Michael writes:

I live in Oxford, MS, and my girlfriend and I researched the availability of Plan B in this state. We knew there might some puritanical problems with purchasing it here in Mississippi – we have all kinds of arcane alcohol laws and only one abortion clinic in the state, after all – and from what we could tell, a pharmacist can refuse to sell Plan B to a woman on religious/moral grounds. But otherwise pharmacies do carry it, and it should be available to a woman as long as she can prove she is over age 18. As this is a university town and a top-ranked party school, we supposed it wouldn't be as hard to get Plan B as in other really small, ultra-conservative rural towns. And we also figured that a corporate pharmacy such as Walgreens would be less troublesome to deal with than a mom-and-pop one.

Well, the other day we decided to be extra-safe and to get the Plan B pill from Walgreens here in town. My girlfriend went and requested Plan B, equipped with the knowledge that it's a non-prescription drug available with ID. She said the pharmacy worker started asking for proof of insurance in order to get the pill. My girlfriend refused and asked to speak to someone in charge. The pharmacist then came, and my girlfriend told him she simply wanted Plan B and that her ID should be good enough. The pharmacist then went about getting the pill, but they also seem to have a policy, a lá abortion clinics, of forcing a waiting period of an hour and giving adoption literature to the person requesting the contraceptive. Now, Plan B is just an additional spermicide, not an abortion pill, but that's another can of worms. In the end, my girlfriend demanded the Plan B immediately, and she got it, but not without a fair amount of interference on Walgreens' part. They also insisted on writing down her driver's license number.

I'm wondering how much trouble other people may have had with Walgreens (or any other pharmacy) over acquiring Plan B. There are several other Red States that make allowances for the pharmacists' "moral concerns" to get in the way of getting Plan B. What are our rights in getting this pill right away? Walgreens' website didn't indicate that they could possibly get all high-and-mighty with her when she went to make the purchase. Could they also get uppity when you buy other kinds of contraception?

(Photo: Monotasker)

Vermont courts found that Wyeth hadn't given adequate warning to doctors and patients that one particular injection method, the one used on Diana, greatly increases the risk of gangrene. Wyeth is trying to use Federal preemption to win the case, arguing that patients is that consumers can't sue a pharma company if the drug has been approved by federal regulators. The case, Wyeth v. Levine, is before the Supreme Court. The Alliance for Justice has made a 22-minute documentary about Diana Levine so you can learn more about her story. Watch it in its entirety, inside...

Access Denied [Alliance For Justice]
PREVIOUSLY: Big Pharma Goes Before Supreme Court To Get State Lawsuits Banned

When the drug program began in 2006, Humana's premiums were among the cheapest. Humana, Mr. Noland said, has provided the most cumulative value for its drug-plan members, saving them an average of $4,900 on drug costs during that time and that the premiums are still in line with rivals.

The drug plans are heavily subsidized by the federal government and are offered through private insurance companies. Insurers will begin advertising their plans Oct. 1, and the six-week enrollment period starts in mid-November.

It's unclear how the price increases will affect the market. Medicare beneficiaries tend to select a plan and stay with it, and the market is highly concentrated.

"Medicare Drug Premium on Rise" [Wall Street Journal]
(Photo: Getty)

Here's the drugs affected by the embargo:

Acyclovir
Cefprozil
Cefuroxime Axetil
Cephalexin
Ciprofloxacin HCl
Clarithromycin
Fenofibrate
Fluconazole
Fosinopril Sodium
Fosinopril Sodium and Hydrochlorothiazide
Gabapentin
Ganciclovir Sodium
Glimepiride
Isotretinoin
Lamivudine
Loratadine (OTC)
Metformin HCl
Nefazodone HCl
Nitrofurantoin; Nitrofurantoin and Macrocrystalline
Ofloxacin
Pravastatin Sodium
Ranitidine
Simvastatin
Terazosin HCl
Valacyclovir HCl
Zidovudine (PEPFAR)

Active Pharmaceutical Ingredients
Clarithromycin
Valacyclovir HCl
Pravastatin Sodium
Acyclovir
Ciprofloxacin HCl
Ganciclovir Sodium *
Gabapentin

These are the citations from the warning letters the FDA sent to Ranbaxy that were not resolved and prompted the import ban:

* The facility's beta-lactam containment program (measures taken to control cross-contamination), which appeared inadequate to prevent the potential for cross-contamination of pharmaceuticals;
* Inadequate batch production and control records;
* Inadequate failure investigations; (A failure investigation is done to address any manufacturing control or product rejection to determine the root cause and prevent recurrence); and,
* Inadequate aseptic (sterile) processing operations.
* The lack of assurance responsible individuals were present to determine the firm was taking necessary steps under cGMP (current Good Manufacturing Practice);
* Inaccurate written records of the cleaning and use of major equipment;
* Incomplete batch production and control records; and,
* Inadequate procedures for the review and approval of production and control records for drug products

FDA Issues Warning Letters to Ranbaxy Laboratories Ltd., and an Import Alert for Drugs from Two Ranbaxy Plants in India [FDA] (Thanks to Chris!)

