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Are You Adhering to Your Prescription Drug Regimen?

March 28, 2013 By: Nadia Category: HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

Adhering to medication means taking the medication correctly, as instructed by a health care professional. This includes filling and refilling the prescription, taking it regularly, and continuing to take it for as long as prescribed. While this may seem simple, the World Health Organization has reported an average medication adherence rate of only 50 percent for people with chronic illnesses in developed countries. So, why is only half of the population taking their medicines as prescribed? Moreover, why is it important to adhere to your medication regimen anyway? Read on to find out why it’s important and how you can improve your adherence.

Why Adherence Matters?

Simply put, it can improve your overall quality of life. Evidence suggests that for many chronic illnesses, higher medication adherence reduces hospital visits. Fewer visits to the hospital mean lower medical costs as well.

Adherence to medication may be ‘easier said than done’ for many people. There are a variety of barriers that may make it difficult for patients to follow their medication therapy. Here are a few of those barriers and suggestions for how to get around them.

Cost

Often times, patients just cannot afford their medications. Perhaps there are alternative drugs available that do not cost as much. Talk with your prescriber or pharmacist. They may be able to help you find a more affordable drug.

You can also visit the Medtipster website, www.medtipster.com, to determine the cost of a prescription. The tool can help you compare the price on related drug products.

Side Effects

Your medicine may trigger unpleasant side effects, causing you to stop taking it. Talk to your doctor about these side effects. They may be able to switch you to a different medicine to reduce the side effects. They may also have suggestions for minimizing the side effects. Your doctor has your best interest in mind and is a knowledgeable resource to help improve your quality of life.

Feeling Better

There are five pills left, but you started to feel better and decided to stop taking your medicine. Before you stop, talk to your prescriber. Stopping early may cause more health problems. For instance, if a patient has a bacterial infection and stops taking his or her medicine early, some bacteria may still be alive. These bacteria could start a whole new strain of resistant germs. (U.S. Food and Drug Administration, 2009). Even though you may feel better, try to continue to take your medicine(s).

Forgetfulness

Make taking your medicine a part of your daily routine. Once you are used to taking your medicines regularly, it will not seem like a burden on your lifestyle. Buying a pill minder dispenser may help; it’s an easy daily reminder to take your medicine. Write down a schedule of when to take your medicines or add it to the calendar on your electronic device.

Health Care Beliefs and Attitudes

Some patients hold certain beliefs or attitudes that stop them from being adherent to their medication regimen. For example, a patient may believe that taking a medication as prescribed will not lead to a predicted outcome or that a particular disease state is not significant or will not lead to severe untoward outcomes. Talk with your prescriber about your beliefs. He or she may have more information about your illness and medicine than you know.  Your prescriber can tell you why it is in your best interest to adhere to taking your medicine(s).

Adhering to your medicine can improve your overall quality of life, so take care to adhere to your prescribed medication regimen. For a better result, you will be glad you attended to your health.

Citrus Fruits and Medications

August 03, 2011 By: PharmaSueAnn Category: Medicine Advice

Citrus fruits especially grapefruit should be avoided when taking many medications, including those purchased over-the-counter.  Do not take these interactions lightly, some can cause potentially dangerous health problems.  Certain chemicals that grapefruit and other citrus fruits contain can interfere with the enzymes that metabolize various medications in our digestive tracts.  If you are uncertain to how you should take your medication(s) consult with your local pharmacist.

Do you use Nitrolingual Spray?

May 17, 2011 By: PharmaSueAnn Category: Medtipster

Ask your pharmacist for the newly released generic equivalent.

Acetaminophen Liquid to be discontinued

May 10, 2011 By: PharmaSueAnn Category: Medtipster

Acetaminophen Liquids are being discontinued mid 2011.  The only available dose of liquid acetaminophen will be the 160mg/5mg dose.  The reason for the discontinuation is due to the potential for over dose errors with the currently available strengths.  Consult with our doctor or pharmacist regarding the appropriate dosing.

Medicine is the best medicine; help patients keep taking it

December 07, 2010 By: Nadia Category: HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: Boston Globe, 12.3.2010

Patients who don’t take their medications are a well-documented problem in medicine. If doctors are to spot patients who might stop complying with prescriptions, it’s vital to have a fuller understanding of why and how it happens.

