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Survey: majority (62%) indicated that PBMs help lower net drug prices: 38% of the more than 950 respondents worked for a PBM
Posted on August 29, 2022 by Pharmaciststeve
2022 Pharmacy Survey Results: PBMs
2022 Pharmacy Survey Results: PBMs | Part 6 (managedhealthcareexecutive.com)
Fairly or not, in the blame game for high drug prices, pharmacy benefit managers (PBMs) often come up as the middlemen who make profits but don’t add much value.
The respondents to our 2022 Pharmacy Survey beg to differ.
A strong majority (62%) indicated that PBMs help lower net drug prices. Only a small group (21%) thought antitrust action to break up the dominant PBMs should be considered. An even smaller group (15%) agreed with strengthening the audit rights for employers and government payers.
But these results are not surprising considering that about 38% of the more than 950 respondents to the survey said they work for a PBM.
The survey was distributed online in late June and early through various channels by Managed Healthcare Executive® and our colleagues at Pharmacy Times®.
Of the remaining respondents, 24% said they worked for a payer organization, 21% said they worked for a provider, 9% for a pharmaceutical company and 8% for consultants (the total is more than 100% because a few respondents said their employers were in more than one sector).
The PBM industry is criticized for being opaque and keeping rebates and pricing arrangements secret. About half (49%) of the respondents said they favor imposing transparency rules on PBMs, and sizable minority (44%) favored requiring formulary placement to reflect the total cost of drugs.
And about half (48%) said value-based contracts between payer and drugmakers would slow the growth in drug expenditures, and about the same proportion (47%) said revising benefit design to create incentives to choose the most cost-effective option would help.
Inflation Reduction Act:
All of prescriptions covered under Medicare Part D or Medicare Advantage – are provided by FOR PROFIT INSURANCE COMPANIES and the PBM companies that the major ones are owned by a Insurance Company..
Were not included in the Inflation Reduction Act… and those entities have since the beginning of Medicare paying for medication – JAN 2006 –
You will not see these two for profit business entities mentioned in the Inflation Reduction Bill…
In the bill, it is stated that as of 2024, premium increases for Medicare Part D & Advantage will be limited to be in align with CPI/COLA – be prepared to see substantial increases in premiums starting Jan 2023
The act limited out of pocket expenses to $2,000/yr – be prepared to see a substantial increases in deductibles… These deductibles a few years ago went from ZERO to close to $500/yr already…
Could we see $2000/yr deductibles starting in 2025, and whoever is sworn in as President Jan 2025 get the blame..?
Could we see 50%-100% increase in premiums for 2023 so pad premiums for premiums increases locked into CPI/COLA starting in 2024 ?
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Missouri, Kansas hospital leaders fear a ‘healthcare crisis’ is coming
Posted on August 28, 2022 by Pharmaciststeve
Missouri, Kansas hospital leaders fear a ‘healthcare crisis’ is coming
As flocks of nurses are leaving hospitals and health systems struggle to return to normal bed space, some healthcare executives in the Midwest worry they aren’t prepared for the fall and winter.
Recent data isn’t lining up with seasonal trends, according to Richard Watson, MD, a co-founder of an app that tracks Kansas hospital transfers.
“These are not COVID beds that we’re needing right now,” Dr. Watson told KCUR. “We need beds across the board. The system is already at a higher level of capacity than it was even last year as we went into this time period. Without a doubt, even without any of the other surges, we’re going into the fall in a precarious position.”
So far in 2022, healthcare turnover reached an all-time high at 24.7 percent, according to the Missouri Hospital Association. In Kansas, the healthcare worker turnover rate was 19 percent and the vacancy rate was 16 percent, the Kansas Hospital Association reported in January.
The shortage of space at Wichita, Kan.-based Ascension Via Christi St. Joseph resulted in more violence against its employees, the hospital’s president told the Kansas Reflector.
