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by Sterling Harpst, 2019 PharmD Candidate

There are many news stories about the digital currency Bitcoin, and some have heard of the technology behind it: blockchain. However, most people are probably unaware of the impact this technology could have on our society, especially within the field of healthcare. Demand for blockchain, is exploding, so let’s look at its potential applications to consider from a patient perspective.

What is Blockchain Technology?

The blockchain is a permanent and public database that shows all transactions that have ever taken place on it.

Think of it as a single spreadsheet that can be simultaneously accessed and edited by a network of computers all around the world. Each time a participant on the network enters a new transaction, the change is reflected on all spreadsheets in real time. What makes this unique is its decentralized nature. In contrast to traditional networks in which the spreadsheet is owned by a single company (i.e. a bank), the blockchain stores the original information in millions of locations at the same time, with no single owner. This ensures all information stored on the blockchain is public and verifiable. It also greatly increases the protection of data, preventing hackers from corrupting a central location that houses every file on the network.1

When a digital transaction or “block” is initiated, it can only be finalized on the spreadsheet if there is public consensus among other participants on the network. This consensus requires multiple decisions regarding whether the information being transferred from one party to another is accurate and decisions are then compared to one another. Once a threshold consensus has been reached, the data is time-stamped and permanently linked to the previous transaction, forming a chain of information that is impossible to alter.2 The blockchain “spreadsheet” can only be distributed to other participants in the network, rather than copied, which eliminates the possibility of altering data and allows for an unbiased and trustworthy source of transaction information. Therefore, this type of network eliminates the need for a middleman to perform these services.

Although this new type of system can be difficult to comprehend, it has the potential to change nearly every aspect of business. In the same way that e-mails can be sent without fully understanding the underlying technology, the blockchain can be used by anyone. This still begs the question for patients – how will it affect me?

How the Blockchain Will Impact Healthcare

Electronic Health Record (EHR)

One of the most significant problems with the healthcare system today is the lack of information sharing. As a patient, many individuals find it hard to understand why one doctor can access their entire medical history, while another has only incomplete notes regarding once yearly office visits. The middleman, in this instance, is the electronic health record company. These entities protect the information that is stored on their software to incentivize other businesses to adopt or pay for the ability to communicate with their program. This can leave patients with partial, mismatching records that hinder the doctor’s ability to provide the best care. Many companies, however, are now proposing the use of a blockchain to solve this problem.

As described earlier, the blockchain allows for a digital “spreadsheet” to be shared across computers with access to the same network. The spreadsheet in this instance, would represent the patient’s electronic health record (EHR). This blockchain network would be personally controlled by the patient, who could then grant access to doctors or other healthcare professionals as necessary. Patients would even have the ability to grant access to only certain parts of the health record, leaving out personal information that doesn’t pertain to the specialist they may be seeing. Once an appointment has concluded, the patient can then subsequently revoke privileges to see the information, if they so choose. Examples of companies pursuing this type of blockchain solution for EHR include Iryo, Patientory, Guardtime, Coral Health, Medicalchain, and more.3

Pharmacogenomics

In the new and growing fields of pharmacogenomics and genetic testing, current industry business models have prompted some to seek another use for the blockchain. 23andMe and AncestryDNA are a few of the most well-known genetic testing companies in the direct-to-consumer market today. By selling patients an opportunity to receive a genetic test through the mail, the need for prescriptions or consultation by a healthcare professional has become something of the past. What few patients know is, a significant portion of their revenue comes from selling the genetic information to pharmaceutical manufacturing companies for the purpose of conducting research. Pharma companies pay billions of dollars each year to obtain this information and use it to direct their future drug development efforts. Unfortunately, patients do not see any kickback revenue as a result.

This practice has prompted companies such as EncrypGen, Nebula Genomics and others to offer a unique answer to this problem. In their models, the “spreadsheet” would be the results of a genetic test. In the same way mentioned prior, patients could both allow and revoke access privileges for Pharma companies to this information. Instead of Pharma companies acting as doctors to use the test results to make clinical decisions, they would instead pay the patients directly for their data.3 This would incentivize patients to not only further research efforts but receive payment at the same time.

The Future of Blockchain in Healthcare

A new generation of healthcare technology companies have launched efforts to create an information structure that performs each of these functions and many more using the blockchain. From prevention of drug counterfeiting to managing data loss in natural disasters, startups are appearing across the country to fix problems that have plagued the healthcare system for decades. Many think this technology is coming to our businesses and personal lives very soon, while others believe it is far from being fully integrated. Either way, with the potential to revolutionize several different areas in healthcare and beyond, the blockchain is a technology worth paying attention to.

 

REFERENCES:

  1. Elliott C, Rosic A, Lind, et al. What is Blockchain Technology? A Step-by-Step Guide For Beginners. Blockgeeks. https://blockgeeks.com/guides/what-is-blockchain-technology/. Published June 22, 2018. Accessed June 25, 2018.
  2. Mearian L. What is blockchain? The most disruptive tech in decades. Computerworld. https://www.computerworld.com/article/3191077/security/what-is-blockchain-the-most-disruptive-tech-in-decades.html. Published May 31, 2018. Accessed June 25, 2018.
  3. Top 12 Companies Bringing Blockchain To Healthcare. The Medical Futurist. http://medicalfuturist.com/top-12-companies-bringing-blockchain-to-healthcare/. Published April 4, 2018. Accessed June 28, 2018.

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by Eli Kengerlinski, 2019 PharmD Candidate
University of Florida College of Pharmacy

Over the years, insulin prices have increased in accordance with newly developed insulins that have come to market. Traditional insulins, short and intermediate acting, as compared to newer rapid and long acting insulins, are less expensive in market value.1 Biosimilar traditional insulins with expired patents (some since 2000) may be a better option for some patients, as their market price has significantly dropped over the years. However, many patients are still having trouble affording their monthly Lantus or Humalog due to their high copays.

