Monthly Archives: October 2012

Albany College of Pharmacy and Health Sciences to Offer New Bachelor’s Degree Program in Chemistry

Albany College of Pharmacy and Health Sciences will offer a new bachelor’s degree program in chemistry beginning in fall 2012. The program is ideal for students with interests in both health and physical science.

All students in the Chemistry program at ACPHS will complete coursework that spans the five traditional areas of chemistry: analytical, organic, physical, inorganic, and biochemistry. Students may choose to focus their studies in the area of medicinal chemistry, where they will learn how to apply chemical concepts to the design, synthesis, and development of drugs. It is this ability to specialize in medicinal chemistry combined with the health oriented environment at the College that distinguishes the ACPHS chemistry program from those of most other institutions.

The Bureau of Labor (BLS) statistics reports that there are currently 84,000 chemists employed in the workforce with a significant number working in either scientific research/development or pharmaceutical/medicine manufacturing. According to the BLS, median annual wages of chemists as of 2008 were $66,230.

Students graduating from the ACPHS chemistry program will compete favorably for these positions with students from more traditional biology and chemistry programs because (1) their area of study is directly relevant to the pharmaceutical and biotechnology industries and (2) the interdisciplinary nature of the training that is part of this program.

For those not seeking employment in the pharmaceutical industry, additional options may include attending graduate school in the biological, chemical or pharmaceutical sciences; pursuing a professional program in an allied health field (e.g., medical school, pharmacy school, et al); or entering a teacher preparation program.

“Chemistry plays an integral role in the field of pharmacy, and so the expertise and resources required to offer this program have existed at the College for many years. As a result, we are well positioned to offer a program of exceptional quality that aligns with the College’s longstanding commitment to the advancement of health care,” said David Clarke, Ph.D., the Dean of the School of Arts and Sciences, which will oversee the program.

In addition to its Doctor of Pharmacy program, ACPHS now offers four bachelor’s programs and six graduate programs.

CVS Caremark today announced the promotion of three senior executives within its retail pharmacy organization. With more than 7,200 stores in 41 states, the District of Columbia, and Puerto Rico, CVS/pharmacy is the leading retail pharmacy in the United States.

(Logo: http://photos.prnewswire.com/prnh/20090226/NE75914LOGO )

Judith Strauss Sansone has been named Senior Vice President of Merchandising for CVS/pharmacy. A seasoned merchant who has worked more than 30 years for the Company, Sansone brings deep industry knowledge to her new role. Most recently, she served as Vice President Merchandising and Pricing, responsible for general merchandise, consumables and front store pricing. During her career with CVS/pharmacy, she has served several roles including Vice President Healthcare Merchandising and Vice President Retail Innovation and Store Design. In addition, Sansone was part of the core team involved in the integration of the former Eckerd, Osco, Sav-on and Longs Drug as part of the acquisition of these chains by CVS/pharmacy.

Robert Price, Chief Marketing Officer of CVS/pharmacy, takes on an expanded role in the company with the addition of retail innovation and store design to his responsibilities. With more than 20 years of retail, strategy and marketing experience, Price will more tightly integrate the store and digital environments to create a more personalized experience for shoppers and patients. At the center of this effort are the proprietary insights drawn from CVS/pharmacy’s ExtraCare loyalty program, the largest of its kind.

Scott Baker, RPh, Executive Vice President, Internal Operations, Real Estate and Supply Chain, adds inventory management and logistics to his responsibilities. In his expanded role, Baker will provide senior level support for inventory management and product flow in partnership with the merchandising and pharmacy teams. Baker also has oversight of real estate, construction and facilities, and front store operations.

“These appointments tap the deep bench strength and diverse talents of our CVS/pharmacy team,” said Mark S. Cosby, President of CVS/pharmacy. “Through the focus of these leaders and their teams, we’re in the unique position to improve the lives of millions of Americans by providing easy, innovative solutions and personalized pharmacy health care at their neighborhood drug store, CVS/pharmacy.”

About CVS Caremark

CVS Caremark (NYSE: CVS) is the largest pharmacy health care provider in the United States with integrated offerings across the entire spectrum of pharmacy care. We are uniquely positioned to engage plan members in behaviors that improve their health and to lower overall health care costs for health plans, plan sponsors and their members. CVS Caremark is a market leader in mail order pharmacy, retail pharmacy, specialty pharmacy, and retail clinics, and is a leading provider of Medicare Part D Prescription Drug Plans. As one of the country’s largest pharmacy benefits managers (PBMs), we provide access to a network of approximately 65,000 pharmacies, including more than 7,200 CVS/pharmacy® stores that provide unparalleled service and capabilities. Our clinical offerings include our signature Pharmacy Advisor™ program as well as innovative generic step therapy and genetic benefit management programs that promote more cost effective and healthier behaviors and improve health care outcomes.

Jeff Gelles: Probing the mystery of drug-supply disruption

Rheumatoid arthritis can be a painful, debilitating disease. But like some of its victims, Fred LeStourgeon was lucky enough to find long-term relief through drug therapy – in his case, with a combination of two widely available generic drugs.

Then something odd happened, and LeStourgeon has been asking questions ever since. Last fall, one of the medications he relied on, leflunomide, nearly vanished from the market – only a much higher-priced brand version, Arava, remained available. And when leflunomide returned, the price had jumped more than tenfold – from about $70 for a three-month supply at his Acme Markets pharmacy to $942.