As many as 40 to 60 percent of those with chronic conditions like high blood pressure, heart failure, or diabetes don’t take their medicines regularly. The reasons vary – some patients never fill their prescriptions; others feel better and stop their drug regimens; in still other cases, side effects or the burden of too many pills discourage patients from refilling their prescriptions. Whatever the motive, failing to take needed drugs leads to worse health and higher spending, as patients land in the hospital for preventable conditions that cost the health care system hundreds of millions of dollars a year.

But a new study this month in the Annals of Internal Medicine, by researchers at Brigham and Women’s Hospital and Harvard Medical School, shines the spotlight on another contributor: Patients not picking up prescriptions that have already been filled.

The analysis, funded by CVS Caremark, looked at over 10 million prescriptions filled over a 3-month span in 2008 and found that 3.3 percent were never picked up. The number seems small, but translates to 110 million abandoned prescriptions per year in the United States. It costs a pharmacy an estimated $5 to $10 to prepare, then return to the shelves, an unclaimed medication, so the authors estimate the problem could be costing more than $500 million a year. CVS Caremark has a clear interest in bringing that number down – but so do patients and doctors.

The problem could worsen as technology evolves: Prescriptions sent electronically were 65 percent more likely to be left behind, probably because they bypass the step of having the patients hand- deliver a slip to the pharmacist. As electronic prescribing continues to take hold nationwide, insurers should be vigilant that prescription fill rates may reflect compliance less accurately than with traditional prescriptions.

Not surprisingly, prescriptions with $40 to $50 copays were the most likely to be abandoned. According to William Shrank, the study’s main author, this means that during economically hard times “even insured patients are experiencing sticker shock, and walking away from the pharmacy, without filling essential medications.”

Doctors are unlikely to know their patients’ copays for drugs, but taking the time to talk about drug costs would help them identify those who might never pick up their prescriptions. Down the road, those extra minutes of chat time at the office become multiple dollars saved at the hospital bedside.

Steep Co-Pays May Cause Some to Abandon Prescriptions

November 17, 2010 By: Nadia Category: HealthCare, Medicine Advice, Medtipster, Prescription News

www.Medtipster.com Source: HealthDay, 11.15.2010 – By Serena Gordon

In these tough economic times, even people with health insurance are leaving prescription medications at the pharmacy because of high co-payments.

This costs the pharmacy between $5 and $10 in processing per prescription, and across the United States that adds up to about $500 million in additional health care costs annually, according to Dr. William Shrank, an assistant professor of medicine at Harvard Medical School and lead author of a new study.

“A little over 3 percent of prescriptions that are delivered to the pharmacy aren’t getting picked up,” said Shrank. “And, in more than half of those cases, the prescription wasn’t refilled anywhere else during the next six months.”

Results of the study are published in the Nov. 16 issue of the Annals of Internal Medicine.

Shrank and his colleagues reviewed data on the prescriptions bottled for insured patients of CVS Caremark, a pharmacy benefits manager and national retail pharmacy chain. CVS Caremark funded the study.

The study period ran from July 1, 2008 through Sept. 30, 2008. More than 10.3 million prescriptions were filled for 5.2 million patients. The patients’ average age was 47 years, and 60 percent were female, according to the study. The average family income in their neighborhoods was $61,762.

Of the more than 10 million prescriptions, 3.27 percent were abandoned.

Cost appeared to be the biggest driver in whether or not someone would leave a prescription, according to the study.

If a co-pay was $50 or over, people were 4.5 times more likely to abandon the prescription, Shrank said, adding that it’s “imperative to talk to your doctor and pharmacist to try to identify less expensive options, rather than abandoning an expensive medication and going without.”

Drugs with a co-pay of less than $10 were abandoned just 1.4 percent of the time, according to the study. People were also a lot less likely to leave generic medications at the pharmacy counter, according to Shrank.

The medications most frequently abandoned were cough, cold, allergy, asthma and skin medications, those used on an as-needed basis. Insulin prescriptions were abandoned 2.2 percent of the time, but Douglas Warda, director of pharmacy for ambulatory services at the University of Chicago Medical Center, said this might be a cost issue, but it could also be that some people are afraid to inject insulin.

The study also found that antipsychotic medications were abandoned 2.3 percent of the time.

Drugs least likely to be abandoned included opiate medications for pain, blood pressure medications, birth control pills or hormone replacement therapy, and blood-thinning medications, according to the study.

Young people between the ages of 18 and 34 were the most likely to forgo their prescriptions, and new users of medications were 2.74 times more likely to leave their drugs behind.

