Pro Pharma Talks

QUESTIONS What do you do if you are insured? How do you afford copays and deductibles? What do you do if you are uninsured? Will Medicaid pay? Will Medicare pay? What if you are poor? What if you are an illegal immigrant? OUTLINE Public health experts predict that tens of thousands and possibly millions of people across the United States will likely need to be hospitalized for COVID-19 in the foreseeable future. And Congress has yet to address the problem. On March 18, it passed the Families First Coronavirus Response Act, which covers testing costs going forward, but it doesn’t do anything to address the cost of treatment. While most people infected with COVID-19 will not need to be hospitalized and can recover at home, according to the World Health Organization, those who do need to go to the ICU can likely expect big bills, regardless of what insurance they have. As the U.S. government works on another stimulus package, future relief is likely to help ease some economic problems caused b

Questions: What does it mean to map the progress of an epidemic? Is testing crucial? What is an algorithm that is used for predicting the progress of an epidemic? What is the difference between out-brakes and modeling? What happens after modeling? Outline – Notes: Data support Testing data to map a population # hospitalizations Deaths Past infectious disease progress Expert surveys Did lock down occur? Out-brakes vs. Modeling How many are going to get the disease? Out-brakes  -- % of current deaths Modeling  -- % of expected deaths based on looking backward Complicating Factors Social factors Geography Cultures _____ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: info@propharmaconsultants.com Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc

Vaccines vs. Treatment -Treatment vs. Prevention    -Treatment is not curative – examples are HTN, anti-diabetic medications, anti-asthma medications    -New options are antibody serum, gene PCR techniques    -Prevention – examples are vaccines, gene transformations -Vaccine manufacturing process    -Production technologies – using flu vaccine as an example       -Egg-based       -Cell based       -Recombinant     -https://www.cdc.gov/flu/prevent/how-fluvaccine-made.htm -Coronavirus vaccine    -Exploratory stage (2-4yrs)    -Pre-clinical stage – animal tests 1-2 yrs.    -Clinical development – ca. 30% make it    -Regulatory review and approval – sign off by FDA and CDC    -Manufacturing – FDA inspects factory and drug labels    -Quality control – quality

-Restrictions       oLimited doctor visits       oTelehealth for showing doctor your current medical signs and symptoms       oLimited medical access (lab) -Management       oCardiac Disease              -CHF: take weight daily – call MD if any increase in weight, then get an Rx for Lasix (Furosemide)              -High blood pressure – keep BP < 140/90 with home monitoring              -ASCVD/high cholesterol – keep diet low in fat              -Lose weight              -Comply with medication regimen            &n

What We Learned From Previous Epidemics / Pandemics Statistics 1918: 50M people killed HIV/Aids: 39M people since 1981 Poverty to risk Inadequate sanitation Poor nutrition Crowded living conditions Lack of healthcare services Poor infection control Lack of public infrastructure Poor governance Epidemics History (very frequent until recent times after 1950s) Cholera —1852-1860 Asian Flu – 1957 Typhus Fever – 1945 Cocolitzli epidemic – 1575 Plague of Justinian – 541 Antonine Plague – 165-180AD Third Plague Pandemic – 1855 Black Death – 1334 Great Flu Epidemic – 1918 HIV/Aids – 1960’s to present Pearls Management – calm, factual, frequent Immediate response!!! Early detection and monitoring – data, data, data! Factual communications from professionals Care isolation – Contact Quarantine Antisepsis / hand washing Social distancing Protective gear (masks, gloves, clothing) Pharmaceutical intervention Prohibit

What do we need to know about inhalant medications? Examples of inhalants = Respiratory for Asthma and COPD, Flonase for allergy, Afrin, Insulin, etc. What should we know about inhalants?  Particle size and why? Why are some drugs administered as inhalants, and some not? How to use them? Good compliance rules What are the general complications? What are the tests required to accompany medication management? What does success look like? _____ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: info@propharmaconsultants.com Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-talks

