The Official Medtipster Blog

www.Medtipster.com Source: The Associated Press – By Ricardo Alonso-Zaldivar – 8.25.2010

A plan by Medicare to try to make it simpler for consumers to pick drug coverage could force 3 million seniors to switch plans next year whether they like it or not, says an independent analysis.

That risks undercutting President Barack Obama’s promise that people can keep their health plans if they like them.

And it could be an unwelcome surprise for many seniors who hadn’t intended to make a change during Medicare’s open enrollment season this fall.

The analysis by Avalere Health, a leading private research firm, estimated that more than 3 million beneficiaries will see their prescription plan eliminated as part of a new effort by Medicare to winnow down duplicative coverage and offer consumers more meaningful choices.

Seniors would not lose coverage, but they could see changes in their premiums and copayments.

Medicare officials dismissed the Avalere estimate without offering their own number. “Anybody who is producing that kind of analysis is simply guessing,” said Jonathan Blum, deputy administrator for Medicare.

But Bonnie Washington, a senior analyst with Avalere, said the company’s analysis used Medicare’s specifications.

For example, Medicare has already notified insurers they will no longer be able to offer more than one “basic” drug plan in any given location. Several major prescription plans, including CVS-Caremark and AARP, offered two basic options throughout the country this year, Washington said. Eliminating that particular form of duplication among the top plans would force 2.75 million beneficiaries to find new coverage, according to Avalere’s estimate.

When other changes are taken into account, as many as 3.7 million Medicare recipients may have to switch, the analysis concluded. That amounts to about 20 percent of the 17.5 million enrolled in stand-alone drug plans.

Avalere serves industry and government clients with in-depth research on Medicare and Medicaid. The company’s president was a health care budget analyst in the Clinton White House.

Former Medicare administrator Leslie Norwalk said the change might make things easier for people signing up for Medicare but harder for those already in the program.

“If you’re in a plan that you like and you have to change it, it will be disruptive,” said Norwalk, acting administrator under President George W. Bush. “It depends on how (Medicare) handles it to try to make it as seamless as possible.”

Reducing the number of Medicare drug plans has long been a goal for consumer advocates. This year, nearly 1,600 plans offered a dizzying range of options, many of which were not significantly different.

But Medicare is going ahead with the consolidation in a hard-fought election year. Republicans have barraged seniors with charges that Obama and the Democrats raided the program to expand coverage for younger generations under the health care overhaul. Obama’s promise that people can keep health plans they like was made in the context of that broader debate, but the president has repeatedly assured seniors their Medicare benefits are safe.

“Some opponents of the (health care) law may say that this is taking away choices, but we have heard from our members for years that the (drug coverage) options can be confusing,” said Nora Super, AARP’s top health care lobbyist. The seniors lobby supports the change. AARP’s public policy branch is separate from its business side, which sponsors Medicare and other insurance plans.

Medicare official Blum said the agency is working with insurers to keep disruptions to a minimum. For example, seniors could be automatically reassigned to a comparable plan offered by their insurance company. Premiums may not necessarily be any higher, Medicare officials said.

“We are not reducing the number of (insurers). We are not reducing the number of quality plans,” said Blum, adding that having fewer, more distinct choices will benefit seniors. “That puts beneficiaries in a stronger, rather than weaker position.”

Besides eliminating duplicative basic coverage, insurers that offer more than one enhanced coverage plan will have to show they are clearly different.

Medicare is expected to release its list of drug plans for 2011 late next month. Instead of 40 or more choices in each state, seniors may have around 30 plans to pick from.

Copyright © 2010 The Associated Press. All rights reserved.

www.Medtipster.com Source: Employee Benefit News – By Kathleen Koster – 8.18.2010

According to a new survey by National Business Group on Health, more than half (53%) of large U.S. employers plan to revise their 2011 health care benefit programs in the wake of health care reform legislation and anticipated large benefit cost increases next year.

Also considering the provisions of the Patient Protection and Affordable Care Act, 19% of respondents are scaling back changes they planned to make while an equal number are making no changes.

The remaining respondents were still undecided pending further review of the final regulations.

