transfer a prescription

The internet is a convenient option for purchasing many necessities, but can you fill your prescriptions online? In many cases, yes. There are generally two ways to fill a prescription online:

  1. Use an online pharmacy or mail-order pharmacy to fill your prescription; the pharmacy then mails you the prescribed medications.
  2. Use the patient portal on your pharmacy’s website to request an Rx refill online, and then pick up your medicine in person.

How Online and Mail-Order Pharmacies Work

An online or mail-order pharmacy allows you to order your medications over the internet (or by phone) and have them mailed directly to you. This is a convenient option but there are some drawbacks. Your medications take longer to arrive so you want to be sure you keep up with your refills. Some, but not all, online pharmacies have automatic refills available.

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Is It Safe to Buy Medication Online?

There are legitimate online pharmacies, and it is generally safe to use them. However, there are also several safety risks with online pharmacies. You may come across unethical companies that operate in a risky or even illegal manner. They may sell you counterfeit medications, drugs that aren’t FDA-approved, or medication that is expired or defective.

Unreputable online pharmacies may even sell Rx meds to people who don’t have a prescription. Be especially careful with international pharmacies. There are strict federal laws against importing certain substances from a foreign country.

How to Protect Yourself When Using Online Pharmacies

To protect yourself, watch out for these red flags.

  • Lack of contact information. Always check the website for contact information and verify that there is a U.S. address and valid phone number listed. Try calling the number to see if it is legitimate.
  • Availability of drugs without a prescription. If the pharmacy does not require a prescription to complete your transaction, or it advertises that you can obtain drugs without a prescription, do not go through with your order.
  • Drugs that are not FDA-approved. If you see any drugs that haven’t been approved by the FDA, stay away from the pharmacy.
  • No pharmacist available to answer questions. A reputable pharmacy will employ one or more licensed pharmacists to answer your questions.
  • Lack of a valid U.S. license. The National Association of Boards of Pharmacy (NAPB) verifies online pharmacies that are properly licensed. Look for a VIPPS (Verified Internet Pharmacy Practice Sites) seal and a “.pharmacy” website domain.

Do Online Pharmacies Save You Money?

Many people turn to online pharmacies to save money. Some legitimate online pharmacies offer discounted prices on medications, but many cut corners to offer discounts. The drugs may not be properly manufactured and as a result, may be too strong or too weak.

Rather than focusing only on price, you should focus first on safety. Once you have a list of reputable online pharmacies, then you can compare pricing.

Some online or mail-order pharmacies allow you to use discount drug programs when ordering your medication. Call or chat with a customer support representative and see if they accept any savings programs. For example, PillPack and Health Warehouse accept the ScriptSave WellRx prescription discount card.

Online Patient Portals

Online patient portals are offered through a traditional brick-and-mortar pharmacy like Walmart or CVS. These online portals offer a convenient way to request Rx refills from your home, office, school, etc. Once your prescription is filled, you must go to the pharmacy in-person to pick up your medication.

Patients can still use a pharmacy discount card with these portals. Simply bring your card or mobile app with you to the pharmacy when picking up your medications.

Rx Savings On The Go

ScriptSave WellRx is dedicated to negotiating discounted prices on as many medications and at as many pharmacies as possible. If you’re struggling to afford your medication, try downloading our mobile app. It allows you to search and compare drug prices to find the best discount in your area.

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There are a variety of reasons to move your medications from one pharmacy to another. It could be that you found a better price, you’ve recently moved to a new area, or you’re looking for a location closer to your workplace. Regardless of the reason, transferring prescriptions between pharmacies is a straightforward process.

Here are the steps to transfer your prescription to a different pharmacy:

  1. Call or visit the new pharmacy to request an Rx transfer.
  2. Give the new pharmacy the names of all the medications you want to transfer, along with dosage and Rx numbers.
  3. Provide your current pharmacy’s contact information. The new pharmacy will contact your old pharmacy and take care of most of the process.
  4. Wait for the transfer to be completed, allowing at least 1-3 business days.

Information to Share with Your New Pharmacy

When you contact your new pharmacy, be sure you have your health and prescription information available. Specifically, you will need to tell the pharmacist:

  • Your full name and date of birth
  • Your address and phone number
  • All known allergies (food and medicines)
  • The names of all the prescriptions you’re transferring
  • The strength and dosage of your medications
  • Rx number for each medication (the 7-digit number on the top left of the label)
  • Phone number and address for your current pharmacy
  • Contact information for your prescribing physician

Allow the New Pharmacy to Handle the Transfer

After you let the new pharmacist know that you wish to move your medications, they will contact your current pharmacist and handle the transfer. If your prescription is out of refills, the pharmacist will also contact your doctor.

To expedite the process, you can check with your doctor and make sure you still have refills before reaching out to the new pharmacy.

Allow Enough Time for the Transfer

Although prescriptions can be moved to a different pharmacy quickly, you should still err on the side of caution and allow at least 1-3 business days for the switch to take effect. If you’re out of medicine and need a refill immediately, you might not be able to access it at the new pharmacy right away. It’s important to make sure you have a sufficient Rx pill supply before making the move.

Be Aware of Exceptions

There are certain prescriptions that cannot be transferred or have a limited number of transfers.

Schedule III, IV, and V medications are classified as controlled substances. You are only allowed one transfer with these types of medications, regardless of how many refills you have left. If you’ve run out of transfers, contact your doctor for a new prescription before attempting to switch pharmacies.

Some examples of Schedule III, IV, and V medications include Tylenol with Codeine, Xanax, and Robitussin AC or other cough suppressants with codeine.

Schedule II controlled substances are not able to be transferred at all due to the risk of substance abuse and dependency they pose. These medications also cannot be refilled, so your doctor will have to write you a new prescription whenever you run out. Examples of these substances include Adderall, Ritalin, and OxyContin.

Additionally, be aware that if any of your Rx medications have run out of refills, your doctor may require you to come in for an appointment before refilling the prescription.

Establish a Relationship with Your New Pharmacist

It’s important that you inform your new pharmacist of all medications and supplements you take, including over the counter medicines that may interact with your prescriptions. Your pharmacist is there to make sure you stay safe and manage your prescriptions effectively. You should establish a relationship with them so they can properly advise you on your medications.

Different Pharmacies Charge Different Prices

Did you know that patients commonly switch pharmacies because it allows them to save money? Many pharmacies charge different prices for the same prescription medication. Consider comparing your Rx prices at different pharmacies from time to time so you can be sure you’re getting the best deal possible.

Are your prescriptions cheaper at another pharmacy?


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Treatment for Depression and Anxiety: The Fight to End Suicide

by Cherokie Dyer, PharmD candidate class of 2020,
University of Florida

Alarming Suicide Statistics

Over the past 17 years, rates for death by suicide has dramatically risen here in the United States. From 1999 to 2016, 25 states had over a 30% increase in their suicide rates. There’s rarely any one reason for someone to commit suicide. However, most suicides are attributed to life stressors, loss of a relationship, and a recent or approaching crisis. Another huge contributor is the presence of a mental health disorder such as depression or anxiety.

