Consumer/Provider Topics
Shepherd MD.* The effect of US pharmaceutical drug importation on the Canadian pharmaceutical supply. Can Pharm J. 2010 Sept/Oct; 143(5):226-33.
Abstract.
Background and objectives: For over a decade, many US politicians have advocated that the US allow personal and commercial drug importation. Currently, the only entities that can legally import a pharmaceutical in the US are pharmaceutical manufacturers. Our objective was to compare the number of prescriptions dispensed in Canada with the US and estimate the effect US drug importation from Canada will have on the Canadian drug supply.
Methods: A model was created to measure the potential effect on the Canadian drug supply. The model uses the number of US prescriptions being sourced from Canada and the number of prescriptions dispensed in Canada in 2007 as the baseline. The number of days to exhaust the 2007 Canadian drug supply was calculated.
Results: The model found that if 10% of the US prescriptions were fi lled from Canadian sources (manufacturer, wholesale or retail), Canada’s 2007 drug supply would be exhausted in 224 days. If the demand from the US reached 20%, the 2007 supply would be exhausted in 155 days. The model was redone focusing on brand name drugs, with generic drugs removed. It was found that with a US demand of 10% and 20%, the 2007 Canadian supply for brand name drugs would be exhausted in 268 and 201 days, respectively.
Conclusion: US drug importation is a threat to Canada’s drug supply. Even if the US demand were 10%, Canada would need to dramatically increase manufacturing, triple drug importation, or most likely control or halt pharmaceutical shipments to the US.
[...]Shepherd, MD*. Black medicine. AQ. 2010 Summer; 4(3):82-5.
The exploring Internet trade in counterfeit medicine.
When you’re sick, taking the right medicine is almost as important as finding a good doctor. But what if the medicine is fake? A black market in counterfeit or low-quality drugs is fast becoming the world’s newest health hazard.
[...]Sugita M, Miyakawa M. Economic analysis of use of counterfeit drugs: health impairment risk of counterfeit phosphodiesterase type 5 inhibitor taken as an example. Environ Health Prev Med. 2010 Jul; 15(4):244-51.
OBJECTIVES: The size of the market for counterfeit drugs throughout the world is considerable. Many cases of health impairment due to counterfeits have been reported. The market share of counterfeits in drug markets in developed countries is smaller than that in developing countries. However, the size of the market for counterfeits of phosphodiesterase type 5…
[...]Chaubey SK, Sangla KS, Suthaharan EN, Tan YM. Severe Hypoglycaemia Associated with Ingesting Counterfeit Medication. Med J Aust. 2010;192(12):716-7.
Cross-border importation of traditional and prescription medications is common, and many of these drugs are not approved by the Australian Therapeutic Goods Administration. Furthermore, counterfeit versions of prescription medications are also available (eg, weight-loss medications, anabolic steroids, and medications to enhance sexual performance). We describe a 54-year-old man with the first Australian case of severe…
[...]World Health Organization. Growing Threat from Counterfeit Medicines. Bull World Health Organ. 2010;88(4):247-8.
Lifesaving drugs are not exempt from the trade in counterfeit medicines. The World Health Organization (WHO) is working with Interpol to dislodge the criminal networks raking in billions of dollars from this cynical trade. Growing Threat from Counterfeit Medicines
[...]Ghodse H. Watching Internet Pharmacies. Br J Psychiatry. 2010;196:169-170.
The number of illegal internet pharmacies selling prescription-only medicines without a prescription is increasing. Large quantities of drugs are dispensed, making drugs of abuse readily available, and further risks are posed by counterfeit medication. Urgent national and international action is required to stop further proliferation of illegal pharmacies. Watching Internet Pharmacies
[...]Jackson G, Arver S, Banks I, Stecher VJ. Counterfeit phosphodiesterase type 5 inhibitors pose significant safety risks. Int J Clin Pract. 2010;64(4):497-504.
Counterfeit drugs are inherently dangerous and a growing problem; counterfeiters are becoming increasingly sophisticated. Growth of the counterfeit medication market is attributable in part to phosphodiesterase type 5 inhibitor (PDE5i) medications for erectile dysfunction (ED). Millions of counterfeit PDE5is are seized yearly and account for the bulk of all counterfeit pharmaceutical product seizures. It has…
[...]Liang BA.* Supporting Pharmaceutical Diversion and Counterfeiting Prosecutions: A Role for Medical Professionals. J Biolaw Bus. 2010;13(1&2): 55-57.
Law enforcement efforts to prosecute pharmaceutical diversion and counterfeiting have begun to emerge as an important deterrent. By enlisting health care providers, the team of law and medical professionals can ensure that the full extent of harms is known to the court, and conviction results in appropriate penalties for this particularly atrocious crime.
[...]Cheng MM. Is the drugstore safe? Counterfeit diabetes products on the shelves. J Diabetes Sci Technol. 2009;3(6):1 516-20.
It is no longer possible to identify counterfeit medical products, including medications and devices, by simply checking packaging and labeling. Improvements in technology have made it cheaper and easier to produce fake packaging and labels, making it nearly impossible for consumers and authorities to detect counterfeits without conducting tests on the products themselves, as illustrated…
[...]Winegar A, Shepherd MD*, Lawson KA, Richards K. Comparison of claim percent gross margin earned by Texas community independent pharmacies for dual-eligible beneficiaries claims before and after Medicare Part D. J Am Pharm Assoc. 2009 Sept/Oct; 49(5):617-2
Abstract. OBJECTIVES: To describe dual eligibles’ claims before and after Medicare Part D and to evaluate the effect that Medicare Part D has had on the claim percent gross margin (CPGM) earned by Texas community independent pharmacies.
DESIGN: Nonexperimental time series study.
SETTING: Texas, October 2005 through September 2006.
PARTICIPANTS: 313 community independent pharmacies.
INTERVENTION: Review of more than 150,000 Medicaid and 300,000 Medicare Part D claims acquired from a drug claims processor.
MAIN OUTCOME MEASURES: CPGM per prescription claim before and after the implementation of Medicare Part D, controlling for generic/brand drug status.
RESULTS: The mean CPGM for prescriptions dispensed before Part D (Medicaid claims) was 26.7%. The mean CPGM for claims dispensed after Part D (Medicare claims) was 17.0% (using ingredient costs in 2006 dollars) or 20.4% (using ingredient costs adjusted to 2005 dollars), a reduction of 36.3% and 23.6%, respectively. Under both Medicaid and Part D, pharmacies earned higher margins for generic drugs (39.9% and 29.5%, respectively) than for brand-name drugs (8.7% and 8.3%, respectively).
CONCLUSION: These results support community pharmacy assertions of lower reimbursements from Part D payers compared with Medicaid payers. Based on these results, pharmacies can respond to this evolving environment by carefully reviewing their Part D plans’ impact on CPGM and taking available steps to increase the proportion of generic drugs dispensed to Medicare beneficiaries.
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