Non-CVS Pharmacy Company Fined For Wrongdoing.

In a shocking press release made public this month, the Drug Enforcement Administration confirmed that the latest target of a pharmacy related investigation was not leading drugstore operator CVS.

"We have concluded an investigation into the diversion of oxycodone through legitimate pharmacies in the state of Florida and onto the streets of cities throughout the country, and have concluded that it in no way involves CVS." said lead field agent Dirk Bradford at a press conference at DEA headquarters this afternoon. "As unbelievable as it may sound, CVS is in no way accused of doing anything wrong at this time."

The investigation uncovered stores that had sold as many as 2,200,000 pills of oxycodone over the course of a year and not a one of them was a CVS. Seriously. The company that has over the years been accused of among other things, bribing state senators, employing fake pharmacists, overcharging both the Medicare system and individual Medicare recipients, as well as letting a customer have an asthma attack in one of their stores because they were a couple dollars short had nothing to do with this scandal.

I'm not kidding you. Six stores lost their DEA license in Florida over this. And a company that is not CVS will pay an 80 million dollar fine.

Walter Brombach, a retail analyst at Goldman Sachs expressed concern the company was losing its competitive edge.

"After being a trailblazer in showing just how far a corporation can go in skirting the law to profitability, these latest developments raise the specter that CVS' competitors may be catching up and developing their own ways of calculating the reward/risk ratio of defying accepted laws and social norms. That being the case I am immediately downgrading my rating on the stock from 'strong buy' to 'hold"

Other analysts were more optimistic, noting that CVS had its own oxycodone scandal in 2012 and this was simply a case of others mimicking the industry leader.

Reached at the company's headquarters in Rhode Island, CVS spokesman Mike DeAngelis said "We remain committed to serving our customers and will work with the proper authorities.....wait....no....this isn't us.....no comment."

This Week's News Headlines. As Fresh As One Of My Five Year Old Blog Posts. Or, I May Be On The World's Longest Acid Trip.

Fans of The Supreme Court and my little blog garden got a taste of my eternal wisdom and foresight this week when they anxiously logged on to their favorite news source and saw this story about the doings of the highest court in the land:

The Supreme Court ruled Monday that brand-name drug makers can be sued for violating the antitrust laws if they make a deal that pays a potential competitor to put off selling a generic version. 

The 5-3 decision is likely to benefit consumers with lower prices. The Federal Trade Commission, which has pursued suits against the drug makers, estimated these so-called “pay for delay” deals cost consumers and health plans $3.5 billion a year.

This is the kind of story that separates my true fans from the pretenders my friends, as those who worship my words knew all about this scam long ago. For the rest of you, I'll bring back The Bullshit Exposure Through Dramatization Players to explain the issue with a repeat performance of their 2007 hit "Can't We All Just Get Along?"

Generic Drugmakers: Oh Big Pharma, can't we just get along? Why, when your patent runs out for a medicine, must we sue each other for years instead of competing in the marketplace? Can't we just play by the rules and both earn a legitimate profit? 

Big Pharma: There, there little guy. You think our lawyers are mean when they sue each other, but really they are doing us both a favor. Yes, you could make a billion dollars selling a generic version of our drug for 70% less than what we charge, but that would involve you actually doing work. When we sue each other, we can settle, and I can pay you three quarters of a billion dollars to do nothing. We both win. 

Generic Drugmakers: But what about the American people, who will continue to have to pay whatever you want to charge for access to this medicine? 

(30 seconds of silence) 

Big Pharma: Here's a big check. 

Generic Drugmakers: You are wise and just Big Pharma.

You read that right (over 5 years ago) Big Pharma has a habit of paying generic drugmakers not to make a product so they can continue to charge the monopolistic prices we all know and loathe. And this week the Supreme Court said they continue to do so at their own peril.

So George Bush's fight against Big Pharma has been won.

