. Prescription opioid-use disorder affects about 2 million Americans each year and is the number one cause of accidental death. Right now, attempts to prevent opioid use disorder focus mainly on reining in prescription practices, which is problematic.

A researcher from Florida Atlantic University’s Charles E. Schmidt College of Medicine has received a five-year, $4 million grant from the National Institutes of Health to help solve the “one-size-fits-all” approach to prescribing opioids for chronic pain. Because of the high heritability, finding the genetic predictors of prescription opioid use disorder is more critical than ever. Currently, little data exists on clinical characteristics and genetic variants that confer risk for opioid use disorder.

In a novel study, Janet Robishaw, Ph.D., professor and chair within the Department of Biomedical Science in FAU’s College of Medicine, and colleagues from Geisinger Health System and the University of Pennsylvania, are assessing clinical and genetic characteristics of a large patient cohort suffering from chronic musculoskeletal pain and receiving prescription opioids. As part of the DiscovEHR project, they have leveraged data from Geisinger’s central biorepository and electronic health record (EHR) database to conduct large-scale genomics research and phenotype development.

With this information, this multidisciplinary team will derive a clinical and genetic profile of prescription opioid-use disorder and use this knowledge to develop an “addiction risk score.” Findings from this study will be key for identifying those who are at low-risk for opioid use disorder from those who are at high-risk and who need additional counseling and access to other treatment options.

“The overall goal of this project is figuring out if there is a unique genetic signature of patients who are most susceptible to addiction,” said Robishaw. “In the first part of our study, we are looking at the clinical characteristics of these patients to understand the cause of their pain and how prescription opioids are affecting their outcomes.”

As part of this initial process, the investigative team composed of Robishaw, Wade H. Berrettini, M.D., Ph.D., Karl E. Rickels professor of psychiatry at the University of Pennsylvania, and Vanessa Troiani, Ph.D., assistant professor at Geisinger, are administering questionnaires that will give them additional information on the patients’ pain phenotype as well as whether or not they’re showing symptomology of prescription opioid-use disorder. It will take them about two years to analyze the data to divide the patient population into cases and controls in order to complete a genome-wide association study, which is the second part of the research project.

The genome-wide association study will help the researchers determine if there is a particular subset of genes and genetic variants that are influencing susceptibility to becoming addicted to prescription opioids. Once they are able to generate the hypothesis that a genetic variant is responsible for increasing risk, the next steps for research will involve functional studies on those top associations to prove causation.

“There is an urgent need to develop clinical, genetic and neural characteristics of patients who are at moderate- to high-risk of becoming addicted to prescription opioids,” said Phillip Boiselle, M.D., dean of FAU’s College of Medicine. “The National Institutes of Health grant awarded to Dr. Robishaw and her collaborators will help them to identify the genetic factors that increase the risk of addiction in patients, which then become targets for new drug development.”

The investigative team stresses the importance of using a multipronged approach to addressing this national crisis, which should involve research, education and engaging patients so that they understand their susceptibility to risks and empower them in their health care decisions.

“Prescription opioid-use disorder is a lifelong problem that requires a thoughtful approach that is not going to be solved just by curtailing prescriptions of these narcotics,” said Robishaw. “We have to employ more rigorous prescribing practices and provide alternative treatments for moderate to severe pain that don’t involve opioids. And, we need to improve access to medication-assisted therapy for those patients already dependent on prescription opioids. Currently, only 7 percent of patients with prescription opioid-use disorder have access to such treatments and this is because of a variety of reasons like costs and availability of these services.”

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The DRUG CRISIS … they don’t talk about.. because docs don’t prescribe it ?

Posted on December 12, 2017 by Pharmaciststeve

Record number of meth users died in San Diego County last year

http://www.sandiegouniontribune.com/news/public-safety/sd-me-meth-stats-20171212-story.html

More than a decade after a full-scale assault on methamphetamine production in San Diego County, the drug is continuing to ravage the region, killing a record number of users last year and hooking more than half of adults who end up in jail, according to a report released this week by the county’s Methamphetamine Strike Force.

The drug was linked to 377 deaths last year in the county — 66 more than the previous year.

“The trend line is very alarming and continues to head in the wrong direction,” county Supervisor Dianne Jacob said in a statement.

Rather than the sudden overdoses often seen with the opioid epidemic, meth is typically a slow killer.

Many of the people dying are middle-aged, long-term addicts who’ve developed other health complications, said Nick Macchione, director of the county Health and Human Services Agency.

Even though meth isn’t cooked in home labs here anymore — largely a result of laws that restrict access to precursor chemicals — the data show addicts are having little trouble accessing it.

The drug is now produced in mass quantities in cartel “superlabs” in Mexico and smuggled across the Southwest border — particularly in San Diego County, where a significant portion hits local streets before the rest moves on to other parts of the country.

Last year, 47 percent of all meth seizures along the border were in the county, according to the U.S. Drug Enforcement Administration and U.S. Customs and Border Protection.

Plus, San Diego meth is cheap — $250 to $450 an ounce last year compared to as much as $600 an ounce in 2015 — and incredibly pure. Nationwide, average purity levels last year tested above 90 percent per gram, according to the DEA.

The high purity and low cost indicate an oversupply in Mexico.

The drug cartels have also been able to adapt to stricter restrictions on precursor chemicals traditionally needed to make meth — first in the U.S. and now in China — by coming up with new techniques and formulations, according to the DEA.

The report also draws a strong link between methamphetamine and crime, showing 56 percent of adult arrestees booked into county jails tested positive for the drug last year. That’s compared to 49 percent in 2015.

The trend continued on a much smaller scale for juvenile arrestees — with 14 percent testing positive compared to 8 percent the previous year.

Both felony and misdemeanor arrests and citations for selling or possessing meth are also up, from 6,849 to 8,428 last year.

Another trend has emerged: Meth is involved in 20 percent of adult abuse cases reported to Adult Protective Services — mostly meth-using adult children victimizing their parents, according to the report.

Meth’s troubling trajectory in the region comes as attention has drifted to battling the nationwide opioid and prescription drug crisis. The Strike Force report stresses that more is needed to bring the meth story back into focus.

That wasn’t hard to do back in the mid-90s, when the Strike Force was established at a time San Diego was unofficially dubbed the “Meth Capital of the World.” But the county might now be fatigued on the issue, after hearing about it for so many years, Angela Goldberg, who works as the group’s facilitator, said in an interview earlier this year.

Besides greater public awareness, the Strike Force urges greater drug screening in older adults, wrap around treatment services to get addicts and their families into recovery, and continued use of intervention courts to treat underlying problems.

“Sending addicts to jail or prison without addressing their addiction problems does not solve the drug problem in our community,” District Attorney Summer Stephan said in a statement.

Have you noticed that the DEA is really not too interested in going after meth distribution… you see there is a legal prescription meth (DESOXYN) and it is indicated for ADD/ADHD.. and very few prescribers use it.. SO… there are very few prescribers that the DEA has to build a fake case against to seize their assets using Civil Asset Forfeiture Law.. since all the people ODing on meth is being imported from Mexico and ILLEGAL.. Just like most everything else… just have to follow the MONEY TRAIL

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