(Photo: Schodts)

"When we did testing with consumers, what we found out was John really resonated with them," said Jim Sage, senior director and leader of the Lipitor marketing team at Pfizer.

The Wall Street Journal describes the commercial as "visually similar to some of the Jarvik ads, in that it shows Mr. Erlendson in an outdoorsy setting, biking and picnicking by the water with his wife and son — a notable ad with Mr. Jarvik showed a body double rowing a racing scull across a lake."

Rather than impress you with his resume (John is actually a talent agent, if you must know), the new Lipitor pitchman encourages you to be smarter than he was. Silly, John. He tried to control his cholesterol with diet and exercise. What was he thinking?:

"Talk about a wake-up call. I had a heart attack at 57," Mr. Erlendson says in the commercial's opening, in which he's filmed in close-up and black-and-white. "My doctor told me I should have been doing more for my high cholesterol. What was I thinking? But now I trust my heart to Lipitor."

Pfizer Brings Back Lipitor Ads — Without Robert Jarvik [WSJ Health Blog]
Pfizer Drops Celebrity Pitch in New Lipitor Spots [WSJ via Gawker]

They're not the same after all. The Target generic on the right is 1/2 the strength of the name brand on the left. How? Check the dosing...your recommended intake of the generic is twice as much as the name brand. So in this case, the generic is not only cheaper, it's inferior.

It's not enough to just read the price tags, also check out the product labels to make sure you're really comparing apples with apples.

(Thanks to Bruce!)

Whether it says CD, CR, ER, LA, SR, XL, XR, or XT, the letters really stand for a version of the drug that releases differently into the body. By coming up with different variations on old drugs, pharmaceutical companies can keep the profits rolling on drugs whose patents have expired. Best of all, if they can get the doctor to write one of these letter sequences after the drug's name, the pharmacy can't substitute a lower-priced generic (unless a generic of the extended release version is already on the market).

For example, Wellbutrin (bupropion) came out in 1985 requiring 3 pills a day. In 1996, 36 months before the old patent expired, they came up with Wellbutrin SR, only 2 pills a day. In 2003, 5 months before the SR patent expired, Wellbutrin XL was released, only one pill a day.

A 3 month supply of 300 mg of bupropion per day retails on average for $270. You'll have to pay $693 and $656 for Wellbutrin SR and XL, respectively. Over the course of a year, that's $1080 extra dollars. Is it really worth paying 2.5 times as much just for one fewer pill?

There are exceptions where an extended formula works better, like short-acting calcium channel blockers like nifedipine, or Parkinson's treatment drug Sinemet CR. Luckily, in both cases, the extended release versions are available as lower-costing generics. Furthermore, a certain medication might otherwise be too hard to time correctly if several pills are needed a day at specific intervals. As always always always, any change in your medication needs to be discussed with your doctor.

[source: How To Save On Prescription Drugs]
RELATED: 14 Ways To Save On Drugs Big Pharma Doesn't Want You To Know

ELIMINATE NONESSENTIAL PRESCRIPTIONS
1. Eliminate medicines that are no longer needed
2. Eliminate medicines that no longer work
3. Eliminate medicines that have never worked
4. Eliminate medicines that were never needed

THINK OUTSIDE THE PRESCRIPTION DRUG BOTTLE
5. Treat with lifestyle changes
6. Use nondrug treatments
7. Prevent disease naturally

STEER CLEAR OF OVERPRICED REDUNDANT DRUGS
8. Don't "Ask Your Doctor" (for Advertised Drugs)
9. Insist on generic drugs
10. Insist on cheaper medicines with the same class
11. Insist on a cheaper class from the same treatment goal

PLAY IT SMART!
12. Cut costs by splitting tablets
13. Don't treat side effects of one drug with another
14. Comparison-shop

Be sure to talk to your doctor before changing anything about your medication. In fact, that's the very first thing Jardini wants you to do, schedule a "treatment review" visit where you discuss the efficacy and cost and ask the right questions about the treatment you're getting. "It is not just tough luck if your doctor chooses costly medicines for you," writes Jardini, "The system is designed this way....a health care revolution...needs to take place in the United States...but it will only start when patients enlist physician support and refuse to be denied affordable care...prohibitive cost is an intolerable side effect too."