In the year of 2017, the CDC states that there were:

  • 44,965 suicide deaths
  • 13.9 suicide deaths per every 100,000 people
  • 39% of adults 18 and older had serious psychological distress in the past 30 days
  • 56.8 million physician visits resulted in mental, behavioral, and neurodevelopmental disorders as a diagnosis
  • 5.5 million emergency room visits were due to mental health disorders

The Good News

The amount of people being treated for depression and anxiety disorders is also rising. In 2012, the World Health Organization stated that 350 million people across the globe were affected by depressive disorder. This is followed with an increase in diagnosis and treatment of these disorders.

Common Anti-Depressant and Antianxiety medications include:

Brand Name Generic Name Drug Class
Zoloft Sertraline Selective Serotonin Reuptake Inhibitor
Lexapro Escitalopram Selective Serotonin Reuptake Inhibitor
Prozac Fluoxetine Selective Serotonin Reuptake Inhibitor
Wellbutrin Bupropion Dopamine/Norepinephrine Reuptake Inhibitor
Cymbalta Duloxetine Serotonin/Norepinephrine Reuptake Inhibitor
Effexor Venlafaxine Serotonin/Norepinephrine Reuptake Inhibitor
Pristiq Desvenlafaxine Serotonin/Norepinephrine Reuptake Inhibitor
Remeron Mirtazapine Alpha-2 Antagonist
  Amitriptyline Tricyclic Antidepressant

It’s great that more people are getting help for their mental health conditions. The increase in people getting treatment will help to decrease the number of people wanting to harm themselves. If you have sought treatment for anxiety or depression or know someone who sought treatment, I am so happy! Everyone’s life is valuable. If you or someone you know suffers from anxiety or depression and hasn’t yet felt comfortable seeking treatment, don’t hesitate. The awareness of these conditions and options for treatment are expanding; set up an appointment to talk about what you are experiencing.

Things to Remember about your Antidepressants or Antianxiety Meds

These medications take time to work. In many cases, you won’t see an effect until after about 1 month. Taking your medications as prescribed can help strengthen their effectiveness and prevent side effects like dizziness, fatigue and nausea. If significant time passes and you still don’t feel any better, ask your doctor to try you on another medicine. Never quit these medicines abruptly as this can result in bothersome, and sometimes serious withdrawal symptoms. Be sure to follow your doctor’s instruction to taper these medications if it’s determined that they need to be stopped.

Outside of Medicine

Outside of prescription medication, these are 3 valuable ways to improve mental health. Incorporating these changes along with your medication can also increase their effectiveness.

Nutrition: Your body makes all your brain chemicals from the food you eat daily. That’s your protein, complex carbohydrates (fruits, veggies, whole grains), and good fats. If you don’t eat this kind of balanced diet, you may consider taking a daily multivitamin.

Sleep: Getting close to 8 hours of sleep each day gives your body the time to make more brain chemicals. It’s the best opportunity for your body to fix and replace other cells like the nerves and muscles.

Exercise:  Daily exercise improves your brain activity and increases the release of brain chemicals. A great example would be going for a brisk walk outside. The movement, along with getting at least 10 minutes of sun each day, is another great way to both exercise and get your daily vitamin D allowance. Not to mention exercise is a good way to relieve anxiety and avoid personal stressors! 

Suicide Lifeline

If you or someone you know are thinking about harming themselves in any way, call the National Suicide Prevention Lifeline at 1-800-273-8255. You can also text HOME to 741741 to receive texts from the Crisis Text Line. If you feel there is an emergency, you should always call 911 or go to the nearest hospital.

References:

Suicide Prevention websites:

https://www.crisistextline.org/

https://suicidepreventionlifeline.org/

Statistics:

https://www.grandviewresearch.com/industry-analysis/anxiety-disorders-and-depression-treatment-market

https://www.cdc.gov/nchs/fastats/mental-health.htm

https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a1.htm?s_cid=mm6722a1_w

Medication and Nutrition information:

https://www.fda.gov/consumers/free-publications-women/depression-medicines-help-you

http://www.martiefankhauser.com/


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by Jennifer Bingham, PharmD, BCACP & Stephanie Forbes, PharmD

The Prescription Opioid Addiction Epidemic

Pain is complex and the sensation and intensity can vary among individuals who are suffering, so there are many treatment options — mind-body techniques, acupuncture or physical therapy, and medications, both over the counter and prescription. For many patients with severe pain from injuries or surgery, opioid painkillers are supposed to provide pain relief, but because they have been heavily marketed and inappropriately prescribed, there has been an ever increasing number of deaths throughout the U.S. caused by misuse and addiction.

What is Narcan®?

Narcan® (naloxone hydrochloride) is an opioid antidote.1 It is indicated for patients that has suspected opioid overdose symptoms, such as respiratory and central nervous system depression.1 It is available in two formulations, including injectable and nasal preparations. The nasal spray contains one dose per unit,1 hence it is important to contact 9-1-1 for emergency medical assistance once opioid overdose is suspected to ensure additional assistance is available if needed. 

Who Should Use Narcan Nasal Spray?

Narcan nasal spray is intended for use by people who are experiencing an opioid overdose or are showing signs of opioid overdose.2,3 As mentioned above, it’s use is not a substitute for emergency medical care. Whenever administering Narcan, always call 9-1-1 right away.  Since it is an opioid antagonist, Narcan only works to reverse the effects of opioids, both prescription and non-prescription. Some examples of opioids it reverses are morphine, codeine, opium, hydrocodone, heroin and methadone.4

Who should have Narcan Nasal Spray?

People who receive Narcan are typically taking high doses of opioids for pain management over a long treatment period.2,5 Additionally, those taking extended-release or long-acting opioid medications or receive rotating opioid medication regimens may also have Narcan.   Patients who have a known hypersensitivity to naloxone hydrochloride should not use Narcan.1 Narcan access (needing a prescription) varies across states and the medication should be replaced before the expiration date passes.5

How to Store Narcan Nasal spray?

Narcan nasal spray should be stored in the blister and cartons provided until use.1 A controlled room temperature between 59°F to 77°F with protection from light is recommended for storage, and the product should not be frozen. The nasal spray may be stored at temperatures outside of this range (39°F to 104°F) for brief periods of time only.

Ask your pharmacist if you should talk to your provider about Narcan.

References:

  1. Narcan Nasal Spray (naloxone hydrochloride) [prescribing information]. Radnor, PA: Adapt Pharma Inc; January 2017.
  2. Naloxone. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/treatment/naloxone/. Last Updated April 11, 2019; Accessed June 3, 2019. 
  3. Coffin, Phillip MD, MIA. Prevention of lethal opioid overdose in the community. UptoDate®. Last Updated June 25, 2018. Accessed June 3, 2019.
  4. What Are Opioids. Department of Health and Human Services. https://www.hhs.gov/opioids/prevention/index.html. Last Updated May 15, 2018. Accessed June 4, 2019
  5. Opioid Overdose Reversal with Naloxone. National Institute of Drug Abuse. https://www.drugabuse.gov/related-topics/opioid-overdose-reversal-naloxone-narcan-evzio/. Last Updated April 2018, Accessed June 3, 2019.