“It is not so much a COVID crisis as it is a healthcare crisis,” Steven Stites, MD, chief medical officer of the University of Kansas Health System, told KCUR. “Many hospitals are going to be faced with financial shortfalls and may close. We’re at a little bit of a precarious tipping point right now in healthcare.”
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Will Drug Prices Actually Fall?
Posted on August 27, 2022 by Pharmaciststeve
Will Drug Prices Actually Fall?
https://www.daily-remedy.com/will-drug-prices-actually-fall/
Sometimes we think we solved something, when we merely changed the game.
President Biden’s signature healthcare legislation, the Drug Pricing Plan, which was previously rolled into various versions of the Build Back Better Plan and now the Inflation Reduction Act, has finally passed both houses of Congress and signed into law.
Now Medicare can apparently negotiate the price of drugs.
“It’s a huge deal,” says Stacie Dusetzina, professor of health policy at Vanderbilt University. “It really does break a lot of new ground and fix a lot of problems.”
It has been proclaimed as the savior of healthcare, echoing sentiment similar to the passing of the Affordable Care Act, or Obama care. But such exuberance might be premature. Or, as Stacie Dusetzina says moments later: “It is a modest start.”
To understand why we should approach the law with a bit of caution, we must begin with the concept of price in healthcare. Many were shocked to hear the government cannot directly negotiate drug prices. But that is only partially true. The government has always influenced price, just not in the direct way we see in other industries.
Previously, drug prices were set by drug manufacturers and pharmacy benefit managers and, to a lesser extent, the pharmacies themselves. The federal government, namely the health policy makers leading different health administrations, was forbidden from interfering in drug prices because of an aptly titled clause, “noninterference”.
It stipulates the Department of Health and Human Services, which oversees the Food and Drug Administrative and the Centers for Medicare and Medicaid Services, “may not interfere with the negotiations between drug manufacturers and pharmacies and PDP [prescription drug plan] sponsors, and may not require a particular formulary or institute a price structure for the reimbursement of drugs.”
Libertarians would argue in favor of this model. After all, it suggests that the market dynamics of the supply chain set drug prices. Manufacturers sell to distributors who sell to retailers, and whoever has the most influence in the supply chain sets the price. But in the pharmaceutical industry, market conditions do not influence supply chains. Patents do. And that makes all the difference.
Patent protection allows drug manufacturers to limit the competition and produce drugs for a minimum of ten years. It also limits the ability of those down the supply chain to affect drug prices, including the pharmaceutical distributors and insurance carriers.
Take such protections away and you would have lower drug prices because conceivably, you will have more competition – or so the politicians would have us believe. But market protections in the pharmaceutical industry go beyond patent protections, or the cost of innovation. They are set by manufacturing licenses, distribution rights, and other means of bureaucratic control set through the pretense of regulatory oversight.
In short, market forces do not set drug prices. They are offset by entities with undue market influence that engage in shared profiteering under the guise of cost sharing. Just look at the profit margins enjoyed by pharmaceutical manufacturers and distributors compared to healthcare providers. When a pharmaceutical company offers rebates to patients, it appears to be providing discounts. But the rebates come with strings attached, such as giving the company exclusive distribution rights.
So while it appears the pharmaceutical company is minimizing out-of-pocket expenses for patients, it is actually increasing profits by preventing market competition.
The law will not change this dynamic because no one in positions of power wants to stop the gravy train of drug discovery. There is too much money in innovation. And whatever concessions are made in lowering the drug prices will be compensated for somewhere else.
This much becomes apparent when we look at the law itself. It reads more like a hedge fund investment strategy that uses derivatives to set price changes. In the law, Medicare does not actually control drug prices directly, as some reports would have you believe. Instead, it exerts an influence over the average price of select drugs and its rate of increase.
Specifically, the ones with limited generic or biosimilar competitors that are already exorbitantly priced. The law explicitly says: only the fifty drugs with the highest Medicare spending would be eligible. Those exempt would be drugs under patent protection and those that serve small markets comprising less than 1 percent of the Medicare annual spend or those that treat rare diseases.