How to Save on Prescription Drugs: 20 Cost-saving Methods [Amazon]

(Photo: xysmas (Aaron))

Here’s how it works: Many health insurers contract with PBMs to administer their drug plans. Among other functions, the PBMs negotiate lower drug prices with pharmacies. But some PBMs, under a practice allowed by Medicare, then charge a higher price to health insurers and, ultimately, both the government and patients. Though the opaque practice is common in the private insurance market, Medicare currently has a proposal to curb it, because the agency is worried the tactic, by inflating patients’ drug costs, is speeding their pace toward the “doughnut hole” coverage gap.

The differences between what the PBMs pay pharmacies and what they charge the plans can range from a few dollars to well over $100. In one case, a Medicare patient filled a prescription for a 90-day supply, or 270 pills, of the generic antinausea medication prochlorperazine. The difference between what the PBM, Express Scripts, paid the pharmacy and the price that showed up on the patient’s explanation of benefits was $146.53.

Well, that seems high. The PBM told the WSJ that mark-ups over $100 are rare, and that the money is used to help " fund programs that drive patients away from branded drugs and toward generics that ultimately still cost less."

Generics Are Cheap, but They Could Be Cheaper [WSJ Health Blog]
(Photo: Daquella Manera )

In December 2007, John (not his real name) was in hospital with an infection and he was given Cipro. “Shortly after starting treatment with Cipro, I felt a "popping" in my shoulders,” he says. “At the time, I could barely move my arms and since then I have suffered constant pain; I am only now starting to improve thanks to physical therapy.”

Any patient taking these drugs and experiencing tendon pain should immediately stop taking them, stop any exercise, and contact their doctor.

Antibiotics can harm tendons, FDA warns [Reuters]

He consumed 1 teaspoon measured in a medicine cup which in its concentrated state contained 20 times the prescribed dose (100mg) and within hours, his organs began to fail and had to be placed on a ventilator.

The KSLTV article says,

Laurie Scott said, "This shouldn't have happened. It was needless. It was senseless and it's changed lives forever, not just Jessie, but there are other people who love him and his future."

Laurie trusted what she gave her son, what had been filled, was correct.

"I always ask questions. I've always medicated him his whole life. I'm the caregiver and it makes it extremely difficult," she said.

After 16 days in ICU, Jessie moved to intermediate care for another four days, then to HealthSouth for intensive therapy.

Wal-Mart Corporation issued the following statement to KSL News: "This is a very sad situation. Our thoughts are with this young man and his family."

There was a dramatic turn of events this weekend. For the first time, Jessie spoke, though the words are limited and intermittent. We will continue following his story in the weeks and months to come.

What makes this even more infuriating is that pharmacists receive extensive specialized training to prevent these exact types of situations. We are supposed to be able to trust that the medication the pharmacy prepares won't kill us, or worse. We are, however, shocked that Walmart seems to actually be acknowledging the error—they usually deny everything until the point of absurdity. Our thoughts are with the Scott family, we hope that Jessie gets better soon.

Teen in coma after wrong dose of medication [KSLTV] (Thanks to Seth!)

Home buyers should look beyond low prices for long-term values [Consumer Reports] "Follow these tips to help secure the best deal [on a home] you can."

New ways to save on drugs [CNN Money] "Here's the news you need to know to avoid the worst of the pain - no clandestine trips to Canada required."

The Four Pillars of Investing [Get Rich Slowly] "For the past year, I've been looking for a book to recommend for novice investors, a book that would offer sensible advice without becoming too technical. I believe I've finally found that book."

5 stupid 'fixes' for money woes [MSN Money] "If a solution sounds too good to be true, it probably is. And the words 'quick and easy' should set off alarm bells."

— FREE MONEY FINANCE

(Photo: Tengaport)

(Photo: Ben Popken )

The article says,

The most common, widely publicized conflicts have involved pharmacists who refuse to fill prescriptions for birth control pills, morning-after pills and other forms of contraception. They say they believe that such methods can cause what amounts to an abortion and that the contraceptives promote promiscuity, divorce, the spread of sexually transmitted diseases and other societal woes. The result has been confrontations that have left women traumatized and resulted in pharmacists being fired, fined or reprimanded.

In response, some pharmacists have stopped carrying the products or have opened pharmacies that do not stock any.

