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pharmacypracticenews.com
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Q&A: Eric Tichy, PharmD, on organ transplant pharmacy.
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A.S.P.E.N. shines light on hospital malnutrition.
OPERATIONS & MGMT
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Are you automatizing mediocre skills sets in your pharmacy?
POLICY
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New ICD codes can derail reimbursement. Tips for surviving a 340B audit. Generic drug labeling triggers a fierce debate over patient safety.
TECHNOLOGY
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Barcoding, automation boost outpatient pharmacy performance.
EDUCATIONAL REVIEW
Medication Errors: A Year in Review See insert after page 36.
Spotlight on BLEEDING MANAGEMENT
CLINICAL FDA, ISMP warning: chemotherapy may melt some CSTDs.
Volume 42 • Number 4 • April 2015
Careful planning, standardized protocols among keys to success
New Treatments, New Challenges T
here’s a lot of encouraging news if you’re a hospital pharmacist managing patients with bleeding disorders. The FDA, for example, recently approved a new therapy for adults with acquired hemophilia A. Although a rare condition, affected patients can pose a huge treatment challenge due to the complexity of this autoimmune disorder. Thus, any new agent represents a significant advance, according to one expert we interviewed as part of our special section on bleeding management, which begins on page 14. Other timely section topics focus on the newer anticoagulants that have reshaped this drug class. Although it’s always a plus to have expanded treatment options, one downside is the formulary juggling that may occur when deciding on a preferred agent. For one hospital’s experience in choosing its go-to glycoprotein IIb/ IIIa inhibitor for acute coronary syndrome, see page 22. And just to keep this therapeutic area even more interesting, the FDA last month approved another new anticoagulant: a t: edoxaban (Savaysa, Daiichi Sankyo), which got the agenccy’s nod for reducing the risk for stroke and systemic embolissm in patients with non-valvular atrial fibrillation (page 20). Also on tap is the latest standardized approaches to warfarin reversal (page 16), how to assess the evidence supporting off-label use of antithrombin concentrates (page 15) 5) and a new study showing the benefits of low-molecular-weight heparin for preventing blood clots in cancer patients (page 18).
Hurdles Remain For Biosimilars— Including Savings Arlington, Va.—Is the March FDA approval of Zarxio, Sandoz’s filgrastim biosimilar, a) the dawning of a new age of access to low-cost complex biologic agents in the United States, or b) the first step on a long road to convincing stakeholders of the drugs’ savings potential, safety and efficacy? Experts speaking at a recent symposium on biosimilars tended toward the latter camp. They identified a number
Part 1 of a 2-Part Series
Cost-Cutting Initiatives Have A Happy Ending: Quality Care Anaheim, Calif.—Science trumps marketing! Education devours ignorance! Data defeat fear! The narratives behind a batch of studies presented at the American Society of Health-System Pharmacists 2014 Midyear Clinical Meeting are the stuff of novels, but they also have a more pragmatic resonance: Pharmacists keep finding ways to slash costs while preserving safety and efficacy. The Pharmacy and Therapeutics (P&T) Committee at Kalispell Regional Healthcare in Kalispell, Mont., is a case in point, having likely won friends in the C-suite after implementing two cost-cutting initiatives. The first—a conversion from the granulocyte colony-stimulating factor (G-CSF) analog filgrastim (Neupogen, Amgen) to its biologic equivalent, tbo-filgrastim (Granix, Teva Pharmaceuticals/Cephalon)—yielded a 59% savings in spending (poster 4-080).
see BARRIERS, page 28
see BOOSTING SAVINGS, page 10
New Product Tev va introduces seven new enoxaparin dosa age strengths. See page 32
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