The law also places upper and lower bounds on drug prices and the extent to which those prices can change. It is advertised as a way to prevent drug prices from increasing faster than inflation, though it will more likely be used to prevent drug prices from decreasing too quickly.
It all reads like financial speculation, more than actual legislation, which may be the point. The pharmaceutical industry knows how to reap a profit, and this law will do little to curtail that trend. True, the advertised cost of drugs will be lower, but drug makers will simply shift how they cost share to keep drug prices within the defined parameters, while reaping additional revenue elsewhere.
The law is rife with moral hazards. Even those criticizing it do not understand how easily the law can be manipulated. Some have claimed we will see fewer drugs once we enact it. This is partially true. Drug innovation will continue. But we will see fewer drugs – available to all patients.
With fewer rebate mechanisms available and tighter restrictions on the upper limits of drug prices, we will see fewer drugs for those unable to pay out-of-pocket expenses, as well as lower out-of-pocket expenses for those who have always been able to pay. The law will exemplify how implicit moral hazards create health disparity. The have’s will continue to have and the have-not’s will continue to have not.
But the profiteering will not stop. Though profiteering was never the problem. It was finding a fair solution to drug costs, one that shares costs across the supply chain and among all patient populations.
Instead, we bounded and capped drug prices to restrict the cost sharing of drug prices and limit drugs to a limited part of the patient population.
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Omicron Boosters Are Coming, But They Weren’t Tested on People. Here’s What You Need to Know
Posted on August 27, 2022 by Pharmaciststeve
Omicron Boosters Are Coming, But They Weren’t Tested on People. Here’s What You Need to Know
https://news.yahoo.com/omicron-boosters-coming-weren-t-141554424.html
With nearly all the new COVID-19 infections in the U.S. coming from the Omicron BA.4 and BA.5 subvariants, it makes sense that health officials are considering switching to a different vaccine to protect the public.
White House COVID-19 response coordinator Dr. Ashish Jha expects the first Omicron-specific booster to be available in mid-September at the earliest, if the U.S. Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) authorize and recommend the shot. In late August, both Pfizer-BioNTech and Moderna submitted requests to the FDA for authorization of their Omicron-specific boosters.
But with the fall and winter fast approaching—the seasons when respiratory viruses like SARS-CoV-2 spread even more efficiently, as students return to school and people huddle indoors—getting the booster ready requires a more efficient review and regulatory process. And that includes considering safety and efficacy data from animals, not people.
Back in June, the FDA’s panel of independent vaccine experts met to consider switching the country to a new booster that targets Omicron, given how quickly that variant is dominating new infections. At the time, the two largest COVID-19 vaccine makers, Pfizer-BioNTech and Moderna—which both make mRNA-based vaccines—had developed shots against an earlier Omicron variant, BA.1. The panel decided that if health authorities were going to change the booster shot to target Omicron, the next one should protect against the BA.4 and BA.5 subvariants, which would continue to account for almost all cases in the winter season.
They asked the vaccine manufacturers to develop a new vaccine, one that combined the original vaccine and also targeted Omicron BA.4 and BA.5. At the end of August, both companies submitted data on their new, bivalent vaccines to the FDA for emergency use authorization.
Given the short time they had to develop the shot, however, the data only included information on the safety and efficacy of the booster in animals.
Human studies are planned and will be ongoing even if the FDA and CDC decide to authorize the shots and the government starts distributing them.
The FDA has also decided to review the animal study data without consulting its advisory committee again.
That has vaccine experts divided. Dr. Paul Offit, a member of the advisory committee, says this strategy makes him “uncomfortable” for several reasons. He notes that the data presented from Pfizer-BioNTech and Moderna in June involving their BA.1 booster shot, which focused on the levels of virus-fighting antibodies the vaccine generated, were underwhelming. “They showed that the neutralizing antibody titers were between 1.5- and two-fold greater against Omicron than levels induced by a booster of the ancestral vaccine,” he says. “I’d like to see clear evidence of dramatic increase in neutralizing antibodies, more dramatic than what we saw against BA.1, before launching a new product. We’re owed at least that.”