"This allows a pharmacist who does not wish to be involved in stopping a human life in any way to practice in a way that feels comfortable," said Karen Brauer, president of Pharmacists for Life International, which promotes a pharmacist's right to refuse to fill such prescriptions. The group's Web site lists seven pharmacies around the country that have signed a pledge to follow "pro-life" guidelines, but Brauer said there are many others.

"It's just the tip of the iceberg," she said. "And there's new ones happening all the time."

Virginia does not have any laws or regulations that would prohibit a pro-life pharmacy, and is not considering adopting any, according to the Virginia Board of Pharmacy.

Critics also worry that women might unsuspectingly seek contraceptives at such a store and be humiliated, or that women needing the morning-after pill, which is most effective when used quickly, may waste precious time.

"Rape victims could end up in a pharmacy not understanding this pharmacy will not meet their needs," said Marcia Greenberger of the National Women's Law Center. "We've seen an alarming development of pharmacists over the last several years refusing to fill prescriptions, and sometimes even taking the prescription from the woman and refusing to give it back to her so she can fill it in another pharmacy."

Everyone has their own personal beliefs regarding human reproduction. However, when it is your job to provide health services to the public, we don't understand how those beliefs are more important than the customers'.

'Pro-Life' Drugstores Market Beliefs [Washington Post]
(Photo: Getty)

What are we looking for?

For example, in this AmbienCR commercial, the announcer says:

"Sleepwalking and eating or driving while not fully awake with amnesia for the event have been reported."

Driving while not awake? With amnesia? Neat!

If you've noticed a disturbing side-effect in a tv drug ad, watch the ad again and write down exactly what the announcer says and the name of the drug, and email it to us at tips@consumerist.com. Put "Disturbing Side Effect" in the subject of your email. If you can find a clip of the advertisement on the internet, please include a link. If you have a commenter account, feel free to leave your suggestion in the comments.

We'll pick the top 10 and feature them in a Consumerist post. Thanks!

From the economist's perspective, the question of whether we are spending too much on health care cannot ultimately be answered by looking at total expenditures relative to GDP or the federal budget. Rather, the question, whatever we spend, is whether we are getting our money's worth.

He suggested that in our current system, decisions were made with the idea that "someone else will pay for it," either the government, or private insurance.

"The best way to reduce the fiscal burdens of health care is to deliver cost-effective health care throughout the entire system," Bernanke said.

You can read the full text of his remarks here.

Challenges for Health-Care Reform [FED]
(AP Photo/J. Scott Applewhite, File)

CBS explains the scheme,

To save taxpayer dollars, Medicaid limits how much it pays for popular forms of drugs. But it doesn't bother to set price-ceilings on rarely-used versions.

Take generic Zantac, or ranitidine, for example. The antacid is a huge seller in tablet form. Medicaid limits payment to 34 cents apiece.

The same drug as capsules has no price-ceiling because it was so rarely-prescribed. Medicaid pays $1.25 each. Walgreens figured it could pocket millions by switching patients from tablets to capsules.

The article also says,

By gaming the system, Walgreens managed to change over almost all Medicaid customers from cheap generic Zantac tablets to pricy capsules.

In Florida alone, it cost taxpayers an extra $1.2 million the first year.

And the pill-switching went on for several years nationwide, including other prescriptions: generic Prozac (fluoxetine) for depression, and generic Eldepryl (selegiline) for Parkinson's.

Walgreens denies wrongdoing and declined to be interviewed. But they recently agreed to pay back the government more than $35 million.

And they're not the only ones. CVS and Omnicare quietly settled similar cases coughing up $86 million more. The whole pill-flipping episode proves just how imperfect some drugstore chains can be.

Whether Walgreens' pharmacists are secretly mocking you, or just being so incompetent that they prescribe a drug that causes a miscarriage, it seems they can do nothing right. Hopefully, this little multi-million dollar fiasco they've created will be a catalyst for change at the woeful pharmacy, but we won't hold our breath.

Walgreens Accused Of Scamming Taxpayers [CBS]
(Photo: Okasan1)

My thyroid medication, having been around for 40+ years, has been considered a generic for years by every insurance company I've had in the the past five years (same employer, but the plans keep changing). The costs for my usual three-month prescription have been going up, from 15$ 5 years ago up to 30$ for the past couple of years. So I was a little surprised that yesterday BlueCrossBlueShield of Maryland would only pay $14.92 on a $75 total for my usual 3-month prescription, leaving me to pay $60.08 as a co-pay.