Among employers who will be making specific changes to their health benefit plans to comply with the new law, 70% said they will remove lifetime dollar limits on overall benefits while 37% said they will make changes to annual or lifetime limits on specific benefits.

Approximately one-fourth will remove annual dollar limits on overall benefits while 13% reported they will remove pre-existing condition exclusions for children.

The survey, based on responses from 72 of the nation’s largest corporations representing more than 3.7 million employees, was conducted in May and June 2010.

“While the health reform law has forced employers to evaluate their health care benefit strategies and decide whether to comply with the law or lose grandfathered status, they haven’t lost sight of the fact that controlling rising costs remains one of, if not, their highest priority. They have to foot the bill, not the government,” says Helen Darling, president of the National Business Group on Health. 

“In fact, with cost increases expected to accelerate next year, many of the plan design changes employers are making are being done to help curb those increases, as they have to do every year,” she adds.

Employers estimate their health care benefit costs will jump to an average of 8.9% next year, compared with an average increase of 7% this year. To help curb those increases employers plan to use a wider variety of cost-sharing strategies.

According to the survey, 63% of employers plan to increase the percentage employees contribute to the premium, up from 57% who did so this year, while 46% plan to raise out-of-pocket maximums next year compared with 36% this year.

In order to further mitigate costs, employers are shifting to consumer-directed health plans. In fact, 61% of plan sponsors will offer a CDHP in 2011.

While the most common type of plan employers will offer is a high-deductible plan combined with a health savings account (64%), the survey found a large spike in employers moving to a full replacement plan.

Among employers offering a CDHP, the number moving to a full replacement plan doubled from 10% this year to 20% in 2011.

“Consumer directed health plans are living up to their expectations as a way to help save employers money and put employees in greater control of their health care.  In fact, offering these plans was the most often-cited tactic by employers to control costs.  We fully expect that employer interest in CDHPs, and especially full-replacement plans, will continue to increase in the future,” says Darling.

As the health reform law makes Medicare Part D benefits richer as the “doughnut hole” closes between now and 2020, 5% of employers plan to drop retiree health coverage in 2011 while 60% are considering doing so in the future.

In attempt to cut costs with wellness initiatives, 41% of employers offered premium discounts for completing health assessments while 22% offered premium discounts for participating in tobacco cessation programs.

In addition, one in four (25%) of plan sponsors plan to raise the co-pay or co-insurance for retail pharmacy prescription drug benefits while 21% plan to do the same for mail-order pharmacy benefits.

Copies of the survey report can be found at www.businessgrouphealth.org.

www.Medtipster.com Source: Dow Jones Newswires, By Dinah Wisenberg Brin – 8.11.10

The U.S.’s big pharmacy benefit managers continue to offer clients better deals this year as they compete for business, but they don’t appear to be sliding into a frenzy of unreasonable pricing.

In the current “selling season,” when PBMs look to sign customers for the following year, discounts on new contracts have deepened by one or two percentage points, on average, from a year ago. While PBMs are still lowering their pricing, the pace is slower than a year ago, when PBMs were willing to expand discounts by as much as five percentage points, according to benefit consultants who guide employers on choosing a vendor.

It is unclear how the lower prices will impact margins next year at large PBMs like Medco Health Solutions Inc. (MHS), CVS Caremark Corp. (CVS) and Express Scripts Inc. (ESRX). The increased use of generic drugs, which lowers PBMs’ costs, allows them to be more flexible with prices. That accounts for some of the discount.

The big PBMs have reported lower margins this year, citing a variety of reasons. Medco, though, specifically mentioned lower pricing on renewing contracts, among other items.

PBMs “are taking a little bit of a hit to margin, not much, but they are taking one,” said Michael Jacobs, national clinical practice leader at Xerox Corp.’s (XRX) Buck Consultants. He said the companies have ways of making up elsewhere for client discounts — through greater operating efficiency, cost-shifting to members or raising prices on other drugs.

PBMs handle prescription-drug benefits for employers and health plans, negotiating pricing — including rebates and discounts — with drug makers and pharmacies. They also run their own profitable mail-order pharmacies. The competitive industry has come under increasing pressure to pass along rebates and discounts and improve transparency.

