Generic Prescription Drug Info

As influenza season shifts into high gear, with 24 states now reporting widespread activity, the nation’s infectious diseases experts are urging supermarket pharmacies with free-antibiotics promotions to educate their customers on when antibiotics are the right prescription - and when they can do more harm than good.

Several grocery store chains nationwide began offering free antibiotics this winter. Some are linking the promotion to cold and flu season, despite the fact that antibiotics do not work against these viral illnesses. Furthermore, antibiotics can have serious side effects, and their misuse is contributing to the increase in antibiotic-resistant infections such as methicillin-resistant Staphylococcus aureus (MRSA).

Therefore, the Infectious Diseases Society of America (IDSA) and the Centers for Disease Control and Prevention (CDC) have written to supermarkets with free-antibiotics promotions asking them to join “Get Smart: Know When Antibiotics Work,” a campaign from CDC to educate consumers about the importance of using antibiotics appropriately.

“Taking an antibiotic when you don’t need it won’t help you, and may in fact do more harm than good,” said IDSA President Anne Gershon, MD. “At a time when antibiotic overuse is helping to create drug-resistant superbugs such as MRSA and few new antibiotics are being developed, supermarkets need to be responsible in how they promote antibiotics.”

Studies show many people believe that antibiotics can cure a cold or the flu, and tend to ask or pressure their clinicians to provide them. Every year, tens of thousands of people are prescribed antibiotics for these conditions, even though they will do no good and can be harmful. A recent study in Clinical Infectious Diseases estimates that antibiotics are responsible for 142,000 emergency department visits each year, mostly because of allergic reactions.

“Supermarkets have the power to protect their customers’ health,” said Lauri Hicks, DO, medical director of CDC’s “Get Smart” program. “If they sought to educate people about when antibiotics work and when they don’t, they would be doing a great public service.”

In letters to Wegmans, ShopRite, Stop and Shop, and Giant, IDSA and CDC suggest that supermarkets could begin with CDC’s easy-to-understand posters, brochures, and other educational materials.

IDSA suggests supermarkets offer free flu shots rather than free antibiotics as a way to save customers money while protecting their health. “We applaud supermarkets’ desire to look out for their customers in these difficult economic times,” Dr. Gershon said. “As flu season heats up, free influenza vaccinations would be a proven-effective way to keep customers healthy.”

Consumers say they are spending an estimated 3% less on prescription drugs this year versus last year thanks, in part, to the economic downturn, according to Kurt Salmon Associates’ recent evaluation of more than 8,000 shoppers’ opinions.

The decline is likely the result of a continued shift towards lower-cost generic drugs and an increasing number of consumers who are looking to save money by self-medicating or simply reducing overall drug consumption.

KSA’s analysis suggests that retailers that can manage consumers’ perceptions of price — as much as price itself — are the most likely to be successful in the prescription drug category, especially in the present economy.

Wal-Mart gaining share; Target gets high advocacy and price-to-value

For example, many retailers have adopted discount and generic drugs programs. But Wal-Mart Stores Inc. has been the most successful at marketing its discount drug offering and appears to be gaining share from traditional drug chains, such as Rite Aid Corp., which consumers perceive as having higher prices.

Target Corp. also could prove an advantage in the prescription drug category. Consumers give the multiline retailer high advocacy and price-to-value scores.

Conducted in partnership with Prosper Inc., a leader in online market intelligence, the research includes more than three years’ worth of comprehensive consumer data and shows that:

– Prescription drug users are increasingly price sensitive. In January 2009, 20% of prescription drug consumers cited price as a reason for switching retailers, which is up from 16% in 2008.

– Retailers with a value orientation are winning the share war in this economy. Wal-Mart grew its customer base 9% over the past year.

– The share gains for value-based retailers come at the expense of the stores that consumers perceive as having higher prices. Rite Aid lost a disproportionate amount of market share to Wal-Mart, approximately 2% over the past year, because consumers believe it has higher prices.