Now an extra 30$ extra every three months won't make me broke, but I do wonder why I'm paying 120$/month for insurance that is basically useless to me. I called BlueCross and their response was that my prescription isn't considered a generic anymore but a "nonpreferred Tier 3 medication" (whatever that means) with a copay of $100. Since the total cost of my prescription is $75, they "pay" a pro-rated percentage. When I asked about my limited options were since I'm already taking a "generic", their response (and this is a quote) was "we can change our copays at any time".

I can't be the only one in this situation, since thyroid hormones are among the most prescribed medications in the country. Since I don't have a thyroid, not taking medication isn't an option for me.

I also wrote to my employer: it's a small company, so BCBS is the only option we have for insurance. We all just renewed our insurance on 5/1/2008, and the paperwork we were all given in April to mull over said my prescription would remain @$30 for a a three-month supply.

I do have an out as far as changing insurance companies, since I'm getting married and my future husband can add me to his insurance. The wedding isn't until next year, however, so we may have to go to the courthouse in the very near future - like next week - so I can get better health insurance.

First, the bad news. Along with Synthroid, Levoxyl is actually brand name (source: Drugs.com, Medicine.net). I don't know whether the insurers in the past mistakenly said it was a generic or what, but it looks like BCBS is right.

Now, the good news. The generic for Levoxyl is levothyroxine, and Target will sell you a 3-month supply for $10. So will Wa-Mart.

Even if you're paying for this out of pocket, it's cheaper than your copay was even 5 years ago. Hope this saves you some money, and a trip to the courthouse. Of course, consult your doctor first before switching out any medication (especially as some commenters are saying generics can actually vary subtly from the brand name, and some patients can have adverse reactions to different kinds of thyroid meds). Here's another potentially useful idea from commenter Bohemian:

"Some people can't take the generic versions of the brand name thyroid medications. They do actually have a different formula to them so some people are unable to properly absorb the generic drug.

She could try disputing the BCBS change. Most BCBS plans still consider synthroid to be a lower tier medication so the copay is cheap. Sometimes a doctor's note stating that the patient can not take the generic alternative is enough to get an exception to the increase thus putting the drug back to the lower tier pricing."

(Photo: trekkyandy)

She took the drugs because she thought she'd been given a generic for her normal prescription, but when she started feeling ill, she called CVS and asked them about the strange new drug. They told her it wasn't a generic for her usual prescription, but they did offer to refill it for her. Finally, Dorothy looked up the drug on the internet. That's when she found out it was a powerful chemotherapy drug.

Ms. Enriquez ended up in the hospital, and CVS ended up in Fox 5, New York's "Hall of Shame." Fox 5 went to the CVS with their camera crew and tried to interview the pharmacist who made the mistake. He wasn't willing to talk, but they did notice that he was supervising more assistants than is allowed by law. When they asked him about the violation he smiled and answered, "You're good!"

Shame, Shame, Shame: Medication Mistake [Fox 5]

Costco $962
AARP.com $1005
Wal-mart $1073
Walgreens.com $1153
CVS.com $1177
Independents $1192
CVS $1205
Safeway $1207
Shopko $1209
Publix $1219
Hannafor $1226
Walgreens $1276
Rite Aid $1302

Costco sells nearly all their goods at close to cost, so their primacy is no surprise. Results may vary, but it shows you shopping around, even for drugs, makes for a healthier wallet.

America's best drugstores [Consumer Reports]
(Photo: Getty)

9. Having sex can cause a heart attack in men.
Mostly untrue. Per hour, the chances of a 50 year old, non-smoking male suffering a heart attack is about 1 in a million. During sex this increases to 2 in a million which is still negligible.

8. High blood pressure causes headaches.
Very untrue except for in extreme rare cases. High blood pressure usually has no superficial symptoms at all.

7. Diabetics crave sugar.
Mostly untrue. Some diabetics require sugar if their glucose is too low but craving sugar by itself does not equal diabetes.

6. Women need to self-examine their breasts.
Very untrue. Research shows that self-exam has no effect in terms of breast cancer outcomes because it isn't sensitive enough to detect important lumps. In fact it can cause harm by subjecting examiners to increased anxiety. The same holds true for testicular self-exam in males.

5. Diet cuts cholesterol.
Mostly untrue. In clinical trials, diet alone could only cut cholesterol by 10%. Doctors rarely suggest diet changes alone if your cholesterol really needs lowering.

4. Headaches alone can be a sign of a brain tumor.
Totally untrue. Actual tumors produce other symptoms like personality change, fits, or shaking.

3. You shouldn't mix antibiotics and alcohol.
Totally untrue with the exception of the antibiotic metronidazole. Most interactions between alcohol and antibiotics are so small that they're irrelevant.