You read that right, and I remain as baffled by this as I was the day I first visited the subject. The man who brought us The Iraq war, the one who so skillfully managed the other conflict he started in Afghanistan, the person who gave us Guantanamo and laid the groundwork for the spy state we now live in....took Big pharma to task for overcharging the American people.

Do you think he even knows? Maybe he has no idea and he's gonna be really mad when he finds out.

Or maybe John Roberts has a prescription for Crestor. That's the only other idea I've got. Even my great wisdom has limits it would seem.

Of course I theorized at the time I was on acid, which still might explain a lot actually.

Anyway, I am wise and insightful. Mostly.

Rite Aid, Battered Like A Wife Of OJ Simpson, Somehow Manages To Rise From The Dead And Limp Around Like A Mutant Zombie.

CAMP HILL, PA- In a surprise news conference today that turned out mostly to be a one man monologue, Rite Aid CEO John Standley announced what he called "a bold new era of service to our customers, our patients, and our employees."

"Let's be honest, this company's been in trouble for a long time now, and our recent announcement of a return to profitability after six years surprised me as much as anyone. Naturally the first thing I thought of was that the boys in accounting screwed up again, they're not exactly the sharpest pencil in the drawer you know."

"Then I thought maybe it was a practical joke, and I got scared. Lying on official SEC filings, no matter how funny, is something that could put me in jail. And the stories Marty (former Rite Aid CEO Martin Grass) has to tell can make the hair on your back curl."

"But then it began to sink in. We just might make it. All our hard work, well, mostly my hard work, is finally starting to pay off. Our vision, our determination, and our drive, has finally put us in a place where after a three month period we have more money left than we spent. After I let that sink in, I asked myself 'now what are we going to do with it?'

"Why not use it to build something different, I asked myself. Why not use our near death experience as a teachable moment, an opportunity to show the world that when an organization buckles down, looks deep inside itself, and demands incredible sacrifices from its members in order to survive, that it should use that survival to show the world that those sacrifices were worthwhile. That's why I'm pleased to announce the new Rite Aid, committed to being the most dynamic and rewarding place to work in the whole drugstore industry. From now on, our business leading program, "RiteLife" will strive to find ways to let our employees know we value and care for them as people."

"For example, obese people have by and large a lower quality and shorter life than those of us of normal weight. So our new program of mandatory weigh ins is just a way of showing how we care for you. And the savings generated by not having as many fat asses on our payroll will go a long way towards generating many more profitable quarters to come."

"Profitable...and rewardable...for you!!! Just think of every time you step on the scale soon to be installed in every breakroom as like a treat from Grandma. Without the calories!!"

"And if you think that's exciting, just wait until you see what else RiteLife has in store. I don't want to give away too much, but let me just whet your appetite with 5 words, keystroke loggers and phone taps! All perfectly legal, after you sign the RiteLife Rewards Release form."

"One thing's for sure. Now that we have some monetary resources coming in, every employee will soon know just how much we care. About everything they do."

"Everything."

Reached for comment, CEO of leading drugstore chain CVS Larry Merlo said "Groundbreaking my ass, we've been weighing the fatties for months now. And just because he got away with firing some jackass who shot off his mouth in front of the whole goddamn internet he thinks he's head of the CIA or something. That punk doesn't have the slightest idea what controlling someone's life is about."

"Trust me" Merlo concluded, "No one cares for their employees more than CVS."

"No one."

Crucified And Reborn. You May Now Refer To Me As Pharmacy Jesus.

It's been the worst kept secret in the world here in my little corner of the pharmacy world, and those of you who haven't caught on by now deserve to know.

I bought my own drugstore.

I'm not kidding you. I could drive to the nearest pharmacy right now, unlock it, and fill you a prescription if you had one. Because that nearest pharmacy would be mine. I can do whatever I want, including telling you to get the fuck out.