_____ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: info@propharmaconsultants.com Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-tal

 Corona Virus (2019-nCoV) 1. What it 2019-nCoV is? 2. How it spreads? 3. Vaccines 4. Prevention CDC Information 2019 Novel Coronavirus (2019-nCoV) is a virus (more specifically, a coronavirus) identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China. Early on, many of the patients in the outbreak in Wuhan, China reportedly had some link to a large seafood and animal market, suggesting animal-to-person spread. However, a growing number of patients reportedly have not had exposure to animal markets, indicating person-to-person spread is occurring. At this time, it’s unclear how easily or sustainably this virus is spreading between people.  The latest situation summary updates are available on CDC’s web page 2019 Novel Coronavirus, Wuhan, China. _____ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: info@propharmaconsultants.com Website: http://www.propharmaconsultants.com/ Face

Blood Shortage  1. Usage = 32K pints of blood used every day in US 2. Type of blood in short supply = Type “O” 3. Impact – 4.5M      a. 220mg-250mg of Iron lost for every donation – 24-30 weeks to replace iron      b. Normal Iron levels = 10-30 mmol/L (also ferritin < 10mcg/L) 4. Donor requirements (Red Cross) – Good health, weight >= 110 pounds, >= 17 years old      a. Eat iron rich foods (spinach, red meat, fish, poultry, beans, iron fortified cereals and raisins)      b. Drink an extra 16 oz fluids      c. Avoid fatty foods (hamburgers, fries, or ice cream)      d. No upper age limit 5. OTC and homeopathics, herbals, nutritional supplements are acceptable 6. Anti-depressants, Xanax, ADHD drugs -- OK 7. Restrictions (Red Cross) – anyone who has used self-injected non-prescription drugs, anyone who lived in UK for >= 3 months (and other parts o

Topics for Security Talk 1. PHI = personal health information 2. Security      a. Passwords – 8 characters can be hacked in less than 1 minute      b. Two Factor Authentication      c. Confidentiality refers to protection of information shared with an attorney, therapist, physician (or other) from being shared with third parties without express consent. ... Privacy, on the other hand, refers to the legal protection of personal medical information from being shared on a public platform.Mar 4, 2019 3. Privacy      a. Professional Code of Ethics           1. A pharmacist respects the autonomy and dignity of each patient. A pharmacist promotes the right of self-determination and recognizes individual self-worth by encouraging patients to participate in decisions about their health. A pharmacist communicates with patients in terms that are understandable.   

Medical Devices - BP meters, blood glucose monitors  - The basic regulatory requirements that manufacturers of medical devices distributed in the U.S. must comply with are:        - Establishment registration,        - Medical Device Listing,        - Premarket Notification 510(k), unless exempt, or Premarket Approval (PMA),        - Investigational Device Exemption (IDE) for clinical studies. - MEDICAL Devices        - Diagnostic equipment includes medical imaging machines, used to aid in diagnosis. Examples are ultrasound and MRI machines, PET and CT scanners, and x-ray machines. Treatment equipment includes infusion pumps, medical lasers and LASIK surgical machines. - Home Use Devices        - Safety & Efficacy        - Medical devices that are authorized b

What you need to know about Healthcare in 2020. ______ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: info@propharmaconsultants.com Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-talks

Topic:  Washing Hands - Goal – Prevention of infections and spreading disease - How – water 100 degF or 38 degC, soap (?) for 20 seconds - When           - Preparing food           - Using toilet or changing a diaper           - Blowing nose, coughing, sneezing           - Treat wounds or caring for a sick person           - Handling garbage           - Handling pets and their food - Hand Sanitizer           - Must have >= 60% alcohol           - Antibacterial sanitizer is OK when hands are not dirty - Antibiotic resistance           - Global health threat &nb