Currently, the industry is engaged in its selling season for 2011 contracts, with billions of dollars in new and renewing business up for grabs or already won.

“Pricing got more competitive this year,” said Kristin Begley, national pharmacy practice leader at benefits consultant Hewitt Associates Inc. (HEW), who didn’t see much switching among her large, national clients, many of which contract with CVS Caremark or Medco.

Rebates got better, and there were “overall better deals across the board,” Begley said. Also, she said, most Hewitt client bids this year required full transparency on pricing structure, with PBMs earning an administrative fee and making money on mail-order while forgoing a margin on drugs dispensed at retail.

PBMs are offering clients better discounts on generic drugs, said David Dross, partner and managed pharmacy practice leader at the Marsh & McLennan Cos. (MMC) Mercer LLC consulting business. Dross added that he has seen some bigger discounts for brand-name drugs as well, although underlying costs on branded drugs generally are increasing.

PBM managements have indicated pricing trends are rational, even though a Sanford C. Bernstein & Co. employer survey earlier this summer suggested a “notable deterioration of the PBM pricing environment,” with more than 40% of respondents noting a decrease in prices.

“Our pricing disciplines have been applied consistently for the past several years as well as going forward to 2011,” Medco spokesman Lowell Weiner said. Medco CEO David Snow Jr., who earlier this year noted instances of aggressive pricing, said last month that he was feeling more comfortable with the competitive marketplace.

Meanwhile, Express Scripts CEO George Paz has said that while “pricing has always been extremely aggressive,” the company uses clinical tools to help drive out costs.

Per Lofberg, who heads CVS Caremark’s PBM operation, recently told analysts that pricing is “intensely competitive like it always … has been, but it’s fundamentally very similar to the past. When plans go out for bid, they are always looking for better economics, and that’s a very important part of the negotiations.”

John Malley, eastern region pharmacy practice leader at Towers Watson & Co. (TW), said PBM pricing isn’t irrational, although it is changing in structure so that players offer better pricing without necessarily losing margin.

“So more simply put, the level of discounts off prescription drugs is not that different between last year and this year, but the overall value of this year’s deals, all in, is better than last year” for the clients, Malley said.

Pricing will become less important a competitive factor as more drugs go generic, Mercer’s Dross predicted. PBMs already are trying to differentiate their clinical offerings, which aim to close gaps in care, customize prescriptions based on genetics and improve compliance to produce better health outcomes and lower costs.

www.Medtipster.com Source: LA Times – Author: Karen Ravn

Here’s a list of questions that you should pose before taking your medications home.

You’re tired, hungry, cranky, and you’ve been waiting in line forever. Now your pharmacist is offering to discuss your new prescription — the last thing on earth you want to do.

Do it anyway.

The warnings and descriptions on the obligatory information sheet are meant only for a general audience. Your pharmacist can offer pertinent details — and emphasize the aspects most important for you.

So don’t go home without getting answers to these questions:

What is the medication for?

In other words, make sure you get what you think you’re getting. Mistakes happen. If the medication the pharmacist prepares for you is a fertility drug and what you wanted were birth control pills, this is a prime time to find out.

What is the name of the medication?

Physicians don’t always tell patients the name of the drug they’re prescribing, and patients don’t always remember when they do. It’s not enough to know you’re taking “these big fat horrible-tasting pink things” twice a day. Your dentist, your insurance agent, the on-duty physician in an ER — all might need the actual name of your medication. You should know it.

How should you take the medication?

Some medications should be taken with food. Some should be taken only when you’re standing up. Some (especially those that are enteric-coated or designed for controlled release) can be harmful — even fatal — if they’re crushed. Only if you know the best way to take your medication can you hope to have the best results.

When should you take the medication?

Some drugs should be taken in the morning. Some should be taken at bedtime. And with some, precise timing is more crucial than with others. For example, if you’re supposed to take a pill twice a day, it would probably be OK to take it at 8 a.m. and 10 p.m. But that schedule wouldn’t be OK if you’re supposed to take a pill every 12 hours.

What is your medication supposed to do — and how soon is it supposed to do it?