Here's the thing though, now that I *can* tell people to get the fuck out....I have yet to meet anyone I would want to say that to. I said during my entire sentence toiling away for the chains that I would act like a professional as soon as I was treated like one, and the people of this community have called me on that. They're glad I'm here. Person after person has shaken my hand and welcomed me to town. I go about my day to day routine and people want to stop and make friendly smalltalk. I had almost forgotten what friendly was like. One man routinely brings eggs from his farm and I had no idea how yellow egg yolks could be. Not one person has asked me why their prescription is taking so long.

Probably because it never takes that long to fill one. It's amazing how much quicker things can move when there is no corporate bullshit and there is the freedom to staff a workplace adequately.

This may be bad news for you though, if you are a fan of my little blog garden, as I fear I may have turned into the pharmacy blogger version of Aerosmith. The creative process when done well almost always feeds off misery, and I gotta be honest, I haven't been miserable in a good while now. Haven't had so much as a sip of scotch in at least two months, and that is the God's honest truth. So if you start reading my posts and begin secretly begging me to get back on the sauce the way I so desperately want Steven Tyler to get back on the smack, I understand.

But it's not gonna happen. I haven't been this unmiserable since college.

So, I'll try to come here and check in and entertain from time to time, but if I have learned nothing else, it is that running a business...and I mean running a business and not just "managing" a pharmacy by paying attention to the metric of the month, is an incredible time suck. There aren't many free minutes in my life right now my friends, but there is so much less stress.  I wish Rite Aid would have fired me years ago, but I understand now why it couldn't happen.

You see, my time in your pharmacy world was necessary. These last 20 years in retail have only been preparation to show you the way out. Crucified and now reborn, I await for you to follow the path to redemption I have blazed. I realize now, I am pharmacy's chosen one.

I am... Pharmacy Jesus.

Today's Cruel Little Legal Joke

An actual line from the actual California Pharmacy Permit application:

"any non-pharmacist owner who commits any act which would subvert or tends to subvert the efforts of the pharmacist-in-charge to comply with the laws governing the operation of the pharmacy is guilty of a misdemeanor"

To which CVS says......BBBBWWWWWWAAAAAAHHHHAAAHHHAAAHAAAAAA!!!!!!! What a quaint little law from a different time. Kinda like the one still on the books in the nearest town from here that says a driver has to honk his horn at the city limits in order to warn any horses on the street.

"But.....why were you looking at a pharmacy permit application Drugmonkey?" some of you may be asking.

More will be revealed my friends. Stay tuned.

Insist On Brand Name Poly-Vi-Flor Or Your Baby Will Be Crazy, Mentally Challenged, Eaten By Their Own White Blood Cells, Then Finished Off By Cancer.

I just saved you the effort of reading the latest fax from Zytera Pharmaceuticals with that headline. Those of you wise enough to already have a copy of my latest book know that Zytera is the company that bought the rights to the Poly-Vi-Flor and Tri-Vi-Flor brand names, and that both products were boring old baby vitamins on the market as long as anyone can remember, only requiring a prescription to make sure your kid wasn't getting too much fluoride, the tooth hardener that turns your teeth to mush when taken in excess.

Anyway, boring old product most doctors still prescribe by name, even though 99.9% of those prescriptions have been filled with a generic for decades, then a new company buys the name. Most of you know where this is going. The old "minor change" trick. The company buys the name, makes a minor change in the formula, and now, all the sudden all those Poly-Vi-Flor prescriptions can no longer be filled with the cheap generic. I'm looking at you Auralgan.

In the case of Poly and Tri-Vi-Flor......Zytera uses a slightly different form of folic acid, one of the B vitamins. The folic acid we eat or take in vitamin supplements, like a gazillion other drugs and food parts, is metabolized into the form your body eventually uses. That is the full time job of your liver. Changing the stuff you eat into the stuff you use. Zytera uses the form of folate that comes out of your liver for the new Poly and Tri-Vi-Flor.

Ho hum.