Primary Care Pharmacies

Over the 20 years Mark Taylor has been a pharmacist, he’s seen customers come into his store and pull their pants down or yank their shoes off to see if he could identify a swelling or a rash.

That sort of behavior is likely on the rise: While the economy remains in a slump and people continue to lose health benefits, it’s becoming more common for them to turn to their pharmacists rather than their doctors to address minor health problems.

“It’s definitely more prevalent now than ever before,” said Taylor, who owns Jersey Shore Pharmacy in Egg Harbor Township.

To meet the needs of their customers, pharmacists today provide services that were once the province of primary care physicians. Many offer a battery of vaccinations, from the more common, like those for influenza and pneumonia, to the more specialized, like tetanus, diphtheria, and meningitis. And some of the chain drugstores like Walgreens and CVS now have walk-in clinics staffed with nurse practitioners who can diagnose, treat and write prescriptions for common illnesses like strep throat, bladder infections, pink eye, and ear infections.

This trend isn’t just about health and healing, however.

“We’re always looking to offer more services,” Taylor said. “You’re always looking for ways to get people into your store.”
A Late State

New Jersey was actually one of the last states to allow pharmacists to offer vaccinations. The Pharmacy Practice Act was signed into law in 2005, but lobbyists for the physician community requested that any rules regarding immunization be approved by both the New Jersey Board of Pharmacists and the state Board of Medical Examiners, a process that took about four years.

Some drugstores began offering vaccinations seven or eight years ago by bringing in nursing agencies that were already licensed to give them, but it wasn’t until 2009 that pharmacists were authorized to offer them — for people over the age of 18. They are still prohibited from vaccinating minors.

“It was a concession [to the physicians’ lobby] that these protocols be approved by both boards,” said Laurie Clark, legislative counsel for the New Jersey Pharmacists Association, the industry’s trade group. “The intent wasn’t to take business away from physicians. The intent was to make immunizations more available.”

In fact, fears of a pandemic may be what prompted New Jersey to finally pass the legislation, according to Kristen Binaso, a spokeswoman for the American Pharmacists Association and a practicing pharmacist in New Jersey.

“If you traveled to the West Coast, pharmacies there have been immunizing for at least 10 years. For some reason, the East Coast lagged behind,” Binaso said. “It wasn’t until New York had a champion in the New York City health department, who warned about a pandemic if vaccines weren’t readily available, that New York got legislation passed.”

New Jersey followed suit shortly thereafter, she said.
On the Rise

Since pharmacies began offering immunizations, the number of people vaccinated in the state has gone up, and that’s a good thing, said Linda Gooen, president of the New Jersey Pharmacists Association.

That trend comes as no surprise to pharmacists, who argue that they have more contact with patients than doctors do, so it makes sense that they should be the ones to take care of inoculations.

“Because we see them more often than they would go to their doctor, we have a relationship with them, and we can provide them with immunizations more promptly than a physician would,” said Joseph Tarallo, who owns Park Plaza Pharmacy in Matawan. “But if we have patients who are compromised, we will refer the person back to their physician for a follow-up to the vaccination.”

But immunizations are just part of a pharmacy’s expanded role.

“Pharmacies are really changing from community drugstores to community health destinations,” said John Colaizzi Jr., chairman of the New Jersey Pharmacists Association and a manager at Walgreens, where four of its stores have walk-in clinics. “If there’s anything severe, we would refer you to a physician or emergency room, but most visits to the ER are for minor illnesses, and those are things that our nurse practitioners can treat.”

The pharmacists growing role is making some doctors take pause. While they acknowledge that making immunization more accessible is good for society at large, they also argue that people are doing themselves a disservice if they’re turning to a drug store for healthcare and are no longer seeing a doctor. At-risk patients, such as those with diabetes or other chronic illnesses, for instance, need to see a doctor on a regular basis for monitoring and preventative care, said Lawrence Downs, CEO and general counsel for the Medical Society of New Jersey, which represents the state’s physicians.

“Clearly there’s a public health benefit for getting the most people vaccinated. That’s not disputed. But for at risk people, people with chronic conditions, those folks can benefit from having their vaccinations in a doctor’s office because there are underlying conditions that can be treated at the same time,” Downs said. “We want to make sure those people aren’t forgoing their physician visit just because they can get their vaccine at Walmart.”

How many people getting their vaccinations at a drugstore rather than a doctor’s office? Figures for New Jersey aren’t available, but the Center for Disease Control and Prevention (CDC) publishes statistics for the entire country — and they offer some guidance.

According to the CDC, “For adults overall, a doctor’s office was the most common place (39.8 percent) for receipt of the 2010-11 influenza vaccine, with stores (e.g., supermarkets or drugstores) (18.4 percent) and workplaces (17.4 percent) the next most common.”

The federal agency continues, “The proportion of adults vaccinated in stores (18.4%) during the 2010-11 season increased in each age group compared with the 1998-99 and 2006-07 influenza seasons, when 5% and 7% of adults, respectively, were vaccinated in stores. This increase likely resulted partly from changes in state laws allowing pharmacists to administer influenza vaccinations to adults.”
Cutting Corners

Dr. Martin Neilan, a primary care physician in Wayne, says getting your healthcare in a drugstore is cutting corners.

“There’s nothing more important than establishing a relationship with your primary care provider or doctor,” he said. “To run in and run out of a pharmacy and get your shots is not a proper way to obtain healthcare.”