While conducting human studies does take more time, Offit says even a small trial involving about 100 people to measure their antibody levels after getting a BA.4/5 booster would be helpful. “You can boost people and measure their neutralizing antibodies two weeks later,” he says. Such information could also be critical in setting realistic expectations for the Omicron booster. The public might feel it’s a panacea that signals the end of the pandemic, but without any data showing how well the booster will protect people from not only getting sick, there might be unrealistic expectations about what the boost can do. “I get a little nervous, frankly, when I hear this [booster] is going to be miraculous,” Offit says.
Other experts see it a little differently. Based on the fact that the mRNA vaccines have been administered to millions of people so far, with relatively few safety concerns, and given that the vaccines have been effective in protecting people from getting hospitalized or dying of COVID-19, even during the latest Omicron surges, they argue that changing the strain of virus in the vaccine doesn’t require the same extensive testing that the original shot did. “The totality of evidence is relevant here,” says Dr. Ofer Levy, director of the precision vaccines program at Boston Children’s Hospital, and also a member of the FDA’s vaccine advisory committee. “We are in a situation where we need to pivot as variants emerge, and if we try to be too rigid in our approach, we will always be behind, and not giving the population optimal protection.”
Levy says that the latest Omicron-specific boosters that the FDA is considering contain a combination of mRNA targets against both the original virus and Omicron BA.4/BA.5, so the data on safety and efficacy from the original vaccine in protecting against hospitalization and death is relevant. While the data on this vaccine does come from animals, using that data to decide whether or not to authorize the booster is a matter of “hedging bets.” There is data showing that even vaccinated and boosted people can get mild to moderate COVID-19 disease, because their vaccine-induced protection is waning, so boosting with a shot that is better matched to the Omicron subvariants circulating now is a reasonable bet, even if the data on its efficacy comes from animals and not people. “I think it’s the right decision,” says Levy.
There’s no guarantee that the FDA will authorize the new bivalent vaccines, although all signs point to an authorization that could come in a week or so. If the shots are released and people get boosted, health officials will be carefully monitoring data from those vaccinees to ensure that the assumptions they made about the safety and efficacy of the booster hold. And hospitalization rates in the coming winter will reveal whether betting on the new Omicron-specific booster was the right decision.
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WHIO ‘Tranq Dope’ is a powerful new, potentially deadly drug raising alarms locally
Posted on August 27, 2022 by Pharmaciststeve
seems like the “street drug dealers” and the drug cartels … are bringing out more “new drugs” that the brand name pharmas do.. but.. then I suspect that the street dealers and the cartels are doing any clinical trials about safety and appropriate dosing 🙁 This new “street drug” may spread faster than the first version of COVID-19
‘Tranq Dope’ is a powerful new, potentially deadly drug raising alarms locally
https://sports.yahoo.com/tranq-dope-powerful-potentially-deadly-232715058.html
A new drug called “Tranq Dope” is raising alarms in the Miami Valley because it is a combination of opioids and a drug used to sedate animals.
“We don’t expect it to be too long before it comes right up I-75 into the Miami Valley,” Charles Patterson, health commissioner, Clark County Combined Health District, told News Center 7′s Kayla McDermott on Friday.
There have already been 18 deaths from opioid use in Clark County this year, and Patterson said he fears the count will increase with a new drug entering the market.
Xylazine is the main drug used in Tranq Dope, most commonly found in veterinarian’s offices as a tranquilizer for animals.
“It’s a sedative, a muscle relaxer for animals, such as cattle,” Wendy Doolittle, CEO at McKinley Hall Inc. addiction center in Springfield. “So, it’s not approved for any human consumption.”
Patterson said the Xylazine has been watered down and spread as a similar to heroin type of drug.
When mixed with either opioids or fentanyl, the combination can be lethal.
Doolittle issued an ominous announcement: “I think we are about to see our death rate increase as a result of this being on the streets.”