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Benzer Pharmacy Partners with ScriptSave to Provide Prescription Discounts and Grocery Guidance

TAMPA, FL (June 27, 2019) – Benzer Pharmacy Holding, LLC announced today they will partner with ScriptSave® to provide their customers ScriptSave WellRx Premier, which offers discounts on prescription medications, medicine adherence tools, and drug interaction alerts. ScriptSave Prescription Savings Programs have helped consumers save more than $10 billion over the past 25 years.

Grocery Guidance, Medication Management and Prescription Savings

scriptsave wellrx benzer pharmacy app imageScriptSave WellRx Premier is a technology enabled prescription savings and medication management program. ScriptSave WellRx Premier not only delivers prescription discounts to Benzer Pharmacy customers, it will also provide new tools that promote medication adherence and Grocery Guidance to find healthier foods aligned with the customer’s health goals.

“This program is sure to help all Benzer customers, not just those who are uninsured,” Meghann Chilcott, Chief Technology and Marketing Officer for Benzer Pharmacy. “We encourage every customer, regardless of their health care coverage, to keep a card on-hand to reduce out-of-pocket prescription costs.”

Take Your Medicine and Refill Reminders

Customers can download the free WellRx Premier mobile app, which shows the lowest medication prices at local pharmacies, provides helpful medication information and images, grocery guidance for help reaching dietary goals, direct pharmacist support through “Ask a Pharmacist”, and medication reminder tools to promote adherence and wellness, or simply visit the website.

”We sincerely appreciate our relationship with Benzer Pharmacy, and we are excited to provide them with our innovative products. A value-added program, like ScriptSave WellRx Premier, attracts new customers and creates loyalty with existing customers. We look forward to sharing other new ScriptSave solutions with Benzer in the near future,” said Dan Johnson, Vice President of Network Strategy for ScriptSave.  

About ScriptSave:

For 25 years, ScriptSave has been closing the gaps in prescription coverage with innovative savings and adherence programs, like ScriptSave WellRx, for the uninsured, under-insured, and insured. ScriptSave WellRx is designed to boost medication adherence by providing cost saving opportunities, information, prescription management, and reminders. Millions of Americans use ScriptSave products – yielding more than $10 billion in consumer savings on prescriptions.

Twitter: @SSWellRx

Facebook: Scriptsavewellrx

About Benzer Pharmacy:

Founded in 2009, Benzer Pharmacy is a chain of independent retail pharmacies specializing in compounding and specialty medication. Currently, there are 82 corporate-owned and 34 franchise locations situated throughout 29 states, including Florida, Michigan, Virginia, West Virginia, North Carolina, Tennessee, Texas, Georgia, Nevada, Louisiana, New York, Missouri, Mississippi, Maryland, Ohio, Indiana, and Idaho. Projections call for continued rapid growth as the organization seeks to substantially increase its customer base, while ensuring experiences match expectations at every touchpoint.

Facebook: https://www.facebook.com/BenzerPharmacy

LinkedIn: https://www.linkedin.com/company/benzerpharmacy

Instagram: https://instagram.com/benzer_pharmacy

ScriptSave Contact:

Dan Johnson, Vice President of Network Strategy ScriptSave
djohnson@scriptsave.com


 

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ScriptSave WellRx Marks Silver Anniversary –
25 Years of Prescription Savings, Totaling $10 Billion, and a Brand New Innovation to Help Patients Who View Food as Medicine

A new analysis from the prescription discount program, ScriptSave WellRx, has revealed the savings from the company’s pioneering efforts to lower out-of-pocket costs for millions of patients paying cash for their prescriptions. The results: more than $10 billion dollars of savings, as the company marks its Silver Anniversary with the release of a brand new module that can assist patients with their grocery choices.

Founded in 1994, ScriptSave has been a pioneer and innovator, leading the way in terms of creating tools and programs designed to help un- and under-insured patients better afford their medications. Working in close collaboration with many of the nation’s pharmacy and grocery chains, ScriptSave has created incredible savings opportunities for patients.

With the latest update to the ScriptSave WellRx mobile app, ScriptSave has announced a new wellness-focused tool that provides grocery guidance. Using the new tool, consumers can check:

  • ensure the foods they are eating are consistent with their goals for general wellness
  • choose foods better aligned for pregnancy
  • select appropriate foods for other health conditions, including heart health and diabetes.

Users of the app can even find similar food options that are better aligned with their needs. As with most other programs and offerings from ScriptSave, the ScriptSave WellRx app (and the new grocery guidance toolset) is available to users at no cost.

Prescription Savings - ScriptSave WellRx

ScriptSave Never Stops Innovating

scriptsave wellrx food index imageOther pioneering innovations that are also available (free) in the latest app release include:

  • geo-targeted price-drop alerts for prescriptions medications, allowing users to see when the prices for their own medications come down at nearby pharmacies;
  • medication refill and ‘take your pill NOW’ reminders, helping to ensure prescribed medication adherence, and;
  • medication interaction alerts, to flag possible life-threatening drug or lifestyle interactions.

The newest release of the ScriptSave WellRx app, can help guide shoppers while they browse the aisles at the grocery store or as they take stock of their pantry. It’s a clear expansion outside of ScriptSave’s traditional domain. Moving beyond just pharmacy and prescription medications, the grocery guidance module can guide users towards more health-conscious food selections. It’s designed to help users concerned with chronic conditions like diabetes or heart health, and can help identify appropriate food selections for pregnant women.

These latest innovations to the app’s features are the result of more than two years of ongoing product development. Along the way, the team even managed to pick up a few awards for prototype versions of the app (including as a category winner at the 2017 National Association of Chain Drug Stores’ Product Showcase). ScriptSave’s Vice President of Product & Technology, Shawn Ohri, noted that the timing of this release to coincide with ScriptSave’s Silver Anniversary could hardly seem more fitting or rewarding to the team.

$10 Billion Saved

Meanwhile, an in-depth analysis of the traditional prescription savings programs that ScriptSave has been evolving throughout the course of its 25 years of innovation, shows how the business has helped an estimated 85 million patients in the US save a total of $10 billion on their prescription medication costs. In 2018 alone, the prescription discount program saved consumers $450 million on medications.

ScriptSave WellRx’s free savings cards and prescription coupons—which can be found online or in the mobile app—can help save patients up to 80% on their medications, with average savings of around 60%. In terms of dollars and cents, the average cash saved by patients using ScriptSave WellRx in 2018 was $30.85 per prescription.

Ohri noted that with the ever-increasing prices of medication in the US, ScriptSave WellRx is helping patients pay for the medications they need to not only get over a cold or fever but, in some cases, survive.

“This is our 25th anniversary, and during those years we’ve helped patients save $10 billion on prescriptions they need to get and stay healthy,” said Ohri. “Our prescription discount programs help consumers save money they can use on other critical expenses, like keeping the roof over their heads, putting food on the table for the family and buying school supplies for their kids. We continue to operate with a start-up mentality, bringing new and innovative solutions to help people manage their health and wellness.”

