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Specialty drugs now account for half of the cost of treating patients with rheumatoid arthritis (RA) or hepatitis C (Hep C), according to 2 studies presented by St. Paul-based Prime Therapeutics (Prime) and Blue Cross and Blue Shield of Minnesota at the Academy of Managed Care Pharmacy’s 25th Annual Meeting & Expo in San Diego, in April.

Medication errors and adverse drug events (ADEs) pose large threats to patient wellbeing and safety. Medication errors are the most common errors occurring in hospitals. Preventable ADEs are linked with 1 in 5 injuries or deaths. Medication errors occur at key points of transition during the hospital stay. 4-6 At one institution, failure to reconcile medications at transition points accounted for 50% of all medication errors and 20% of ADEs. Medication errors and ADEs are harmful, but also costly to the patient and the healthcare system.7 Complete and accurate medication reconciliation is crucial for reducing medication errors and ADEs

Implementation of a pharmacy service that provides dosing, monitoring, education, and ensured safe transition from the inpatient to the outpatient setting is associated with improved patient satisfaction with overall care and with care related to anticoagulation management, according to a study published in the Annals of Pharmacotherapy.

Although the prevalence of diabetes mellitus in hospitalized patients remains unknown, an estimated one-fourth of inpatients experience hyperglycemia.1 Hyperglycemia is linked to poor health outcomes, and there is evidence that intensive glucose control in the hospital reduces mortality, need for dialysis, infections, and length of stay.2 The American Diabetes Association (ADA) publishes clinical practice guidelines annually, which offer clinicians, patients, researchers, and payers current, evidence-based recommendations on all components of diabetes care, general treatment goals, and tools to evaluate the quality of care. The updated guidelines focus on changes in the recommendations for care of the hospitalized diabetes patient.

The appropriate use of specialty drugs is a major priority for health plans and will become increasingly important for future growth over the next 3 to 5 years, according to a comprehensive survey on payer approaches to specialty drugs. Furthermore, the research finds significant variation in what health plans view as emerging areas of opportunity to manage these drugs.

Total spending on medicines declined by 3.5 percent, according to the IMS Institute for Healthcare Informatics report, Declining Medicine Use and Costs: For Better or Worse?” report. In addition, nominal pharmaceutical spending reached $325 billion in 2012, or real per capita spending of $898, a decline of one percent.

On March 29, 2013, FDA approved canagliflozin (Invokana, Janssen Pharmaceuticals, Inc.), a once-daily tablet, indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

Women taking fourth-generation oral contraceptives, which use a progestin that is antiandrogenic, are at increased heart risk. The drugs significantly lengthen the corrected QT (QTc) by 3.6 milliseconds, according to a recent study in the Annals of Noninvasive Electrocardiology.

Teenagers who received DTaP (acellular pertussis vaccine) in their first 2 years of life had a 6 times higher risk of contracting pertussis compared with those who received DTwP (whole-cell pertussis vaccine) in their first 2 years of life, according to a study online in Pediatrics.

Older patients with chronic obstructive pulmonary disease (COPD) may be at increased risk for cardiovascular events with newly prescribed long-acting beta-agonists (LABAs) and long-acting anticholinergics (LAAs) and need to be followed closely by their healthcare providers, according to a study published online May 20 for JAMA Internal Medicine.

Obesity is a growing problem in the United States. Currently, 68% of adult Americans are overweight (BMI >25 kg/m2).1 Of those, 35% are obese (BMI >30 kg/m2) and 6% are morbidly obese (BMI >40 kg/m2). It is estimated that by 2030, 51% of the population will be obese and 11% will be morbidly obese.1 We are often confronted with dosing drugs in an obese patient. Unfortunately, many clinical trials exclude or have limited overweight patients enrolled; thus, optimal dosing for both safety and efficacy in this population is lacking. Pharmacokinetic studies in obese patients have shown that the volumes of distribution of lipophilic drugs and the clearance of hydrophilic drugs can be increased. For this reason, dosing in obesity should be patient- and drug-specific.

Decolonization of all intensive care unit (ICU) patients with antimicrobial soap and ointment significantly reduces all bloodstream infections, including methicillin-resistant Staphylococcus aureus (MRSA), according to a study published in the New England Journal of Medicine.

Men using long-term, high dose prescription opioids for back pain were about 50% more likely to be using medications for erectile dysfunction than men with back pain who were not using opioids, according to a study published in a recent issue of Spine.

Outpatient hemodialysis facilities realized a 32% decrease in overall bloodstream infections and a 54% decrease in vascular access-related bloodstream infections after Centers for Disease Control and Prevention (CDC) guidelines were used, according to a new study.

Soon after FDA expressed concerns over the higher dosages and safety profile, including daytime drowsiness, of the proposed sleep agent known as suvorexant (Merck), the Agency’s Peripheral and Central Nervous System Drugs Advisory Committee voted 13-3, with 1 abstention, in favor of the safety of 2 proposed starting doses of suvorexant - 15 mg in patients over the age of 65 and 20 mg in patients under the age of 65.

Sandoz is conducting a voluntary nationwide recall at the U.S. hospital/user level of 2 lots of its injectable methotrexate sodium, USP, 25 mg/mL, 40 mL vials, as a result of the discovery of particulate matter during routine quality examination of vials included among the manufacturer’s retention samples.

Sandoz has become the first company to gain the FDA approval to produce a generic version of Atacand (candesartan cilexetil), the popular heart drug that generated an estimated 120 million in domestic sales last year.

An examination of people’s behaviors as they relate to drug use in the 20th century has shown that people will expend a large amount of energy to acquire any agent that has the ability to alter their minds, bodies, or behaviors in order to achieve a euphoric effect.

The proposal of the investigational sleep agent called suvorexant (Merck), is believed to target sleep disturbances and insomnia through a different mechanism compared to the agents that are currently on the market, but FDA has concerns over the higher dosages of the drug and its safety profile.

Actavis Inc. announced May 20 its plans to acquire Warner Chilcott in a stock transaction deal, which is worth approximately $8.5 billion. The merger is expected to create a global specialty pharmaceutical company serving the women’s health, gastroenterology, urology, and dermatology therapeutic sectors, according to a joint company release.