GLG News by David Zimmerman, PharmD

Implications: This drug will allow patients in severe pain to get the necessary pain relief and not have to worry about the other patients that abuse the drug.

Analysis: I am a practicing pharmacist and remember the Talwin crisis about 20 years ago when the junkees were abusing Talwin as a pain medication. Talwin changed the medication to Talwin-NX by adding Naltrexone to the Talwin drug and the abuse was totally eliminated. I am sure if this drug is approved we will see the identical results.

Implications: It is important to understand the generic implications when it comes to drug product olacement on the formulary.

Analysis: I disagree with the previous analysis.

As soon as a generic come out, it is placed in tier 1 and the brand alternative is quickly placed in the highest tier or not covered at all.

As the director of clinical affairs for a PBM, I placed the generic Fosamax in tier 1 immediately. I placed Fosamax brand in tier 3 immediately.
I moved Actonel and Boniva to tier 2 now, and in 3-6 months will probably place Actonel and Boniva in tier 3.

With regards to profitability, I will MAC generic Fosamax (or another branded drug) when 3 manufacturers of the generic are available in the marketplace. This includes "authorized" generics too.

If a PBM offers full transparency, then the savings will be passed along to the client, and not kept by the PBM. It depends how the PBM contract was negotiated and what it says with the client.

Implications: This article is informative because it draws conclusions about Zyprexa.

Analysis: I have been a practitioner in the LTC arena for many years. Zyprexa, Olanzapine, in both injectable and oral forms are terrific drugs when used properly. There is no comparison between a drug like Haloperidol to this atypical antipsychotic.

Implications:     Physicians have been prescribing lower dose Cialis...off label... for a long time. The FDA finally agreed and approved it.

Analysis: It could change the industry by Viagra and Levitra developing a lower dose daily tablet.

Implications: Exubera is a great product. However, the delivery system was difficult to use and educate the patients how to use. Hopefully, the next generation of the product will be in a smaller more user friendly cannister.

Analysis: Inhaled insulin should be a great product for diabetics.

Implications: I know that Pfizer finally came out with the inhaled insulin after many years of hype. Unfortunately its launch and the product has been a flop, primarily because of the size if the inhaler. It is large and looks like a can of tennis balls. It is difficult for the patient to understand the dosing and usage as well. However, it was a good try for a first generation product. I think our country is getting better at managing diabetes with the new onset of drugs available.

Analysis: Soon there will be another inhaled insulin product in a smaller, easier to use inhaler.

Implications: I disagree with the Reuters article. Tamiflu is a safe and effective drug for the young and elderly population.

Analysis: According to the manufacturer literature:
A total of 4,187 subjects (adolescents, healthy adults, and elderly patients) participated in phase 3 prophylaxis studies, in which 1,790 subjects received the recommended dosage of 75 mg once daily for up to 6 weeks. Adverse reactions were qualitatively very similar to those seen in the treatment studies, despite a longer duration of dosing (see the following table). Reactions reported more frequently in subjects receiving oseltamivir than in subjects receiving placebo in prophylaxis studies, and more commonly than in treatment studies, were aches and pains, dyspepsia, rhinorrhea, and upper respiratory tract infections. However, the difference in incidence between oseltamivir and placebo for these reactions was less than 1%. There were no clinically relevant differences in the safety profile of the 942 elderly subjects who received oseltamivir or placebo compared with the younger population

Implications: Soma has been around for many years. Now we have a new strength? Probably because there is no generic available on the 250mg.

Analysis: We have used Soma  350mg and its generic for 20 plus years. The junkies started using this drug because of the abuse factor.
In the old days the drug was made by Wallace, now it was sold to Medpointe...and revived with a new strength. Clever marketing!
The current acquisition cost to a pharmacy of generic Soma 350mg is 0.03/tablet (3 cents). The current acquisition cost to a pharmacy of the new Soma 250mg is $2.25/tablet. Quite a difference in price!
Why would a physician prescribe it due to the price differential?
Why would a cash patient pay for it due to the price differential?
Why would a PBM put Soma 250mg on its formulary?
Good Luck.

Implications: Patients may have little understanding of a particular disease state or how to treat it, but with TV advertising they are asking their physicians to prescribe a particular advertised product which is usually quite expensive. There are usually comparable treatments available at a lower cost.

Analysis: As a practicing clinical pharmacist, I have years of experience in this area.