WellRx Mobile App Helps Consumers Find Lowest Prices at the Pharmacysrciptsave wellrx price drop alerts - image

At its core, ScriptSave WellRx negotiates drug prices in bulk with pharmacies across the nation, giving it access to pricing information for most prescription drugs being sold at independent and chain pharmacies. Consumers can access this data at no cost with the free ScriptSave WellRx mobile app and website.

This provides a fast, easy, free way for patients (and physicians) to get a second opinion on what an out-of-pocket cost might be. Patients can price-check all their family’s medications at most pharmacies in any zip code with just one click.

The price-check tool is available for free—no sign-up necessary—and features savings on medications at over 65,000 retail pharmacies across the U.S. In 2018, the program delivered average savings of 60%, with potential savings of 80% or more (relative to the cash price of those prescriptions being filled).

Patients can download the free ScriptSave WellRx mobile app (for iPhone and Android) or visit the website for more information.


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too many drugs - scriptsave wellrx blog image

by Ryan Lowe, PharmD Candidate,
University of Arizona

The More Medications, The Merrier?

Have you ever heard of the term “polypharmacy” before? When you break that word down you get “poly”, which means multiple, and “pharmacy”, which means medications. Polypharmacy is defined as the use of multiple drugs, or more than are medically necessary.1 Depending on who you’re talking to will determine where their cut off is for ‘multiple drugs’, with some thinking as few as three is considered polypharmacy, while others say you need as many as five.

An example of using more drugs than are medically necessary would be having two blood pressure medications when your blood pressure has been running low. There are a lot of concerns about polypharmacy, especially in the elderly population.

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Polypharmacy in the Elderly

A study published in 2004 wanted to find out how prevalent polypharmacy was in the nursing home setting. With over 13,000 patients in the study, they found that approximately 40% of them were taking 9 or more medications.2 While 9 medications may seem absurd, as this study shows it’s not that unheard of.

As you can well imagine, taking multiple medications can lead to a variety of potential concerns. First off, the more medications you take means the more money it will cost to pay for those medications. Added hospital or clinic visits to manage those medications also contribute to the rise in costs. Another major concern is that of drug side effects, commonly referred to as Adverse Drug Events (ADEs).

Some patients report a side effect to one medication which then gets an entirely new medication to replace it. This can lead to a cycle of adding new medications which leads to polypharmacy. The more medications you must take also makes it harder to remember when to take them. Some patients struggle to take only one or two medications every day, so having upwards of nine becomes a very daunting task. Despite all these risks, there is still one concern that is at the forefront of any pharmacist’s mind: drug interactions.

The Major Risk of Drug Interactions in Polypharmacy

Drug-drug interactions, or DDIs, happen when one medication interferes with the way another medication works in your body. If you are taking nine medications at the same time, there is a much greater risk that at least two of those drugs will interact with one another. These interactions can range from the benign to the severe, sometimes increasing the effect of one drug or preventing it from doing its job.

Here is a list of some (but not all) of the most common drug interactions:

  • Warfarin: If you take warfarin to help thin your blood to prevent a stroke or DVT, you should know that warfarin has numerous DDIs. Ibuprofen or Aleve should be avoided when taking warfarin, and many antibiotics can also affect the level of warfarin in your body.
  • Grapefruit: You may have heard about some drugs interacting with grapefruit (including juice), but what drugs and why? Grapefruit can block an enzyme in your body that many drugs use as their metabolizing agent. When this happens, the amount of drug rises in your body to sometimes dangerous levels. If you’re taking any of these drugs then you should avoid eating grapefruit: some statin medications (like simvastatin and atorvastatin), nifedipine, cyclosporine, buspirone, amiodarone, and fexofenadine (generic Allegra).3
  • Levothyroxine: When you take levothyroxine, you’re supposed to take it one hour before you eat breakfast in the morning. This is because levothyroxine interacts with almost every food you can think of. If you take the drug with breakfast, lunch, or dinner then it will not be able to absorb fully, and it won’t reach its desired effect.

There are several tools available to check for drug interactions. The free ScriptSave WellRx app has a feature that allows you to check the medications you are taking for any harmful interactions. The app also has a lot of other useful features. For example, you can set reminders for taking your medications in case you have a hard time keeping track of them all, or when to refill them. You can also look up information about your medications including what it should like and possible side effects. The app is available for both Apple and Android, and can also be used in Spanish! If you still have questions, you can call the Ask a Pharmacist line at 1-866-268-2611 to speak to a pharmacist directly.

References:

  1. Maher, Robert L, et al. “Clinical Consequences of Polypharmacy in Elderly.” Expert Opinion on Drug Safety, vol. 13, no. 1, 2013, pp. 57–65., doi:10.1517/14740338.2013.827660
  2. Dwyer, Lisa L., et al. “Polypharmacy in Nursing Home Residents in the United States: Results of the 2004 National Nursing Home Survey.” The American Journal of Geriatric Pharmacotherapy, vol. 8, no. 1, 8 Feb. 2010, pp. 63–72., doi:10.1016/j.amjopharm.2010.01.001.
  3. “Consumer Updates – Grapefruit Juice and Some Drugs Don’t Mix.” U S Food and Drug Administration Home Page, Office of the Commissioner, 18 July 2017, www.fda.gov/ForConsumers/ConsumerUpdates/ucm292276.htm.

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

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by Ryan Lowe, PharmD Candidate,
The University of Arizona College of Pharmacy

For many patients with diabetes, insulin has become a mainstay of their therapy. Despite the addition of newer drugs on the market (like the exciting GLP-1 agonists such as Victoza (liraglutide), insulin remains a popular choice among physicians for its numerous benefits. The dose of insulin can be easily adjusted; if your blood sugars are running high then simply try taking two more units and reevaluate in a couple of days. Insulin is also a great drug when used in combination with other medications such as metformin; these combinations allow for greater control of a patient’s diabetes. According to a study from the CDC, the percent of patients taking both insulin and an oral medication increased between 1997 and 2011. This suggests the importance of both types of medication in diabetes management. 1

What are the different types of Insulin available?

Insulin can be divided up into two categories: long acting and short acting. Most patients start out with a long acting insulin before a short acting insulin is added. The most common long acting insulin is Insulin Glargine, or Lantus. Another long acting insulin you may see is Insulin Detemir, or Levemir. These insulins are normally dosed once a day, and they work to keep your fasting sugars (your blood sugar when you’re not eating any food) within normal limits.  The most common side effect of long acting insulin is hypoglycemia, or low blood sugar. When you take too much insulin your body eats up too much glucose, resulting in low blood sugar levels. If you are hypoglycemic then you may start shaking, feeling dizzy or faint, and feel confused or anxious. The quickest remedy for this is eating a high sugar snack or drink, such as a glass of orange juice. As noted earlier, one of the main benefits of long acting insulin is being able to adjust the dose more frequently to find the perfect dose for you. With a tablet medication it is harder to find the perfect middle ground; you either take one tablet or you take two. Insulin doesn’t work that way; since insulin is a liquid injection you can easily take a little more or a little less than you were previously to account for your blood sugar levels.