– Despite the increasing importance of price perception, location remains the no. 1 reason why consumers choose a particular retailer for prescription drug purchases. Walgreens and CVS continue to maintain share based primarily on convenient locations.

– Price-sensitive consumers are responding to discount prescription drugs programs. More than half (57%) of Wal-Mart pharmaceutical shoppers cited the retailer’s $4-generic-drugs program as a main reason for their choice of retailer.

According to the most recent Pharmacy Today Over-the-Counter Product Survey conducted by the American Pharmacists Association (APhA), pharmacists believe that 83 percent of consumers purchase over-the-counter products that were recommended by their pharmacist. With more than 100,000 nonprescription medications on the market and more than 1,000 active ingredients, it’s critical that patients consult their pharmacist to maximize the benefits from medications and minimize the potential for harmful drug interaction and/or side effects.

The survey, completed by nearly 1,000 APhA member and non-member pharmacists, also reveals that on average pharmacists counsel 31 patients per week about over the counter medications? Patients who seek their pharmacist’s advice include patients suffering from an acute or chronic condition (92 percent), patients that are worried about using an OTC product with other prescription medications (84 percent), and patients worried about taking OTC products with a specific disease/condition (74 percent).

“Pharmacists are the only health professionals specifically trained in nonprescription medications,” said John A. Gans, APhA’s Chief Executive Officer. “Patients can take an active role in self care by reading medication labels, knowing the active ingredients in their medications, and asking their pharmacist questions.”

One of APhA’s goal in conducting the annual Pharmacy Today Over-the-Counter Product Survey is to educate consumers that pharmacists have the knowledge and training to help them select right OTC medications. As part of the survey, pharmacists are asked to tabulate the OTC products they recommend per week in 77 different product categories. The results of the survey are published as a supplement to the February issue of Pharmacy Today. Click here to view the entire Pharmacy Today Over-the-Counter Supplement.

As the medication experts, pharmacists are trained in both prescription and over-the-counter medications and can provide patients with important information about how medications may interact with certain foods, other medicines or dietary supplements. Pharmacists are the most accessible health care providers and APhA encourages patients to actively seek their advice about the proper use of medications.

A Somerset GP is backing a national campaign to tackle the problem of antibiotic resistance. Dr Harry Yoxall, a GP in Taunton and Secretary to the Somerset Local Medical Committee, said: ‘Antibiotics don’t work on colds, most coughs, sore throats or even the flu. Using antibiotics unnecessarily will increase resistance to them and make it harder to treat serious bacterial infections in the future.’

The latest campaign to remind the public that antibiotics are ineffective against viral infections was launched last week.

National press and radio advertising aimed at patients and clinicians, hope to raise awareness and reduce the number of unnecessary requests for antibiotics from patients. Scientists predict that continued over use of antibiotics could make treatment for common bacterial infections, such as pneumonia, much more difficult to treat in the future as strains of bacteria become resistant to antibiotics.

“If you are suffering with cold and flu symptoms or a sore throat you should rest, take plenty of fluids and speak to your pharmacist who will advise you on over the counter remedies that are available,” said Dr Yoxall.

‘Bacteria will always try to find ways to survive by evolving and developing resistance to antibiotics so we must stay one step ahead of the game.’

For 24 hour a day, seven days a week health information and advice call NHS Direct on 0845 4647, or you can visit http://www.nhsdirect.nhs.uk

Consumers are more likely to receive information about medications from magazine advertisements that include a “drug facts box,” rather than the brief summaries currently used, according to a study published on Tuesday in the Annals of Internal Medicine, USA Today reports. For the study, Steven Woloshin and colleagues at Dartmouth University, tested the effectiveness of drug facts boxes for a statin and the blood thinner Plavix, both medications for heart disease, as well as a proton pump inhibitor and an H2 blocker, both treatments for heartburn.