Why is insulin important?

Insulin plays an important role in managing patients with Diabetes Mellitus (DM). Patients with Type 1 DM have limited ability to produce endogenous insulin due to their pancreas’s inability to properly function. Patients with Type 2 DM can also have increased dependence on insulin therapy use as their disease state progresses. It is crucial for certain diabetic patient populations to have insulin at hand as they cannot control their sugar levels with just oral medications (eg. Metformin) that have no effect on insulin production. Type 1 DM population, there’s a greater need for basal (intermediate or long acting) as well as mealtime (rapid or short acting) insulin.

What options do you have?

Lifestyle modifications towards a healthier diet and exercise can be the most important changes any diabetic can make, and help ensure proper management of your condition. Monitoring your daily sugar levels, managing your weight via carb counting or following the plate method2, as well as exercising 30 minutes a day, five times a week, are all great habits to ensure effective DM management.

From January 2014 to July 2018, short and intermediate acting insulins have dropped in price equaling less than half of rapid and long acting insulins in the market today.1 Even if newer insulins offer better sugar control, their high prices make it difficult for patient access. For these specific patient populations, traditional insulins should be considered to ensure patient adherence to DM therapy and prevent patients using less of their insulin. If you’re having trouble paying for your insulin, then ask your provider if short and intermediate acting insulins would be right for you. Also contact your insurance company to see if you qualify for additional programs (eg. Medicare, Medicaid).

Furthermore, ask your provider if there are generic alternatives to your rapid or long acting insulin. For example, Admelog costs 12 to 15% less than Humalog while Basaglar costs about 15% less than Lantus on a per insulin unit basis.3 Therefore, it is important to ask for biosimilar generics that have the same active ingredient as they are usually cheaper.

Another affordable alternative to ensure access to insulin would be switching patients on high cost insulin pens to vials. Even though pens are more convenient and patient friendly, vials should be considered, especially if you’re having trouble affording your insulin. However, do ensure that you are instructed on how to properly inject your insulin.

If you’re still having trouble affording your insulin, ask your local pharmacist for a manufacturer savings card. If you need help with diabetic medications, visit www.wellrx.com for substantial prescription savings at pharmacies throughout the U.S. and Puerto Rico.

REFERENCES:

  1. Eisenberg Center at Oregon Health & Science University. Premixed Insulin Analogues: A Comparison With Other Treatments for Type 2 Diabetes. 2009 Mar 25. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007-. [Table], Price of Insulin. Available from: https://www.ncbi.nlm.nih.gov/books/NBK45287/table/clininsulin.tu1/
  2. Lara Hamilton. “How to Create Your Plate.” Diabetes Forecast, Nov. 2015, diabetesforecast.org/2015/adm/diabetes-plate-method/how-to-create-your-plate.html
  3. “Sanofi Launches Follow-On Insulin Lispro, Admelog.” The Center for Biosimilars Staff, 9 Apr. 2018, www.centerforbiosimilars.com/news/sanofi-launches-followon-insulin-lispro-admelog.

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By Pawel F. Kojs, PharmD Candidate Class of 2019,
University of Arizona College of Pharmacy

Morning sickness or nausea and vomiting in pregnancy (NVP) occurs in 70-80% of pregnant women.  In the United States, roughly 4 million women are affected each year.  This is more common in women that live in Western countries.1 A small percentage of women are affected each year with the more extreme form of morning sickness called hyperemesis gravidarum (HG).1

To help with this condition, there are many remedies to consider with your provider.

How can diet help with morning sickness?

With respect to diet, it is best to avoid large meals and eat smaller meals more often throughout the day.  Eating more protein and less fat is advised as well.2

Even though it’s difficult, eating foods that do not have a high flavor profile and ones that are low in fat helps reduce the time it takes for food to leave the stomach.  This in turn helps with reducing the amount of symptoms one would have with morning sickness.2

Which options can help me with morning Sickness?

There are different options to help treat morning sickness. Avoid smells, foods, tastes, and smells that trigger that nauseous feeling. Talk to your healthcare provider before taking any new prescription or over-the-counter (OTC) medications, and nutritional/herbal supplements.

Prescription Options

Disclaimer: Always consult with your provider before taking any medication during pregnancy.

OTC Options

These options for pregnancy related nausea and vomiting are commonly used. The types of medications are available at your neighborhood pharmacy, but it is recommended to monitor for drowsiness or sedation.

Disclaimer: Always consult with your provider before taking any medication during pregnancy.

Prenatal Supplements

It is advisable to talk to a doctor regarding getting a proper prenatal supplementation. You and your provider can discuss how much folic acid you should take. US Department of Health & Human Services Office of Women’s Health (DHHS) recommends taking at least 400 – 800 micrograms of folic acid daily, starting at least three months before conception.3 Prenatal supplements should be taken on an empty stomach. If you experience stomach upset, try taking it before bed with a light snack.

References:


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does sunscreen cause cancer - scriptsave wellrx blog image

by Pattiya Wattananimitgul

According to the Centers of Disease Control and Prevention (CDC), approximately 5 million Americans are treated with skin cancer each year.1 Overexposure of ultraviolet (UV) rays from the sun is proven to be a major cause of skin cancer.2 In fact, approximately 90% of all skin cancers are associated with exposure to the sun’s harmful rays.3 One way to protect your skin from the harmful UV rays is wearing a sunscreen. However, you may have heard that ingredients in sunscreens can cause cancer, and not just skin cancer but also breast, prostate, and other types of cancer.4 But is it true? Does sunscreen, which is supposed to protect us from skin cancer, actually lead to cancer and other health problems?