Short acting insulin works much quicker than the long acting insulins, hence the name. There are two common short acting insulins: Insulin Lispro, or Humalog and Insulin Aspart, or Novolog. These insulins are commonly taken after a meal. The idea behind this is that the insulin will counteract a large spike in blood sugar gained by eating a large meal. However, these insulins are rarely taken alone; rather they are normally used in combination with long acting insulin to combat both types of sugars: fasting and post-prandial, or post-eating sugars. Hypoglycemia is still a risk with these short acting insulins, but it isn’t as great a risk as with the long acting insulins. One consideration that has been on many patient’s mind, however, is the rising cost of insulin – and Humalog specifically has been in the news lately.

Why is Humalog making headlines?

Humalog is a short acting insulin manufactured by Eli Lilly, a drug company responsible for numerous popular medications. Eli Lilly released some pricing information about Humalog, and the numbers are raising some eyebrows among patients, healthcare providers, and even politicians. An insured patient will typically pay around $135 a month for Humalog (which is a decrease of 8.1% from 2014). When you don’t factor in the rebates typically covered by an insurance company, the monthly price of Humalog rises to $549.2 These differences have gotten a lot of people talking. Eli Lilly hopes that the information they released will help shed some light on the often-muddled issue of rising drug costs. Politicians on both sides seem to agree that drug costs need to come down in America, but the solution to this issue is not an easy one. Eli Lilly themselves hope to improve the situation by releasing a “half-price” Humalog under the generic name Insulin Lispro. The cost will be $137.35 per vial, which should significantly improve the annual cost for those uninsured patients with diabetes.3

In response to the Eli Lilly price drop for Humalog, Sanofi recently announced a program that they hope will make a difference in the cost of insulin.4 They unveiled a Netflix-like program that takes that model directly to patients, supplying insulin products for a flat monthly rate instead of the usual cost per prescription or refill. The drugmaker will use its Insulin Valyou Savings Program to deliver insulin products for $99 per month. For that monthly fixed price, Sanofi will offer up to 10 boxes of insulin pens and 10 mL vials per month, regardless of a patient’s income. The new $99-per-month price could be as little as one-tenth of the amount patients would have paid previously.

References:

  1. “Age-Adjusted Percentage of Adults with Diabetes Using Diabetes Medication, by Type of Medication, United States, 1997–2011.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 20 Nov. 2012, www.cdc.gov/diabetes/statistics/meduse/fig2.htm.
  2. Lovelace Jr., Berkeley. “Eli Lilly Sheds Light on Confidential Pricing, Discloses Charges for Popular Diabetes Drug Humalog.” CNBC, CNBC, 25 Mar. 2019, cnbc.com/2019/03/25/eli-lilly-discloses-pricing-data-for-its-popular-insulin-humalog.html.
  3. “Lilly to Launch a Half-Price Version of Insulin.” CNBC, CNBC, 4 Mar. 2019, www.cnbc.com/2019/03/04/lilly-to-launch-a-half-price-version-of-insulin.html.
  4. “Sanofi provides unprecedented access to its insulins for one set monthly price” Sanofi, 10 Apr. 2019   http://www.news.sanofi.us/2019-04-10-Sanofi-provides-unprecedented-access-to-its-insulins-for-one-set-monthly-price 

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by Haley Stenquist, PharmD Candidate Class of 2019
The University of Arizona College of Pharmacy

A new group of generic medications are hitting the prescription drug market in 2019. At ScriptSave, we get a lot of questions about generic medications vs. brand name prescription drugs. “A” rated generics meet the same quality standards as brand name prescription drugs and so they provide the same medical benefits. A drug that is “A” rated by the FDA as a generic equivalent contains identical active ingredients as the brand name drug, the same dosage as the brand name drug, and delivers the same concentrations of drug to the bloodstream within the same amount of time. So what are the differences and what’s coming to a pharmacy near you?

Are Generic Drugs the Same as Brand Name?

Yes, generic drugs are “copies” of the brand name medication that was developed by a company other than the one that originally brought the branded medication to market. Generic drugs are available for a fraction of the price of brand name medications, so consumers are naturally eager for the generics to hit the market. Per the FDA guidelines, a generic drug application must first display the following parameters:

  • The generic drug is “pharmaceutically equivalent” to the brand
  • The manufacturer is capable of making the drug correctly
  • The manufacturer is capable of making the drug consistently
  • The “active ingredient” is the same as that of the brand
  • The right amount of the active ingredient gets to the place in the body where it has effect
  • The “inactive” ingredients of the drug are safe
  • The drug does not break down over time
  • The container in which the drug will be shipped and sold is appropriate
  • The label is the same as the brand-name drug’s label
  • Relevant patents or legal exclusivities are expired2

How Long Does It Take for a Drug to Become Generic?

After an application for a patent of a new drug is filed with the United States, it is granted patent exclusivity for 20 years.  The path to generic drugs coming to market was made cheaper, easier, and faster after the introduction of the Drug Price Competition and Patent-Term Restoration Act of 1984 or known as the Hatch-Waxman Act. This allowed companies to submit an abbreviated new drug application (ANDA). About one year before the expiration of the patent drug, companies that are wanting to manufacture the generic drug will submit the ANDA to the FDA. Generally, after that patent has expired and the ANDA is approved, a generic counterpart can be introduced into the market.1

First Generic Drug Approvals for 2019

Currently, the FDA has approved 16 first-time generics in 2019 between different manufacturers (each manufacturer must submit their own ANDA). These include:

  • pyridostigmine bromide syrup—Mestinon Syrup
    • Improves muscle strengths in patients with myasthenia gravis
    • Novitium Pharma LLC—03/08/2019
  • levofloxacin ophthalmic solution, 1.5%—Iquix Ophthalmic Solution
    • Treatment of corneal ulcer caused by certain bacteria
    • Micro Labs Limited, India—02/27/2019
  • deferiprone tablets, 500mg—Ferriprox Tablets
    • Treatment of transfusional iron overload due to thalassemia syndromes
    • Taro Pharmaceuticals Industries Limited—02/08/2019
  • sevelamer hydrochloride tablets, 400mg, 800mg—Renagel Tablets
    • Control of serum phosphorus in patient with chronic kidney disease
    • Glenmark Pharmaceuticals Limited—02/08/2019
  • levomilnacipran extended-release capsules, 20mg, 40mg, 80mg, 120mg—Fetzima
    • Treatment of major depressive disorder (MDD)
    • Amneal Pharmaceuticals Company GmbH—02/04/2019
  • acyclovir cream, 5%—Zovirax Cream
    • Treatment of recurrent cold sores in immunocompetent patients over 12 years of age
    • Perrigo UK FINCO Limited Partnership—02/04/2019
  • Wixela Inhub (fluticasone propionate and salmeterol inhalation powder, USP) 100mcg/50mcg, 250mcg/50mcg, 500mcg/50mcg—Advair Diskus
    • Treatment of asthma in patient over 4 years of age and COPD maintenance (250mcg/50mcg)
    • Mylan Pharmaceuticals Inc.—01/30/2019
  • sirolimus oral solution, 1 mg/mL—Rapamune
    • Prophylaxis of kidney organ rejection in patient over 13 years of age
    • Novitium Pharma LLC—01/28/2019
  • vigabatrin tablets USP, 500mg—Sabril Tablets
    • Treatment of refractory complex partial seizures (CPS) in patients over 10 years of age that have failed multiple alternative treatments
    • Teva Pharmaceuticals USA, Inc.—01/14/2019
  • ingenol mebutate gel, 0.05%, 0.015%—Picato Gel
    • Treatment of topical acne
    • Perrigo UK PINCO Limited Partnership—01/07/2019 (0.015%) and 01/09/2019 (0.05%)
  • lurasidone hydrochloride tablets, 20mg, 40mg, 60mg, 80mg, 120mg—Latuda Tablets
    • Treatment of schizophrenia and depressive episodes associated with bipolar disorder in adults
    • Torrent Pharmaceuticals Limited, Accord Healthcare Inc., Lupin Limited, InvaGen Pharmaceuticals, Inc., Amneal Pharmaceuticals Company GmbH—01/03/20193

