Pepin's Pharmaceutical Prattle for 09-16-2002
	Quote of the day: Nothing is more pleasing and engaging than the sense of having conferred benefits. Not even the gratification of receiving them. Ellis Peters

Good day mate! As you enter the season of open enrollment…try to remember the quote above. People seem to work as much for "benefits" as they do for the pay they receive. In this "employers market" for good people they may seem only a necessary expense…. and one that keeps increasing. While it is rare for employees to rave about their benefits…..they do appreciate them….especially if they ever lost them due to a "down sizing", "right sizing" or just plain old "lay-off". . Picture how you'd feel without them! (Pretty ugly) So you will have to take gratification in knowing that you are helping families, workers, children, spouses get healthy, stay healthy and be productive. We all appreciate your work. Hang in there!

1 "Sniff…sniff…DO I'mb nod cryin'…I can't get by anDihistabines….sniff"
	More plans are considering elimination of prescription non-sedating antihistamine because Claritin will go OTC. (Not just Wellpoint anymore) This makes sense to me. …Click here for full story.

2) States likely to get hooked on this....

The Sunshine State requires rebates from pharma to be on Medicaid formulary…and the federal judges agree. Watch for the Domino effect now! This is one step taken by government to assure that rebates will not go away. Thus begins another Love-Hate relationship much like the tobacco companies and the states…they love the tobacco tax revenue but hate what the smoking does to their healthcare bill. Giving higher rebates to the states will only push the pharma companies to raise prices to everyone….eventually even the States themselves. …Click here for full story.

3 FDA throws a wrinkle into BOTX ads….
	Hollywood has second thoughts about actor who use BOTOX because they can't express themselves as well….FDA has reservations about BOTOX promotions and wants all brochures and TV ads pulled…Manufacturer thumbs its non-wrinkled nose at them.…Click here for full story.

4 I smell a new prior authorization….or is that just a cigarette?

Patients with Crohns' are less likely to respond to Remicade (aka Infliximab) if they smoke. The authors offer no good reasons. I suspect that it may be due to enzyme stimulation caused by the smoking… more like the aminophylline /smoking interaction. It is an orphan product so we may never know. Although this sounds like the stuff of NEW prior authorization criteria…it should not. This might be better as a physician or patient education piece. …Click here for full story.

5 At $5 Million/day maybe she could make up her mind!
	Prilosec court ruling update….there is none. This is giving everyone "heartburn". The judge just took another high profile case so the ruling could come soon. Each day of delay is another $5 million in sales retained by AstraZeneca. (Merck gets 30% so it profits for each day of delay too). I need a job like that…the less I do the more I earn! …Click here for full story.

6 Carpel Tunnel vision!

Surgery touted as the best treatment of carpel tunnel syndrome. The study compared splints to surgery….surgery won….surprise! No mention of vitamin B6 treatment… which appears to help. Some pregnant women will get carpel tunnel syndrome even without repetitive stress injury. Something about the pregnancy causes their vitamin B6 levels to fall. Replacement seems to do the trick. Other risk factors include menopause, thyroid disease, and diabetes. For those with carpel tunnel syndrome….you may wish to try (with your physician's blessing) high doses of vitamin B6 (pyridoxine)- that is 100mg 2 times per day for 4 to 8 weeks. (Don't EVER go over 300mg/day).The studies are not conclusive but may be worth a try. If you experience any weird side effects report them to the physician (see above where I mentioned you should have permission and direction.) …Click here for full story.

7 Pop, Soda, or Coke……? Which is it?
	An interesting article on the regional differences in how people refer to soft drinks. The "prattle" part of this story has to do with the "Phosphate" angle….and the soda jerks of pharmacy days gone bye… …Click here for full story.

8) I have Plague and Anthrax….. Not the actual diseases…the silk ties. Infectious Awareables is our new partner…just in time for that online holiday shopping (Columbus Day is just around the corner). I have purchased ties at the site before and they are top-notch quality. Any purchase at the site benefits PHARMWORKS and supports "the Prattle" if you initially link to it from this site. They sell women's scarves, men's boxers, caps, T's, and more. The general theme is that the striking patterns on the merchandise come from pictures of microbes taken under a microscope. Rich, vivid colors and interesting patterns. So "Get your Syphilis…get your gonorrhea…get your dental plaque…." …Click here to shop at Infectious Awareables. You can also just click on INTERNET LINKS from the main menu.

Have a GREAT week! (Shop 'til you drop!)

Disclaimer: "Pepin's Pharmaceutical Prattle" (AKA "The Prattle") is the property of PHARWORKS, LLC and Steven M. Pepin, Pharm. D, BCPS. The opinions expressed are those of the bald-headed author. To be added to or removed from the distribution list please e-mail your request to ppp@pharmworks.com . All insightful comments from readers are thoughtfully considered (the rest are callously discarded).