Neilan says if patients no longer see their doctors for vaccinations or when they get sick, they may no longer go in for their wellness visits either, which is where they talk to the doctor about other health issues that may have come up and where the doctor may catch something before it gets worse.

” We haven’t discovered some rare disease in someone through a well visit, but they do give people an opportunity to raise other health issues for us to discuss,” he said.

If the new system is working properly, pharmacists should be encouraging their patients to go for their checkups, said Clark of the Pharmacists Association.

People on the move: pharma jobs

Replacing Carmine is former president of Lilly USA Dave Ricks, who will take the role of senior VP and president of Lilly Bio-Medicines.

Also retiring from the firm is fellow long-term member Frank Deane, head of global manufacturing operations.

John Lechleiter, the firm’s chairman, president, and CEO, described Carmine and Deane as “pillars of the company who have had a lasting, worldwide impact on our people and our business.”

in-PharmaTechnologist presents its round-up of the latest career moves within the pharmaceutical industry, including news from Eli Lilly, Roche, and Merck.

Eli Lilly has shuffled its leadership team after the retirement of Lilly Bio-Medicines leader Bryce Carmine, and the head of global manufacturing operations Frank Deane.

John Lechleiter, the firm’s chairman, president, and CEO, described Carmine and Deane as “pillars of the company who have had a lasting, worldwide impact on our people and our business.”

Replacing Carmine is former president of Lilly USA Dave Ricks, who will take the role of senior VP and president of Lilly Bio-Medicines.

He will be succeeded as Lilly USA president by Alex Azar, who has been VP of US managed healthcare services and Puerto Rico since 2009.

Deane’s replacement is Maria Crowe, who was previously Lilly’s senior VP for global drug product manufacturing.

Lechleiter added: “We’ll certainly miss Bryce and Frank and the extraordinary leadership they provided.

“At the same time, we’re very fortunate to have talented leaders who are well-prepared and ready to step into these critical roles.”

Roche has named Harsukh Parmar as the new head of translational and experimental medicine (TM) for the inflammation discovery and translational area.

Harsukh joins Roche from Astra Zeneca where he was VP and global head of early clinical development in the respiratory and inflammation therapeutic area.

In his new position – based at the company’s Nutley, US, division – he will be take charge of TM’s role in delivering first-in-class compounds to the lifecycle investment point.

Of his new appointment, Jacques Banchereau, Nutley’s chief scientific officer said: “He will provide valuable expertise and advice on target selection and the development of early stage compounds in our Inflammation pipeline.”

Merck has announced that its chairman Richard Clark will retire from the company and the board of directors.

The news comes after Clark stepped down from his role as president and CEO, handing over to Kenneth Frazier. In his stead, Frazier will also become chairman.

Clark said: “I have been a part of Merck for more than 39 years – I always have and always will consider Merck to be an important part of my life and my extended family.”

The Council of Radionuclides and Radiopharmaceuticals (CORAR) has selected Michael Guastella as its new executive director.

He replaces founding executive director Henry Kramer, who will retire later this year.

Guastella was most recently theVP of marketing and product development for the Nuclear Pharmacy Business of Cardinal Health – a position he held for seven years.

John Butler has become the new CEO at Inspiration Biopharmaceuticals.

The company is the only biopharma focused exclusively on the development and commercialisation of new treatment options for people with hemophilia.

Butler has more than 20 years experience in the field of commercialisation for innovative therapies.

He replaces Michael Griffith, who will become chief scientific officer, and will remain as president at Inspiration.

Big pharmacy’s influence feared in Canada’s patient care guideline authors, says study

Too many doctors and researchers who help create guidelines for patient care have financial ties to the pharmaceutical industry, according to a study that investigated conflict of interest among a group of major Canadian and U.S. health care organizations.

More than half of panel members who develop clinical practice guidelines for the treatment of diabetes and high cholesterol — conditions which generated $70 billion in drug sales in 2010 — have received compensation by pharmaceutical companies, the U.S. researchers report. The compensation is in the form of consultancy payments, honorariums, speakers’ fees and research grants.

The study, published online Wednesday in BMJ: The British Medical Journal, found the problem was more serious in Canadian specialty organizations, with 83 per cent of panel members having industry ties. Among the American specialty organizations, 58 per cent of panel members had such ties.

“That indicates there is a potential risk of industry influence on guideline recommendations,” said Dr. Jennifer Neuman, the study’s lead author and instructor in the department of preventive medicine at New York’s Mount Sinai School of Medicine.

“Guidelines serve to standardize care and inform evidence-based practice and ultimately to protect patients. Their freedom from bias is very important.”

The study evaluated 14 sets of clinical care guidelines — three from Canada and 11 from the U.S. — published between 2000 and 2010. The guidelines are a key reference for physicians who screen and treat patients for high cholesterol and diabetes.

The investigators found more than half of those who chaired guideline panels had conflicts. They also found one out of nine panellists who had reported no conflict of interest did have industry ties.

The Canadian Cardiovascular Society, a 2,000-member medical specialty society whose mandate is, among others, to promote cardiovascular health and care through knowledge translation, had the highest prevalence of conflict among organizations included in the study. Every one of their 23 panel members had a conflict of interest — three of which were not declared — at the time the society published its 2009 practice guidelines for high cholesterol.

The Canadian Diabetes Association, the other Canadian specialty organization included in the study, released practice guidelines in 2008. At the time, 73 members of its 93-member panel had industry ties. The Canadian Diabetes Association was not available for comment.