Newest Generics of 2019

  • As of 03/12/2019, the FDA approved a new generic of Diovan (valsartan) among the vast recalls from multiple manufacturers, this was granted to Alkem Laboratories Limited.4
  • Lannett announced FDA approval for aspirin and extended-release dipyridamole capsules, 25mg/200mg—Aggrenox Capsules for secondary prevention of stroke and transient ischemic attacks (TIA) on 03/27/2019.5

Forecasted Generics for the Remainder of 2019

The Impact of Generics

It is a long, grueling process for a brand name medication to finally be released to the market as a generic, taking in excess of 20 years. Generic medications are instrumental in helping alleviate the financial burden of prescription medication costs in patients. Each year, the effect continues to grow. In the first quarter 2019, there is already a large impact with new generic medications coming to market. This impact is forecast to continue throughout the year, especially with the possibility of heavy hitters such as Lyrica and Restasis.

References:

  1. “S.1538 – 98th Congress (1983-1984): An Act to Amend the Federal Food, Drug, and Cosmetic Act to Revise the Procedures for New Drug Applications, to Amend Title 35, United States Code, to Authorize the Extension of the Patents for Certain Regulated Products, and for Other Purposes.” gov, 24 Sept. 1984, www.congress.gov/bill/98th-congress/senate-bill/01538.
  2. Center for Drug Evaluation and Research. “Generic Drugs – What Is the Approval Process for Generic Drugs?” U S Food and Drug Administration Home Page, Center for Drug Evaluation and Research, www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/genericdrugs/ucm506040.htm .
  3. Center for Drug Evaluation and Research. “First Generic Drug Approvals.” U S Food and Drug Administration Home Page, Center for Drug Evaluation and Research, fda.gov/Drugs/DevelopmentApprovalProcess/HowDrugsareDevelopedandApproved/DrugandBiologicApprovalReports/
    ANDAGenericDrugApprovals/default.htm
    .
  4. Office of the Commissioner. “Press Announcements – FDA Provides Update on Its Ongoing Investigation into ARB Drug Products; Reports on Finding of a New Nitrosamine Impurity in Certain Lots of Losartan and Product Recall.” U S Food and Drug Administration Home Page, Office of the Commissioner, fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm632425.htm.
  5. “Generic Drug for Stroke Prevention Granted FDA Approval.” Pharmacy Times, pharmacytimes.com/news/genericdrug-granted-fda-approval.
  6. “Pipeline Report Generic Drugs .” Welldynerx. welldynerx.com/content/uploads/2019/02/Generic-Drugs-Feb-2019-2-12-19.pdf.
  7. “Upcoming Generic Drugs.” Corporate Pharmacy Services, corporatepharmacy.com/page/upcoming_generic_drugs.

 

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by Cindy Cho, PharmD Candidate Class of 2019,
The University of Arizona College of Pharmacy

When most people think of a diet that leads to poor diabetes control, they may think of a diet high in carbs and sugar. While those types of food do impact your blood sugars, consuming too many saturated fats can be an enemy against diabetes control,too. This is because a hallmark of pre-diabetes, type 2 diabetes, and worsening type 2 diabetes is insulin resistance.

Saturated Fat and Insulin Resistance

First, what is insulin? Insulin is a hormone produced by your pancreas to control your blood sugar levels. Insulin helps move the sugar from the blood into your cells for storage and energy. In other words, insulin is the key that unlocks the door of our muscle cells to let sugars in. Insulin resistance in the state of your body where insulin is not responding properly to move the sugar into the cells, which causes a rise in blood sugars as a result. The pathophysiology of insulin resistance is somewhat convoluted, but what is known is that saturated fat plays a role. It has been known since 1927 that increased consumption of fat delays the process of blood sugars going into the cells, which means that sugars hang around longer in the bloodstream.1 The results of both animal and human studies also show that a high intake of saturated fat is associated with insulin resistance and development of type 2 diabetes.2 This is because an uncontrolled state of insulin resistance leads to a higher risk of getting type 2 diabetes. People are also at higher risk of insulin resistance if they are overweight or obese.

Not All Fats are Bad

Contrary to the connotation of the word, not all fats are unhealthy. Two main sources of fat that we will focus on are saturated and unsaturated fats. Saturated fats are found commonly in animal products, such as red meats and dairy products. On the other hand, unsaturated fats come from mainly plant based sources and consists of foods like olive oil, nuts, and avocados. Studies have shown that in people with diabetes, saturated fats cause insulin resistance whereas unsaturated fats can improve insulin sensitivity.3 Because of this, the consumption of vegetables fats is favored in place of animal fats and processed grains.3 Not only are plant based foods lower in saturated fats, they are generally lower in calories and jam-packed with nutrients and fiber to nourish the body.

Ways to Improve Insulin Resistance

Lifestyle changes, particularly diet, address ones of the root causes of type 2 diabetes: insulin resistance. Following a plant-based diet can be a solution since animal products can contain a high amount of saturated fat. A plant-based diet generally includes legumes, whole grain, fruits, vegetables, and nuts, and discourages most animal products and refined foods.4 The Adventist 2 study, which included about 89,000 people extended across 50 years, demonstrated a substantial decrease in diabetes incidence in those who ate a vegetarian diet. The study also suggested that those who eat meat once or more days a week have significantly higher rates of diabetes.5 Plant-based diets also have been shown to work better in reducing blood sugars, body weight, and cardiovascular risk compared to diets that include animal-based products.6

Plant-based eating patterns, such as the DASH diet, healthy Mediterranean, and healthy vegetarian diets, have been shown to be associated with better health and lower risk for disease according to nutritional epidemiology, randomized controlled intervention trials, and most literature.7 These diets are also appropriate for the vast majority of people. Furthermore, exercise, with or without weight loss, helps improve insulin sensitivity so your body can use the insulin it naturally produces better.8 That in turn can mean lower doses of your diabetes medications, or even coming off the diabetes medications altogether, which can lower your costs on how much you spend on diabetes care. It is shown that after adjusting for population age and sex differences, the average medical expenses for people living with diabetes were about 2.3 times high than people who do not have diabetes.9

Dangers of Uncontrolled Blood Sugars

Controlling blood sugars is important because the longer a high amount of glucose is in the bloodstream, the more damage it can cause to your blood vessels, nerves, and tissues. Therefore, it is very important to have your doctors check your feet, eyes, and kidneys at least yearly if you have diabetes. People with uncontrolled blood sugars are also at higher risk for cardiovascular complications like heart attacks and strokes and are more prone to infections.10 Plant-based diets have demonstrated improvements in blood sugar control, which can possibly reduce or prevent the incidence of long-term complications of type 2 diabetes.

