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1. The science of Covid-19 2. Pneumonia Vaccine 3. Immunocompromised patients do well with most vaccinations including RSV – these patients at increased risk of infections – new research indicates that vaccinations against human papillomavirus, hepatitis B, herpes zoster are not a problem to give 4. Misinformation Prevention is KEY! Once you have C…

PP Talks – A Model for High Quality, Low Cost Health Care Rational -Arguments over ACA indicate that it is worthwhile to find another solution that uses basic principles to deliver high quality at low cost –The Cure That Works, by Sean Masaki Flynn Message -- health care first rate, easily accessible, and inexpensive Singapore health care system Ta…

1. Who Makes HC Policy? a. State differences – access, price and coverage b. Individuals affected – i. 17M buy insurance ii. 29M don’t have insurance iii. MCare & Medicaid not affected – State expansion of Medicaid, but higher rates of inflation in Red States 2. Hospital Closures & Medicaid Expansion a. ACA improving health care? i. Hospitals close…

What do people believe in fake medicines? 1. Differences between fake and counterfeit? a. Counterfeit is medicine without active ingredient, contaminated, or wrong ingredient i. Counterfeit examples – Fentanyl, Oncology meds – BCNU, Botox, Artesunate for malaria, antibiotics, meningitis vaccines, ED drugs b. False treatments i. Examples – fake mira…

PP Talks -- Is It Common for Compounds to Fail the FDA Approval Process? 1. Stages of FDA Approval Process IND a. Phase 1 – Safety – 20-100 healthy, 2 yrs. b. Phase 2 – Effectiveness – 100-500 patients, 2 yrs. c. Phase 3 – Effectiveness & ADR, 1K-5K, 3.5 yrs. 2. Vaccines a. Phase I fails = 37% b. Phase II fails = 69% c. Phase III fails = 42% d. Bio…

What is it? Colorectal cancer 3rd most diagnosed cancer in US (men & women) S/S = blood in stool, GI irritation, irregular stools, chronic diarrhea, sudden weight loss Diagnostic = colonoscopy – polyps, inflammation, ulcers, abnormal growths ACS testing guidelines Asymptomatic, negative family history, no polyps – every 10 years Low-risk polyps – 5…

What aren’t people talking about health care? Rationale Covid-19 Disruptions POV and lab decreased MDs financially restrained Hospitals losing money Patients lack access New diagnoses/therapies down Telehealth rising Unemployment rising Drug cost reduction CMS force PhRMA to publish drug prices on TV Legislation disallowing gag clauses Expand prici…

1. Public discussion - New information - Politics - MD subspecialties - Sources of data - Nonsense - PP Disclaimer 2. Expertise - Experts - ID specialists / epidemiologists - CDC - WHO - NIH - Survey data - FDA for potential treatments - Mistakes - Data acquisition / politics 3. Pearls - New treatments - Bogus treatments - Comps – 2019 vs. 1918 - I…

The War Over Covid-19 Expertise and the Politicization of Health Public discussion -New information -Politics -MD subspecialties -Sources of data -Nonsense -PP Disclaimer Expertise -Experts -ID specialists / epidemiologists -CDC -WHO -NIH -Survey data -FDA for potential treatments -Mistakes -Data acquisition / politics Pearls -New treatments -Bogus…

Questions for PP Talks – Covid-19 & Children 1. Rationale? a. Symptoms less severe than in adults b. Children may carry the virus w/o S/S, but may transfer it c. Data is variable and in many cases based on limited groups or on case reports 2. What do we know? a. 22% of US population is children b. 1.7% are reported cases (similar to China data) c. …

1. What is the current situation? a. US – slow response, extremely poor national management, high uninsured rate, high out-of-pocket costs, and comparatively low medical system capacity b. States in competition over purchasing PPE 2. What are other countries doing? a. International experience – management, global partnering b. Asian experience – us…

1. What is off-label drug use? a. Off-label drug use is when doctors prescribe medications for unapproved uses b. FDA cannot control how doctors prescribe c. 20% of Rx in US are fore off-label uses 2. Why use a drug for off-label purposes? a. Tried all other options without success b. Literature to support drug’s use, even if limited c. Different d…

1. Goal: Lower drug cost so that they are affordable to patients a. US Rate of Inflation (2017-2019) = 2.14% to 1.8% b. CPI = 2.0% c. CPI (health care) = 2.8% (2019) 2. Drug Cost Transparency a. Transparency = cost b. CA SB17: WAC >= $40 with 16% inflation in prior year, or 32% inflation in last 2 years 3. How do they differ? Are they effective? Pr…

Science & Data vs. Misinformation & the risks of overemphasizing Covid-19 to the detriment of other diseases 1. Where is the science behind Covid-19? 2. What treatments have been approved? What treatments are of no value? 3. With the emphasis on Covid-19 vaccine, what are the risks for standard vaccinations for measles, mumps, chicken pox, etc.? 4.…