Oxybenzone

Oxybenzone is a common active ingredient in sunscreens that absorbs the UVA and UVB radiation and then dissipates it as heat.5 Oxybenzone penetrates through the skin, and then gets metabolized and excreted through urine and feces.6 Some studies suggest that oxybenzone may have an impact on the endocrine system, disrupting hormone levels and potentially causing hormone-related cancer. These studies were actually done on rats. A human study suggested that oxybenzone, even at a high concentration, does not cause hormone disruption. The conclusion is that oxybenzone is an FDA-approved chemical to protect your skin from the sun’s radiation, and currently there is not enough evidence to prove or suggest that oxybenzone causes hormone disruption and cancer in humans.3,7,8

Retinyl Palmitate

Retinyl palmitate is another ingredient commonly added to sunscreens as a skin conditioner. It is a form of vitamin A, known to help slow down premature skin aging. There is some concern, based on a small number of studies, that the free radicals generated from retinyl palmitate may cause changes to our cells and cause skin cancer. However, no studies suggested that these changes are cancerous or increase cancer risks.3,7,8 In fact, a form of vitamin A called retinoids has been used for decades to help protect people with high risk of developing skin cancers from getting skin cancer, according to the American Academy of Dermatology.9

Zinc Oxide and Titanium Dioxide

Zinc oxide and titanium dioxide are nanoparticles that physically protect your skin from UVA and UVB radiation. Some studies indicated that these active ingredients can be absorbed in the skin and cause cells damage. However, according to current studies, these nanoparticles stay on the skin’s surface and do not penetrate the skin when applied.3

Protect Yourself from UV Rays

The main takeaway is that you should always wear sunscreen when going outside, even when it’s cloudy. The known benefits of regular sunscreen use outweigh the unproven risks of potential toxicity. The type of sunscreen you use is up to you, whether it is chemical or physical. However, make sure the ingredient protects both UVA and UVB radiation (broad-spectrum) with SPF of at least 30. Below is a chart by the Skin Cancer Foundation of US Food and Drug Administration (FDA)-approved active ingredients that can be found in sunscreen and their UV action spectrum.3 When using sunscreen, make sure to cover all the exposed skin and reapply the sunscreen every two hours, or right after swimming or sweating. Other ways to protect yourself from the harmful UV rays are9:

  • Seeking shade between 10 a.m. to 2 p.m., when the sun’s rays are strongest
  • Wearing protective clothing such as lightweight long sleeve shirt, pants, broad-brimmed hat, and UV-protection sunglasses
  • Avoiding tanning beds

active ingredients in sunscreen - scriptsave wellrx blog image

Warwick, M. L., MD, MB, & Wang, S. Q., MD. (2011, November 11). Suncreens: Safe and Effective?
Retrieved August 6, 2018, from https://www.skincancer.org/prevention/sun-protection/sunscreen/sunscreens-safe-and-effective

Resources

  1. Cancer Prevention and Control. (2015, September 03). Retrieved August 6, 2018, from https://www.cdc.gov/cancer/dcpc/research/articles/sunscreen-use.htm
  2. The Facts About Sunscreen. (2018, January 11). Retrieved August 6, 2018, from https://www.melanoma.org/understand-melanoma/preventing-melanoma/facts-about-sunscreen
  3. Warwick, M. L., MD, MB, & Wang, S. Q., MD. (2011, November 11). Suncreens: Safe and Effective? Retrieved August 6, 2018, from https://www.skincancer.org/prevention/sun-protection/sunscreen/sunscreens-safe-and-effective
  4. Do Sunscreens Cause Cancer? (2018, June 12). Retrieved August 6, 2018, from https://sciencebasedmedicine.org/do-sunscreens-cause-cancer/
  5. How does sunscreen work? (2017, August 14). Retrieved August 6, 2018, from http://www.loc.gov/rr/scitech/mysteries/sunscreen.html
  6. Jiang, R., Roberts, M. S., Collins, D. M., & Benson, H. A. E. (1999). Absorption of sunscreens across human skin: an evaluation of commercial products for children and adults. British Journal of Clinical Pharmacology, 48(4), 635–637. http://doi.org/10.1046/j.1365-2125.1999.00056.x
  7. Janjua, N. R., Mogensen, B., Andersson, A., Petersen, J. H., Henriksen, M., Skakkebæk, N. E., & Wulf, H. C. (2004). Systemic Absorption of the Sunscreens Benzophenone-3, Octyl-Methoxycinnamate, and 3-(4-Methyl-Benzylidene) Camphor After Whole-Body Topical Application and Reproductive Hormone Levels in Humans. Journal of Investigative Dermatology,123(1), 57-61. doi:10.1111/j.0022-202x.2004.22725.x
  8. Can the chemicals in sunscreen cause cancer – Canadian Cancer Society. (n.d.). Retrieved August 6, 2018, from http://www.cancer.ca/en/prevention-and-screening/reduce-cancer-risk/make-healthy-choices/be-sun-safe/can-the-chemicals-in-sunscreen-cause-cancer/?region=on
  9. Is sunscreen safe? (n.d.). Retrieved August 6, 2018, from https://www.aad.org/public/spot-skin-cancer/learn-about-skin-cancer/prevent/is-sunsceen-safe

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imprtance of iodine - scriptsave wellrx blog image

by Marcus Harding
PharmD Candidate Class of 2019, University of Arizona

What is Iodine and why is it important?

