Publication Date 01/12/2009         Volume. 1 No. 7   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the December 2009 edition of i2p - Information to Pharmacists E-Magazine.
When i2P first began in February 2000, it was decided that a fortnightly publication might prove to be the optimum publishing cycle.
This thought was soon dispelled as it was found that having sufficient content to maintain this cycle became a problem.
Oh for those quieter times!
The cycle then became monthly and has been maintained up to now.
The problem is now coping with the volume of news and opinion that is generated on a daily basis.
Very much the reverse of the year 2000 - a statement for our time and how the pace of pharmacy life has increased.

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Recent Comments

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For some pharmacists the truth will be ‘inconvenient’. WHY is it so??

James Ellerson

Sir Winston Churchill said “Truth is incontrovertible, malice may attack it and ignorance may deride it, but, in the end, there it is.”
Elvis Presley said “Truth is like the sun. You can shut it out for a time, but it ain't goin' away.”

At the PAC 2009 Conference John Menadue’s forthright messages made it abundantly clear that the sun was shining very brightly indeed.
Here are the ‘message sticks’ that resonated with me:

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About that "Un-Invitation"

Dr John Dunlop (PGDipPharm, MPharm, DPharm(Auck), FACPP, FNZCP, FPSNZ, MCAPA)

It was interesting reading John Menadue’s speech given at the Pharmacy Australia Congress in Sydney in October.
It was even more interesting to read of the UN-invitation by the Queensland branch of the College of Pharmacy Practice and Management, the stance taken by the Pharmacy Guild of Australia and the Pharmaceutical Society, to support only pharmacy activities provided from within a community pharmacy.
How draconian is that?
Research has demonstrated, as has the low uptake of new professional services from within a community pharmacy, that the existing community pharmacy model is not compatible with the implementation of these new professional opportunities.
The two major arguments put forward are ‘lack of time’ and ‘lack of funding’.

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A Green Pharmacy is Gold

Neil Retallick

Simon Divecha, Director of GreenMode, a consultancy that assist business and people to find their carbon and sustainable advantages spoke at the recent Pharmacy 2009 Conference.
Simon has assisted businesses including BP Solar, Origin Energy, Lend Lease, ANZ and IAG.
His challenge to community pharmacy is to identify and take advantage of the opportunities that exist for businesses that have such close relationships with their local communities.

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What are we doing to ourselves?

Heidi Mahon

Over the last months, I've noticed the position taken by both the Guild as well as individual pharmacists on our on-line forums.

In his recent address Mr John Menadue poses the question - are pharmacists the most change-resistant health profession?

And if so, what is our future likely to hold?
What can we do about it?

Personally, I have to agree with him - if we as a group - and not just the Guild, DON'T take innovation as a prerequisite for how we practice our profession, then in 20 years time, what will we have left?

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Picture - the wood for the trees

Pat Gallagher

Another year has gone by and what have we done with technology in the health sector?
A good question that deserves a long and detailed review as a written dissertation by somebody learned and influential in health informatics, government, consulting or from the many agencies, departments and committees engaged in delivering e-health service to the Australian public; notably as a value proposition for the tax payers in the greater voting public cohort.

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Advancing Self Care

Neil Johnston

Imagine a pharmacy that had a range of eye catching kiosks that utilised easy to use touch screen technology.
Not passive kiosks, but kiosks that are interactive with customers/patients to efficiently provide a perceived need.
It’s not a new idea, but the marketing of health care through kiosks certainly represents an organised method of transferring information to customers/patients and assisting them to make good health decisions.
One current form of kiosk that is beginning to take hold in Europe and the US is the vision kiosk.

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Wind Farm will Power Sydney's Desalination Plant

Staff Writer

Source: AAP NewsWire

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Communications Technology - a nudge from the big end of town

Staff Writer

National Health IT assumed prominence recently when the National Business Council of Australia wrote directly to prime minister, Kevin Rudd, urging him to create a focus on communications technology and to invest appropriate funds.
I wonder if they were aware of the organisational performance 0f NEHTA and their inability to date, to actually deliver suitable infrastructure and systems.
And with $'s millions already wasted by NEHTA I am sure there is hesitancy by government to spend even more, given the dismal track record to date.
Health communications is stuck in a deep groove.
But it is interesting to note that the Business Council of Australia see productivity and investment opportunities in health if only the primary health players could integrate better and talk to one another.
Shared health communications underpins this potential benefit as the many writers for i2P have continually pointed out.
With the big end of town taking more interest, maybe government and health professionals can align themselves more fluidly.
A read of David More's blog article from a NEHTA insider in this edition of i2P, leaves you still wondering how an alignment can take place without removing the NEHTA structure completely.

Health info needs urgent technological injection

Source: Industry Search -24/11/2009

http://www.industrysearch.com.au/Features/Health-info-needs-urgent-technological-injection-4306

Read the BCA letter in full here

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Powering up by osmosis

Staff Writer

An unusual form of renewable energy has emerged recently in a novel format involving the use of fresh water and salt water interaction across a membrane that creates osmotic pressure.
This pressure has been demonstrated to be able to drive a turbine that can produce an electric current.
Osmotic pressure is well known in medicine with adjustments having to be made to eye drop and injection formulas to minimise the pain associated with the administration of these medicine forms.

The process is a more controllable form of natural energy when compared with weather-dependent versions of energy generation (solar, wind, tidal etc) and has a reasonably small and discrete footprint in the environment.
With a bit of imagination it is not too far of a stretch to have the salt water filtered through another form of membrane to create fresh water to be recycled within a closed system.

Norway tries osmotic power to harnessing power of salt

Source: Industry Search

http://www.industrysearch.com.au/News/Norway-tries-osmotic-power-to-harnessing-power-of-salt-42094

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Insuring the Disabled

Staff Writer

Prime Minister Kevin Rudd is to be commended for the initiative in having a look at the feasibility of creating a no fault disability insurance scheme.
Disability can cause disaster to any family structure and can be a constant drain on financial resources that can add to further stresses up to, and involving bankruptcies.
By putting in place a proper financial underpin, each family member is enabled to be productive and self-sustaining. This can create a net gain to the taxation base when viewed globally, to include service providers and industries that can feed off that activity stream.

PM calls for national disability reforms

Source:DPS Guide to Aged Care

http://www.agedcareguide.com.au/news.asp?newsid=4178

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Should patents apply to the natural world?

Staff Writer

I can't but help wonder if the move to be able to patent all things natural is a smart move.
Take for example the Neam tree that grows wild in the northern part of Australia.
The leaves of this tree make a great insect repellent with no known side effects.
An entrepreneurial Australian a few years back, decided to grow these trees and was surprised to have legal documents served on him claiming royalties and damages from some obscure US company that had registered a patent for all things Neam.
Unfortunately, there was no legal defence for the Australian grower.
Now there is an outcry by vested interests because the Australian government has resisted pressures to allow the patenting of human genes.
All sorts of calamities are therefore predicted for the local biotech industries.
But I wonder if these claims will prove to be valid?

Follow the debate in this article:

Ban drives 'biotech industry to its knees'

http://www.news.com.au/story/0,23599,26309574-5011761,00.html?from=public_rss

Source: AAP

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Public Hospitals - Time they were fixed

Staff Writer

Queensland Health struggles through another drama after using instruments that had been used on patients and left unsterilised.
But it's not just Bundaberg Hospital that is sick - the entire Australian hospital system needs a radical overhaul.
The Rudd government had promised to "fix" the problem after taking office, but so far has not made any noticeable progress.
Read about the latest problem.

Qld Health cleaning up after dental sterilisation scare

Source: ABC Online

http://www.abc.net.au/news/stories/2009/11/18/2745842.htm

By Chris O'Brien

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Patient uses initiative to attract nurses

Staff Writer

If anyone has ever been a patient in a hospital and tried the buzzer to get assistance from a nurse, then here is a new innovation to get attention.
Not that the nursing fraternity should shoulder the blame.
It's the politicians and the lack of political will to solve this issue and many others.
Congratulations to the patient and his initiative in dialling triple O.
Read the full story here:

Man rings triple-0 from hospital bed

Source: ABC Online

by Cate Grant

http://www.abc.net.au/news/stories/2009/11/18/2745829.htm

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What's good for climate is good for health

Staff Writer

Health professionals from around the world are slowly waking up to the fact that climate change can induce adverse effects on health.
At i2P we have been carrying messages for just on two years, regarding climate change effects, including research reports from our own writer Con Berbatis, in the hope that official pharmacy would see the need and develop policies and strategies for pharmacists to adopt.
Now, with the formation of the International Climate and Health Council a recognised forum is available to be addressed.
Will pharmacists be given a seat at the table?
Perhaps the Pharmaceutical Society of Australia should find out.

Health Professionals Around The World Launch The International Climate And Health Council

Source: Medical News Today

http://www.medicalnewstoday.com/articles/172330.php?nfid=20247

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Ageing slowly and safely

Staff Writer

The ageing process is relentless with function loss noticeably diminishing over the age of 60.
Supplementation of nutrients holds one key to slowing down some of the processes, in particular the loss of muscle mass and the subsequent aches and pains that follow as the skeletal system is no longer held together in an optimum manner.
This process can be a contributor to falls and more serious damage.
Not being able to adequately stay on your feet as you age, robs you of your independence.
It would seem that a strategy of slowing down slowly might be prudent for the age demographic entering retirement - the "baby-boomers".

Antioxidants could help preserve muscle strength

Source: Reuters Health
By Marilynn Larkin

Found at this link

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Are we planning for future skill shortages?

Neil Johnston

National Seniors Agency have published a report indicating that Australia will have a shortfall of 1.4 million workers by 2025.
This shortage will also be reflected in the profession of pharmacy.
It is pointed out that a smart move would be to match an improved workplace to match specific requirements for mature-aged employees and thus retain them for longer periods..
APESMA has recently published an online survey in an endeavour to poll employed pharmacists on the issues that affect them specifically. Obviously, this is a move in the right direction, and much of what they are polling has a direct relationship to mature-aged employees.

So what is community pharmacy doing to retain their senior pharmacists?

Very little, it seems.

i2P asked Mark Coleman to comment and his commentary appears below the news item:

Comments: 1

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Vaccines to target chronic lifestyle illnesses

Staff Writer

articles by this author...

Editing and Researching news and stories about global and local Pharmacy Issues

The lack of blockbuster drugs in the pipeline has turned many pharma companies towards the vaccine market and the preventive medicine market.
The promise is to treat or prevent, major chronic lifestyle illnesses.
However, consumer resistance continues to build against vaccine use (such as H1N1 swine flu vaccine) as more knowledge is circulated regarding manufacturer practices, the use of mercury preservatives, the lack of proper testing before release - building to many patients walking away from vaccine use completely.
Many health professionals agree.
Hopefully more thoughtful strategies will emerge so that both manufacturers and patients can benefit.
Follow the story here.

Vaccines on horizon for AIDS, Alzheimer's, herpes

By LINDA A. JOHNSON, AP Business Writer

http://www.sfgate.com/cgi-bin/article.cgi?f=/n/a/2009/11/17/financial/f104839S88.DTL&feed=rss.business

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Many could be on the market in five years or less.

Contrast that with five years ago, when so many companies had abandoned the vaccine business that half the U.S. supply of flu shots was lost because of contamination at one of the two manufacturers left.

Vaccines are no longer a sleepy, low-profit niche in a booming drug industry. Today, they're starting to give ailing pharmaceutical makers a shot in the arm.

The lure of big profits, advances in technology and growing government support has been drawing in new companies, from nascent biotechs to Johnson & Johnson. That means recent remarkable strides in overcoming dreaded diseases and annoying afflictions likely will continue.

"Even if a small portion of everything that's going on now is successful in the next 10 years, you put that together with the last 10 years (and) it's going to be characterized as a golden era," says Emilio Emini, Pfizer Inc.'s head of vaccine research.

Vaccines now are viewed as a crucial path to growth, as drugmakers look for ways to bolster slowing prescription medicine sales amid intensifying generic competition and government pressure to cut down prices under the federal health overhaul.

Unlike medicines that treat diseases, vaccines help prevent infections by revving up the body's natural immune defenses against invaders. They are made from viruses, bacteria or parts of them that have been killed or weakened so they generally can't cause an infection.

Investment in partnerships and other deals to develop and manufacture vaccines has been on a tear — and accelerating since the swine flu pandemic began. Billions in government grants are bringing better, faster ways to develop and manufacture vaccines. Rising worldwide emphasis on preventive health care, plus the advent of the first multibillion-dollar vaccines, have further boosted their appeal.

While prescription drug sales are forecast to rise by a third in five years, vaccine sales should double, from $19 billion last year to $39 billion in 2013, according to market research firm Kalorama Information. That's five times the $8 billion in vaccine sales in 2004.

"What was essentially 25 years ago a rounding error now has become real money," says Robin Robertson, director of the U.S. Biomedical Advanced Research Development Authority.

That jump is due to a couple of new blockbuster vaccines and rising use of existing ones. The government's list of recommended vaccines for children since has more than doubled since 1985 to 17. It now also calls for a half-dozen vaccines for everyone over 18 and up to four more for some adults.

The last decade brought breakthrough vaccines against pneumococcal disease and rotavirus — two of the world's top killers — meningitis, cervical cancer and more.

Better technology to create and mass produce vaccines is bringing progress in preventing tropical dengue fever and new threats like superbugs MRSA and C. difficile, even ending addiction to cocaine and nicotine. Success on some vaccines in development, particularly for Alzheimer's and AIDS, likely would bring billions a year in sales.

Just this fall and early next year, the swine flu vaccines are expected to bring their makers at least a couple billion extra dollars.

That's despite the five manufacturers for the U.S. not being able to meet an optimistic plan to first make seasonal flu shots and then produce 120 million doses of swine flu vaccine by mid-October — an unprecedented task. But they are steadily catching up with demand.

Unlike most vaccines now "manufactured" in mammal, yeast or other cells — quickly, purely and at high yields — flu vaccines are still grown over many weeks in chicken eggs because it's economical and those newer, faster methods aren't U.S.-approved yet. Because swine flu vaccine grew slower than expected, there have been shortages — and lines of anxious consumers.

But a horde of biotech companies, many using multimillion-dollar government grants, already are testing state-of-the-art technology for the next pandemic.

Scientists — including some at J&J's new vaccine partner, Holland's Crucell NV — even are working to develop the holy grail: a universal flu vaccine targeting a part of the virus that doesn't change year to year.

And some future vaccines will come in patches, pills and nasal sprays, rather than painful shots.

In the last century, vaccines dramatically lengthened lifespans by stopping diseases that killed or disabled millions, from smallpox to polio.

After all those successes, many pharmaceutical companies instead focused on lucrative daily pills for chronic diseases. By the middle of this decade, only a handful were still making vaccines, which are harder to produce than chemical-based pills, making yields unpredictable.

That led to the 2004 fiasco when half the U.S. flu shot supply was lost overnight, plus continuing periodic shortages of some kids' vaccines.

Today, five companies supply flu vaccine: GlaxoSmithKline, Switzerland's Novartis AG, Australia's CSL Biotherapies, MedImmune, part of Britain's AstraZeneca PLC, and France's Sanofi-Aventis SA.

There's been more research on flu vaccines in the last five years than in the previous 20, notes Dr. William Schaffner, Vanderbilt University's head of preventive medicine and a spokesman for the Infectious Diseases Society of America.

Now many drugmakers are rethinking vaccines.

Britain's GlaxoSmithKline is gunning to become the world's top vaccine manufacturer by revenue, unseating pioneer Merck & Co. This spring, Glaxo opened a state-of-the-art vaccine packaging plant in Marietta, Pa., west of Philadelphia, so it can expand in the U.S. market.

Glaxo, which sold only one vaccine in the U.S. 13 years ago, now sells 12 here — and 30 worldwide. It has 20 more in human testing, including ones for meningitis and malaria.

J&J, which previously avoided vaccines, plans to build a full vaccine portfolio, starting with universal flu and Alzheimer's vaccines, says research head Dr. Paul Stoffels.

Even Pfizer Inc.'s $68 billion acquisition of Wyeth in October was partly about getting its vaccine expertise, now being put to work against Alzheimer's. Wyeth makes the most successful vaccine ever, Prevnar, which protects children from ear infections and potentially deadly pneumonia and blood infections. Prevnar brought in $2.7 billion in 2008 sales, and with approval of an improved version pending, billions more a year are expected.

Experts call Prevnar the "game changer." It was the first vaccine to exceed $1 billion in annual sales, followed by Merck's cervical cancer shot Gardasil, with $2.3 billion in 2008 sales.

"Vaccines are now perhaps seen to be more attractive than drugs," says Dr. Stanley Plotkin, a former University of Pennsylvania professor and industry researcher who helped develop the German measles and rotavirus vaccines.

Vaccines command higher prices — roughly $375 for the three-shot Gardasil series — and so are more profitable than in the past. With only one or two makers of most vaccine types, price competition is rare in wealthy countries. Plus, they rarely face generic competition.

For flu shot makers, the risk of having to throw out millions of unused doses here come spring has plunged as U.S. guidelines have steadily widened to include 83 percent of Americans. Use has jumped from 20 million doses in 1990 to 113 million last year.

And many companies are partnering with promising biotechs, the World Health Organization and global charities, or setting up deals with local drugmakers abroad, to inexpensively manufacture vaccines in developing and middle-tier countries that increasingly want them to prevent much-higher health care costs.

"What you had was, everybody out of the water," says analyst Steve Brozak of WBB Securities. "Now, everybody's back in the water."

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