Racism’s Impact on Health Care 1. Scope of topic = any civic, cultural, spiritual divisiveness 2. Scale = racism, sexism, antisemitism, genderism, etc., emblematic of hatred, brutality, senseless violence, exclusion, bias 3. Genesis of this podcast – police murder of George Floyd and a history of police violation of their oath 4. How do health care…

1. What has changed? a. Decreased MD office visits b. Decreased well visits c. Decreased oversight of chronic diseases d. Telehealth e. Changes in billing rules to allow for indirect patient care 2. How has technology impacted health care? a. Historical – health care behind other industries b. Current – catching up with telehealth, apps, home monit…

1. What does “second wave” mean? 2. What is transmissibility and severity of COVID-19? a. After relaxation of interventions (social distancing, population behavior change, contact tracing) b. Covid-19 hits during fall flu season c. Problem is overcapacity of the health care system 3. Precedence – H1N1 pandemic in 2009 4. Immunity Passports – Chile …

QUESTIONS What do you do if you are insured? How do you afford copays and deductibles? What do you do if you are uninsured? Will Medicaid pay? Will Medicare pay? What if you are poor? What if you are an illegal immigrant? OUTLINE Public health experts predict that tens of thousands and possibly millions of people across the United States will likel…

Questions: What does it mean to map the progress of an epidemic? Is testing crucial? What is an algorithm that is used for predicting the progress of an epidemic? What is the difference between out-brakes and modeling? What happens after modeling? Outline – Notes: Data support Testing data to map a population # hospitalizations Deaths Past infectio…

Vaccines vs. Treatment -Treatment vs. Prevention -Treatment is not curative – examples are HTN, anti-diabetic medications, anti-asthma medications -New options are antibody serum, gene PCR techniques -Prevention – examples are vaccines, gene transformations -Vaccine manufacturing process -Production technologies – using flu vaccine as an example -E…

-Restrictions oLimited doctor visits oTelehealth for showing doctor your current medical signs and symptoms oLimited medical access (lab) -Management oCardiac Disease -CHF: take weight daily – call MD if any increase in weight, then get an Rx for Lasix (Furosemide) -High blood pressure – keep BP < 140/90 with home monitoring -ASCVD/high cholesterol…

What We Learned From Previous Epidemics / Pandemics Statistics 1918: 50M people killed HIV/Aids: 39M people since 1981 Poverty to risk Inadequate sanitation Poor nutrition Crowded living conditions Lack of healthcare services Poor infection control Lack of public infrastructure Poor governance Epidemics History (very frequent until recent times aft…

What do we need to know about inhalant medications? Examples of inhalants = Respiratory for Asthma and COPD, Flonase for allergy, Afrin, Insulin, etc. What should we know about inhalants? Particle size and why? Why are some drugs administered as inhalants, and some not? How to use them? Good compliance rules What are the general complications? What…

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Corona Virus (2019-nCoV) 1. What it 2019-nCoV is? 2. How it spreads? 3. Vaccines 4. Prevention CDC Information 2019 Novel Coronavirus (2019-nCoV) is a virus (more specifically, a coronavirus) identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China. Early on, many of the patients in the outbreak in Wuhan, China r…

Blood Shortage 1. Usage = 32K pints of blood used every day in US 2. Type of blood in short supply = Type “O” 3. Impact – 4.5M a. 220mg-250mg of Iron lost for every donation – 24-30 weeks to replace iron b. Normal Iron levels = 10-30 mmol/L (also ferritin < 10mcg/L) 4. Donor requirements (Red Cross) – Good health, weight >= 110 pounds, >= 17 years …

Topics for Security Talk 1. PHI = personal health information 2. Security a. Passwords – 8 characters can be hacked in less than 1 minute b. Two Factor Authentication c. Confidentiality refers to protection of information shared with an attorney, therapist, physician (or other) from being shared with third parties without express consent. ... Priva…

Medical Devices - BP meters, blood glucose monitors - The basic regulatory requirements that manufacturers of medical devices distributed in the U.S. must comply with are: - Establishment registration, - Medical Device Listing, - Premarket Notification 510(k), unless exempt, or Premarket Approval (PMA), - Investigational Device Exemption (IDE) for …

What you need to know about Healthcare in 2020. ______ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: info@propharmaconsultants.com Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPh…

Topic: Washing Hands - Goal – Prevention of infections and spreading disease - How – water 100 degF or 38 degC, soap (?) for 20 seconds - When - Preparing food - Using toilet or changing a diaper - Blowing nose, coughing, sneezing - Treat wounds or caring for a sick person - Handling garbage - Handling pets and their food - Hand Sanitizer - Must ha…

Update on HIV/AIDS HIV-1 is a more dangerous virus than HIV-2: AIDS developed in 54% of people with HIV-1 and 43% of people with HIV-2. After eight years, half of those with HIV-1 had died. In comparison, after 15 years, half of those with HIV-2 had died. The Food and Drug Administration (FDA) recently announced the approval of Dovato, the first co…