If you’re coughing and sneezing and feeling achy all over, should you expect the medication to stop all this bad stuff or just some of it? If your medication is supposed to make your migraine go away, should you expect the pain to ease in five minutes? Five hours? Five days? Unless you know how — and how fast — your medication is supposed to act, you have no way to know if it’s working.

What should you do if you miss a dose?

In general, it depends on how much you miss it by, says Jeff Goad, associate professor at the USC School of Pharmacy. If you’re supposed to take a dose every eight hours and you remember half an hour late, it’s probably OK to take it right away and then resume your regular schedule with the next dose. On the other hand, if you don’t remember until half an hour before you’re due to take the next dose, you shouldn’t try to make up for the dose you missed. But medications vary, and it’s best to find out about your own specifically.

Should you keep taking the medication until it’s all gone or just until your symptoms go away?

It’s important to keep taking some medications, especially antibiotics, until you’ve used them all up, even if you feel better before that. You can take other medications only “as needed” — i.e., only when you’re experiencing the problem they’re supposed to treat. Other medications are for chronic conditions and are meant to be taken over the long term, perhaps for life.

Is it safe to stop taking the medication whenever you want?

If your medication is intended to make your broken arm hurt less and you stop taking it, your arm will probably hurt more — but probably nothing worse than that will happen. If your medication is an antibiotic intended to cure a bacterial infection and you stop taking it before you finish the full course, some bacteria will probably survive and multiply and may make you sick again. Plus you may be contributing to the rise of antibiotic resistance — since the bacteria that did survive (and multiply) will be the ones most resistant to the antibiotic.

It may be even less wise to stop taking other medications abruptly on your own. If you suddenly stop taking a medication meant to lower your blood pressure, for example, your blood pressure could spike dangerously.

What side effects should you watch out for?

In addition to the effects you want your medications to have — making your blood pressure go down or your energy level go up — drugs may have effects you’d rather they didn’t, such as making you fall asleep in a meeting with your boss. Some side effects are more common than others, and some are more serious. You need to know which are which, how you can avoid them (if possible) and what you can and should do about them if they occur. For example, the standard recommendation for medications that make you drowsy is to avoid driving or operating heavy machinery.

What interactions should you watch out for?

If you’re already taking any over-the-counter medications, herbal remedies, dietary supplements or other prescription drugs, or if you drink alcohol, your new medication might act in undesirable ways. It could be ineffective. It could be dangerous. There are ways to avoid some bad interactions, such as scheduling your doses appropriately. And there are times when the medications themselves should be avoided.

How should you store the medication?

Proper storage will ensure that your medication is as effective as possible. Usually this means in a cool, dry, dark place. Sometimes it means in the refrigerator or freezer. But for the most part it means not in the medicine cabinet in your bathroom, where conditions are often warm and moist.

Is there a way to save money on your prescription?

Physicians tend to underestimate the price of expensive drugs and overestimate the price of inexpensive ones, according to a study published in the journal PLoS Medicine in 2007. So they may not always have a very good idea of how much the drugs they prescribe are going to cost their patients. Often pharmacists can suggest changes or substitutions for prescribed medications that will save patients money.

In California, if your physician prescribes a brand-name drug and you’d rather take a less expensive generic, your pharmacist can make the substitution without consulting the prescribing physician. To change to a different drug, however, pharmacists do need the physician’s approval. Even with a hefty financial incentive, patients are sometimes reluctant to take their pharmacists’ advice.

“They think what their physicians prescribed must be better or they wouldn’t have prescribed it,” says Kathy Besinque, an associate professor at the USC School of Pharmacy who also works part-time at Patton’s Pharmacy in Santa Monica. “But really, physicians have many choices that would work.”

“Some patients assume generic drugs are less effective than brand names,” says Julie Donohue, associate professor in the graduate school of public health at the University of Pittsburgh. In fact, generics contain the same amounts of active ingredients as do the brand names they are meant to be substituted for.

“As a pharmacist myself, I would take generics,” says Ken Thai, owner of El Monte Pharmacy in El Monte.

Cost issues can affect people’s insurance coverage. “Sometimes insurance plans won’t cover new medications,” Besinque says. “They want patients to try old, less expensive ones first.”