2. Your tiredness may be caused by anemia.
Mostly untrue. Tiredness by itself is common and usually caused by lifestyle issues. Many times people with tiredness have blood tests that reveal anemia but it was probably not the actual cause of the tiredness.

1. Flu shots give you the flu.
Totally untrue. The vaccine does not contain live virus so it cannot cause the flu. However, many people will contract the cold or the flu around the time of their flu shot and link it to their flu shot.

The top medical myths [The Times]
(Photo: Getty)

No word yet on whether Target and Kroger (who also offer a $4 drug program) will match Walmart's new offer. Midwest grocery store chain Meijer offers some commonly prescribed antibiotics for free with a prescription.

Wal-Mart offers more low-priced drugs [Reuters]
(Photo: Aaron K Smith )

PPH Class Action: Not Too Late [LawyersAndSettlements]
(Photo: freerangestock.com)

When publishing their own clinical trials (designed, conducted, and sponsored by Merck), documents were found describing Merck scientists often working to prepare manuscripts and subsequently recruiting external, academically affiliated investigators to collaborate on the manuscript as guest authors. For instance, rial 078 (a randomized, doubleblind study to investigate whether rofecoxib could delay the onset of Alzheimer disease in patients with mild cognitive impairment) was designed and conducted principally by scientists at Merck. FIGURE 2 shows the title and author list both from draft and published versions of the manuscript describing the trial. Both the title and the authorship were modified to attribute authorship to 3 academically affiliated investigators (first, second, and third authors) on the published article, in addition to the 8 Merck scientists who are attributed authorship on both the draft and published versions of the manuscript (1 Merck scientist is attributed authorship on the draft but not the final manuscript). Of note, only 1 of the 3 academically affiliated investigators who are attributed authorship on the published article was acknowledged in the draft version as a participating investigator in the rofecoxib 078 study group. In an internal e-mail discussing where to publish trial 078 as the draft is circulated, one of the Merck scientists states, "I think you should be the first author since you have done virtually all of the writing." Although there are minor differences in language and organization between the draft and final versions of the manuscript (particularly in the abstract, as opposed to the text), the results presented are almost identical, reinforcing that the trial itself and the analyses were complete before the academically affiliated investigators were involved in the manuscript.

Guest Authorship and Ghostwriting in Publications Related to Rofecoxib (PDF) [JAMA]
Merck Wrote Drug Studies for Doctors [NYT]

WalMart advertises that generic prescriptions are just $4.00 for up to a 30 day supply. What they don't tell you is that it must be what they consider a "commonly prescribed dosage," so if your doctor decides you need a different dosage they count it as separate prescriptions. For example, if a pill comes in 10mg, 20mg or 40mg strengths and your doctor wants you to take 30mgs. WalMart counts that as 3 - 10mg prescriptions and charges you $12.00 for a 30 day supply.

The information about the dosage is not on the store signs, I found it on their website. Recently I had such a prescription filled; when I questioned the pharmacist about the price difference he became upset and was very rude to me.
Debra

Any pharmacists out there want to explain how this works?

Concerns over "behavioral issues" with Singulair developed over the past year. Merck periodically updated the drug's labels to include warnings for tremors, depression and anxiety. FDA spokesperson Susan Cruzan said reports of suicides by "three or four" people who were taking Singulair prompted Merck to clarify suicide warnings on labels and patient information sheets in October 2007.

"When the company does that and we think there's a reason to look at it, we'll go back and analyze the data," said Cruzan, who stressed that the FDA cannot prove a link between the Singulair and the reported suicides. "We are going back to review all of the data to determine whether there is a cause-and-effect relationship."

The current warning label on Singulair reads:

"The following additional adverse reactions have been reported in post-marketing use: Psychiatric disorders: agitation including aggressive behavior, anxiousness, dream abnormalities and hallucinations, depression, insomnia, irritability, restlessness, suicidal thinking and behavior (including suicide), tremor."

Doctors Not Concerned by US FDA Probing Safety of Merck's Singulair [ABCNews]

Shannon told her doctor and he called in a prescription to a different pharmacy and took care of the insurance. The doctor now tells all his patients to avoid CVS. "Now I go to a local independent pharmacy where the pharmacist knows me by sight," writes Shannon. "When you get a prescription filled, particularly at CVS, have them watch as you count the pills in front of them. You count your change, you check the bag to make sure you get the two apple pies you ordered from McDonalds, so it makes sense to make them wait and watch while you make sure you are getting what you pay so much for."

(Photo: Sexy Fitsum)

A lawsuit alleging fraud by the chain-drugstore company was brought by an Illinois pharmacist and joined by the federal government and 23 states that paid for the medication.