What You Can Do

Talk to your doctor or dietitian about eating more plant-based foods. It may also be easier to think of changes to what you eat as a lifestyle choice instead of as a diet. Small changes to the foods you consume can make a big impact on your health in the long run. Eating healthier doesn’t mean it has to be more expensive either. Shopping for produce in season, or even visiting your local 99 cent store that carries groceries can be helpful methods to save you money and keep you healthy too. You don’t have to be vegan to experience the benefits of a plant-based diet either. Any steps you take to adding more plant-based foods onto your plate can improve your blood sugars.5

Key Takeaways

To summarize, striving to increase the amount of plant-based foods you eat, minimize consumption of animal-based foods, increase your physical activity, along with taking your diabetes medications regularly, can make a positive impact on your blood sugars and overall health!

References:

  1. Dietary Factors That Influence The Dextrose Tolerance Test, J. Shirley Sweeney MD, Archives of Internal Medicine, December 1927
  2. ARIC Study Investigators; Plasma fatty acid composition and incidence of diabetes in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study, The American Journal of Clinical Nutrition, Volume 78, Issue 1, 1 July 2003, Pages 91–98, https://doi.org/10.1093/ajcn/78.1.91
  3. Rachek, L. (2014). Progress in Molecular Biology and Translational Science (pp. 267-292). Elsevier.
  4. McMacken M, Shah S. A plant-based diet for the prevention and treatment of type 2 diabetes. J Geriatr Cardiol. 2017;14(5):342-354.
  5. Tonstad, S., Stewart, K., Oda, K., Batech, M., Herring, R., & Fraser, G. (2013). Vegetarian diets and incidence of diabetes in the Adventist Health Study-2. Nutrition, Metabolism and Cardiovascular Diseases,23(4), 292-299. doi:10.1016/j.numecd.2011.07.004
  6. Trapp, Caroline B., and Neal D. Barnard. “Usefulness of Vegetarian and Vegan Diets for Treating Type 2 Diabetes.” Current Diabetes Reports, vol. 10, no. 2, 2010, pp. 152–158., doi:10.1007/s11892-010-0093-7.
  7. Laddu, D., & Hauser, M. (2019). Addressing the Nutritional Phenotype Through Personalized Nutrition for Chronic Disease Prevention and Management. Progress In Cardiovascular Diseases, 62(1), 9-14. doi: 10.1016/j.pcad.2018.12.004
  8. Duncan GE, Perri MG, Theriaque DW, Hutson AD, Eckel RH, Stacpoole PW: Exercise training, without weight loss, increases insulin sensitivity and postheparin plasma lipase activity in previously sedentary adults. Diabetes Care 26:557–562, 2003
  9. Economic Costs of Diabetes in the U.S. in 2017. (2018). Diabetes Care, 41(5), 917-928. doi: 10.2337/dci18-0007
  10. American Diabetes Association. 2019 Standards of Medical Care in Diabetes. http://care.diabetesjournals.org/content/42/Supplement_1. Published December 17, 2018. Accessed December 17, 2018.

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by Cindy Cho, PharmD Candidate Class of 2019,
The University of Arizona College of Pharmacy

In short, no. You cannot get pneumonia from the pneumonia vaccine. With all of the news coverage about vaccines, it is important to equip yourself with the knowledge on what vaccines are, how they work, and why they don’t cause disease, so you can make an informed decision on your health.

What is a vaccine?

A vaccine is a substance that contains very small amounts of weakened or dead germs to stimulate your body to produce immunity against certain diseases. Before the invention of vaccinations, the only way a person’s body can gain immunity to certain diseases is to (hopefully) survive an infection from the germ that causes the disease. For example, if a person gets pneumonia, an infection of the lung, from a certain germ and survives, their body will remember that specific germ if it were to come across it again. By remembering the germ, the body can protect itself and fight off the infection more efficiently to prevent sickness in the future. Vaccines provide a similar immune system response to help the body create immune system cells to remember disease-causing germs to protect your body, but the best part is that vaccines don’t come with the risks of getting the actual disease or its associated complications. Some vaccines can provide protection against multiple types of germs that cause the same disease to better protect against epidemics.1

What are pneumonia vaccines?

Now that you understand how vaccines work, let’s talk about the pneumonia vaccines! There are two pneumonia vaccines intended for use in the United States by the Food and Drug Administration (FDA), which includes the pneumococcal conjugate vaccine (PCV13 or Prevnar 13) and the pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax 23).2 Both of these pneumonia vaccines contain inactivated, or dead, germs. Because these vaccines contain dead germs, they cannot replicate in the body or cause disease.1 The differences between the two pneumonia vaccines are shown below:

  • Prevnar 13: this is a conjugated vaccine, which means it contains a protein that is joined to a part of dead bacteria to improve the protection the vaccine provides. Doctors give this vaccine to children at 2, 4, 6, and 12 through 15 months old. Young children need multiple doses of this vaccine to boost their protection since their immune system is not yet mature. Adults who need this vaccine only get a single dose. The vaccine has 13 in its name because it helps protect against 13 types of pneumococcal bacteria that most commonly causes serious infections in children and adults.2
  • Pneumovax 23:  this is a polysaccharide vaccine, which means it is made to look like the surface of certain bacteria in order to help the body build protection against that germ. Doctors give a single dose of this vaccine to people who need it. CDC recommends one or two additional doses for people with certain chronic medical conditions. The vaccine has 23 in its name because it helps protect against serious infections caused by 23 types of pneumococcal bacteria.2

 So, who needs the pneumonia vaccines?

Great question! Pneumonia disproportionately affects the young, the elderly, and the immunocompromised, so the CDC recommends these vulnerable patient populations to receive the pneumonia vaccines.3 The CDC created an immunization schedule that outlines when the two pneumonia vaccines should be received.

CDC recommends vaccination with the pneumococcal conjugate vaccine (PCV13 or Prevnar 13®) for:2

  • All children younger than 2 years old
  • All adults 65 years or older
  • People 2 through 64 years old with certain medical conditions*

CDC recommends vaccination with the pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax23®) for:2

  • All adults 65 years or older
  • People 2 through 64 years old with certain medical conditions*
  • Adults 19 through 64 years old who smoke cigarettes

*Certain medical conditions such as: chronic heart disease, lung disease, liver disease, diabetes, HIV, or certain cancers warrant some adults to receive the pneumonia vaccines before the age of 65.4

What are the side effects of the pneumonia vaccines?

