Editorial: ACA Meeting

Last week I had the opportunity of attending the 2010 Annual Conference of the American College of Apothecaries (ACA) and the American College of Veterinary Pharmacists (ACVP). It was held at the KingsMill Resort & Spa in Williamsburg, VA. Wow, what a great place for a meeting and golf and boating and fishing and tennis and�and eating!

The program was excellent with presentations on new drugs, PCAB, pharmacists care, hypertension, financial management, and a whole series of presentations on veterinary compounding. It was well worth the trip for the program and fellowship with other pharmacists.

For those not familiar with ACA, their mission involves the translation and dissemination of knowledge, research data and recent developments in professional pharmacy practice for the benefit of pharmacists, pharmacy students, and the public. This is achieved through regular distribution of periodicals, development of major publications, and continuing education courses on clinical and administrative topics and conducting educational conferences. For those not familiar with ACA, the following are a few points of interest:

• ACA is clarifying and expanding membership opportunities. ACA has membership categories for pharmacists and nonpharmacists alike, and one does NOT have to be invited to join.
• Members need to support and agree to help promote the vision and mission of the College as ACA moves forward in a very responsible manner to meet the needs of its members.
• ACA is not just a compounding organization. While it does have many members who compound, some members do not compound. ACA promotes a professional pharmacy practice model.
• A major focus of ACA is veterinary pharmacy, which is promoted through the ACVP.
• ACA is not an elitist organization but tends to attract members who are strongly focused on specific professional practice initiatives, and because the organization is relatively small (less than 500 members), it is easy for members to network and build relationships that enable them to share ideas in a noncompetitive environment.

I have attended and spoken at numerous ACA meetings over the years and have always enjoyed doing so, and I have gained valuable information from them. ACA and ACVP generally have their meetings in very, very nice facilities that are "family-friendly." For more information, go to www.americancollegeofapothecaries.com.


Loyd V. Allen, Jr., PhD, RPh
Editor-in-Chief

Procrit and Epogen Recall
Certain lots of Epogen and Procrit (Amgen Inc.) sold by Johnson & Johnson are being recalled because they may contain "extremely thin" glass flakes. About 200 lots of Epogen are included but J&J said that shouldn't disrupt the supply of the drug to patients, nor will it have a material financial impact on the company.
http://online.wsj.com/article/SB10001424052748704523604575511852897470656.html

Low Testosterone Levels and Viagra
Low testosterone levels may be the culprit for many Viagra users. Low testosterone can be a sign of various health problems. It has been stated that more than half the Viagra prescribed to men is not working and men with erectile dysfunction could be wasting their money when their real issue is low testosterone.

Testosterone levels in men generally peak in their mid-20s and then slowly decline throughout life. Testosterone replacement therapy can be prescribed and can change the lives of patients.
http://www.bbc.co.uk/news/health-11404927

Seniors Get Drugs from Online Canadian Pharmacies to Cut Costs
Prescription eye medication for a 72-year-old patient jumped from $47.13 to $113.23 in the past nine months at his neighborhood drugstore. The patient found the same medication for $21.25 online at a Canadian pharmacy.

The patient, from Dallas, is one of an estimated 68,000 Texans who order drugs from online Canadian pharmacies each year, according to the Canadian International Pharmacy Association. As U.S. costs have risen, seniors in the North Texas area on fixed incomes say the only option they have is to get prescriptions filled online from Canada. Top-selling medications for high cholesterol and arthritis, like Lipitor and Celebrex, can be found online for half the prices seen at local pharmacies.

Actually, importing drugs from Canada is illegal, but the U.S. Food and Drug Administration does not prosecute people importing a 90-day supply of prescription drugs for personal use.

In some cases, many of the drugs are not actually coming directly from Canada as they are made to appear, but are being diverted from other countries. Canadian pharmacists may not really know where they are coming from. The general manager of the Canadian International Pharmacy Association stated that drugs cost less in Canada because the Canadian government has a system that absorbs some of the costs. The drugs from Canada cost 50 to 80 percent less than they cost in the U.S.

To address the safety concerns, the association has a program for checking pharmacies. Any patient can go to Canadadrugs.com and check for pharmacies with an oval red seal of the Canadian International Pharmacy Association. The seal is a "stamp of approval" by the Association and then patients can do their own price comparison.

The National Association of Boards of Pharmacy recommends finding a pharmacy that is a Verified Internet Pharmacy Practice Site (VIPPS). Not sure if it is a VIPPS? Go to vipps.nabp.net and paste the online pharmacy's address into the verification field at the bottom of the screen. Click "verify" for an immediate answer.

Finally, a website, LegitScript.com, keeps a database of pharmacy websites that are either approved, up for review, or deemed unacceptable. Recently, LegitScript.com had 51,928 pharmacy websites in its database, of which only 341 meet its approval; 1,088 are candidates for approval; and 50,499 do not meet standards set by the National Association of Boards of Pharmacy.
http://www.dallasnews.com/sharedcontent/dws/dn/latestnews/stories/
092810dnbuscanadadrugs.242e963.html

Ethics of Placebo Control Debated for Osteoporosis Trials
An important question today concerns withholding a therapy with proven effectiveness in preventing serious adverse outcomes in at-risk patients and can it ever be ethical?

This is a question of pressing importance for developers of new osteoporosis drugs, for whom placebo-controlled trials are the quickest and cheapest way to prove that an investigational drug reduces fracture risk.

Two Vanderbilt University researchers contend that clever study designs cannot change the fact that patients assigned to placebo would nearly always suffer more fractures than they would if they were taking an approved osteoporosis drug.

As a result, placebo-controlled studies will seem to nearly always be unethical. Can such trials be justified by regulatory preferences for placebo-controlled studies, the approval of local IRBs, or informed consent from the participants?

This is a difficult situation and there are interesting points on both sides. The Helsinki Declaration on research ethics allows for placebo controls as long as "no major harm" is expected.
http://www.medpagetoday.com/PublicHealthPolicy/Ethics/22482

�that drug shortages are threatening the health and safety of U.S. citizens? Drug shortages are now at an unprecedented high, particularly high-use medications which include emergency drugs, pain medications, and anesthetic agents.

Bring Drugs Home
Encourage the pharmaceutical industry to do what it takes to get drug API manufacturing back in the U.S. This may mean working with Congress to change some laws and by providing incentives to the chemical synthesis companies for gearing up to restore this vital function in our healthcare system.