The complaint, filed in 2003 in U.S. District Court for Northern Illinois, alleges that CVS pharmacies switched Medicaid patients taking the generic form of stomach medication Zantac to capsules from tablets. Medicaid sets maximum reimbursement prices for the tablet form of the drug but not for capsules, which are more expensive but prescribed less frequently by doctors.

The suit alleges that the switch cost taxpayers as much as 400% more than what would have been paid for tablets. The pill-switching allegedly took place from April 1, 1999, through Dec. 31, 2006.

The case was brought by Bernard Lisitza, who worked as a pharmacist processing CVS prescriptions. Mr. Lisitza previously filed a suit against pharmacy company Omnicare Inc. that settled in 2006 for $50 million. Both suits were filed under the False Claims Act, which allows people to file claims alleging fraud against the government and lets them recover a share of any payments.

CVS denied wrongdoing.

CVS to Pay $36.7 Million Over Claim Of Improper Switch of Medications [Wall Street Journal]
(Photo:afagen)

Last week my mom told me about the unfortunate experience she had at Walgreen's. She had recently switched to a new antidepressant and when she came down with a cold was concerned about taking OTC cold medicine with it.

She went to the pharmacy counter and asked the pharmacist (at least she assumed it was the pharmacist, they were wearing the lab coat) if it was safe to take cold medicine with the Effexor. The pharmacist replied that they didn't know. Not exactly a helpful answer, but I am sure there was a valid reason they couldn't answer the question. What happened next was disturbing. My mom then asked if it would be ok to skip her Effexor for a day, so she could take the cold medicine without worrying. The pharmacist responded that "If you don't take that Effexor no one will want to be within 25 ft of you."

Now my mom isn't ashamed of her depression, can laugh about it and is comfortable talking about. But this made her extremely embarrassed and uncomfortable about using the pharmacy. My mom is not dangerously depressed, but this pharmacist should have known better than to say this to a depressed person. You never know how unstable a person is. My mom chose not to complain, but I thought this was an example of how one employee can really alienate a customer.

Thanks,

Beth

(Photo:meghannmarco)

Good Morning America

(Thanks to Cheryl!)

The "way in which we presented Dr. Jarvik in these ads has, unfortunately, led to misimpressions and distractions," Pfizer's president of world-wide pharmaceuticals, Ian Read, said. "Going forward, we commit to ensuring there is greater clarity in our advertising regarding the presentation of spokespeople."

Jarvik, who wore a white coat in the ads even though he isn't a licensed physician, and used a stunt-double for the rowing scenes in one commercial, isn't going quietly. He's issued a statement of his own. In it, Dr. Jarvik defends his use of a stunt double (The insurance company made him do it! Really!) and mourns his lost job:

I spent most of my summer vacation time during high school on the water, sailing, rowing, fishing, and scuba diving. At the time the ad was filmed, I was certainly fit enough to row for the shoot. I trained to row for it, and I intended to do so. But at the last minute, I was informed that the insurance carrier for the shoot would not permit me to row because the water temperature in the mountain lake at that time of year was about 40 degrees — so cold that if I had an accident, I could drown within minutes because of hypothermia. So the production company hired a rower experienced with that kind of racing shell for the distant shots. It never occurred to me that anyone would consider this dishonest. The message remains: heart health.

Recently, Pfizer chose to stop running the ads, through which I was able to appeal to so many viewers to pay attention to their heart health and to ask their doctors about Lipitor. My message has been sincere and correct — Lipitor can indeed help prevent heart disease in many millions of people, a great many of whom are not presently taking any cholesterol-lowering medication.

Jarvik: My Credibility Was Justified and Fairly Represented [WSJ Health Blog]

The NY Magazine article contains some pretty freaky stuff. It seems that, for some people, taking Chantix turns everyday life into a David Lynch movie. The FDA says "vivid, unusual, or strange dreams may occur while taking Chantix." The problem, it seems, is that for some people... these dreams don't just happen while you're asleep.

The next night, I nodded off listening to Radiohead's In Rainbows, feeling a little guilty that I'd paid zero dollars for it. I had a quick blip of a dream: A dark, inky fluid was jolting violently from the corners of my ceiling, zigzagging its way across the walls and wooden floor in jerky sync to the music.

It was only a dream, though it seemed more immediate and visceral than my usual fare, which I rarely remember after waking up. The following night, things got even stranger. I fell asleep with Bravo blaring on my TV and dreamed that a red-faced Tim Gunn was pushing me against the wall. "But I always thought you were so nice," I said.

By night four, my dreams began to take on characteristics of a David Cronenberg movie. Every time I'd drift off, I'd dream that an invisible, malevolent entity was emanating from my air conditioner, which seemed to be rattling even more than usual. I'd nap for twenty minutes or so before bolting awake with an involuntary gasp. I had the uneasy sense that I wasn't alone.

I smoked a cigarette, then tried going back to sleep. But each time I started napping, I'd dream that something increasingly ominous—carbon monoxide? Vampires?—was sucking vital essence out of me. Soon the clock on my desk read 3:20 a.m.

The most unsettling thing about sleeping on Chantix is that I never felt like I was truly asleep. Some part of me remained on guard. It was more like lucid dreaming, what I thought it might feel like to be hypnotized. And it didn't entirely go away come morning. As I showered, shaved, and scrambled into clothes, I tried to shake a weird, paranoid sense that I'd just been psychically raped by a household appliance.

FDA Issues Public Health Advisory on Chantix [FDA]
This Is My Brain on Chantix [NYmag]

Had a problem with my Mom's Medicare Part D Prescription Drug plan with Humana. Their mail order pharmacy (RightSource) advertises a two-week turnaround from date of sending-in an order to receipt of medications. However after three weeks, RightSource had not acknowledged receipt of the order. A RightSource phone rep said the logging-in of orders was being delayed by two to three weeks due to heavy volume. This delay — in the case of meds for a 93 year-old lady — was unacceptable.

I was able to find the email address for Humana's CEO Michael B. McAllister (who last year earned $3.33 million in compensation). The email is mmccallister@humana.com. I sent him an email which began with "Congratulations on Humana's record-breaking 2007 performance in membership, revenue and profit." I then explained my Mom's problem and asked for assistance. Within 24 hours I received an email from a customer care representative at Humana apologizing for the problem, telling me that my Mom's order had been located and that the order was being over-night shipped.

ABC News says that Dr. Jarvik has been paid a guaranteed $1.35 million for the ads, which feature him espousing the virtues of Lipitor in a doctoriffic-looking lab coat and rowing around a lake talking about "when diet and exercise aren't enough."

Here's our favorite part of the story—the New York Times says that Dr. Jarvik uses a stunt double when he's shown rowing in the commercials.

As it turns out, Dr. Jarvik, 61, does not actually practice the sport. The ad agency hired a stunt double for the sculling scenes.
"He's about as much an outdoorsman as Woody Allen," said a longtime collaborator, Dr. O. H. Frazier of the Texas Heart Institute. "He can't row."

Jodi, the Seattle-based casting agent, told me that I was everyone's first choice so far, but it was up to the client. And no, it wasn't my sterling (or tarnished) sculling technique that impressed them; by genetic luck of the draw and male-pattern baldness I was the best body double available for Dr. Jarvik, who it turns out is my age, an inch taller and five pounds heavier than I.

Naturally, Congress is very concerned about fake rowing—they're sending out letters to Pfizer's ad agencies to inquire about it, as part of their overall investigation into the Lipitor commercials. We guess they're worried because fake rowing would play into an overall picture of deceptive advertising.

In response to all the Congressional attention, Dr. Jarvik has been popping up on the morning chat shows and has even released a statement on his website defending his choice to shill Lipitor:

I do not practice clinical medicine and hence do not treat individual patients. My career is in medical science. I have earned Bachelors, Masters, and MD degrees, and I have received honorary Doctor of Science, Doctor of Engineering, and Doctor of Medicine degrees. I am presently President and CEO of the company that manufactures the Jarvik 2000 heart. I have collaborated closely with many top surgeons and cardiologists from dozens of leading medical centers in the United States, Europe, and Asia. I have been named Inventor of the Year and have received a Lifetime Research Achievement Award among other honors. The Jarvik 7 and Jarvik 2000 hearts have been displayed at the Smithsonian Institution as part of their exhibit called "Treasures of American History."

Statement by Dr. Jarvik Regarding his Role as Lipitor Spokesman [Jarvik Heart]
Dr. Robert Jarvik Lipitor Ad [NYT]
Drug Ads Raise Questions for Heart Pioneer [NYT via WSJ Health Blog]

"We need a way to synthesize data about the effectiveness of health care products and services in a standardized, objective fashion that will be considered reliable and trustworthy by all decision makers," said Dr. Barbara McNeil of Harvard School of Medicine, who worked on the report.

"A system coordinated by a single, national entity that can prioritize and coordinate these evaluations would enable us to sort the wheat from the chaff and make sense of it all," McNeil said in a statement.

"Report seeks one-stop source for health info" [Reuters]
(Illustration: Getty)