Besides recommending less expensive medications, pharmacists can help patients save money in other ways too. For example, a pill that’s twice as strong as the one your physician prescribed usually doesn’t cost twice as much, Besinque says. So if the double-strength pill can be split in half, you can get the same amount of medication for less. Similarly, for medication you take long-term, you can often save money by buying more pills at once — e.g., 60 pills probably won’t cost twice as much as 30.

Does your pharmacy provide any special services that will make your life easier?

Some pharmacies can package your medication in daily doses, making it easier to take the right amounts. CVS Pharmacies recently began a free program to make it easier to refill prescriptions you take for chronic conditions. If you sign up for the new service, the store will simply refill any such prescriptions automatically — and then call you to let you know they’re ready.

Remember: It’s never too late, and it’s never too dumb.

If you get home and start taking your new medication and only then think of a bunch of questions about it, not to worry. “You can call your pharmacist with any question about your prescription at any time,” says Anne Burns, vice president for professional affairs for the American Pharmacists Assn. In fact, it’s just natural to have more — and possibly more important — concerns after you’ve taken the medication for a while.

In any case, “there are no bad questions,” Thai says. “The more communication people have with their physician and pharmacist, the better. When people don’t say anything, that’s when we run into problems.”

www.Medtipster.com Source: LA Times – Author: Karen Ravn

Here’s a look at five of the most-prescribed drugs and their possible risks, side effects and possible interactions.

Some drugs are so common that consumers — at their peril — don’t think twice about them. But each drug, whether prescription or over-the-counter, poses risks. To highlight these risks, we offer up a few details on five of the most-prescribed medications, with additional input from pharmacists interviewed for this package of stories.

Hydrocodone with acetaminophen

Brand names: Vicodin, Lortab

Description: A combination of a narcotic (hydrocodone) with a non-narcotic (acetaminophen) pain reliever, it’s prescribed for moderate to severe pain.

Most serious risks: Abuse and addiction; acetaminophen overdose. Too much acetaminophen can cause severe liver damage, even death, but many patients aren’t aware of this danger — or of how many medications contain acetaminophen. Acetaminophen is the active ingredient in Tylenol, but it’s also found in many other medications.

Possible side effects: Constipation, drowsiness, dizziness, nausea, vomiting, stomachache.

Common interactions: Barbiturate anesthetics (e.g., thiopental); cimetidine (Tagamet); antidepressants, including monoamine oxidase (MAO) inhibitors such as phenelzine (Nardil) and tricyclic antidepressants such as amitriptyline; sodium oxybate (GHB). These may lead to excessive sleepiness or create breathing difficulty.

And our pharmacists say . . . : This is probably one of the most abused drugs on the market. While taking this drug, avoid taking alcohol and other drugs that cause sleepiness. If you drive while taking it, you can be cited — and convicted — for driving under the influence. Check the labels of any other medications you are taking to see if they contain acetaminophen, and only take one source of acetaminophen at a time. Fluids and fiber can help prevent constipation, but you may also need to take laxatives. Taking this drug with food can reduce stomachache. The dizziness or drowsiness that can come with the drug can increase the risk of falls — a serious danger for older people.

Lisinopril

Brand names: Prinivil, Zestril

Description: An ACE (angiotensin-converting enzyme) inhibitor, lisinopril improves blood flow by interfering with the production of angiotensin II, a substance that constricts blood vessels and releases hormones that raise blood pressure. It’s prescribed for high blood pressure and heart failure and to improve survival chances after heart attacks.

Most serious risks: Birth defects if taken while pregnant; hyperkalemia, a condition caused by high levels of potassium that can lead to an irregular heartbeat; nausea; slow, weak or nonexistent pulse; and even heart attacks. It is a particular risk in patients with poor kidney function.

Possible side effects: Nagging dry cough, dizziness. Less common but more severe: swelling of the face and lips, difficulty swallowing or breathing, itchiness.

Common interactions: Diuretics (may increase risk of low blood pressure); diabetes medications (may increase risk of low blood sugar); lithium (may increase lithium concentrations to toxic levels); potassium (may cause retention of potassium, so potassium supplements can lead to hyperkalemia); nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen (these reduce the excretion of ACE inhibitors, so their concentration in the bloodstream increases).