Update on HIV/AIDS HIV-1 is a more dangerous virus than HIV-2: AIDS developed in 54% of people with HIV-1 and 43% of people with HIV-2. After eight years, half of those with HIV-1 had died. In comparison, after 15 years, half of those with HIV-2 had died. The Food and Drug Administration (FDA) recently announced the approval of Dovato, the first complete two-drug HIV treatment regimen for people who previously have not been on antiretroviral therapy. Why is Dovato significant?  It offers the potential for these people to take their two-drug regimen in one single tablet. PrEP: Truvada is a brand-name prescription medication that's used for treating HIV infection. It's also used for preventing HIV infection in people who have a high risk of getting HIV. This use, in which the treatment is given before the person may be exposed to HIV, is called pre-exposure prophylaxis (PrEP). Antiretroviral therapy may soon be obsolete, as scientists have successfully used immune cells to kick the dormant form of H

Childhood Issues • Storage       o Keep out of reach       o Products not prescriptions       o Child-resistant packaging • Safety       o Administer as prescribed or labeled       o Use dosing device (teaspoon, tablespoon, measuring cup, etc.)       o Write clear instructions to caregivers       o Share info with babysitters, family, friends • Destruction       o Clean out used or expired medications       o Put in sealable bag and bring to pharmacies • Safe Administration       o Teach about always given by adult       o Rx not candy       o Drug use – storage, read drug label and facts, follow dosing instructions • Poisoning     &nbs

Compliance – Easy to talk about, but hard to do! o Drug Compliance – definition       o Same as compliance with doctor visits, lab draws, device use, BP measurements, BG measurements       o Take medications as prescribed by your doctor       o The best drug taken for the right reasons is no good, if it is not taken       o Education is primary method o History       o A problem for decades       o No general solution       o Unintentional non-adherence              o https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-12-98              o 62% forgot              o 37% ran out of medication

Statistics       o >30 million people in US, 1 in 4 don’t know they have it       o 84 million US adults have prediabetes, and 90% don’t know they have it       o 7th leading cause of death in US       o Type 2 diabetes accounts for 90% to 95% of all diagnosed cases       o # of adults diagnosed with diabetes has doubled with age and overweight/obese Risk factors       o Overweight       o >= 45 y/o       o Parent, brother, or sister with T2D       o Physically active < 3x/week       o Gestational diabetes (diabetes w/pregnancy) or given birth to baby weighing > 9 pounds       o African Americans, Hispanic/Latino Americans, American Indians, Alaska Natives, Pacific Islander

Topic:  Care Transitions What are care transitions?        -Acute to home or chronic care/step down        -Example:  Hospital to home Concern        -Don’t want patient to return to the hospital within 30 days for same problem       - Medicare refusal to pay for certain conditions to promote prevention  Issues        -Understand discharge orders        -Comply with discharge orders        -Drug coordination from pre-hospital, to in hospital, or post-hospital regimen        -Labs and services to follow up Examples        -Pneumonia & Serious infections – injectable to oral antibiotic,  antibiotics compliance, monitor for symptoms (temperature, swelling, pain, GI symptoms, dizzy/con

Value & Ethics in Drug Pricing       1. What is the argument between high prices and value?       2. How is value determined?              a. ICER              b. NICE              c. Cochran Reviews       3. How is pricing determined?       4. What is the ethical question?              a. Support prescription and prescriber’s plan              b. 20% of standard Rx are for off-label              c. 50% of cancer treatment is off-label or unapproved       5. Actions to bridge

Outline for OTC Talk What are OTC’s? Authorized for safety, not efficacy Many OTC were once prescription so effectiveness is ensured How should they be used? Oral – symptomatic Topical – low severity problems Cost-Benefit No doctor visit unless the condition does not improve No labs Buy generics if available Caution when paying for store-brand or private label as they cost similar to a brand Information Resource Pharmacists – them most educated in medication physiology, pharmacology and clinical effects Request OTC Formulary: https://www.123formbuilder.com/form-4856229/ ______ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: info@propharmaconsultants.com Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceut