Wednesday, July 04, 2012

By The Way, I Hate To Be The One To Break It To You If You Haven't Heard, But There's A Vicodin Train Wreck Coming. Every Prescription You Fill For Vicodin Is About To Be A Pain In The Ass.

Read it and weep my friends:

In the third quarter of 2012, VICODIN will be available in the following new formulations: 
 •  VICODIN® (hydrocodone bitartrate and acetaminophen tablets, USP) 5 mg/300 mg
 •  VICODIN ES® (hydrocodone bitartrate and acetaminophen tablets, USP) 7.5 mg/300 mg
 •  VICODIN HP® (hydrocodone bitartrate and acetaminophen tablets, USP) 10 mg/300 mg

You know the bullshit we went through with the "new" Auralgan? It'll be kinda like that. Except it'll be every other goddamn prescription we fill.

All in the name of liver safety of course. Because a 300mg dose of acetaminophen is at least 10 times as safe as the 325mg generic Norcos.

And by safe, I mean profitable for Abbott Labs. No word yet on the new Vicodin pricing, but the current bullshit 5/300 brand, Xodol, has a generic that runs $184.98 per 100 tabs.

The 5/325 goes for $28.81 at Costco.

25mg of  Tylenol. That's the only difference. And you'll probably be paying over six times as much.

This letter from Abbott is signed by an MD, who is somehow able to simultaneously claim to be a health care professional and sleep at night.

At least it's not as bad as the time they thought about making AIDS patients drink a product that tastes like vomit. 

(Thanks to the alert reader who tipped me to this).


21 comments:

Pharmaciststeve said...

Sure he is able to sleep well at night... he has taken whatever steps necessary to assure that his HUGE salary/paycheck keeps coming in and that his stock options are safe.
Narcissism is alive and well...

Stavros Krysiak said...

New from Kellogg Vicodin Corn Flakes.

Andie said...

What a freakin' scam!

Renee said...

Non-pharmacy-person question: Will doctors really prescribe it? Does it mean the old formulation (with the cheap generic) will no longer be available?

DrugMonkey, Master of Pharmacy said...

Renee,

Here's how this scam will go down. Doctors already prescribe Vicodin. Lots of Vicodin. It's probably the most prescribed med in almost any drugstore in the country.

Since it's been around for awhile though, almost all those Vicodin prescriptions get filled with a cheap as dirt generic. Right now the prescription your doctor hands you for Vicodin gets filled with a 5mg hydrocodone/500mg acetaminophen tablet.

When this reformulation hits the market though, "Vicodin" will no longer mean 5/500, and any prescriptions that say "Vicodin" cannot be legally filled with the old 5/500 formula. Anything written for Vicodin after their new bullshit hits the market has to be filled with their new 5/300 crap.

Abbott claims they are doing this in response to an FDA request to lower the amount of acetaminophen in products. The FDA has been on a kick about acetaminophen and liver toxicity of late. Thing is, there is currently a competing product by the name of Norco that is available in a 5/325 formulation and cheap generic. Abbott is taking advantage of the fact doctors are used to writing the word "Vicodin" on their prescription pads by changing the formula of Vicodin just enough to make it different from other brands. And charging you an arm and a leg, even though that doctor is intending to prescribe the old 5/500 formula.

This kind of thing has been done before, but never with a med of Vicodin's popularity. Which is why everyone involved, except for Abbott labs, in in for one huge train wreck.

I will punch the next Abbott sales rep I see in the face.

Texas Pharmacy Chica said...

....Pharmacy Chick has already proposed to REVOLT:

http://pharmacychick.blogpharm.com/2012/05/29/abbotts-announcement-today-about-vicodin/

I really don't see myself ordering in ANY Abbott Vicodin. The only reason for ordering it is to fleece patients or their insurance companies or maybe to line the pockets of Abbott executives. With weasel fur.

was1 said...

I've been saying for years that if a company changes the formulation of a drug, they should also be required to change the name. That way there is no confusion about what the doc intends for the patient.
Once again, the FDA fails to do their job.

wiley said...

It would make more sense for the drug company to make an effort to educate people about the amount of acetaminophen it takes to cause organ failure, a list of drugs that also contain acetaminophen, and some kind of reminder about how numbers add up in such a way that taking a pill with 25 mg less of acetaminophen does not mean that you can safely pop an extra pill.

Something like this:

In excessive doses, acetaminophen is toxic to the liver. In fact, it's the most common cause of drug-induced liver failure.

Acetaminophen can damage the liver when you take more than the highest recommended daily dose (4,000 mg) at one time, or when you take lower doses several times daily that exceed a total of 4,000 mg daily.

If I'm not mistaken, one of the reasons so many people have destroyed their livers with vicodin AND tylenol was because they didn't know that tylenol was in vicodin.

Anonymous said...

Wow. I bet the insurance company will change the formulary and make patients pay cash. You got to love hour knowledge is power. I am a pharmacist without insurance so I know how it feels when you shop around to buy alternative version of certain meds.

Texas Pharmacy Chica said...

I second was1: FDA should not allow reformulated drug to keep the same name. Auralgan, Rynatan (re-re-reformulation), now Vicodin.

Oh, and the fentanyl patch mess: matrix vs. reservoir, Mylan beat everybody by releasing the matrix generically before Duragesic the brand converted from reservoir to matrix, but was then a true generic? Now the Mylan brand is a true generic, since Duragesic has since reworked their patch to a matrix, but Actavis makes a reservoir patch still, so technically it is generic of 'old' Duragesic, but not 'new' Duragesic......ackkkkk...however, FDA maintains they are all interchangeable...

Anonymous said...

This is the perfect place and time for the American Pharmacist Club or whatever that crew in D.C. calls itself these days to CONFRONT the boyz at ABBOTT and demand that they cease and desist. I expect them to move on it any day now..In fact I see a magazine article THE PHARMACIST ROLE IN MINISCULE APAP DOSE CHANGING or "I went to school for six years for a so called doctorate and it's illegal for me to swap APAP 300 for 325". I hope someone warned the rehab clinics.

Rex Henricus

Anonymous said...

What about the senate bill that passed rescheduling ALL hydrocodone products to c-II?

Anonymous said...

Are the generics 5/500, 7.5/750, 10/500, 10/650 and 10/660 still going to be available or pulled?

Anonymous said...

Pulled 01-01-2014 I think.

StMarc said...

If memory serves, max recommended dose of acetaminophen is 800mg.

I propose that we require Abbott to market ONLY a 5mg/800mg under the trade name "Vicodin." You have an rx for Vicodin, that's what you get. Convenient! Fewer pills to take! Lower overhead costs!

What do you think?

Anonymous said...

What do you fill when the Rx is for Lortab 5/325? Or, Lortab 5? Or, Vicodin 5/500 or 5/325? Or, Lortab 5/300? Or...

Anonymous said...

Vic HP Brand has already been pulled from shelf in my area; had to get partial in June. My pharmacy is holding generic of same for July refill. So, by the end of 3rd qrt, all Vic products will be removed--however it appears the BRAND of new with 300mg APAP being available--is lagging, causing significant problems. And, there is no generic because it is a new patent --so yes, it will cost signficantly for a time to come. For some reason I couldn't take Lortab yrs ago; made me quite tired, but Vicodin did not. I may have to take it anyway--as I am not going to pay 300.00/mo for this "replacement".. and I refuse to go up a Tier to Class II which requires handwritten RX ea month, brand new issue, no refills. I'll have to deal with this until the new "reformulation" of Vicodin has gone generic. What a mess.

Anonymous said...

OK King Henry,

I like your idea, but unfortunately our trade organizations are too busy getting sexual favors from pharmaceutical companies to care about us and give us the power to change an APAP dose by 25 mg, a completely insignificant amount unless you are under 30 lbs. State boards are not going to touch this thing unless others have done something similar first. Which means nothing is going to happen.

And this is where I will voice my opinion that legal marijuana should be dispensed only via pharmacies. Not some place like the 'Little Green Pharmacy' or such like. Any state where this takes place is just another state board with no balls, boobs or soul.

Regards,

Regina Texana.....

Hospital Pharm said...

Thank God this type of crap doesn't happen that often in Canada. Paxil CR being a memorable exception. I am SO GLAD I am not a retail pharmacist in the US!

rxster said...

Received a rx for "Vicodin 5/325" called MD to verify strength, MD subsequently screamed at me for 20 min, saying that he has never heard of norco, that vicodin comes in 5/325 and I should be smart enough to know what he meant anyway. Also said he was planning to file a complaint against me and told his patients not to use our pharmacy. When brought to the attention of my supervisor he essentially agreed saying I should just fill the generic hydrocodone/apap 5/325mg because "we know what he meant". Is it just me or would this be an illegal generic interchange???

Anonymous said...

Oh, OH OH it gets better.

All of the dentists in my area had ALREADY swapped their RX software months ago, before the product was even available.

They're all still switched too. So if they type in "Vicodin 5" (their strength of choice around here), it defaults to the 300 APAP rather than the 500.

FUCKING headache, have to call them 90% of the time (the other 10% get excited and quivery as soon as they hear "brand"), and they act all huffy that we're 'bothering' them too much. Especially the Medicaid Dental Mill. HATE THEM.

Best part was my PIC (yes I'm a tech) blowing me off when I said "hey maybe we should put this in the ACCURACY notes since it's already causing miss-fills" (stupid miss-fills to an extent, but sill a miss-fill).