You may be wondering, “Why do I need iodine in my salt or other food?” Iodine is an essential element our bodies need that we cannot produce on our own, and therefore need to get it from food sources1. Iodine is needed to produce the thyroid hormone, which is important for bodily functions related to metabolism and how our cells use the energy they are given1. Iodine is found in foods such as cheese, milk, eggs, ice cream, saltwater fish, iodized table salt and some multivitamins1. Most people get their daily intake of iodine from iodized table salt1. There is, however, a large population of people who have heart disease or high blood pressure, who are asked by their doctors to not consume as much salt as others.

Who should reduce their salt intake and by how much?

iodized salt - scriptsave wellrx blog image

Heart disease and high blood pressure afflict a large percent of the U.S. population today. The American Heart Association’s (AHA) Heart disease and Stroke Statistics of 2018 estimates that 31.1% of the world’s population has high blood pressure, and they predict that by 2035, more than 45% of the US population will have some form of cardiovascular disease2. It is because of these abnormally high numbers that the AHA has diet and lifestyle recommendations for being “heart healthy,” that they recommend to everyone, not just people who have heart disease or high blood pressure.

One such recommendation is to reduce the amount of sodium consumed each day. Sodium can cause water retention in your body, increasing blood pressure and making your heart work harder than it needs to3. The average American consumes more than 2,400 milligrams of sodium per day. The AHA recommends having less than 1,500 milligrams per day3. For reference, 1 teaspoon is about 2,300 mg of salt. The AHA reports that the body really only needs about 500 milligrams per day, so eating a heart healthy diet will still get you enough sodium to meet the daily requirements3.

How do I get enough Iodine on a low sodium diet?

So, what can you do to make sure you get enough iodine daily, while eating a heart healthy diet?  It is simple. The body needs 150 micrograms of iodine per day1. For reference, a teaspoon of iodized salt contains about 400 micrograms of iodine1. If you wanted to cut out salt in your diet and be under 1500 milligrams of salt per day, that is still at least 260 micrograms of iodine per day, which is greater than the 150 micrograms a day that your body needs. Keep in mind that the majority of people in the US are getting such large amounts of sodium through salty snacks, processed meats, and the typical “unhealthy foods” that the AHA is trying to help people avoid. Make sure that the sodium you do consume is iodized so that you are reaching that 150-microgram daily recommendation.

Overall, there is no need to fear not getting enough iodine while restricting sodium in your diet, as long as you make sure the salt you eat is iodized, and not coming from processed meats, potato chips and other salty snacks. Following the American Heart Association’s recommendations, you should still be getting more than the recommended daily amount of iodine. If you are concerned about the amount of iodine in your diet, there are multivitamins out there that contain 150 micrograms that can be taken daily.  As always, if you have any questions or concerns, your local pharmacist is well equipped to answer your questions and help guide you in the right direction.

 

References

  1. “Iodine Deficiency.” American Thyroid Association, http://thyroid.org/iodine-deficiency/.
  2. Benjamin, Emelia J, et all. “Heart Disease and Stroke Statistics— 2018 Update: A Report From the American Heart Association.” American Heart Association, 2 Mar. 2017, http://circ.ahajournals.org/content/137/12/e67.
  3. “How Much Sodium Should I Eat per Day?” Sodium Breakup, http://sodiumbreakup.heart.org/how_much_sodium_should_i_eat.

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by Robert “Jed” Swackhammer, Ohio State University

Many patients think that only pharmacists work at pharmacies. However, there is much more that goes on behind the pharmacy counter. In fact, most pharmacies include a team of trainee technicians, registered technicians, certified technicians, student pharmacists, and pharmacists. A common question is, what are the differences between technicians and why they are important? This answer is an essential reason why pharmacies can run safely, effectively and efficiently.

More Than Just a Cashier

A pharmacy’s foundation starts with the development of its technicians. To initiate the process, an individual must have, at minimum, a high school diploma or equivalent to become a technician. But we should also consider the required skills. In Florida, for example, The Rasmussen Pharmacy Technician College states that skills required of technicians and are “frequently defined as clerical, customer service, critical thinking and basic medical knowledge.”[1]

Preceding the application process, an individual must first complete pharmacy training, and is titled as a technician in training or a trainee technician. So to be considered a registered technician, most states require trainee technicians to register with their state board of pharmacy.[2] However, it’s always important to check your states requirements, as they may change. Lastly, to become a certified pharmacy technician, one must take and pass the national certification exam provided by the Pharmacy Technician Certification Board (PTCB). After passing the exam, a pharmacy technician is entitled to apply to any available pharmacy technician position within the nation.

Providing Optimal Care

Knowing what it takes to become a pharmacy technician, it is also reasonable to recognize their value to the pharmacy team. The Bureau of Labor Statistics states that the need for pharmacy technicians will continue—specifically an increase in 12% from 2016-2026, due to the number of pharmacy schools and graduating pharmacists. As a result, it is vital that we meet this balance, so that pharmacists within pharmacies can continue to provide optimal patient care. Especially, by utilizing pharmacy technicians, as they always help to relieve pharmacists of certain tasks and responsibilities.[3]

Recognizing Value

For this reason, it is vital that current and future pharmacists recognize the value of their pharmacy technicians. Moreover, it is important that pharmacists challenge technicians and their knowledge, skills, abilities and other characteristics (KSAOs) to keep them engaged and up-to-date.[4]

For example, in 2017, the Journal of the American Pharmacists Association published a summary article of the Pharmacy Technician Stakeholder Consensus Conference. This article stated that more than “44,000 pharmacy technicians answered 1 of 2 surveys related to job analysis, which assessed how frequent specific tasks were being performed. Additionally, the PTCB stated that they will continue to analyze job analyses to help develop better pre-certification requirements and future certification programs in advanced community pharmacy and sterile compounding.”[4]

It is vital that student pharmacists and pharmacists recognize their technicians to drive the profession forward and continue to deliver optimal patient care.