Not to hear the folks at Zylera tell it though, after the usual blah blah blah about how the new formulations are NOT pharmaceutically equivalent to previous (inexpensive) formulations, this is what today's fax said, word for word:

Recent studies have indicated that 40-75% of the population has a genetic variant called methylenetetrahydrofolate reductase also known as MTHFR that impairs the ability to process folate. This defective gene leads to elevated levels of homocysteine and defective methylation. Defective methylation is associated with psychiatric illnesses, such as schizophrenia, depression and bipolar, as well as autoimmunity disorders, ADD, autism, spina bifida, Down's syndrome, miscarriages, and cancer.

I'm not making this up. Basically a pharmaceutical manufacturer this day sent out a fax to pharmacies around the country that essentially said... HOLY MOTHER OF GOD IF YOU DON'T USE BRAND NAME POLY-VI-FLOR THE BABIES WILL BE CRAZY AND RETARDED AND DEAD!!! THEIR OWN WHITE BLOOD CELLS WILL JOIN UP WITH RAMPAGING CANCER TO EAT THE CHILDREN FROM THE INSIDE!!!!! BE AFRAID BE AFRAID BE AFRAID!!!!!!

I will step back here and remind you we are talking about baby vitamins. Hopefully you won't need me to tell you that 40 to 75% of babies born in the last 40 years have not turned out to be spina bifida wrecked schizophrenics, despite how badly the people at Zylera would like you to believe that. My guess is there's a reason these incredibly irresponsible bullshit claims were made in a fax, and not in the more permanent and traceable form of a postal letter or advertisement.

So thank you Zylera. Before I got this fax the temptation was very strong not to use my limited amount of time behind the counter calling doctors to explain why Poly-Vi-Flor is now bullshit. You can bet your left testicle that whenever I see a prescription for your crap in a bottle from now on though, time will be made.

Fuckers.

My New Book Is Now Here In All Its Glory And In All Forms Paper And Electronic. Get Your Copy Or Be Forever Doomed To Pay Too Much For Your Vicodin.

Because those of us in the know all know that the new Vicodin is a rip off. Nothing but a cynical ploy to take advantage of the brand name of the most prescribed drug in America in order to score some unearned dollars.

If you don't know that, then you seriously need to get on Amazon right now. Click on this link as fast as you can. 

Or click here if you get your words from a Nook. 

If you do know that, and wanna know more about this kind of crap in a bottle, than you really should click on that link too. 'Cause you'll find a new book chock full of examples of the bullshit that sometimes passes for innovation in the world of Big Pharma.

Doryx anyone? Treximet? Makena? And more zit creams than you can shake a stick at.

Actually now that I think about it, I'm realizing this may just be the most important book ever written. Seriously. Everyone from kids with zits to seniors with Alzheimer's will benefit from the words I have written. I never realized until now just what a humanitarian I am.

I should get an award. Anyway, here's another excerpt so you can see what I'm talking about.

 Aricept 23

The Med

Aricept, the brand name of donepezil, is a member of a class of meds known as cholinesterase inhibitors. It works by increasing the amount of acetylcholine in the brain, and has become a cornerstone of Alzheimer's therapy. While not a cure, it can delay the progression of symptoms and is one of the limited options available to sufferers of the disease. As such it became a blockbuster seller for its makers, the Japanese company Eisai and their American partners Pfizer, generating over $2 billion in annual revenue. It was set to lose its patent protection in November of 2010 however, which would lead the way for generic competition.

The Scam

I almost didn’t list the meds in this book alphabetically, because I wanted to save this one for last, as it crosses a line I thought would never be crossed. Aricept was available for years in 5 and 10 milligram strengths. Shortly before its patent protection was set to expire however, Eisai and Pfizer applied for approval of a 23 milligram version.

“What an odd number” you may be saying to yourself. Notice how that odd number cannot be reached by using the soon to be cheap 5 and 10 mg strengths.

Still, it is intuitive that a higher dose of medication would improve clinical outcomes. Science doesn’t run on intuition though, in science things have to be proven, so a study was started. The FDA set a benchmark that said the new strength had to improve both cognitive (mental) and global (overall) function in Alzheimer's patients in order to be approved.  