Reactions to the pneumonia vaccine can occur, such as cold-like symptoms, but it is important to realize that those are adverse reactions to the vaccine and not pneumonia itself. Talk to your doctor if you have allergies to any ingredients in vaccines. Below are common adverse reactions to the pneumonia vaccines:

Mild side effects reported with Prevnar 13 can include:2

  • Reactions where the shot was given
    • Redness
    • Swelling
    • Pain or tenderness
  • Fever
  • Loss of appetite
  • Fussiness (irritability)
  • Feeling tired
  • Headache
  • Chills

Mild side effects reported with Pneumovax23 can include:2

  • Reactions where the shot was given
    • Redness
    • Pain
  • Fever
  • Muscle aches

Why are the pneumonia vaccines important?

Vaccines, like the pneumonia vaccines, can prevent or decrease the severity of diseases. Unfortunately, around 50,000 people die from pneumonia in the United States each year.3 It is passed along through airborne droplets, such as from a cough or sneeze, so it is a highly contagious infection.2 It is crucial to receive the pneumococcal vaccine to not only protect yourself but to protect your loved ones around you. Especially if you have a breathing condition like asthma or COPD, it is important to have the pneumonia vaccines to prevent respiratory infections that can potentially make your breathing worse. Talk to your provider or local pharmacy if you are due for your pneumonia vaccine today.

References:

  1. Principles of Vaccination. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/pubs/pinkbook/prinvac.html. Published September 8, 2015. Accessed February 14, 2019.
  2. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/vpd/pneumo/public/index.html. Published December 6, 2017. Accessed February 14, 2019.
  3. Top 20 Pneumonia Facts (2018). American Thoracic Society.  https://www.thoracic.org/patients/patient-resources/resources/top-pneumonia-facts.pdf. Accessed February 14, 2019.
  4. Recommended Adult Immunization Schedule for ages 19 years or older, United States, 2019. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html#note-pneumo. Published January 2019. Accessed February 14, 2019.

 


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by Jamie L. Voigtmann, PharmD Candidate 2019
Saint Louis College of Pharmacy

There are many aspects in life that can decrease prescription fill rates. This in turn causes medication non-adherence, where patients are unable to take their medications regularly as prescribed by a physician. It’s a common and costly problem across America.

What Prevents Patients from Filling Prescriptions?

Barriers to medication adherence include lifestyle preferences, fear or uncertainty about the effectiveness of new medications or adverse reactions, The complexity of instructions and or drug regimens, personal beliefs, and insufficient funds also come into play.1 Patients who have insufficient funds to pay for medications include, not only decreased socioeconomic status, but also all patients that qualify as low-income based on age, gender, race, location, and family size. Patients who have financial restrictions will commonly delay prescription refills, as well as subsequent copays, by splitting pills, taking pills every other day, or even discontinuing medications on their own. This is because many chronic conditions require multiple medications for treatment and many medications are expensive even with insurance.1

The Low-Income Populations Includes Elderly Patients

As mentioned previously, low-income patients not only include race, location, and family size, but also age. As patients become ≥ 65 years old they are most likely dependent on Medicare for health insurance coverage, since it is offered through the government. Elderly patients who experience decreased prescription fill rates have been associated with having increased out-of-pocket costs with prescription medication coverage, lower net worth, and lower household incomes.2 This is important to consider because as patients age their health often declines, indicating more need for medications. It is also imperative to think about this aspect as many Baby Boomers fall into this category, increasing the number of patients sharing Medicare benefits.

Which Types of Medications Do Low-Income Patients Struggle To Get?

A common misconception is that patients with low-income only have trouble affording newer novelty medications, such as HIV, Hepatitis C, and oncology medications. With these types of medications, many patients including the middle and upper economic classes struggle to pay for the medications due to the outstanding drug cost dictated by the manufacturers. Low-income patients also struggle with common health conditions such as asthma, diabetes, and high cholesterol. Patients who are in a lower socioeconomic class experience significantly less control over their asthma and commonly experience increased exacerbations compared to patients who belong to a higher economic class.3

When considering Type-2 Diabetes Mellitus, patients with high-incomes had increased compliance to treatment regimens including diet, exercise, and medications.4 The high-income patient’s also checked their A1c more often and were associated with higher self-care ability.4 Finally considering cholesterol medications, a recent study showed that low-income patients were willing to give up their cholesterol medications if a copay was present because the benefits are not commonly felt unlike insulin for diabetes or lisinopril for increased blood pressure.5

Low-Income vs. High-Income Prescriptions

It is interesting to realize what types of medications low-income patients are filling at the pharmacy, compared to high-income patients. According to The New York Times, high-income patients receive more cosmetic medications to treat baldness, erectile dysfunction, wrinkles, and eyelashes.6 These patients were also more likely to purchase medications to treat mental health.6 They also had more prescriptions for birth control pills due to a consistent prescription from a regular doctor.6 Medications that are more commonly received by low-income patients include HIV and Hepatitis C, most likely due to lack of education in transmission and poor access to healthcare.6

Lowering Overall Drug Costs

Overall, the relationship between income and prescription fill rates at the pharmacy is much more complicated than low-income patients having decreased prescription adherence.6 Different patients are more likely to develop certain diseases or illnesses that would increase healthcare costs. Patients also differ on when they seek medical attention, resulting in a significant cost even before a physician writes a prescription.6 Regardless of income, it’s important to treat patients with as few medications as possible while still treating chronic conditions to help lower overall drug costs for all patients.

References:

  1. Mishra SI, Gioia D, Childress S, Barnet B, Webster RL. Adherence to medication regimens among low-income patients with multiple comorbid chronic conditions. Health Soc Work. 2011; 36(4): 249–258.
  2. Zivin K, Ratliff S, Heisler MM, Langa KM, Piette JD. Factors influencing cost-related nonadherence to medication in older adults: a conceptually based approach. Value Health. 2010; 13(4): 338-45.
  3. Bacon SL, Bouchard A, Loucks EB, Lavoie KL. Individual-level socioeconomic status is associated with worse asthma morbidity in patients with asthma. Respir Res. 2009; 10: 125.
  4. Habib F, Durrany AM. Effect of age and socio-economic status on compliance among type 2 diabetic patients. Curre Res Diabetes & Obes J. 2018; 7(3): 555714.
  5. Watanabe JH, Kazerooni R, Bounthavong M. Association of copayment with likelihood and level of adherence in new users of statins: a retrospective cohort study. J Manag Care Pharm. 2014; 20(1): 43–50.
  6. Quealy K, Sanger-Katz M. The prescription drugs that rich people buy. The New York Times. February 7, 2019. https://www.nytimes.com/2019/02/07/upshot/income-strong-predictor-drug-purchases-serious-diseases.html. Accessed March 9, 2019.

 


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