Counties in Ohio are beginning to test overdose victims for the drug. If you’re trying to find a detox center in Portland, check them out now.
In Hamilton County, the coroner’s office reports that 15 overdose victims that have tested positive for Xylazine in their systems.
Patterson said the Hamilton County Coroner’s Office has registered those deaths and has been able to perform screens for toxins in the blood.
Narcan won’t reverse the effects, Doolittle said, and those who survive using the drug are left with skin that starts to turn black at the injection site and then the skin starts to deteriorate, to break down. And it literally looks like just black decayed skin that continues to just kind of grow and peel could result in amputations.
Tranq Dope is so new the Ohio Department of Health still has several questions they want answered, such as whether the drug is the same from state to state in terms of composition and how much tranquilizer is in each dose.
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DONALD HYUNGJOON KIM, MD., “VICTORY,” UNITED STATES MOTION DISMISSED INDICTMENT, 9-0 SUPREME COURT RULING IN RUAN-KHAN
Posted on August 25, 2022 by Pharmaciststeve
DONALD HYUNGJOON KIM, MD., “VICTORY,” UNITED STATES MOTION DISMISSED INDICTMENT, 9-0 SUPREME COURT RULING IN RUAN-KHAN
“IF EVER ONE THINKS THEY’RE TOO SMALL TO MAKE CHANGES, THEN THEY HAVE NEVER SLEPT IN A TENT WITH A MOSQUITO !!!”
REPORTED BY
NORMAN J CLEMENT RPH., DDS, NORMAN L.CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., INC.T. SPIRIT OF REV. C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., IN THE SPIRIT OF THE HON. PATRICE LUMUMBA, IN THE SPIRIT OF ERLIN CLEMENT SR., WALTER F. WRENN III., MD., JULIE KILLINGWORTH, LESLY POMPY MD., CHRISTOPHER RUSSO, MD., NANCY SEEFELDT, WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, BEVERLY C. PRINCE MD., FACS., NEIL ARNAND, MD., RICHARD KAUL, MD., LEROY BAYLOR, JAY K. JOSHI MD., MBA, ADRIENNE EDMUNDSON, ESTER HYATT PH.D., WALTER L. SMITH BS., IN THE SPIRIT OF BRAHM FISHER ESQ., MICHELE ALEXANDER MD., CUDJOE WILDING BS, MARTIN NJOKU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS
“WE ARE NOT POWERLESS, AND THROUGH OUR VIDEOS, WRITINGS, AND PHOTOGRAPHS WE WILL EXPOSE THE ABUSES AND TYRANNY JUST AS THE VIDEO WAS RECORDED BY THE CELL PHONE CAMERA OF YOUNG DARNELLA FRAZIER, BORE WITNESS TO THE MURDER OF GEORGE FLOYD THE BLOG youarewithinthenorms.com BARES WITNESS AND BOTH ALLOWS THE SYSTEM TO BE HELD ACCOUNTABLE”
UNITED STATES MOTION DISMISSED INDICTMENT BASED ON 9-0 SUPREME COURT RULING IN RUAN-KHAN
UNITED STATES’ MOTION TO DISMISS INDICTMENT
The United States of America, pursuant to Federal Rule of Criminal Procedure Rule 48(a), respectfully moves this Court to dismiss the Indictment, returned June 17, 2020, in the above-styled case without prejudice. Such action would best meet the ends of justice for the following reasons:
(OBJECTIVE STANDARDS)
1. On June 17, 2020, a federal grand jury issued an Indictment charging Defendant Donald Hyungjoon Kim, M.D. with 154 counts of distributing controlled substances outside the usual course of medical practice and without medical necessity to include 3 counts of distribution with death resulting. (Doc. 1.)
