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AusPharm news

American Pharmacist's Association responds to FDA action on compounded HRT products : 17/01/2008 :

The American Pharmacists' Association (APhA) has issued a statement in response to warning letters sent to seven US pharmacy operations by the Food and Drug Administration (FDA) regarding the use of the term "bio-identical hormone replacement therapy" and the use of estriol in such products.

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Poll: keeping your cool : 16/01/2008 :

By golly we've had some hot days in Tassie in the last week or so and it hasn't exactly been 'cool' in Victoria or WA either. This got us thinking about medicines storage. Most medicines have a 'Store below 25°' stamp on them but what does this really mean? 

For many pharmacies, air conditioners keep both staff and shelf stock within permitted storage conditions. During working hours. 

But what about overnight? How do you handle this issue during summer in your pharmacy? Leave the air conditioner on? Does it matter? Please let us know what happens in your pharmacy by voting in this week's AusPharm poll at left

Win an AusPharm pen: What is this and how would you make it? : 15/01/2008 :

Thanks to those who sent along their enries yesterday. Entries are very light on from the under 50's so, come on you young folk, get your entries in!


In a post to AusPharmList on Tuesday Terry Irvine writes: "Individual powders, extemporaneous pills, suppositories, cachets, ointments, bulk powders, mixtures with tincture of opium - ah those were the days!"

Well, here's one for you Terry!

The script below was written by Dr David Leake on September 9, 1948 for patient Mrs Arnold (Bill's mum!) and duly dispensed by Cohen's Chemist in Tamworth and subsequently by DJ Coote Chemist in Barraba.


Two AusPharm pens are on offer for the best translation of the script complete with directions on how you would make the preparation. You must also say what you think the patient charge for this was and, also, what you would charge to make it in 2008.

One pen goes to the best entry from an over 50 year old and another for the best entry from an under 50 so please tell me which side of the line you fall when submitting your entries.

Click here to see an enlargement of the script. Click here to submit your entry. Click here to post a comment to AusPharmList.

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Progress towards shared electronic health records? : 15/01/2008 :

Health and Ageing Minister Nicola Roxon and Minister for Human Services Joe Ludwig yesterday announced that Medicare Australia had been contracted by the National E-Health Transition Authority (NEHTA) to develop a Unique Healthcare Identifier (UHI) service.

The UHI service will accurately and uniquely identify people who receive healthcare in Australia and the people who provide healthcare, as well as the places where it is provided. The UHI program is being developed to support progress toward the proposed establishment of a national Shared Electronic Health Records System (SEHR).

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Where to now with Nurof*en Plus? : 14/01/2008 :

Nur*fen Plus was in the news last week with claims that up to 5% of the Australian population could be addicted to the product. While the 5% claim sounds silly there is no doubt that the product is subject to misuse/abuse due to the high cod*ine content.

In our 'quickie' poll, run over the weekend we asked 'listers what should be done about this. The results, shown below, suggest that the majority of pharmacists think the present arrangements are inadequate, with only 14% of respondents ticking the 'things are OK' option. On the other hand, 24% thought that at least larger pack sizes should go S4 and almost half of those voting think that even small packs should be S3 (presently S2) with a limit of one per customer before medical (ie GP) review.

In a statement issued on Friday, Nuro*en's Plus manufacturer, Reckitt Benckiser point out that Nuro*en Plus is only available from pharmacies adding 'As part of their duty of care, the primary concern of the pharmacist is the health and wellbeing of consumers. This includes exercising professional judgment to prevent the supply of medicines likely to affect a consumer's health adversely or supplying excessive quantities of medicines particularly those which have a potential for abuse or addiction.'

So where to now? Reschedule to S3/4? Or, is it as Michael Scavone suggests in a post to AusPharmList today, that pharmacists need to be both better equipped and more prepared to say 'no' (see Kevin de Vries's article 15/2/207 'The role, responsibility and risk of saying 'No' as a practising pharmacist'. 


Aussie CMI better than UK or US CMI : 14/01/2008 :

'Listers have been scathing in their criticism of CMIs on AusPharmList over the years. Well....

Australian Doctor last week reported on a recent study published in the Journal of the American Pharmacists Association which found that Australian CMIs are better than those available in the UK or US.

The survey examined information for four drugs against US criteria, which required leaflets to include all relevant clinical information in an accurate and readable format for patients.

However, acording to Mr Ian Chalmers, CEO of Medicines Australia, although Austraian CMI was on the right track "The biggest problem now is making sure that consumers of prescription medicine actually receive CMI."

You can read the Australia Doctor article here.

