Pepin’s Pharmaceutical Prattle for 07-07-2003
	Quote of the day: There is no reason for any individual to have a computer in his home. Ken Olson, President, Digital Equipment, 1977

Good morning! Well, we can't all be right all of the time. Computers are an integral part of our lives. It is hard to remember that computers are just tools. They can be used for "good" or "bad". Most of us use them all day at work and then for "fun" at night. What was once only available to the best reference librarian is now close to us at the click of a mouse. Now physicians can use handheld devices to get all sorts of information (in addition to stock quotes!) Maybe Ken Olson was thinking beyond his time and really meant to say that we will not need computers in our homes because we will have them in our hands. (I'm feeling generous today). There are hurdles to physician use of this technology but they are not insurmountable. There just has to be more "gain" than "pain" for the physicians. The vendors of the handheld devices are working on it and RxHub is out there to coordinate their efforts. See below for some of the progress being made.

1) Will the cost of your Ford go down due to the Medicare Prescription drug benefit?

Employers are looking at the legislation as a way to get out from under the crushing expense of providing drug coverage to retirees. Those companies without a true retirement plan won't be as excited about it….they paid their dues with the 401K, 403B, etc. In 2000 Ford made $141 Billion on $5 million units in North America. This bill could save the $50 million. Expenses per unit would decrease by $10. Maybe they will be able to add another cup holder or two… after all…the taxpayers will be paying the freight. Hey…that's us! …Click here for full text of story. http://www.nytimes.com/2003/07/02/business/retirement/02RETI.html

2) About 2% of all prescribing is done as e-prescribing with only about 6% of the physicians hooked up.

I think that physician fear of getting stuck with outmoded equipment after a large investment in technology is what is keeping the lid on it. Physicians also do not want to be fumbling with the gadget in front of patients. They can simultaneously think, talk and write on a conventional paper pad but must give the device their full attention to get the prescription into the handheld. Better interfaces and a turn-key systems approach would go a long way to market penetration….but then again…what do I know? …Click here for access to one company devoted to e-prescribing. www.surescripts.com

3) …and Rhode Island is willing to push the handheld technology…..
	With the chain drug stores involved, it just might work! …Click here for full text of story. http://www.informationweek.com/story/showArticle.jhtml?articleID=10800290

4) Merck makes Emend(s). FDA approves anti puke drug, Emend (aprepitant).
	A pretty good name suggesting mending of emesis (vomiting). Drug interactions with oral contraceptives (and other drugs) may limit the market. Not to be used for "the flu" or other small time stomach offenders… main use will be an adjuct to cancer treatment. …Click here for full text of story. http://www.fda.gov/bbs/topics/NEWS/2003/NEW00886.html Here's your story Heidi!

5) Florida to bust physicians for bad writing
	(as if the above wasn't enough reason to try e-prescribing.) New law has the docs either typing or printing all prescriptions in an effort to limit errors. …Click here for full text of story. http://www.wesh.com/health/2300292/detail.html

6) Let's get the lead out… of Kaopectate!

Bentonite clay contains too much lead. California settles a law suit to reduce the amount in the product. Right now it just requires a warning label. As you know lead can cause brain, hearing and kidney damage, impair growth, cause other health problems. It seem true to form that California would start the rush to "non-leaded"! …Click here for full text of story. http://news.moneycentral.msn.com/ticker/article.asp?Feed=RTR&Date=20030627&ID=2668815&Symbol=US:PFE

7) Xolair approval may take your breath away
	Cost for this second line therapy for asthma could be between $500 and $3000 per month. This may be self administered by sub-cutaneous injection every 2 to 4 weeks. A likely candidate for prior authorization. …Click here for the company website http://www.xolair.com.

8) Don't call me…I'll call you.
	The national DO NOT CALL system awaits you. Just click on the link and enter up to 3 telephone numbers to have your phones blocked. Now all we need is the same service for e-mail addresses to stop (or slow down) spam…. Any takers? …Click here for full text of story http://www.donotcall.gov/default.aspx. …Click here for some fireworks!

Have a GREAT week!... Steve

Disclaimer: "Pepin's Pharmaceutical Prattle" (AKA "The Prattle") is the property of PHARMWORKS, LLC and Steven M. Pepin, Pharm. D, BCPS. The opinions expressed are those of the bald-headed author. To start or stop any drug without the advice a supervision of you physician would be stupid. So don't do anything based upon what you read here without professional advice. To be added to or removed from the distribution list please e-mail your request to spepin@pharmworks.com . All insightful comments from readers are thoughtfully considered (the rest are callously discarded). Copyright 1998-2003 PHARMWORKS,LLC all rights reserved.