And our pharmacists say . . . : This medication should never be used by pregnant women. ACE inhibitors are generally less potent in African Americans. Also, studies have shown that when taking lisinopril (or other ACE inhibitors), African Americans are at increased risk for angioedema (swelling similar to hives but under the skin and potentially life-threatening). Seniors too are at higher risk for angioedema. Also, if seniors are taking a diuretic and then start taking lisinopril too, their blood pressure may drop too quickly. It’s better to start with lisinopril and add the diuretic later. If you drink alcohol while taking lisinopril, that can also make your blood pressure drop too much. Because lisinopril suppresses your body’s ability to quickly adjust blood pressure, you could faint if you jump out of bed or stand up too fast. Avoid potassium supplements or salt substitutes containing potassium.

Simvastatin

Brand name: Zocor

Description: Like other statins, simvastatin inhibits a particular liver enzyme (HMG Co-A reductase) to reduce the liver’s capacity for making cholesterol. It’s prescribed to reduce LDL cholesterol, often called “bad cholesterol.”

Most serious risks: Birth defects if taken while pregnant; (rarely) rhabdomyolysis, a severe breakdown of skeletal muscle that can lead to acute renal failure and death should myoglobulin (a muscle protein) leak into the blood or urine (making urine dark).

Possible side effects: Constipation or diarrhea, upset stomach, mild muscle or joint pain.

Common interactions: Digoxin (digitalis), warfarin (Coumadin), gemfibrozil, niacin, cyclosporine, danazol, verapamil, amiodarone. Simvastatin may increase the effects of digoxin and warfarin. The other drugs — as well as grapefruit or grapefruit juice — may increase the risk of muscle cramping, myopathy (muscle disease) and rhabdomyolysis.

And our pharmacists say . . . : When taking this drug, stick to your cholesterol-lowering diet — or you’ll defeat the purpose. Take at the same time every day, preferably at night. Do not take while pregnant. Do not drink grapefruit juice or eat large amounts of grapefruit. Avoid alcohol, which can raise triglyceride levels and possibly damage your liver. Muscle-related side effects are more likely in the elderly than in younger patients, and they may be more serious in the elderly, since they’re already declining in muscle strength. In addition, the link between statins and muscle pain is easy to miss in the elderly because they often have pain from other causes.

Levothyroxine

Brand names: Levothroid, Levoxyl, Synthroid, Unithroid

Description: A thyroid hormone, levothyroxine is prescribed for hypothyroidism, a condition in which the thyroid gland doesn’t produce enough thyroid hormone.

Most serious risks: High blood pressure, even a heart attack, if the dose is too high — or if someone with normal thyroid production takes it in an attempt to lose weight. The latter is especially dangerous for someone who’s also using amphetamines.

Possible side effects: Side effects are relatively rare because this is the same chemical the thyroid itself makes. But if the dose is too low, you may continue to have symptoms of hypothyroidism (e.g., fatigue, sluggishness, unexplained weight gain). If the dose is too high, you may develop symptoms of hyperthyroidism (e.g., sudden weight loss, increased appetite, nervousness or anxiety). Tell your physician immediately if you have chest pain or a rapid or irregular heartbeat or pulse.

Common interactions: If you take insulin or other diabetes medications, the correct dosage may change if you start taking levothyroxine. Many other medications can also interact with levothyroxine, including non- prescription drugs, vitamins, minerals and herbal supplements.

And our pharmacists say . . . : Take once a day in the morning on an empty stomach 30 minutes before breakfast or other medications. If you take iron, calcium or antacids (e.g., Mylanta, Maalox), you should take them at least four hours after levothyroxine. Scheduling can be a problem for seniors who take medication for osteoporosis, which also has to be taken by itself before breakfast. Talk to your physician or pharmacist to set up a schedule to make sure you take both. Levothyroxine is usually taken for life, although the dosage may change. (Get an annual blood check to determine if you’re at the right level.) Dosage may need adjustment during pregnancy. If you stop taking levothyroxine without medical supervision, serious complications can result. If you miss a dose accidentally, you can take it later in the day, but do not try to “make up” for it by taking an extra dose the next day. Small changes in your thyroid pill can cause large changes in thyroid levels in the blood. So you should continue to take the same brand that you start on and get stabilized on. Don’t shop around and change brands from month to month. Hypothyroidism can cause cognitive difficulties, and some patients admitted to nursing homes with a diagnosis of dementia can be “cured” by taking levothyroxine.

Azithromycin

Brand names: Zithromax, Zitromax, Sumamed

Description: A macrolide antibiotic, azithromycin works by stopping the growth and reproduction of bacteria (as opposed to killing them directly). It’s in the erythromycin family and can be taken by patients who are allergic to penicillin. It’s prescribed for a wide range of bacterial infections.

Most serious risks: As are all antibiotics, the drug is completely ineffective against viral infections, yet it’s often prescribed without testing to see if an infection is viral or bacterial. This leads to widespread overuse that contributes to the growth of resistant bacteria — i.e., bacteria impervious to available antibiotics.

Possible side effects: Nausea, abdominal discomfort, vomiting, diarrhea.

Common interactions: Azithromycin may interact with a number of medications. Tell your physician or pharmacist about any other medications you take — including vitamins, nutritional supplements, herbal products and non-prescription drugs — in case your doses need to be changed.

And our pharmacists say . . . : Azithromycin is usually taken once a day for one to five days. This is a big plus in comparison to another popular antibiotic, amoxicillin, which is usually taken for seven to 10 days. But as with amoxicillin and all other antibiotics, you can’t stop taking it as soon as you start feeling better. You have to finish your prescription. Stopping early increases the risk that the infection could come back. If you take antacids (e.g., Maalox, Mylanta), take them at least two hours before, or four hours after, taking azithromycin. If you miss a dose, don’t double up. Take the next dose on time and continue on schedule until the prescription is gone. When patients with viral infections take an antibiotic, they may feel better four or five days later and assume it has worked — but really the infection has just run its course.

Tired of paying the highest brand co payment on your prescription drug plan! Ask your retail pharmacist for alternatives to discuss with your doctor at your next appointment. We are pretty friendly people and love to talk with our patient/customers. Here are just a few:

Brands without generics/therapeutic alternatives with generics
Uroxatrol. Vs. Tamsulosin (Flomax)
Prevacid sol tab vs. Lansoprazole caps (Prevacid)
Nexium vs. Omeprazole(Prilosec)
Ambien CR vs zolpidem (Ambien)

Savvy innovations keep drug stores ahead of the game

www.Medtipster.com Source: Drug Store News, 8.6.10 – by Michael Johnsen

Consumers are working more, playing more, shopping more and learning more online than ever before. So the click-and-consult services proffered by Walgreens and Rite Aid not only represent today’s cutting edge technology, but also provide a peek into how consumers may interact with their healthcare team tomorrow.

Other national pharmacy operations can’t be too far behind. Because making pharmacists accessible to patients on their terms, in their time, allows pharmacy retailers the chance to “shake their moneymaker,” as the saying goes.

Pharmacists are drug stores’ most valued assets, and making them available to consumers 24/7 through their own computer screens is an important extension of the brand that doesn’t necessarily incur greater labor costs. Especially as these cyber-pharmacists are able to consult patients from coast-to-coast out of one central location. And if more patients get it in their heads that consulting pharmacists at their convenience on their laptops, smart phones or iPads is the new time-efficient way to get the best answers to their health questions, that can only improve efficiencies at the store level.

Providing a more comprehensive pharmacy service by incorporating an interactive online component also may boost patient retention. During an exclusive interview with The Drug Store News Group last fall, banking veteran and now Walgreens’ SVP e-commerce Sona Chawla explained that those forward-thinking bank institutions that had implemented online banking services in the beginning found that those account-holders who took advantage of those services were less likely to migrate to another bank and just as likely to visit an actual brick-and-mortar branch.

And now Walgreens and Rite Aid will find out if the same will hold true for pharmacy patients — making a more loyal patient who not only increases his or her actual interaction with the pharmacy online but also continues to make as many visits to the actual stores.