Aricept 23 flunked. The study showed only slight improvement in cognitive function and no improvement at all in global function. The FDA however, against the advice of both a clinical and statistical reviewer, approved Aricept 23 anyway. The New York Times reported that Dr. Russell Katz, director of the F.D.A.’s neurology products division, “acknowledged side effects from the higher dose ‘could lead to significant morbidities and even increased mortality,’ but concluded that the drug most likely improved overall functioning even though the study did not show that.”

Two points about what just happened here:

1) “but concluded that the drug most likely improved overall functioning even though the study did not show that.” So much for science not running on intuition, as the intuition of the right person was what got this drug approved. The medical professions have become used to numbers being massaged, facts being twisted, and any and everything possible being done to put a med in the best light possible in the scientific literature, but this is the first time I’m aware of when they’ve given up on even pretending like the scientific facts matter. “The study did not show that,” and it still didn’t matter.

2) Which might be forgivable if it were done in the name of trying anything possible to help the victims of a terrible disease. But Katz also “acknowledged side effects could lead to significant morbidities and even increased mortality.” Just to be clear, morbidity is a fancy word for sickness. Mortality is one for death.

So the FDA approved a drug that did not meet its criteria for effectiveness, and that its head of neurology products said may leave more people dead. That’s the story of Aricept 23 in one sentence.

Oh, and Aricept 23 costs about 90 dollars a month more than the safer and effective 10mg generic version.

What To Do

Let me be clear: Aricept 5 and 10mg are perfectly appropriate choices for Alzheimer's patients. It’s only when the dose went up to 23mg that it crossed the line into bullshit. There may be isolated cases where a dose that high is beneficial, but they tried to prove its effectiveness at that dose and got marginal results. What Aricept 23 does do is more than triple the incidence of nausea and vomiting, increase by 60 percent the chance of diarrhea, and depletes your loved one’s assets by over a thousand dollars a year. Unless there is a good reason not to, stick with the lower doses.

_____________________________________________

Wow. That was awesome. And there's plenty more where that came from my friends.

You are just a click away.

You Are The Donkey Here. The Chair Is CVS.

Or Rite Aid. Or Walgreens. You get the idea.

And sometimes the chains that bind us are 7,000 store corporations.

But, you do not have to be bound to that plastic chair my friends. Trust me on this. News is coming soon.

I'm free.......:)

So, Yeah, The New Book's Still Coming. Here's An Excerpt To Whet Your Appetite

Remember that nice cover I talked about last time? You can blame it for the current delay. I think "Scribus" is some sort of Latin word that translates as "software from hell"

Nothing that can't be handled though, it'll just be a matter of finding some time to work it in now that I have another project. A big project. Huge this project is. In about a month or so I'm gonna drop a bomb on you muthas that you may not believe. In the meantime, here's a piece of my book. Just to recap for those of you playing along at home. It's called "The Pharmacy Ripoff List" and it calls out 50 of the biggest pieces of crap stocked on pharmacy shelves across the country. Like this one....

_______________________________________________________________________________

Chapter 25: Latisse

The Med

When I first heard of Latisse, it made me question my medical knowledge. Later, as I learned more, it made me question my sexuality. Latisse, you see, is the first prescription eye drop to treat hypotrichosis, which sounds scary and serious. My first thought was maybe hypotrichosis was the fancy medical name for African River Blindness or some other dreadful sight-threatening condition. But when I looked it up I learned that scary sounding hypotrichosis is actually:

”inadequate or not enough eyelashes”

This was a problem? I started a search for the signs and symptoms of this condition. I wondered what the prognosis was for sufferers. Allergan, the maker of Latisse, seemed very excited about it, so I figured this new treatment must be some type of revolutionary medical breakthrough. But after I dug into things for awhile, I learned that most “patients” that were to come to me with prescriptions for Latisse simply wanted to be sexier.