MUST PROVE BEYOND THE REASONABLE DOUBT
2. On June 27, 2022, the Supreme Court issued its opinion in Ruan v. United States, — U.S. —-, 142 S.Ct. 2370 (2022). In Ruan, the Supreme Court held that the government must “prov[e] that a defendant knew or intended that his or her conduct was unauthorized,” which inserted a mens rea requirement that had not previously been recognized. Id. at 2382; see United States v. Khan, 989 F.3d 806, 825 (10th Cir. 2021),
Case 5:20-cr-00163-PRW Document 53 Filed 07/29/22 Page 2 of 3
vacated and remanded by Ruan, 142 S.Ct. 2370 (holding that “§841(a)(1) and § 1306.04(a) require the government to provide that a practitioner-defendant either: (1) subjectively knew a prescription was issued not for a legitimate medical purpose; or (2) issued a prescription that was objectively not in the usual course of professional practice”).
INDICTMENT WAS DEFECTIVE
3. Based on this intervening Supreme Court ruling, the United States has concluded that the Indictment is defective. As such, the government believes that the ends of justice would best be served by dismissing, without prejudice, the Indictment in this case.
WHEREFORE, the United States requests that this Court enter an Order dismissing, without prejudice, the Indictment filed herein on June 17, 2020.
Respectfully submitted,
ROBERT J. TROESTER United States Attorney
Harvey Silverglate
Mr. Silverglate, a Boston criminal-defense and civil-liberties litigator, is the author of “Three Felonies a Day: How the Feds Target the Innocent” (Encounter, second edition 2011).
June 12, 2015, 6:42 pm ET
WHEN TREATING PAIN BRINGS A CRIMINAL INDICTMENT
” Federal drug-enforcement officials have made it a serious felony for doctors to overprescribe painkillers or, as the applicable law states, to prescribe controlled substances “other than for a legitimate medical purpose and in the usual course of professional practice.”
But the line between legitimate and illegitimate prescription—as drawn by the Drug Enforcement Administration (DEA) and the Justice Department—is far from clear. This puts physicians in great legal jeopardy and too often leaves their patients to suffer needless agony.
The Hidden mantra of the DOJ and DEA
“The atmosphere around prescribing for chronic pain had become so fraught that physicians felt they must avoid opioid analgesics even in cases when it contradicted their view of what would provide the best care for their patients.
In some cases, this desire to reduce opioid prescribing translated to doctors tapering patients off their medications without patient consent. In other words, it meant that physicians would no longer accept patients who had a history of needing high-dose opioids.”
THE STRUGGLE
THE RULE OF LAW
The Rule of law is the most fundamental concept of our country without it our society crumbles which then allows for an agency to take anything they want unchecked based on their own manufactured rules and misinterpretation of laws, medical procedures guidelines. Thus creating their own science and facts.
In healthcare the great fear at the moment is the DEA operates unchecked as a rogue sub agency of government operating outside the rule of law creating their medical science.
ANALYSIS
Ruan provides: “ A strong scienter requirement helps reduce the risk of “over-deterrence,” i.e., punishing conduct that lies close to, but on the permissible side of, the criminal line.” An objective standard of care was not proven. The indictment used the improper evidentiary standard.”
THE JOURNEY
“AND IT SHALL BE CALLED YOUAREWITHINTHENORMS”
FOR NOW, YOU ARE WITHIN
THE NORMS
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NYC: Democratic Primary Winner Declares Victory For ‘Socialism’
Posted on August 25, 2022 by Pharmaciststeve
If this is representative of the USA’S potential future ?… for some reason… makes me not unhappy for being near the end of my life expectancy. Is it just me, but is this another female from New York city and looks/sounds like AOC ?
Because of the 2020 Census – 7 states gained House members and 7 states lost House members.. A member of the House represents about 700,000 constituents in their state. So during the 2010-2020 period abt FIVE MILLION of our citizens shifted the states they live in and from the graphic below – TEXAS was the biggest winner. California – for the first time EVER – lost a seat in the House, because of MORE PEOPLE MOVING OUT THAN MOVING IN.
I have a concern that “socialism” will lead to some sort of universal health insurance and if we follow Canada’s lead … here is a recent article about the state of Canada’s healthcare system Euthanasia Is Now A Leading Cause Of Death In Canada, And Ethicists Are Freaking Out and guess who may be first on THE LIST, the high acuity – sickest of the sick and the ones that are consuming the most healthcare $$$ ?