Prescription orders that were delivered to the pharmacy electronically — via the computer — were 64 percent more likely to be abandoned than prescriptions walked into the pharmacy.

“We’re definitely not saying that e-prescribing is bad; it’s great, but there appear to be some unintended consequences,” said Shrank.

There was no way to tell if people never tried to pick up their prescriptions, or if they went to retrieve them but chose to leave them behind because of the cost.

Warda said he believes that more patients might pick up their medications if the instructions from their physicians were clearer. For example, prescriptions for proton pump inhibitors were left at the pharmacy 2.6 percent of the time. These medications reduce the amount of acid in the stomach and can help prevent heartburn or more serious problems. “If the physician message is, ‘You need to take these medications for two to three months and it will reduce your pain and help your body heal,’ fewer people might abandon these medications,” he said.

Plus, if cost is an issue for you, bring it up with your doctor ahead of time, he added. “Don’t get blindsided at the pharmacy. Always ask your physician if there’s a generic option, or if there’s something cheaper that might work just as well. Sometimes people are embarrassed to say anything, but it’s better to ask and get a medication you can afford.

“If you get to the pharmacy, and you can’t afford the medication, follow up with your doctor or ask the pharmacist if there’s a cheaper alternative,” suggested Warda.

FAQs About Blood Sugar Levels And Blood Glucose Meter Readings

October 28, 2010 By: Nadia Category: HealthCare, Medicine Advice, Medtipster, Prescription News

What should my blood sugar be??

You and your doctor will determine what your target blood sugar levels should be after some testing and properly answered questions about your diet, exercise, and any medications you are on.

For people without Diabetes, according to many doctors and experts, blood sugar levels should be:

Between 70 and 120 mg/ dL

For people with Type 2 Diabetes:

  • Fasting (not eating for a suggested period of time): up to 130 mg/dL
  • After most meals: less than 200 mg/dL

Why should I check my blood sugar?

Learning how to monitor your own blood sugar levels with a meter is a good thing to do. It helps you see how food, physical activity, and medicine affect your blood sugar levels. The readings can help you manage your Type 2 Diabetes day by day or even hour by hour. Make sure you keep a record of your results for your doctor to review.

How do I test my own blood sugar?

Consult with your doctor or pharmacist for proper technique when using the machine. Be sure you know how to test your blood sugar levels the correct way. There are many different meters out there, choose the one that makes most sense to you and recommended by either your doctor or pharmacist.

How often should I check my blood sugar levels?

Self blood sugar tests are usually done before meals, after meals, and/or at bedtime. Ask your doctor when and how often you need to check your blood sugar. Your doctor may recommend more or less than average readings.

If I test my own blood sugar levels, do I still need the A1C test?

Yes. An A1C is a 3 month average of your blood sugar levels. Therefore you cannot cheat on this test. The results of both the blood sugar tests that you do yourself and A1C tests help you and your doctor get a complete picture of your control of Type 2 Diabetes.

Visit www.medtipster.com to find a pharmacy/mini clinic in your neighborhood offering low cost Hemoglobin A1C tests!

Prescription for success: Ask your pharmacist

August 12, 2010 By: Nadia Category: HealthCare, Medicine Advice, Medtipster, Prescription News

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.”

Pharmacy Benefit Manager Fees Must Be Reported on Schedule C

February 22, 2010 By: Nadia Category: Medtipster, Prescription News

Source: U.S. Department of Labor, 2/2010

The Department of Labor published FAQs to supplement FAQs published in July 2008, and to provide further guidance in response to additional questions from plans and service providers on the requirements for reporting service provider fees and other compensation on the Schedule C of the 2009 Form 5500 Annual Return/Report of Employee Benefit Plan. Inquiries regarding these supplemental FAQs may be directed to EBSA’s Office of Regulations and Interpretations at 202.693.8523.

The new FAQs — numbers 26 and 27 — note that PBMs perform many services for which they are compensated, including services as a third-party administrator, claims processor, and developer of the plan’s formulary and pharmacy network. The FAQs make clear that fees for these services would be reportable as direct compensation on Schedule C.

Q26: Pharmacy Benefit Managers (PBMs) provide services to plans and are compensated for these services in various ways. How should this compensation be reported?