That was a surprise to me, because I’m pretty sure I’ve never once said to myself, or heard anyone else ever say anything like, “Whoa!! Check out her eyelashes!!” I’ve never once had eyelashes figure into a dating decision or complimented a woman on hers a single time. Maybe eyelashes play a role in human sexuality that I was completely unaware of. Maybe I’m some sort of pervert.

The Scam

Or maybe Allergan is taking advantage of the extreme shallowness that prevails in modern society. Latisse is nothing new. It is simply a repackaging of the anti-glaucoma medicine Lumigan. The people at Allergan noticed that glaucoma sufferers using their product sometimes grew thicker eyelashes, so they put it in a different box and pretended it was something new. It is not. It is the same stuff, in the same strength, with the same side effects, including the risk that it may change the color of your eyes to brown. The only difference is Latisse is packaged with a supply of little brushes that make applying it to your lashes easier. Let me repeat this to be clear: There is no difference between Latisse and Lumigan other than the name on the box.

If you decide that sexy eyelashes are what you want though, and you really desire the little brushes to help you put on your Lumig....er....Latisse, be ready to pay around $110 a month.

What To Do

Pick up a book, because a smart woman is the sexiest of them all. Why do you think librarians and nurses play such prominent roles in fantasy lives? While you’re in that book maybe you’ll learn that African River Blindness has taken the sight of over 300,000 people even though it can be treated for only a few dollars. Maybe then you’ll be at the bar talking about the unfairness of it all and you’ll sweep a socially conscious hunk of a man right off his feet. Or, at the very least, you could join a gym, and develop the parts of your body a shallow man-pig would actually be attracted to while doing wonders to improve your overall health.

Because Latisse, while marketed for the treatment of hypotrichosis, is far more effective in curing “more money than brains” syndrome.  

____________________________________________________________________


Holy crap this sounds like a great book. After reading that chapter again I am nothing but thankful this night I have a copy here on my computer that I can read anytime I want. 

Soon you will too my friends. Just as soon as the Scibus is overcome. 

Fucking Scibus.

Drugmonkey, What's This I Hear About A New Book? I Hope It Addresses A Need And Maybe Annoys Some Drug Companies.

Well you are in luck my friends, because the new book does just that.

Lemmie ask you something. Are you tired of the bullshit you end up stocking on your shelf? When I say Doryx everyone who's ever worked in a pharmacy knows exactly what I'm talking about. There is a whole sub industry that has evolved in the pharmaceutical world over the last few years devoted to ripping off people and their insurance companies.

Solodyn. Need I say more? In case I do check out the product offerings from Shionogi Inc. A company built on crap. Every day I hear the eyes rolling from the pharmacy workers of the world as the Latisse, Sarafem, Treximet and Paxil CR roll out the door.

Not to mention the Aricept 23. It was the Aricept 23 that pushed me over the edge. They crossed a line with that med I thought would never be crossed.

I also hear your voices every day as you slap the label on the Acanya and deal with another goddamn "savings card." "Someone really needs to call bullshit on this." you say over and over again. Well now someone has.

Me.

I've taken 50 of the biggest rip offs disguised as medicine ever to stink up a pharmacy counter and called them out for the world to see. Aplenzin, Duexis, Moxatag and Zipsor. They're all here plus lots more. All together in one handy guide to the way loopholes are taken advantage of in order to maximize the separation of patient and money that happens with every medical encounter. I explain what they are, what the rip off is, and what to do about it for each of them.

"What a great thing to have available for your patients", the Drugmonkey said to every independent pharmacy owner. What a great thing to sell next to your cash register. I can hook you up at wholesale prices.

It's coming soon my friends. Like within days. I'm going away fro the weekend, but when I get back I'll post a sample for you all to see. In the meantime I'll tell you the cover looks nicer than my last one. If you're the type of person who judges a book by nothing but its cover, you're gonna think this one is way better.

It's about time someone wrote this book.