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The content of this blog post — says it all — doesn’t need a TITLE
Posted on August 24, 2022 by Pharmaciststeve
I went thru the archives on my blog and found this blog post can’t always judge a book by its cover ? and here is a hyperlink within this post that I believe is also interesting reading from my blog’s archives.
I have expressed my confusion to Barb about all this destructive/disruptive behavior… she had a simple answer “…you were never a girl in Jr-Sr High School..” so the community is having to deal with some people using the social skills they used during puberty and they either never grew up when they left high school and/or they have DUG THEM UP and reconstituted those skill sets…. when they became – so called – pain advocates.
Only those in the community can “sanitize ” the community of these destructive malcontents. I am sure that those – on the outside – are paying attention to what is going on… and see this as further justifications for reducing opiate Rxs and lowing opiate production quotas even more… We know that the war on drugs focuses on maybe the 2% of chronic pain pts that will become addicted and the over whelming of the opiate OD/poisoning is from illegal fentanyl but “they” keep stating that all addicts started with a Rx opiate. How long before someone tries to invoke a BAKER ACT/5150 on some within the community? Isn’t filing a false police report ILLEGAL – please read below
I am sharing the following:
Pain Community: So I’m being investigated not APDF and Claudia was absolutely right. Brittney Dulworth, Kelli Sprague Baker, Claudia and apparently Beverly Diaz and Bev Shulman, which I’m surprised about. So here’s the deal, they sicked the agents on me for selling drugs because I gave tens of thousands of names to doctors who were good to pain patients in the past. They turned in a doctor in Indiana and I’m frustrated and worried about the gentleman. Someone who works for the pain community turning in doctors? Okay confused and confused to why she didn’t do the research. My phone contains an abundance of patients who reached out for help with names of medications and doctors names. Amanda and I obtained an attorney and plan to go to town on all these people. Doctors have left that organization and left messages on her wall as to why before Claudia turned off comments on the Doctor’s posts which led to the Doctor’s reaching out to me. What this does for patients now is the old generic google search, the eenie, meenie miney mo for Doctor’s. As soon as this is resolved which shouldn’t take too long, I will start my crusade again because to hell with them I’m here for the real deal, the patients in dire need of obtaining Doctors that can help CPP’s which is what I always stood for. That being said if any and I repeat ANY of you are on her list of groups, I’m so sorry I won’t be able to help you for obvious reasons and this pains me as she even posted she was the cause of the investigations. Y’all want an advocate like that then good luck my friends! I’m more than a little pissed as it cost me a small fortune to protect all the folks and doctors I’ve helped! Until this calms down APDF advocates will do the absolute best they can at finding you doctors! They may know a guy. But I will be staying quiet and invisible which is hard for me to do but I must for my family first and foremost as well and my APDF family. I’m so glad these women work so close to law enforcement and I wish you all well. Me personally I wouldn’t trust them to ride my bike. Its up to you though and as for now any groups that support her and her peoples bullying will not be working with APDF. I never cared what group you belonged to before but now I do because I have been put in a position where I have to. $5,000 in lawyer fees cuts a lot of ties and sadly it had to come down to that. These Doctors and PA’s that defended me are my heroes and the heroes of the CPP community as a whole. We will be back with a damn vengeance sooner rather than later and maybe Claudia and Company knows some more Doctors but hey good luck. In the meantime I will be working my ass off as usual in the background of course. and if you know anyone from APDF please reach out with any questions and concerns for your medical needs. If CM people can’t help then maybe APDF will find you a solution. Cancer spreads fast folks and that’s all I got to say. One thing for sure she does have access to law enforcement I can guarantee you that. Still off Social media besides Tik Tok and IG until she gets a hold of that. Call me crooked, call me a con man, call me anything you want maybe I am all that but one thing I always stood for is chronic pain patients. While my family is eating bologna and top ramen because of all the legal fees as the lawyer is eating snow crab and prime rib, know I will protect all of your information even if I have to go to prison. Signed, Some guy in Kentucky
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Does your generic opiate meds not work very well anymore ?