 

References

[1] Koehler, T.C., Research in Social and Administrative Pharmacy (2018), https://doi.org/10.1016/j.sapharm.2018.06.017

[2] Pharmacy Technician License Requirements by State. Pharmacy Times. https://www.pharmacytimes.com/technician-news/pharmacy-technician-license-requirements-by-state#wa. Published 2015. Accessed August 6th 2018.

[3] Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Pharmacy Technicians, on the Internet at https://www.bls.gov/ooh/healthcare/pharmacy-technicians.htm. Accessed August 6th 2018.

[4] Zellmer W, McAllister E, Silvester J, Vlasses P. Toward uniform standards for pharmacy technicians: Summary of the 2017 Pharmacy Technician Stakeholder Consensus Conference. Journal of the American Pharmacists Association. 2017;57(5):e1-e14. doi:10.1016/j.japh.2017.06.014


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Chances are good that you are spending too much on your prescription medications. Every day we receive phone calls, emails, and comments on Facebook about the staggering prices people pay for the medications they need. People are struggling. We get it. That’s why we launched ScriptSave WellRx – to bring prescription savings to everyone.

How Does It Work? Who Can You Trust? Are Prescription Savings Cards Legit?

There are a lot of companies in the discount prescription space, so how do you know who to trust? How do prescription saving cards work? The short answer is, we negotiate discounts on bulk drug purchases with pharmacy owners at more than 65,000 pharmacies nationwide. The discounts we’ve negotiated are off the cash prices for your medications. More affordable prescriptions bring in more customers who buy more, so it pays off for the pharmacies.

You can feel safe with the resources we share and savings we deliver. ScriptSave WellRx is part of Medical Security Card Company, LLC; bringing some of the most advanced technology, pharmacy expertise and customer service in the industry for the past 25 years.

ScriptSave WellRx in the News

A recent article on prescription costs and savings from The Mighty1 highlights how widely prescription prices can vary between discount companies. Check out their comparison on the medication, Savella:

Savella (Milnacipran)

Savella is a nerve pain and antidepressant medication often used to treat fibromyalgia. Currently, only the brand version is available.

savella pricing scriptsave wellrx prescription savings image

 

How Much Will You Save?

Try our free price comparison tool to see if we can help you save. The ScriptSave WellRx program is FREE to all patients, and the price-check tool is available 24/7, without the need for an account or any personal details. In other words, the program can be used risk-free and with nothing to lose. We even provide free medication management tools, refill reminders and an “Ask a Pharmacist” helpline. We’re doing our best every day to help patients get safe, hassle-free savings.

 

References:

  1. How to Save Money on Your Prescription Drug Costs – The Mighty
    https://themighty.com/2018/08/how-to-save-money-prescription-drug-costs/

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Epidiolex: A new CBD epilepsy drug

by Roxanna Orsini,
PharmD Candidate Class of 2019, University of Arizona

Treatments are available that can successfully control seizures for most people with epilepsy. However, there’s a soon-to-be-released medication, recently approved by the FDA, called Epidiolex.

What is Epidiolex?

Epidiolex (cannabidiol) is a new FDA-approved epilepsy medication that is derived from Cannabis Sativa plant (marijuana). Cannabidiol (CBD) does not create feelings of euphoria or intoxication, the “high” that is often experienced with Cannabis, which comes mainly from the compound tetrahydrocannabinol (THC), which is also found in marijuana.

Which forms of epilepsy does Epidiolex treat?

The FDA approved Epidiolex for treatment of seizures associated with two rare and severe forms of epilepsy, in patients two (2) years and older.5

  • Lennox-Gastaut Syndrome
    • Begins in childhood and continues to adulthood with some changes in presentation with age.3
    • Often characterized by multiple types of seizures (particularly tonic and atonic) and an intellectual disability.
    • An EEG (electroencephalogram) can display a classic pattern of background slowing and spike-wave bursts with frequencies less than 2.5 per second. 2
    • Found in 2-5% of childhood epilepsies.2
  • Dravet Syndrome
    • Begins during the first year of life and is a lifelong disease.3
    • This is a rare genetic epileptic brain disease.
    • Infants will have normal development up until an increase in seizure frequency occurs after the first seizure which is often associated with a fever. 1
    • Most children develop some level of developmental disability.
    • Seizures can be triggered by various factors such as body temperature, emotional stress or excitement, and photosensitivity.1

Coming Soon!

While Epidiolex has been approved for release, the expected time to market is September 2018. A few things to know about the medication before it is released:

Effectiveness

The study for Epidiolex involved 3 randomized, double-blind, placebo controlled clinical trials which included 516 patients who had either Lennox-Gastaut Syndrome or Dravet Syndrome.3 Results showed that patients taking Epidiolex along with other anti-epileptic drugs (AEDs) showed a decrease in seizure frequency when compared to the placebo.3

Precautions

Side effects (3,5) are often something to be aware of before starting a new medication. A few reported side effects to Epidiolex include:

  • Elevated liver enzymes
  • Sedation
  • Lethargy
  • Sleep Disorders
  • Diarrhea
  • Rash
  • Increase in suicidal thoughts
  • Decrease in appetite
  • Abdominal discomfort
  • Abdominal pain

Cost

The company has not release any official information about cost for Epidiolex, however NY Times analysis estimates a cost of $2,500 to $5,000 a month.4 It is possible that this medication may be approved by insurances so make sure to discuss options with your provider.

Future Opportunities

Even though this medication is only currently approved for these two forms of seizures, it does open the door to future possibilities.  Always keep communication open with your healthcare provider so they can help guide you on therapy options as more clinical studies arise with new information.