Canadian Cardiovascular Society president Dr. Blair O’Neill said the organization’s process for developing guidelines has been updated in the last few years, specifically to address the issue of conflict.

Each of the society’s panels has two chairs, none of whom has done research funded by industry. And of the remainder of the panel, 50 per cent plus one of the members can have no such ties.

But, O’Neill added, it’s impossible for all of them not to have such ties because the level of expertise would be diluted. He explained that there is a limited pool of experts in Canada to begin with and the best ones inevitably have their research funded by industry because the government funding just isn’t there.

“The experts in the field . . . have done research funded by industry because government granting agencies’ purse strings have become ever tighter,” O’Neill said.

While O’Neill argues that the panels had never been biased in the past, the public should now have full confidence in their work, he said.

Neuman said their study found government sponsored panels had significantly fewer members with conflict of interest, which shows that expert panels can be composed of people without ties to industry.

She said health care organizations must be held to one standard to minimize conflict of interest, and that mandates for panel members to disclose industry ties may not be enough to prevent industry bias from influencing practice guidelines.

Trudo Lemmens, an associate professor at the University of Toronto’s law and medical schools, said more must be done to eliminate real and potential conflicts of interest.

“It’s a question of establishing public trust in the system” said Lemmens, who holds the William M. Scholl chair in health law and policy, in the faculty of law.

“The perception of conflict alone creates doubt about the process. It makes you unsure about the level of independence when making decisions,” he said.

Counterfeit drugs targeted by technology in India

Fake drugs like these counterfeit Viagra pose a huge health risk to patients – and destroy confidence in genuine pharmaceuticals

Making pills that could save lives both in India and abroad, Indian pharmaceutical companies are growing faster than ever before.

Worth over $12bn, the industry is expected to grow more than four-fold in the coming decade.

But even as global attention is focused on the healthy growth in India, it is threatened by a serious malaise – counterfeiting. Fake drugs in the system risk not just lives of patients, but also the reputation of drug makers.
Faking it

There are varying estimates of how big the problem is. Up to 25% of the medicines consumed in poor countries could be counterfeit or substandard, according to the World Health Organisation. They define a counterfeit as “a medicine, which is deliberately and fraudulently mislabelled with respect to identity and/or source”.

Counterfeit drugs are a $200bn (£128bn) industry worldwide. Producers need very little investment to set up the manufacturing process and can make huge profits.

With manufacturing costs nearly 40% cheaper than other countries, the authorities are worried India could become an easy target for counterfeiters.

This is why the government has launched a campaign against counterfeit medicines. The drug controller of India says while they have task forces that regularly raid producers, it is increasingly difficult to spot fakes.

Very often consumers cannot work out if they have been treated with a counterfeit product, which may contain non-active or even toxic ingredients.

Deputy drug controller general of India, Dr D Roy, says counterfeit medicines often resemble the originals in chemical composition. But he thinks the biggest problem is the packaging.

Holding up two strips of a medicine for the common cold, he points out that its nearly impossible to find any differences in them.

“This is how consumers are deceived,” he says.

“Retailers too would find it difficult to identify a fake. The packaging industry is not regulated by us. The need of the hour is to evolve a more holistic approach that ensures involvement of all stakeholders in the supply chain.”

Currently, when a company suspects that its drugs are being counterfeited in a particular area, they alert the local office of the drug controller to take action.

The authorities then conduct a raid and seize any fake products found.
Testing times

When a consumer suspects that a drug is counterfeit, the process to get it tested in a government laboratory is slow and expensive.

Technology is now being used to speed up the process.

A committee set up by the Indian Ministry of Health has approved a proposal to put 2D barcodes and scratch-off labels on medicines.

The label works like a telephone recharge coupon. The user scratches off the cover and texts what is underneath to a freephone number, to find out if a pill is real.

Quick response (QR) codes are also being tested. These printed squares are an advanced version of the 2D barcodes. Anyone with a camera-enabled phone and web access can scan the code and be taken instantly to the pharma company website to authenticate the drug.

Leveraging the extensive mobile usage in the country and cloud computing, the pharma industry hopes to increase their credibility. Computer companies see a huge business potential in offering technology solutions to the whole industry.

Hewlett-Packard is one of the companies offering a solution, a cloud-based platform called Global Authentication Service.

This barcode lets pharma companies track drugs through the supply chain

Pharma companies can buy two-dimensional bar codes which will be printed on the packaging material.

The companies can then use the cloud service to monitor the movement of products through their global supply chains. The system is used to trace and authenticate medicines in Nigeria and Ghana.

A Appadurai of HP India says they have used the system in Africa with non-profit social enterprise mPedigree. In India, they are in talks with pharma manufacturers like Cipla, Tablet India and the Chemical & Alkeli Merchants Association (CAMA).

Mr Appadurai says the technology would not be very expensive.

“The two dimensional barcodes would cost around one rupee each. This may mean a firm’s expenditure may rise marginally. However, compared to the litigation costs some pharma companies face, this cost is nothing.”
Bonding moment

In an effort measure the amount of fake drugs in the market, the pharma industry and the authorities have come together.

Measures under consideration include a certification system for pharmacists, and an open source website where consumers and companies can access data on fake drugs.

Bilcare Technologies makes anti-counterfeiting, security and brand protection technologies. These include a handheld scanner to track their security technology nonClonableIDT.

This scanner can check the authenticity of packets of pills

It’s almost like a fingerprint that can be put on any product. The company claims it provides a reliable means to track and trace products across the supply chain – from manufacturer to consumer.