The drug facts boxes included information about the side effects of the medications, as well as the rate that the side effects occurred in clinical trials. In addition, the drug facts boxes quantified the benefits of the medications over a placebo and older treatments. The drug facts boxes also included the year that the medications received FDA approval and alternative treatments that do not involve medication.

According to the study, about 72% of individuals who viewed drug facts boxes for the heart disease medications correctly said that the statin provides a larger benefit, compared with 9% of people who viewed the brief summaries currently used. About 70% of individuals who viewed drug facts boxes for the heartburn medications correctly said that the protein pump inhibitor provides a larger benefit, compared with 8% who viewed the brief summaries currently used, the study found.

Woloshin said that researchers have begun to design a pilot project in which FDA scientists have drafted drug facts boxes as they review new medications (Rubin, USA Today, 2/17).

Expenditures for outpatient prescription analgesics commonly known as painkillers and medicines that treat aches and pains increased from $4.2 billion in 1996 to $13.2 billion in 2006, according to the latest News and Numbers from the Agency for Healthcare Research and Quality. These medications include narcotic analgesics, non-steroidal anti-inflammatory drugs, and Cox-2 inhibitors, among others.

AHRQ also found that for outpatient prescription analgesics from 1996 and 2006:

– The average annual expenditure jumped from $83 to $232 for people who purchased one or more prescription analgesics

– For each analgesic purchased, the average expenditure rose from $26 to $57.

– The total number of prescription purchases increased from about 164 million to 231 million.

Sens. Herb Kohl (D-Wis.) and Chuck Grassley (R-Iowa) on Tuesday announced that they have introduced a bill (S 369) to end agreements under which brand-name pharmaceutical companies pay generic pharmaceutical companies to delay the launch of generic versions of the medications, CQ HealthBeat reports. According to Kohl and Grassley, the number of such agreements has increased since two appeals court decisions in 2005 allowed them. In the statement, Kohl and Grassley, who introduced similar legislation last year, said, “In the two years after these two decisions, the Federal Trade Commission has found nearly half of all patent settlements involved payments from the brand-name to the generic manufacturer in return for an agreement by the generic to keep its drug off the market.”

Kohl, chair of the Senate Judiciary Antitrust, Competition Policy and Consumer Rights Subcommittee, said, “It’s time to stop these drug company pay-for-delay deals that only serve the profits of the companies involved and deny consumers access to affordable generic drugs.” Grassley, ranking member of the Senate Finance Committee, added, “In a time when our federal health care programs such as Medicare and Medicaid are facing extraordinary fiscal strains, this wheeling and dealing only delays the entry of lower-priced medicines in the marketplace.”

Pharmaceutical Research and Manufacturers of America Senior Vice President Ken Johnson said that the group “continues to believe that legislation imposing a blanket ban on certain types of patent settlements could decrease the value of patents and reduce incentives for future innovation.” He added, “A sweeping ban is also unnecessary” because FTC and others “already have the authority to review and evaluate any patent settlement agreement between a brand-name company and a generic company.”

FTC on Monday in U.S. District Court in California filed a lawsuit against Solvay Pharmaceuticals over allegations that agreements with three generic pharmaceutical companies illegally delayed the launch of lower-cost generic versions of the hormone replacement therapy AndroGel (Reichard, CQ HealthBeat, 2/4).

Editorial
The agreement between Solvay and the three generic pharmaceutical companies “keeps prices high” for medications, and “Solvay’s gain was the consumer’s loss,” according to a Los Angeles Times editorial. According to the editorial, such agreements are “anti-competitive and bad for consumers,” and although “companies such as Solvay deserve patent protection,” consumers have a “strong interest in making sure that generic drugs become available as soon as legally appropriate.” The editorial concludes, “At this point, there’s little to be gained, at least for consumers, from backroom deals made by interested corporate parties” (Los Angeles Times, 2/5).