 

References:

  1. Epilepsy Foundation. (2018). Dravet Syndrome. [online] Available at: https://www.epilepsy.com/learn/types-epilepsy-syndromes/dravet-syndrome [Accessed 11 Jul. 2018].
  2. Epilepsy Foundation. (2018). Lennox-Gastaut Syndrome (LGS). [online] Available at: https://www.epilepsy.com/learn/types-epilepsy-syndromes/lennox-gastaut-syndrome-lgs [Accessed 11 Jul. 2018].
  3. FDA.gov. (2018). FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy. [online] Available at: https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm611046.htm [Accessed 10 Jul. 2018].
  4. Kaplan, S. (2018). D.A. Panel Recommends Approval of Cannabis-Based Drug for Epilepsy. [online] Nytimes.com. Available at: https://www.nytimes.com/2018/04/19/health/epidiolex-fda-cannabis-marajuana.html [Accessed 5 Jul. 2018].
  5. Micromedexsolutions.com. (2018). Micromedex Products: Please Login. [online] Available at:
    http://www.micromedexsolutions.com/micromedex2/librarian/CS/B42F8E/ND_PR/evidencexpert/ [Accessed 5 Jul. 2018].

 


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Employers and preventive care - blog image - ScriptSave WellRx

by Benjamin Liang
PharmD Candidate Class of 2019, University of Arizona

Every year, employers are paying more to have their employees insured. A study on the annual growth rate of health care costs found that employers are experiencing 5%-to-6% increases in healthcare costs per year.Early estimates suggest employers will spend over $730 billion on health benefits in 2018 alone.

Curbing Healthcare Costs

Growing health care costs can impact both employees and companies:

  • Employees are becoming more concerned because some of the costs are being passed on by the employers.
  • Increasing costs are pushing large employers to be more involved in healthcare, instead of relying on insurers.
  • As companies grow and costs increase, the amount spent on health benefits will follow suit.  

Saving Money While Providing Better Care

Companies are tackling the increases in health care costs by negotiating with healthcare providers without going through a middleman. By skipping the insurer, large employer groups are spending less and creating a direct path to health care services for  their  employees. These new plans are becoming more prevalent in areas such as the Silicon Valley, where large employee populations can be monitored day-to-day in the work environment.

Healthcare providers are being stationed inside the work space for enhanced patient monitoring, and clinics are being built into the work environments to create better access to healthcare services. The new patient-focused  care plans strive to prevent health conditions, rather than treating problems after they appear. Monitoring employees with  routine check-ups generally costs less than rushing them to the hospital for emergency services.

In California, a partnership between a large employer and a hospital offers a plan that requires healthcare providers to track multiple health indicators on a consistent schedule to prevent unexpected healthcare costs.Many employees are reluctant to switch to a plan that further restricts where they can receive health benefits, but employers are providing incentives to lower the costs to employees.

Some of the incentives include lower monthly premiums and copays. Clinics within the workplace often include necessary amenities for healthcare providers to perform general check-ups, physical therapy, and promote an all-inclusive body, mind, and spirit preventative healthcare approach.

What Can We Learn from Large Employers?

Current healthcare plans that support constant monitoring have allowed employers to save money by reducing high-cost services. Many employers are trying to move towards preventing health conditions rather than treating them after they appear. They are also addressing the inherent conflict for providers, where prevention of expensive healthcare costs reduces the number patients taking part in more profitable care such as emergency services. As we watch these new health plans continue to grow we can observe the benefits of constant monitoring and prevention. If employers continue to promote these plans due to improved health outcomes and costs savings, we may want to take a more preventative approach to our own healthcare.

References

  1. Barnes, K., Judy, R., & Isgur, B. (2018, June 15). Medical Cost Trend. Retrieved from PWC: https://www.pwc.com/us/en/health-industries/health-research-institute/behind-the-html
  2. Caspani, M. (2018, June 15). Soaring costs, loss of benefits top Americans’ healthcare worries: Reuters/Ipsos poll. Retrieved from Reuters: https://www.reuters.com/article/us-usa-healthcare-worries/soaring-costs-loss-of-benefits-top-americans-healthcare-worries-reuters-ipsos-poll-idUSKBN1JB1FD
  3. Humer, C. (2018, June 11). Fed up with rising costs, big US firms dig into health care. Retrieved from Reuters: https://www.reuters.com/article/us-usa-healthcare-employers-insight/fed-up-with-rising-costs-big-u-s-firms-dig-into-healthcare-idUSKBN1J70ZZ

If you’re struggling to afford your medications,
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Your child's medication during school hours - ScriptSave WellRx blog image

by Pattiya Wattananimitgul

How to Handle Your Child’s Medication During the School Year

In the United States, more than 263 million prescriptions are dispensed each year for pediatric patients.1 Chances are, your child may need to take their medications at school. If your child has a medication that they need to take during school hours, whether it is a long-term, short-term, or emergency medication, here are some helpful tips for parents and guardians:

Prior to the School Year1,2

  • Ask the pharmacist to put your child’s medications into two different bottles, each with its’ own label. One to be kept at home and one to be kept at school, if school policy allows.
  • Make sure all the prescription medications kept at school are in an original container (ie., no zip-top bags or foil) and labeled by a pharmacist.
  • Make sure all over-the-counter medications (including supplements) kept at school are in the original containers. Some states require a physician’s written consent and a parent written permission for over-the-counter medications. Be sure to check with your school.
  • It is also important for your child to play active roles in their medication. They should be educated about the effective and safe use of their medicine to help avoid improper administration, dosing errors, and non-adherence.