Another company, PharmaSecure, has come up with a technology called UIMV – unique identification mobile verification. It is a unique code for each product which can be verified by sending texts to the number given.

Manufacturers print these codes on packaging, and monitoring begins the minute the product leaves the factory. This way consignments are protected while in transit until they reach their destination.
Profits warning

Bejon Misra of the Partnership for Safe Medicines says counterfeiting eats into profits and affects the development of new formulations for medicines.

Consumers can text this number to a freephone number to find out if their medicine is real or fake

“In the perennial search for new drugs to tackle viruses and bacteria that are constantly mutating and developing resistance to current medications, the pharmaceutical industry spends billions of dollars every year towards research and development.

“If we fail to reduce the menace of spurious medicines, the cost towards health care can increase phenomenally.”

Prafull D Sheth of the South East Asian Regional Pharmacy Forum says that even if a small percentage of the overall market is found to be counterfeit, it has a big impact financially.

According to the WHO the most frequently counterfeited medicines in wealthier countries are new, expensive lifestyle medicines, such as hormones, steroids and antihistamines.

Government regulations mean drug manufacturers will have to bar code their products

While in developing countries it is those used to treat life-threatening conditions such as malaria, tuberculosis and HIV/AIDS.

The majority of fake drugs available are said to originate in India and China.

India is also one the world’s fastest-growing hubs for generic drug production. A majority of the medicines available in Africa come from Indian generic drug laboratories.

Meanwhile the World Trade Organization says fake anti-malaria drugs kill 100,000 Africans a year and the black market deprives governments of 2.5-5% of revenue.

The government hopes barcoding will give credibility to the generics leaving the country. From 1 October 2011, it will be mandatory for all pharmaceutical exporters to print bar-codes on their tertiary or outer-most packaging.
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It’s important for India to reassure consumers worldwide of the safety and credibility of drugs made here”
Paul Lalvani
Empower School of Health

The order also stipulates the compulsory implementation of a track and trace system will also include secondary-level packaging from 1 January, 2012 and primary packing from 1 July, 2012.

Paul Lalvani is dean of Empower School of Health.

He says around $5bn is invested by the big donor funds in anti-malarial and anti-retro viral drugs.

“80-90% of this comes from India. Drug makers impact the lives of over 6m people around the world who are on anti-retro viral drugs and 200m people on anti-malarials.”

“So it’s important for India to reassure consumers worldwide of the safety and credibility of drugs made here.”

Ensuring that poor people get access to quality drugs is a top priority says the government. But counterfeiting is seriously impacting the growth the pharmaceutical sector has so far been enjoying.

Until the government is able to crack down on fake products in the marketplace, popping a pill could be life threatening.

Walgreens Adds To Leadership Team In Pharmacy, Health And Wellness Division

Dr. Jeffrey Kang will join the company on Oct. 31 as senior vice president of health and wellness services and solutions, reporting to both President and CEO Greg Wasson and President of Pharmacy, Health and Wellness Kermit Crawford.

In addition, Mike Ellis has joined Walgreens as vice president of specialty pharmacy and infusion, reporting to Crawford.

“To advance community pharmacy and our role in the integration and cost-effective delivery of healthcare, we are continuing to strengthen the talent and leadership of our pharmacy, health and wellness organization,” said Crawford. “Jeff comes to Walgreens after a long and diverse career in the healthcare industry. He has experienced the industry from all sides – as a practicing physician, from inside government and in the private sector. With his extensive background in health care, Jeff has the breadth of experience and strategic insight to lead our health and wellness businesses, building a dynamic organization that helps us meet customers’ needs for access to quality, affordable healthcare.”

Most recently Kang, 55, was chief medical officer at CIGNA, where he was responsible for health strategy and policy for its medical, pharmacy and behavioral products. Kang also was responsible for CIGNA’s pay for performance programs, including its patient centered medical home and accountable care organizations. Prior to his position at CIGNA, he served as chief clinical officer at the Health Care Financing Administration (now Centers for Medicare and Medicaid Services) from 1998 to 2002. He also was chief medical officer for the Office of Managed Care from 1995 to 1998.

Kang began his career as the executive director of the Urban Medical Group, a not-for-profit, private group practice in Boston that pioneered the use of physician and nurse practitioner teams to care for frail, elderly patients.

Counterfeit drugs targeted by technology in India

Making pills that could save lives both in India and abroad, Indian pharmaceutical companies are growing faster than ever before.

Worth over $12bn, the industry is expected to grow more than four-fold in the coming decade.

But even as global attention is focused on the healthy growth in India, it is threatened by a serious malaise – counterfeiting. Fake drugs in the system risk not just lives of patients, but also the reputation of drug makers.
Faking it

There are varying estimates of how big the problem is. Up to 25% of the medicines consumed in poor countries could be counterfeit or substandard, according to the World Health Organisation. They define a counterfeit as “a medicine, which is deliberately and fraudulently mislabelled with respect to identity and/or source”.

Counterfeit drugs are a $200bn (£128bn) industry worldwide. Producers need very little investment to set up the manufacturing process and can make huge profits.

With manufacturing costs nearly 40% cheaper than other countries, the authorities are worried India could become an easy target for counterfeiters.

This is why the government has launched a campaign against counterfeit medicines. The drug controller of India says while they have task forces that regularly raid producers, it is increasingly difficult to spot fakes.

Very often consumers cannot work out if they have been treated with a counterfeit product, which may contain non-active or even toxic ingredients.