Posted on August 24, 2022 by Pharmaciststeve
Recently a pt share this hyperlink https://www.drugs.com/comments/acetaminophen-hydrocodone/for-pain.html?status=1
A couple a years ago Barb had a “no efficacy ” with her C-II , when we had it fill at the Winn Dixie close to our FL condo. It was made by Rhodes – which at the time was owned by Purdue Pharma. I talked to the PIC at the pharmacy and she stated that was the ONLY BRAND that Winn Dixie allowed them to purchase from the wholesaler.
The pt that shared that the generic company that she got was Camber https://www.camberpharma.com/ Its parent company, Hetero of Hyderabad India, this website https://www.drugs.com/manufacturer/camber-pharmaceuticals-inc-219.html had this statement “Camber Pharmaceuticals, Inc. manufactures, markets and/or distributes more than 93 drugs in the United States. Medications listed here may also be marketed under different names in different countries. Non-US country and region specific information is not available on this page.” does that last statement mean that the same meds, in the same bottle – just has a different label/name on the outside of the bottle ?
here is another hyperlink https://reviews.birdeye.com/camber-pharmaceuticals-inc-163457133420189 and Camber got a 2.2 overall rating with 84 out of 126 reviews was a ONE – maybe because there was no option to give them a ZERO ?
Some pt have asked me… if they could get the potency of their meds tested… of course they can, I understand such tests are $200 -$300 each time….however if the med is produced off shore … how are they going to sue someone in India or Pakistan ? The FDA is not going to do anything… if you complain to your insurance company – for paying for “defective meds”… they will just tell you to get a med from a different pharma.
The FDA years ago created the ORANGE BOOK https://www.fda.gov/drugs/drug-approvals-and-databases/approved-drug-products-therapeutic-equivalence-evaluations-orange-book and in it.. the FDA has determined what medication(s) a pharma makes is bioequivalent to the brand name product and gives he generic/pharma a “grade” as bioequivalent or NOT.
It is ILLEGAL for a pharmacy to compound meds that are commercially available… but compounding a product that has been independently tested is not meeting the FDA requirement that a med must be between 95%-105% of what is stated on the label.
However, a compounding pharmacy and a doc could come to some sort of an agreement about a specific combination of meds to be compounded. Because compounding pharmacies are allowed to do anticipatory compounding and keep 7-14 days on hand and there are ways to basically do this in a semi-automated process… not how making compounded meds and putting them in capsules – BACK IN THE DAY.
Hydrocodone is not available in a 12.5 mg dose and there use to be a commercially available product that was Demerol and Phenergan… but it was finally figured out that long term use of Demerol created some toxic by products, but Phenergan/Promethazine is known to potentiate the effects of opiates… same thing could be done with Oxycodone … there is no 7.5 mg or 12.5 mg commercial dose.
Insurance companies don’t like to pay for compounding meds, but if the pt clinically showed BETTER PAIN MANAGEMENT with the compounded med than the generic they were taking… could give enough valid reasons for the insurance to pay for the compounded med. IMO, Medicare Part D & Medicare Part C… has a very well defined appeal process and following their rules on appeals, the vast majority of pts seeing a benefit out of a compounded med… perhaps at least 90% would end up getting their meds paid for..
The pt is going to have to start the discussion with their doc that has a lot of pain pts… here is a link to find a independent compounding pharmacy by zip code and radius https://ncpa.org/pharmacy-locator these “poor” generic meds may cause a pt to end up showing “NO OPIATES IN THEIR URINE” and could get kicked from the practice.
Maybe everyone is HAPPY… the doc because the pt is getting better pain management, so is the pt, the compounding pharmacy is happy getting more business… the pharmacy that has been dispensing the cheapest meds they can buy – loses business and so does the generic pharma
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