At the Beginning and During the School Year2,3

  • Provide the school with a full list of your child’s medications, including over-the-counter medicines and supplements. Be sure to update the school with any changes throughout the school year.
  • Talk to the school nurse or teacher ahead of time to make sure your child’s medication will be administered correctly (icorrect medication, dosage, route, frequency). Define who will administer the medication, and who will carry the medications during field trips.
  • School staff are not allowed to determine when to administer “as needed” medications. Be sure that your child’s medication includes specific instruction on when to administer and for what indication (ie., every 6 hours as needed for headache).
  • All medications should be transported by adults to adults. DO NOT let your child carry the medications unless they are capable and responsible to self-administer their medication to carry their own medications, especially for emergency medications that need immediate access, as deemed appropriate by the school.

Emergency Medications2

  • Be sure your child is able to get instantaneous access to emergency medications, like epinephrine injections for allergic reaction, glucagon for low blood sugar, or albuterol for an asthma attack.
  • Acetaminophen, ibuprofen, antihistamines are usually available at school in case your child experiences sudden pain or fever such as headaches, toothache, or menstrual cramps. It is important to sign a waiver granting the school permission to administer these medications in case your child experiences these symptoms.

Lastly, most schools and school districts have policies regarding student’s medication handling. It is important for you to check with your school for specific protocols that you need to follow to make sure that your child is getting the proper care.

 

References

  1. Abraham, O., Brothers, A., Alexander, D. S., & Carpenter, D. M. (2017). Pediatric medication use experiences and patient counseling in community pharmacies: Perspectives of children and parents. Journal of the American Pharmacists Association, 57(1), 38-46. doi:10.1016/j.japh.2016.08.019
  2. Administering Medication at School: Tips for Parents. (2016, December 19). Retrieved July 25, 2018, from https://www.healthychildren.org/English/safety-prevention/at-home/medication-safety/Pages/Administering-Medication-at-Child-Care-or-School.aspx
  3. Guidelines for the Administration of Medication in School. (2003). American Academy of Pediatrics, 112(3), 697-699. doi:10.1542/peds.112.3.697

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Cost of not taking your medications image - ScriptSave WellRx

by Roxanna Orsini

It’s a fact. Medications don’t work if patients don’t take them. Taking your medications as prescribed by your physician can help improve the quality and length of your life.

Importance of taking your medications

According to the Centers for Disease Control and Prevention (CDC), nearly 50% of Americans have used at least one prescription with in the last 30 days. One recent study shows that patients who were compliant with taking their statin therapy medications for at least two years had a 30% reduction in the risk of hospitalization for acute myocardial infarctions (heart attacks).1

Even with all the benefits medications can have on a patient’s health, there is still an issue with adherence to medication therapy.

After a patient visits their doctor

  • 20% – 30% of new prescriptions never reach the pharmacy.2
  • Of those prescriptions that do get filled, 50% of the time they are not taken as prescribed by the doctor.2
  • After six months of treatment for a chronic condition, patients tend to reduce the amount of medication they are taking, or stop treatment altogether.

Annual results of medication nonadherence

  • 125,000 deaths and at least 10% of hospitalizations.2
  • Costs the United States health care system between $100 billion and $289 billion annually.2,3

Most common reasons medication treatments are adjusted

Patients often discontinue or alter how they are taking their medications due to a variety of factors. A patient may no longer be adherent to their prescription therapy due to:

  • Cost of the medication
  • Experiencing a potential side effect
  • The patient no longer felt they needed the medication, and,
  • The patient feeling they are currently taking too many medications.

If a medication is too costly, ask your provider if they have any samples to provide, or even ask about possible generic alternatives. Prescription discount services, like ScriptSave WellRx, can often help reduce the cost. You may be surprised to find our cash prices is even lower than your insurance copay! Visit our website to check your medication prices.

When you’re considering an adjustment to your medication therapy, it’s important to follow up and discuss the decision with your healthcare provider. Some medications, if discontinued suddenly, can cause more harm than good.

Ways to improve the way you take your medications

Complications from medication nonadherence are 100% preventable. Here are a few tips to help you remember to take your medications:

  • Using an alarm or calendar
  • Filling a weekly pillbox
  • Taking the medication at the same time every day, create a routine
  • Ask your pharmacy about getting a 90-day supply
  • Ask your insurance provider if mail order provides prescription benefits.

Make sure to keep open communication with your healthcare provider. There are times a patient does not report a side effect or concern with the medication until the next appointment. Try reaching out to your provider right away. They are there to help you find a medication that can help improve your health condition.

References:

  1. Lansberg, P., Lee, A., Lee, Z., Subramaniam, K. and Setia, S. (2018). Nonadherence to statins: individualized intervention strategies outside the pill box. Vascular Health and Risk Management, Volume 14, pp.91-102.
  2. Rosenbaum, L. and Shrank, W. (2013). Taking Our Medicine — Improving Adherence in the Accountability Era. New England Journal of Medicine, 369(8), pp.694-695.
  3. Viswanathan, M., Golin, C., Jones, C., Ashok, M., Blalock, S., Wines, R., Coker-Schwimmer, E., Rosen, D., Sista, P. and Lohr, K. (2012). Interventions to Improve Adherence to Self-administered Medications for Chronic Diseases in the United States. Annals of Internal Medicine, 157(11), p.785-95.

If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash discount price at pharmacies near you.
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Medicare donut hole header image - ScriptSave WellRx

Medicare “Donut Hole” Changes Being Made and What It Means For You

by Marcus Harding
PharmD Candidate Class of 2019, University of Arizona

Mmmm…donut holes. You may be thinking of relaxing on a Saturday morning, sipping coffee and eating these tasty, sugary, fried treats. Unfortunately,  the type of donut hole we’re talking about is not so tasty.

What is the “Donut Hole?”