PBMs often act as third party administrators for ERISA plan prescription drug programs and perform many activities to manage their clients’ prescription drug insurance coverage. They are generally engaged to be responsible for processing and paying prescription drug claims. They can also be engaged to develop and maintain the plan’s formulary and assemble networks of retail pharmacies that a plan sponsor’s members can use to fill prescriptions. PBMs receive fees for these services that are reportable compensation for Schedule C purposes. For example, dispensing fees charged by the PBM for each prescription filled by its mail-order pharmacy, specialty pharmacy, or a pharmacy that is a member of the PBM’s retail network and paid with plan assets would be reportable as direct compensation. Likewise, administrative fees paid with plan assets, whether or not reflected as part of the dispensing fee, would be reportable direct compensation on the Schedule C. Payments by the plan or payments by the plan sponsor that are reimbursed by the plan for ancillary administrative services such as recordkeeping, data management and information reporting, formulary management, participant health desk service, benefit education, utilization review, claims adjudication, participant communications, reporting services, website services, prior authorization, clinical programs, pharmacy audits, and other services would also be reportable direct compensation.

Q27: PBMs may receive rebates or discounts from the pharmaceutical manufacturers based on the amount of drugs a PBM purchases or other factors. Do such rebates and discounts need to be reported as indirect compensation on Schedule C?

Because formulary listings will affect a drug’s sales, pharmaceutical manufacturers compete to ensure that their products are included on PBM formularies. For example, PBMs often negotiate discounts and rebates with drug manufacturers based on the drugs bought and sold by PBMs or dispensed under ERISA plans administered by a PBM. These discounts and rebates go under various names, for example, “formulary payments” to obtain formulary status and “market-share payments” to encourage PBMs to dispense particular drugs. The Department is currently considering the extent to which PBM discount and rebate revenue attributable to a PBM’s business with ERISA plans may properly be classified as compensation related to services provided to the plans. Thus, in the absence of further guidance from the Department, discount and rebate revenue received by PBMs from pharmaceutical companies generally do not need to be treated as reportable indirect compensation for Schedule C purposes, even if the discount or rebate may be based in part of the quantity of drugs dispensed under ERISA plans administered by the PBM. If, however, the plan and the PBM agree that such rebates or discounts (or earnings on rebates and discounts held by the PBM) would be used to compensate the PBM for managing the plan’s prescription drug coverage, dispensing prescriptions or other administrative and ancillary services, that revenue would be reportable indirect compensation notwithstanding that the funds were derived from rebates or discounts.

More information to follow via our blog at www.medtipster.com

E-Prescriptions Versus Handwritten Prescriptions

February 09, 2010 By: Tylar Masters Category: Medicine Advice

Many prescriptions are transmitted electronically, however, does this mean your privacy and safety are at risk? Or is this a safer, more secure and more beneficial method of prescribing medications?

With the age of technology and electronic, well, everything, we’re seeing a lot of changes in every day life, and in every day business. We’ve seen newspaper circulations drop, paper mail decrease, and who doesn’t have an email address or a home computer?

Your physician’s office most likely has an electronic version of your medical records by now, instead of the old school manilla folders. If not, trust me, it will happen sooner versus later. There are a lot of benefits to this method, the biggest being saving trees and helping the environment. Let’s take a closer look at how this may affect the one piece of paper you typically walk out the physician’s office door with – a prescription.

E-prescriptions are the same as the hand written prescription, only computer generated by your physician. The electronic prescription is sent directly to the pharmacy of your choice. Privacy has been a key concern for many patients with this change in how prescriptions are handled, however, rest assured that the network (transmitting) between your physician’s computer and your pharmacy is a secured and private route.

E-prescribing is more efficient and is faster in most cases. Most of the time, your prescription arrives at your pharmacy before you leave your doctor’s office. It doesn’t always mean it will be ready for you when you arrive, as sometimes pharmacies are busy or you arrive before the pharmacist has had time to fill the script. But, you won’t be waiting around the pharmacy or having to leave and come back. Plus the risk of errors with traditional hand written prescriptions is almost obsolete with e-prescriptions.

Also, remember that all e-prescriptions meet the requirements of Health Insurance Portability and Accountability Act (HIPAA). Your medical history has always contained the record of your prescription, and it being electronic or hand written makes no difference. All medical and prescription information is protected by federal and state laws.

If you have questions about your prescription, your physician or pharmacist will be able to address your concerns. Specific questions about e-prescriptions can be answered by either professional as well. Remember if you’re unsure which pharmacy has your prescription at the lowest cost available, tell your exit nurse at your physician’s office to use Medtipster.com to find the pharmacy to transmit your e-prescription.

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