Childhood Issues • Storage o Keep out of reach o Products not prescriptions o Child-resistant packaging • Safety o Administer as prescribed or labeled o Use dosing device (teaspoon, tablespoon, measuring cup, etc.) o Write clear instructions to caregivers o Share info with babysitters, family, friends • Destruction o Clean out used or expired medic…

Compliance – Easy to talk about, but hard to do! o Drug Compliance – definition o Same as compliance with doctor visits, lab draws, device use, BP measurements, BG measurements o Take medications as prescribed by your doctor o The best drug taken for the right reasons is no good, if it is not taken o Education is primary method o History o A proble…

Statistics o >30 million people in US, 1 in 4 don’t know they have it o 84 million US adults have prediabetes, and 90% don’t know they have it o 7th leading cause of death in US o Type 2 diabetes accounts for 90% to 95% of all diagnosed cases o # of adults diagnosed with diabetes has doubled with age and overweight/obese Risk factors o Overweight o…

Topic: Care Transitions What are care transitions? -Acute to home or chronic care/step down -Example: Hospital to home Concern -Don’t want patient to return to the hospital within 30 days for same problem - Medicare refusal to pay for certain conditions to promote prevention Issues -Understand discharge orders -Comply with discharge orders -Drug co…

Value & Ethics in Drug Pricing 1. What is the argument between high prices and value? 2. How is value determined? a. ICER b. NICE c. Cochran Reviews 3. How is pricing determined? 4. What is the ethical question? a. Support prescription and prescriber’s plan b. 20% of standard Rx are for off-label c. 50% of cancer treatment is off-label or unapprove…

Outline for OTC Talk What are OTC’s? Authorized for safety, not efficacy Many OTC were once prescription so effectiveness is ensured How should they be used? Oral – symptomatic Topical – low severity problems Cost-Benefit No doctor visit unless the condition does not improve No labs Buy generics if available Caution when paying for store-brand or p…

Compounding Pharmacies / FWA - Compound Requirements - Must be for medications for specific patients, for a specific condition, for a specific prescription - Compounding in bulk for multiple patients before prescriptions are received is manufacturing! - Limits - Patients will probably not know - Prescriber will not know unless they have a commercia…

Gender Bias in Medicine and Drug Research 1. Women 51% of population, but few women in clinical research 2. Sex is based on reproductive organs and functions assigned by chromosomes - Gender is self-representation in response to socials institutions shaped by environment and experience - Action: Education, research, workforce development 3. Medical…

All About Vaccines with special guest Dr. Mark Walberg ______ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: info@propharmaconsultants.com Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.co…

Vaping What is it? Is it vapor and flavor only? (From a child’s scientific understanding) Pharmacology principles Is this the same as smoking? Recidivism Initial impact of vaping Complications Respiratory illness Seizures Interventions Same as nicotine? OTC medications Education ______ Make sure to subscribe to get the latest episode. Contact Us: P…

AI in Healthcare Disclaimer – PP develops, innovates and utilizes AI for our clients What is AI? “the theory and development of computer systems able to perform tasks that normally require human intelligence, such as visual perception, speech recognition, decision-making, and translation between languages” Elements of AI Fundamental metrics Example…

1. Quality of prescription drugs a. Health Canada responsible for efficacy and safety of drugs marketed in Canada b. Health Canada operates under the Food and Drugs Act and regulatory mandate under the Food and Drug Regulations c. Most drugs are not manufactured in Canada d. There is no parity between drugs available without a prescription in US vs…

1. Indigent / Homeless Population a. No address b. No phone c. No income, or no money for health care d. No transportation e. No time management f. Information varies dependent on associations g. Information sharing is variable and frequently based on incorrect concerns, false conversations, etc. 2. Health Care Issues a. Poor diet b. Poor exercise …

Travel Health: 1. What are the most common health issues travelers may encounter? a. Travelers diarrhea b. In terms of “things that will kill you”, most travelers die from pre-existing medical conditions (MI) or accidents (specifically MVA) 2. Mentioned vaccines, are there other vaccines people will need to consider besides those for GI bugs? a. Ye…

Devices Used in Therapeutics 1. Types of devices used for TESTING / MONITORING and At-Home Test Kits discussed in this talk – a. Blood Glucose monitors b. Blood pressure monitors c. Prothrombin Blood Coagulation monitors d. Pregnancy test kits e. and others 2. FDA Medical Device Classes a. Class I = low to moderate risk to patient i. 47% of devices…

Beliefs: 1. Cold temperatures bring on cold/flu 2. Going outside with wet hair gives you a cold 3. The flu shot causes the flu 4. Coffee Can Stunt Childhood Development 5. Cracking Knuckles Leads to Arthritis 6. Starve a Fever, Feed a Cold 7. Gluten is Bad 8. Sitting is the New Smoking 9. Eating chocolate gives you acne. 10. Walking around barefoot…