Deputy drug controller general of India, Dr D Roy, says counterfeit medicines often resemble the originals in chemical composition. But he thinks the biggest problem is the packaging.

Holding up two strips of a medicine for the common cold, he points out that its nearly impossible to find any differences in them.

“This is how consumers are deceived,” he says.

“Retailers too would find it difficult to identify a fake. The packaging industry is not regulated by us. The need of the hour is to evolve a more holistic approach that ensures involvement of all stakeholders in the supply chain.”

Currently, when a company suspects that its drugs are being counterfeited in a particular area, they alert the local office of the drug controller to take action.

The authorities then conduct a raid and seize any fake products found.
Testing times

When a consumer suspects that a drug is counterfeit, the process to get it tested in a government laboratory is slow and expensive.

Technology is now being used to speed up the process.

A committee set up by the Indian Ministry of Health has approved a proposal to put 2D barcodes and scratch-off labels on medicines.

The label works like a telephone recharge coupon. The user scratches off the cover and texts what is underneath to a freephone number, to find out if a pill is real.

Quick response (QR) codes are also being tested. These printed squares are an advanced version of the 2D barcodes. Anyone with a camera-enabled phone and web access can scan the code and be taken instantly to the pharma company website to authenticate the drug.

Leveraging the extensive mobile usage in the country and cloud computing, the pharma industry hopes to increase their credibility. Computer companies see a huge business potential in offering technology solutions to the whole industry.

Hewlett-Packard is one of the companies offering a solution, a cloud-based platform called Global Authentication Service.

Pharma companies can buy two-dimensional bar codes which will be printed on the packaging material.

The companies can then use the cloud service to monitor the movement of products through their global supply chains. The system is used to trace and authenticate medicines in Nigeria and Ghana.

A Appadurai of HP India says they have used the system in Africa with non-profit social enterprise mPedigree. In India, they are in talks with pharma manufacturers like Cipla, Tablet India and the Chemical & Alkeli Merchants Association (CAMA).

Mr Appadurai says the technology would not be very expensive.

“The two dimensional barcodes would cost around one rupee each. This may mean a firm’s expenditure may rise marginally. However, compared to the litigation costs some pharma companies face, this cost is nothing.”
Bonding moment

In an effort measure the amount of fake drugs in the market, the pharma industry and the authorities have come together.

Measures under consideration include a certification system for pharmacists, and an open source website where consumers and companies can access data on fake drugs.

Bilcare Technologies makes anti-counterfeiting, security and brand protection technologies. These include a handheld scanner to track their security technology nonClonableIDT.

It’s almost like a fingerprint that can be put on any product. The company claims it provides a reliable means to track and trace products across the supply chain – from manufacturer to consumer.

Another company, PharmaSecure, has come up with a technology called UIMV – unique identification mobile verification. It is a unique code for each product which can be verified by sending texts to the number given.

Manufacturers print these codes on packaging, and monitoring begins the minute the product leaves the factory. This way consignments are protected while in transit until they reach their destination.
Profits warning

Bejon Misra of the Partnership for Safe Medicines says counterfeiting eats into profits and affects the development of new formulations for medicines.

“In the perennial search for new drugs to tackle viruses and bacteria that are constantly mutating and developing resistance to current medications, the pharmaceutical industry spends billions of dollars every year towards research and development.

“If we fail to reduce the menace of spurious medicines, the cost towards health care can increase phenomenally.”

Prafull D Sheth of the South East Asian Regional Pharmacy Forum says that even if a small percentage of the overall market is found to be counterfeit, it has a big impact financially.

According to the WHO the most frequently counterfeited medicines in wealthier countries are new, expensive lifestyle medicines, such as hormones, steroids and antihistamines.

While in developing countries it is those used to treat life-threatening conditions such as malaria, tuberculosis and HIV/AIDS.

The majority of fake drugs available are said to originate in India and China.

India is also one the world’s fastest-growing hubs for generic drug production. A majority of the medicines available in Africa come from Indian generic drug laboratories.

Meanwhile the World Trade Organization says fake anti-malaria drugs kill 100,000 Africans a year and the black market deprives governments of 2.5-5% of revenue.

The government hopes barcoding will give credibility to the generics leaving the country. From 1 October 2011, it will be mandatory for all pharmaceutical exporters to print bar-codes on their tertiary or outer-most packaging.
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It’s important for India to reassure consumers worldwide of the safety and credibility of drugs made here”
Paul Lalvani
Empower School of Health

The order also stipulates the compulsory implementation of a track and trace system will also include secondary-level packaging from 1 January, 2012 and primary packing from 1 July, 2012.

Paul Lalvani is dean of Empower School of Health.

He says around $5bn is invested by the big donor funds in anti-malarial and anti-retro viral drugs.

“80-90% of this comes from India. Drug makers impact the lives of over 6m people around the world who are on anti-retro viral drugs and 200m people on anti-malarials.”

“So it’s important for India to reassure consumers worldwide of the safety and credibility of drugs made here.”

Ensuring that poor people get access to quality drugs is a top priority says the government. But counterfeiting is seriously impacting the growth the pharmaceutical sector has so far been enjoying.

Until the government is able to crack down on fake products in the marketplace, popping a pill could be life threatening.

Avon’s Magellan melds two drug-benefit units

Under pressure to curb rising drug costs, Avon’s Magellan Health Services Inc. is combining its two drug-benefits administrator divisions into one, and named Magellan newcomer Kim M. Mageau to run it.