US FDA acts on compounded HRT Drugs : 11/01/2008 :

The U.S. Food and Drug Administration (FDA) has warned seven US pharmacies that the claims they make about the safety and effectiveness of their so-called "bio-identical hormone replacement therapy," or "BHRT" products are unsupported by medical evidence, and are considered false and misleading by the agency.

FDA says that it regards the use of "bio-identical" as a marketing term implying a benefit for the drug, for which there is no medical or scientific basis. It says it is concerned that unfounded claims like these mislead women and health care professionals.

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Worker's compensation prescriptions: poll results : 11/01/2008 :

After discussion on AusPharmList about the intricacies of supplying 'Worker's Compensation' prescriptions in recent times this week's AusPharm poll asked 'listers how much of a hassle they were for them.

The results, shown below, seem to confirm that it's time to set in place more formal arrangements relating to supply and payment that are 'standard' across the industry. As the organisation representing pharmacies, the Pharmacy Guild would seem to be the appropriate body to progress this.

Post a comment to AusPharmList.

Poll: Nur*fen Plus : 11/01/2008 :

Nur*fen Plus has been in the news this week with claims that up to 5% of the Australian population could be addicted to the product. While the 5% claim appears, at face value, to be ridiculous (that's 210 'addicts' for every pharmacy in the country) there is no doubt that the product is subject to misuse/abuse due to the high cod*ine content.

What should we do to address this issue? Make it S4? Small packs only, all S3? Or is this all a beat up and there really isn't a problem? Please let us know what you think by voting in our snap poll. We'll publish the results on Monday morning.

ASMI: Tightening of controls over complementary medicines not warranted : 10/01/2008 :

On Monday, AusPharm reported on an article published in this week's Medical Journal of Australia in which the authors called for an urgent overhaul of the control and regulation of complementary medicines in Australia.

Dr Ken Harvey and co-authors said that CAMs should be assesses for efficacy at the time of market entry. This is not done at present and according to the authors this has the result that consumers are not able to make an informed choice about CAMs and lack protection from manufacturers who make claims not in accord with the scientific evidence available. They also called for a public education campaign to inform consumers about the current regulatory processes. 

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Poll: worker's compensation prescriptions : 09/01/2008 :

Over the last week or so there has (again) been discussion on AusPharmList about the intricacies of supplying 'Worker's Compensation' prescriptions.

Pharmacies have rules about the supply of all types of medications on the PBS (eg who is eligible, what is eligible, how much, how often, what conditions, what price, when payment is made etc etc). With Insurance companies pharmacies, seemingly, have no rules or minimal documentation (or anything!) in most cases. With insurance companies there is often only the word of the client and/or in some cases the 'case manager' to go on.

In most cases GPs, other health professionals and State Health have clear contracts which are very specific as to what can be supplied and what must be referred to the Insurance Company for approval. If you are a panel beater, you would have a contract with the insurance company. Is it time to set a standard system in place for the supply of 'worker's comp' prescriptions from pharmacies?

What do you think? Please let us know in this week's AusPharm poll.

Blackmores to trial embedded security tagging : 09/01/2008 :

Blackmores are to trial Radio Frequency (RF) labels on a small selection of their products. In a fax to retailers last week Blackmores said they were seeking stockists' 'support and feedback in this collaborative loss prevention measure'.

The RF tags will be embedded in the paper label for bottled products and applied to the inside of the cardboard carton for blister packed products. According to Blackmores these will trigger an alarm if the product passes through a detection field without being de-activated.

The trial is set to start this month.

Nur*fen Plus in the news : 09/01/2008 :

The Murdoch press ran with a big story on Nur*fen Plus yesterday, claiming that 'many Australians are feeding a secret and dangerous addiction to a popular over-the-counter painkiller.'

The story cites the case of a UK woman who died of ibuprofen induced renal failure after a long standing addiction to Nur*fen Plus. It also makes reference to two case reports in the current MJA describing perforated gastric ulcers caused by recreational misuse of Nur*fen Plus.

Surprisingly, on this occasion the News Ltd journalist has not gone after pharmacists who receive only passing mention in the piece. It will be interesting to see whether this story escalates in prominence in the next day or two or quietly fades away. The News Ltd story is here. The internet forum mentioned in the story is here.

NPS: Monitor and support patients on Champix : 08/01/2008 :

The National Prescribing Service Limited has urged health professionals to be aware that some psychiatric symptoms have been reported with the use of varenicline (Champix) and has advised them to monitor patients using varenicline for any behaviour and/or mood changes.

Varenicline must be prescribed as part of a comprehensive program which includes smoking-cessation support and counselling to maximise its effectiveness.