The Medicare coverage gap, better known as the “donut hole,” is a mystery to many, however there are thousands of people that it effects every year1. Simply put, it is a gap in coverage of medications after a certain amount has been contributed2. In other words, after you and your plan have spent a total of $3,750 on medications for the year (not including your deductible), the plan stops covering those medications and you are required to pay the entire cost of the medication out of pocket2. Once you enter the donut hole, and pay a total of $5,000 for the year (including your deductible) you enter what is called “critical coverage,” and you only pay 5% of the total cost for each medication3.

Medicare donut hole image - ScriptSave WellRx

Changes to the Donut Hole

The Affordable Care Act set in motion a plan to get rid of the donut hole completely1,2,4,7. The act set in place a “discount” that each plan member would get every year when they reached the donut hole. This discount would be paid by the manufacturers of the medications, and would increase each year until 2020, when the donut hole would be gone completely2.

  • In 2018, once a member enters the donut hole, they pay 35% of the total cost of the brand name drug, and the manufacturer pays a 50% discount2. This discount would be applied to the total cost spent by you, the plan member.
  • Example: you need a $100 medication, you pay $35, the manufacturer discounts you $50, so it looks as if you payed $85.
    • That $85 goes towards the $5,000 required spending to get out of the donut hole.
    • Once that $5,000 is spent, you reach critical coverage and only pay 5% of the brand name drug cost.

On Friday February 9th, the president signed a budget deal to “get rid” of the donut hole sooner4,5,6,7.

  • In 2019, once you reach the donut hole you will only pay 25% of a brand name drug cost, the insurance company will cover 5% of the cost and the manufacturer will cover the other 70%4,5,6,7.
  • You will receive credit for the 70% discount from the manufacturer, plus the 25% that you contributed for a total of 95% of the drug cost4,5,6,7.
    • This amount will go towards the $5000 threshold, after which you will be in “critical coverage” and pay only 5% of the total drug cost.
  • Example: If you need a $100 medication, you pay $25, the manufacturer discounts you $70, so it looks as if you payed $95.
    • The $95 goes towards the $5,000 to reach critical coverage where you will only pay 5% of the drug cost for the rest of the year.

So, the donut hole will still technically exist, but now instead of paying the full 100% of the cost of your medications, you will only pay 25%, and be credited with 95%.

What does this mean for you?

Healthcare in general can be complicated, especially as you factor insurance and coverage into the mix. There are a lot of numbers and percentages, so if you got lost in the numbers throughout this description, basically this means that if you typically reach the donut hole each year and are expected to pay for medications out of pocket, you will be saving a lot of money. Some people may not have enough medications or a high enough drug cost to even reach the donut hole, which is great, however as people get older they tend to have more health complications and need more medications. This can cost a lot of money. With these new laws and budget deals in place, if you have been reaching the donut hole previously, your total cost savings can increase quite a bit compared to previous years1.

How do you know if you will reach the donut hole?

Once again, the numbers above can be tricky to work through. Luckily there are easier ways to look at cost, spending and discounts.

  • It is estimated that if you pay more than $318 a month, you will enter the donut hole before the end of the year.
  • If you pay more than $743 a month, you will exit the donut hole before the end of the year and enter catastrophic coverage (based on a deductible of $415)4.

These numbers are just estimates based off common coverage and will differ depending on the deductible you have and the coverage you pay for. If you want to find out more about how much you spend compared to how much is covered, there are Medicare Part D donut hole calculators that break it down by each monthly payment4. Lastly, pharmacists are always a great source of knowledge as they deal with these plans on a daily basis, so never forget to ask a pharmacist or even your plan directly if you have any questions regarding the changes.

References:

  1. “2017-01-13.” CMS.gov Centers for Medicare & Medicaid Services, 23 May 2018, www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2017-Press-releases-items/2017-01-13.html.
  2. “Costs in the Coverage Gap.” Medicare.gov – the Official U.S. Government Site for Medicare, www.medicare.gov/part-d/costs/coverage-gap/part-d-coverage-gap.html. https://www.medicare.gov/part-d/costs/coverage-gap/more-drug-savings-in-2020.html
  3. Bunis, Dena. “Medicare Part D ‘Donut Hole’ Will Close in 2019.” AARP, 9 Feb. 2018, aarp.org/health/medicare-insurance/info-2018/part-d-donut-hole-closes-fd.html.
  4. A Preview of 2019: CMS Releases the Proposed 2019 Medicare Part D Standard Drug Plan Coverage Parameters.” Q1Medicare.Com, 2 Feb. 2018, 1524, https://q1medicare.com/q1group/MedicareAdvantagePartD/Blog.php?blog=A-preview-of-2019–CMS-releases-the-proposed-2019-Medicare-Part-D-standard-drug-plan-coverage-parameters&blog_id=397&frompage=18.
  5. Cubanski, Juliette. “Summary of Recent and Proposed Changes to Medicare Prescription Drug Coverage and Reimbursement.” The Henry J. Kaiser Family Foundation, The Henry J. Kaiser Family Foundation, 15 Feb. 2018, kff.org/medicare/issue-brief/summary-of-recent-and-proposed-changes-to-medicare-prescription-drug-coverage-and-reimbursement/?utm_campaign=KFF-2018-Medicare&utm_content=67264845&utm_medium=social&utm_source=twitter.
  6. Larson, John. “H.R.1892 – 115th Congress (2017-2018): Bipartisan Budget Act of 2018.” Congress.gov, 9 Feb. 2018, congress.gov/bill/115th-congress/house-bill/1892?q=%7B%22search%22%3A%5B%22H.R.1892%22%5D%7D&r=1.
  7. “Prescription Drug Benefits.” Social Security History, Social Security Administration, 22 Feb. 2018, www.ssa.gov/OP_Home/ssact/title18/1860D-02.htm.

If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash discount price at pharmacies near you.
You may find prices lower than your insurance co-pay!

 

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