Eileen Oldfield Associate Editor

Recent spike in HIV cases linked to intravenous drug use.

Amid an HIV outbreak in Indiana and associated public health emergency declaration from Gov. Mike Pence yesterday, the pharmacist’s role as a disease educator is moving to the forefront.  

“Pharmacists can educate [HIV-infected patients] about risk reduction strategies, advocate for testing and testing frequency, and refer them to community sites to access services, such as testing,” said Eric K. Farmer, PharmD, BCPS, AAHIVP, an HIV clinical pharmacist at Indiana University Health’s Life Care Clinic, in an exclusive interview with 

. “Of course, pharmacists can always counsel on good sexual health practices, and other kinds of services that are available, like pre-exposure prophylaxis.”

Public health officials have linked the 79 HIV cases reported in Scott County, Indiana, in recent months to intravenous drug use, according to 

Locally and nationally, pharmacists should address adherence to HIV treatment and any other medications the patient might be taking, including OTC medicines, during each patient interaction, Dr. Farmer said.  

Additionally, pharmacists could bridge the gap between patients and other health care team members by encouraging patients to understand their lab test results and various medications. Pharmacists should also stress the importance of bringing complete medication lists when visiting health care providers, Dr. Farmer said.  

Staying aware of antiretroviral medications stocks should be a particular focus for pharmacists, especially in community pharmacies that might not stock the therapies regularly, Dr. Farmer stressed.

“These are typically medicines that patients cannot go without, so pharmacists should problem-solve ways to get a patient a 3-day supply until some can be ordered, or refer a patient somewhere else where they can access medications,” Dr. Farmer said. “For retail pharmacies, it’s very common to have a medication-stocking issue with antiretrovirals. These are very expensive medications, and they’re very expensive to have sitting on the pharmacy shelves, so a lot of times, pharmacies won’t carry them unless they know they have a patient that is on them.”  

Dr. Farmer recommended understanding the local and regional HIV resources available to patients and providers, including AIDS Education and Training Centers or the Clinicians Consultation Center. Pharmacists can also find local and regional HIV and AIDS clinics and then refer concerned patients to these resources.  

Dr. Farmer offered 2 key pieces of advice for pharmacists who may encounter HIV-related questions.  

“I always tell my pharmacy colleagues to consider any drug interaction with an antiretroviral significant, until they learn otherwise. Regardless of when you graduated, seek out and do a continuing education credit on HIV,” Dr. Farmer said. “In the last year, there have been 4 new antiretrovirals that have come on the market, so things are changing rapidly.”   

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In Indiana HIV Outbreak, Pharmacists Spearhead Disease Education

Amid an HIV outbreak in Indiana and associated public health emergency declaration from Gov. Mike Pence yesterday, the pharmacist’s role as a disease educator is moving to the forefront.

Locally and nationally, pharmacists should address adherence to HIV treatment and any other medications the patient might be taking, including OTC medicines, during each patient interaction, Dr. Farmer said.

Additionally, pharmacists could bridge the gap between patients and other health care team members by encouraging patients to understand their lab test results and various medications. Pharmacists should also stress the importance of bringing complete medication lists when visiting health care providers, Dr. Farmer said.

“These are typically medicines that patients cannot go without, so pharmacists should problem-solve ways to get a patient a 3-day supply until some can be ordered, or refer a patient somewhere else where they can access medications,” Dr. Farmer told 

. “For retail pharmacies, it’s very common to have a medication-stocking issue with antiretrovirals. These are very expensive medications, and they’re very expensive to have sitting on the pharmacy shelves, so a lot of times, pharmacies won’t carry them unless they know they have a patient that is on them.”

Dr. Farmer recommended understanding the local and regional HIV resources available to patients and providers, including AIDS Education and Training Centers or the Clinicians Consultation Center. Pharmacists can also find local and regional HIV and AIDS clinics and then refer concerned patients to these resources.

Dr. Farmer offered 2 key pieces of advice for pharmacists who may encounter HIV-related questions.

“I always tell my pharmacy colleagues to consider any drug interaction with an antiretroviral significant, until they learn otherwise. Regardless of when you graduated, seek out and do a continuing education credit on HIV,” Dr. Farmer told 

. “In the last year, there have been 4 new antiretrovirals that have come on the market, so things are changing rapidly.”

The pharmacist's role as a disease educator is moving to the forefront.

Costs have risen 120% in aggregate since 1995.

Cancer drug prices have increased 10% each year since 1995, even after adjusting for inflation and incremental health benefits.

In 1995, 58 leading cancer drugs cost approximately $54,100 for each year of life they were expected to add. The same drugs cost approximately $207,000 for each additional year of life in 2013—an increase of about 120%, in aggregate, a new study from the Massachusetts Institute of Technology (MIT) revealed.

The rising drug prices may reflect more social tolerance for significant health care costs, despite criticism by physicians and other health care groups, the authors said.

“I think the value of good health has really increased enormously over the last few decades,” said study co-author Ernst Berndt, the Louis E. Seleye Professor in Applied Economics at MIT’s Sloan School of Management, in a press release. “We treasure our health and are willing to pay a fair bit for that.”

Although the study found a positive correlation between therapy efficacy and cost, prices tended to increase more than quality.

“We found that the greater the improvement of the drug over existing therapies, the higher the price,” Berndt said in a press release. “So, price was related to quality—but price increased more than did quality.”

In 2013, a group of 100 prominent oncologists claimed that pricing policies involved finding the cost of the most recent similar drug available, and pricing the new product within 10% to 20% of that drug’s cost. Although that assertion is consistent with reference price models of demand, it is often challenging to determine the extent to which a drug’s price relates to its development cost, Berndt said.

The federal 340B drug pricing program may also play a role in the cancer drug cost increases, as the discounts it requires for certain hospitals and clinics may prompt companies to raise therapy prices.

The researchers concluded that price increases relate to research and drug development costs, which also prompt manufacturers to discover new therapies.

“We believe the direction of causation runs from prices to research and development costs—as prices increase, manufacturers are willing to spend more to discover new drugs&mdash;rather than the other way around,” the authors concluded.

Cancer Drug Costs Soared in 2 Decades

In 1995, 58 leading cancer drugs cost approximately $54,100 for each year of life they were expected to add. The same drugs cost approximately $207,00 for each additional year of life in 2013—an increase of about 120%, in aggregate, a new study from the Massachusetts Institute of Technology (MIT) revealed.