Canada needs a national strategy to ensure broad access to prescription drugs, yet plans for a strategy have stalled. Compared with many other countries, Canada lags behind in prescription access and affordability, quality and safety of medication use. A commentary in CMAJ makes the case for reigniting a strategy to benefit Canadians.

“Canada has an overall public health care system, but the lack of coverage for prescription drugs is a gaping hole in the system with adverse consequences for many Canadians,” write Neil MacKinnon of Dalhousie University in Halifax and Ivan Ip of the Health Council of Canada.

The Health Council of Canada released 2 reports regarding the National Pharmaceuticals Strategy on January 30, 2009, with steps to move forward on the strategy, including: catastrophic drug coverage, affordability of prescription drugs, patient safety issues and equal access to medications.

Walgreens (NYSE:WAG)(NASDAQ:WAG) had January sales of $5,220,500,000, an increase of 5.3 percent from $4,957,145,000 for the same month in 2008. Sales in comparable stores (those open at least a year) rose 0.4 percent, while comparable store front-end sales decreased 0.9 percent.

January pharmacy sales increased 5.0 percent, while comparable pharmacy sales increased 1.0 percent. Comparable pharmacy sales were negatively impacted by 2.2 percentage points due to generic drug introductions in the last 12 months. Total prescriptions filled at comparable stores decreased 2.0 percent in January. Pharmacy sales accounted for 66.9 percent of total sales for the month.

Calendar day shifts had a negative impact on the month, as pharmacy patients fill more prescriptions during the week than on weekends. This year, January had one fewer weekday compared to January 2008. Calendar shifts negatively impacted total comparable store sales by 1.2 percentage points, comparable pharmacy sales by 1.8 percentage points and prescriptions filled in comparable stores by 1.9 percentage points.

Total prescriptions filled at comparable stores were negatively impacted by 1.6 percentage points due to more patients filling 90-day prescriptions versus 30-day. Comparable prescriptions filled also were hurt by 0.3 percentage points due to the switch of Zyrtec from prescription to over-the-counter status.

January front-end sales were helped in part by sales of key beauty categories, basic necessities and consumables. Also, Zyrtec’s switch to over-the-counter status benefited front-end sales by 0.2 percentage points.

Fiscal 2009 year-to-date sales for the first five months were $26,280,761,000, up 7.3 percent from $24,497,858,000. Comparable store sales for the fiscal year to date increased 2.2 percent.

Walgreens opened 23 stores during January, including four relocations, acquired four stores and closed one.

At Jan. 31, Walgreens operated 7,154 locations in 49 states, the District of Columbia, Puerto Rico and Guam. That includes 6,658 drugstores, 586 more than a year ago. The company also operates worksite health centers, home care facilities and specialty, institutional and mail service pharmacies. Its Take Care Health Systems subsidiary manages 693 in-store convenient care clinics and worksite health and wellness centers. Franchisees of Option Care, Inc., a wholly-owned subsidiary of Walgreens, are not included in Walgreens location or store count.

Medications that affect a person’s metabolism by helping to lower cholesterol, control diabetes and control weight - accounted for $38 billion of the $208.1 billion that American adults spent on medications in 2006, according to the latest News and Numbers from the Agency for Healthcare Research and Quality (AHRQ).

The estimate comes from an AHRQ analysis that found five therapeutic categories of prescribed drugs accounted for more than 60 percent of consumer spending on drugs in 2006. Among the conclusions:

- Spending was highest for metabolic drugs, which included cholesterol-lowering medications, diabetes drugs, and weight control drugs.

- Cardiovascular drugs, that include blood pressure drugs, as well as diuretics and drugs to control heart rhythm problems, accounted for $33 billion.

- Central nervous system drugs, which include analgesics for pain: $28 billion.

- Psychotherapeutic drugs, which include antidepressants, $17.5 billion.

- Hormones, that are used for osteoporosis, menopausal symptoms, cancer treatment, and other medical problems: $14 billion.