An NPS RADAR review released last Friday (click here) notes that with all new drugs, the full safety and efficacy profile is not known. Varenicline is a new drug in a new class of drugs, therefore some extra uncertainty exists about its safety profile.

For consumers, varenicline is reviewed in Medicine Update which was also released last Friday (click here).

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Hospital politics: and the pharmacists said..... : 07/01/2008 :

Congratulations to Brad Giblett who sent along the winning entry in our competition.

...the Pharmacists thought the idea was a prescription for disaster because it would simply compound the problem as clearly there was mortar this than meets the eye.

Brad wins a matching set of AusPharm pens.

Thanks to the many people who submitted entries, some of which are shown below.

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Tougher regulation of complementary medicines needed : 07/01/2008 :

An urgent overhaul of the control and regulation of complementary medicines is needed in Australia, according to an article published in the Medical Journal of Australia today.

Dr Ken Harvey, Adjunct Senior Research Fellow of the School of Public Health at La Trobe University in Melbourne, and his co-authors say the current controls on the supply and promotion of complementary medicines in Australia are weak.

Complementary and alternative medicines (CAM) are classified by the Therapeutics Goods Administration (TGA) as 'listed goods' and are not evaluated for efficacy. In contrast, 'registered medicines' are individually evaluated by the TGA for quality, safety and efficacy before market entry.

"Despite the widespread and increasing use of CAM, many consumers are unaware that listed medicines do not undergo the same stringent evaluation process as registered medicines", Dr Harvey says.

Dr Harvey's team found that, from 1996 to 2006, over 1000 CAM "weight loss" products were listed by the TGA; most contained multiple unevaluated ingredients (herbs, vitamins, minerals) of dubious efficacy. Promotional claims made about these products were often not in accord with the scientific evidence available. Over the same period, only nine conventional "weight loss" medicines were registered; each contained one evaluated ingredient of proven efficacy.

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Morp*ine/paracetamol combination fails in S3 bid : 04/01/2008 :

'Listers may recall back in September we ran a brief news item about an application that had been lodged with the National Drugs and Poison Scheduling Committee (NDPSC) to include a morp*ine/paracetamol combination product in schedule 3. The rationale for this was that 'slow metabolisers' of codeine should not be denied access to low-dose opioid OTC compound analgesics for mild to moderate acute pain.

The application was duly considered by the NDPSC at its October meeting with the outcomes published in December. The NDPSC decided that "...due to the lack of evidence provided about both the safety and efficacy of the substances in slow metabolisers of codeine and due to concerns regarding the abuse potential of the medications, the current scheduling of these substances remained appropriate."

Given the number of pharmacy break ins and hold ups in recent months, and the potential an S3 morp*ine would have had to add to these, the NDPSC decision sounds like a good one to us!

Poll results: 'missing' PBS scripts : 04/01/2008 :

This week's poll asked people how they handle missing PBS scripts when they are preparing their pharmacy's PBS claims.

As the results above show, people use a variety of techniques with 27% suggesting that there is a better way. Two of these 'better ways' have been suggested in the last couple of days by Mark Shaw and David Haworth.

Are there other strategies in use out there?

Hospital politics - win TWO AusPharm pens : 02/01/2008 :

We've reproduced below the first two verses of a lovely little story with a medical theme. We don't know the source but we have a problem in that the last paragraph is incomplete. We will giving away a matching set of our AusPharm pens (one blue, one brown) to the 'lister who can provide the 'best' conclusion by COB Friday.


When a panel of doctors was asked to vote on adding a new wing to their hospital, the Allergists voted to scratch it and the Dermatologists advised no rash moves.

The Gastroenterologists had a gut feeling about it, but the Neurologists thought the administration had a lot of nerve, and the Obstetricians stated they were all labouring under a misconception.

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What drove you craziest over Christmas? : 28/12/2007 :

This week's poll asked 'listers what they found hard to take in the lead up to Christmas.

'A number of things' is the answer with SN20D punters heading the vote. Certainly, in the pharmacy AusPharm calls home, the number of people with SN cards presenting with outside repeat scripts with 'last dispensing dates' well in the past is quite remarkable. AusPharm, for one, awaits with interest the December 2007 PBS data so we can see what effect SN20DR had on PBS volume.

Also presenting in larger than usual numbers on Christmas eve were patients needing DAA changes. In AusPharm's case one patient needed a new benzo Rx and both her GP and specialist were uncontactable. I'm sure other 'listers have similar stories to tell.

And finally, I'm sure we all gave a thought to those people in jobs where there was a 'civilised' winding down prior to Christmas.

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