The new Magellan Pharmacy Solutions unit will include its ICORE specialty pharmaceutical management busineses and the division that previously oversaw its state-sponsored pharmacy benefits programs.

Mageau, who joined Magellan in March to manage the drug-benefit management division, was named president of Magellan Pharmacy Solutions. She reports to Magellan President Karen S. Rohan.

“The pharmaceutical industry is in the midst of monumental change. While traditional pharmacy costs have been trending negatively, specialty drugs — provider-administered drugs, in particular — continue to threaten the provision of affordable health care,” Rohan said in a statement announcing the consolidation.

Before joining Magellan, Mageau was president and interim chief executive officer, chief operating officer and chief financial officer of Prime Therapeutics LLC, a Minnesota pharmacy benefit manager.

She received her law degree from the William Mitchell College of Law in St. Paul, Minn., and her B.S. in accounting from the Carlson School of Business and Management at the University of Minnesota.

Courtney Opposes Pharmacy Merger

U.S. Rep. Joe Courtney let the Federal Trade Commission know he strongly opposes the proposed merger of two of the three biggest companies that manage pharmacy benefits, Express Scripts and Medco Health Solutions.

The merger is reportedly valued at about $25 billion.

“Like many of my colleagues, I have concerns that the proposal will lead to further market concentration in an industry—where there are already few choices—without realizing cost savings for consumers,” Courtney wrote in a letter to FTC Chairman Jon Leibowitz. “At the same time, this concentration will squeeze community pharmacies, forcing some out of business and creating job losses.”

He’s not alone in his opposition.

“Our members are very concerned about what this proposed merger will mean to patients, employers, state government and pharmacists,” Margherita R. Giuliano, executive vice president of the Connecticut Pharmacists Association, said in July when the merger was announced.

“These large Pharmacy Benefit Managers already have too much power when it comes to controlling health care dollars and they have clearly placed their own corporate earnings first and foremost. This merger will only broaden the power they wield which will ultimately lead to increased prescription drug costs,” Giuliano said.

Appearing before a House antitrust subcommittee two weeks ago, Express Scripts Chief Executive George Paz and Medco Chief Executive David Snow said the market for PBMs was rapidly evolving and includes more competitors than the top three.

But what worries independent pharmacies the most is not only the management of pharmacy benefits for many insurers, governments, and employers, but also the fact that Express Scripts and Medco own their own mail order pharmacy.

According to a Wall Street Journal article, Medco’s Snow reassured independents at a Sept. 20 Congressional hearing that the company wouldn’t have more leverage to steer customers to fill prescriptions by mail order.

But in Connecticut a deal brokered between the state and the labor unions forces the more than 45,000 state employees to get their maintenance drugs, such as blood pressure medication, through mail order.

And while the state gave independent pharmacies a chance to join the mail order program, it was unable to negotiate any rate since the savings were already locked in as part of the labor agreement.

In Connecticut, pharmacies are looking at potentially losing thousands of state employees as patients, Guiliano said.

“The recent SEBAC agreement negotiated with the state mandates that state employees receive their chronic medications through the mail or at a CVS pharmacy,” Giuliano said. “In the latest proposal, any willing pharmacy will be allowed to participate in the mandatory mail order program at the same reimbursement as the CVS/Caremark owned mail order pharmacy – a situation that in most cases will not be affordable to small
pharmacies.”

Rick Carbray, a CPA member and owner of Apex Pharmacy in Hamden, went on to add that “we are also deeply concerned that this PBM merger could mean the further closure of many Connecticut community pharmacies.“

“This is a sad day because there is a world of difference between the personal one-on-one, face-to-face care that community pharmacies offer. It will ultimately also be a loss for the many state residents who are these pharmacies’ patients, as well as a loss for the State of Connecticut due to the lack of revenue and increased unemployment if pharmacies close.

Fifty years later, card store stays relevant in technology-driven world

Fifty years ago, Duey and Virginia McBride moved to Kitsap County “on a lark” to open a pharmacy where Arnold’s Furniture now stands in Bremerton.

The decision to move from Seattle’s Wedgwood neighborhood to Bremerton came after Duey McBride was convinced by a pharmaceutical drug salesman to check out an empty pharmacy building. The aspiring pharmacist saw possibility inside the vacant store, but he had no idea where it would lead.

“We didn’t know what we were doing when we came over, just a couple of kids with a baby and a 2-year-old,” Duey McBride said.

The couple opened McBride’s Westgate Pharmacy in 1961. Seven years later, they expanded, opening the county’s first stand-alone Hallmark card store at 133 Pacific Ave., next to Puget Sound Naval Shipyard. Before opening the second store, Duey McBride said he didn’t even know what a Hallmark card store was.

Fifty years later, the pharmacy is gone, but three Hallmark stores still carry the McBride family name in Kitsap. Duey and Virginia McBride no longer run the stores, they passed the business on to son Scott McBride and his wife, Stacy Ryan. The family also owns Hallmark stores in Tacoma, Oak Harbor and Anacortes.

“Since I was old enough, I probably collapsed cardboard boxes,” Scott McBride said of his first role in his parents’ business. After graduating from college and then working alongside them for years, he bought the business when his parents retired.

A lot has changed since Duey and Virginia McBride opened their first Hallmark store. The couple operated the stores largely during an era when penned correspondence was the primary way to communicate with friends and family living outside the area. It was a time when handwritten thank you notes were the norm and not a novelty.

In recent years, the family has had to expand its offerings in the shops beyond the birthday, anniversary and get well cards. The stores now offer a bag line by designer Vera Bradley, Christmas ornaments, women’s apparel, Yankee Candle Co. candles, gift wrap and other items to bring in income and stay relevant.

Duey McBride says the change is the result of the Internet and the ever-evolving way society communicates.

“Today, the industry is being overtaken by the Internet, Twitter and Facebook,” Duey McBride said. “There’s no expansion in the (gift card) market at all, it’s shrinking.”

Duey McBride doesn’t like the Internet, but he admits it has made it easier to stay in touch with a cousin living in Norway.

His son has a slightly different take on how the industry has changed in recent years. Yes, the business has added new products to its inventory, but greeting cards remain “the backbone of the business,” he said.

“People are always looking to communicate feelings and thoughts and sometimes they struggle to put it in their own words,” Scott McBride said. “Getting a card in a mailbox is more meaningful than an email or a text.”

The family celebrated its 50 years in business over the weekend with customers, offering cake and refreshments and a special sale. Giving back to the community was a long-standing practice of Duey and Virginia McBride when they ran the stores, and it is something Scott McBride and his wife have carried into the next generation. Over the years, the family has raised money for breast cancer research, the Kitsap Humane Society, the YWCA’s ALIVE shelter and Harrison Medical Center’s annual Festival of Trees event.

Business news in brief

Amerisource buys drug-services firm

AmerisourceBergen Corp. said it agreed to buy TheraCom L.L.C., which supplies consulting and reimbursement services for the pharmaceutical and biotechnology industries, for $250 million. TheraCom is a unit of the drugstore operator and pharmacy benefits provider CVS Caremark Corp. The deal is expected to be completed by the end of the year. AmerisourceBergen, Valley Forge, is a distributor of pharmaceuticals. – Paul Schweizer
The Bancorp to buy back stock

The Bancorp Inc., Wilmington, said its board of directors authorized the repurchase of up to 750,000 shares of the company’s common stock, or about 2.5 percent of the total outstanding. The shares are trading at about $7.05, making the repurchase currently worth about $5.3 million. The company operates The Bancorp Bank, which has assets of $2.5 billion and offices in Philadelphia, Exton, Warminster, and several Southern and Midwestern cities, in addition to Delaware.

New UnitedHealth Business Starts Offering Hearing Aids

Health-insurance giant UnitedHealth Group Inc. (UNH) is adding a new dimension to its increasingly broad suite of health-care products: hearing aid sales.

A new UnitedHealth business is launching on Monday four different kinds of hearing aids, made by supplier IntriCon Corp. (IIN), with a goal of helping reach millions of people who don’t get the devices due to high costs and lack of insurance coverage.

The move comes as insurers kick off marketing efforts for their 2012 Medicare-based plans. UnitedHealth is offering new hearing-aid benefits in such plans, but is also selling devices on a retail basis over the Internet, injecting it into a multi-billion-dollar market where major players include European firms Sonova Holding AG (SOON.VX), Siemens AG (SI, SIE.XE) and William Demant (WDH.KO).

UnitedHealth is using its scale–the entire company projects $101 billion in sales this year –plus a proprietary web-based hearing test to offer an alternative to a supply chain it says can lead to devices that are too expensive for many people. The move drew criticism from a professional group for hearing experts, which said online hearing tests can’t replace a face-to-face exam.

“Our goal is to put better hearing within reach of more Americans, including the 47 million with Medicare, which does not cover the significant cost of hearing devices,” said Lisa Tseng, chief executive of the new hearing-aid business, called hi HealthInnovations.

UnitedHealth, based in Minnetonka, Minn., has been expanding its business far beyond the bounds of health insurance. It has a broad array of health-services offerings, including its pharmacy-management business, and it has also acquired physician groups. The latest venture marks UnitedHealth’s first foray into medical-device sales, which the company believes is an industry first.

The U.S. market for hearing aids and other so-called audiology devices is valued at more than $5.7 billion, according to Vancouver-based firm iData Research. About 36 million Americans have hearing loss, and the number is poised to grow as baby boomers age.

The UnitedHealth businesses’ hearing aids will retail for between $749 and $949, which compares with typical prices that can reach thousands of dollars. The new business is also contracting with several UnitedHealthcare Medicare Advantage and Part D drug plans to make devices available to plan members; there will be no out-of-pocket hearing-aid costs for some Medicare Advantage members, the company said.

Previously, the company said industry Medicare plans had some discounts on the devices, but such discounts have been limited by high costs and lack of Medicare coverage.

UnitedHealth is keeping costs low by simplifying the route for patients to get hearing tests and, if necessary, hearing aids. It has an online test designed to work with earphones and is planning a mobile application for smart phones and tablet computers. Based on the results, hi HealthInnovations will custom program hearing devices.

“We’re really leveraging UnitedHealth Group’s scale and our membership base” to keep costs low, Tseng noted. The company will refer patients onto physicians if hearing tests indicate more serious problems, Tseng said.

Therese Walden, president of the American Academy of Audiology, a professional group for hearing experts, said mark-ups for hearing aids cover the cost of important services that benefit patients. An online test can’t take into account all the variables that impact successful treatment for hearing loss, she said, and audiologists help patients maximize the potential of their hearing aids.

“Skimping on the cost-effective tests and care provided by the audiologist, which helps to ensure accurate diagnosis and effective short and long-term care, is not smart,” Walden said.