NABP e-News: February 18, 2010

Google AdWords to Require VIPPS Accreditation for Internet Pharmacies Marketing to US Patients
A new policy adopted by Google AdWords on February 9, 2010 will require US Internet pharmacies to have Verified Internet Pharmacy Practice SitesCM (VIPPS®) accreditation for ads to be accepted. Further, the Google AdWords revised policy allows US Internet pharmacies to target ads only to patients in the US. The policy change will make it more difficult for rogue Internet drug outlets to advertise to unsuspecting consumers. VIPPS-accredited pharmacies have undergone and successfully completed the NABP accreditation process, which includes a thorough review of all policies and procedures regarding the practice of pharmacy and dispensing of medicine over the Internet, as well as an on-site inspection of all facilities used by the site to receive, review, and dispense medicine. An NABP news release includes more information about the new Google AdWords requirement. More information on the VIPPS program, along with a list of VIPPS-accredited pharmacies, is available under Accreditation Programs on the NABP Web site. 

California PMP Data Shows Frequency of Doctor Shopping  
Early data collected from California's prescription monitoring program, the Controlled Substances Utilization Review and Evaluation System (CURES), correlates the frequency of patient “doctor shopping,” or obtaining multiple prescriptions from various providers, with the number of prescriptions patients receive for additional controlled substances, as reported in Medical News Today. The research analysis, presented at the American Academy of Pain Medicine's 26th Annual Meeting, showed that patients prescribed a single additional class of a controlled substance, such as benzodiazepines, had a two-fold likelihood of doctor shopping for multiple opioid prescriptions. A 13-fold increase in doctor shopping was seen when more than one additional drug class was involved. Researchers at the University of California, Davis conducted the analysis using de-identified CURES data, and also found that patients involved in doctor shopping were involved in more than one episode about 50% of the time. NABP convened a Task Force on Prescription Monitoring Program Standards on October 28-29, 2009, to review and identify variations in existing prescription monitoring programs as compared to the Model Prescription Monitoring Act found in the Model State Pharmacy Act and Model Rules of the National Association of Boards of Pharmacy (Model Act) and to recommend revisions, if necessary, to the NABP Model Act; the report of the task force will be released in March.

USP Seeks Comments on Revised Standards for Compounded Medicine
United States Pharmacopeial Convention (USP) has revised and updated quality guidelines in the Quality Assurance Pharmaceutical Compounding General Chapter. The use of compounded medicines has grown, and the new standards will help ensure that they are of high quality and purity. New content includes sections on training; physical testing of dosage units; weight and volume assessment; cleaning and disinfecting; containers, packaging, repackaging and storage; and outsourcing. USP seeks comments on the proposed General Chapter revision; compounding pharmacists and other interested parties can submit comments in the January – February Pharmacopeial Forum through April 15, 2010.

Study Suggests Dosing Devices Impact Parents’ Administration Errors
A study published in the Archives of Pediatrics & Adolescent Medicine assessed the dosing accuracy of a group of parents by dosing instrument type. The study also considered how the parents’ health literacy influenced dosing accuracy. Parents were asked to measure a five milliliter dose of liquid medicine using five standardized instruments: a dosing cup with printed markings, a dosing cup with etched markings, a dropper, a dosing spoon, and two oral syringes. 85% of parents dosed accurately with the dropper, spoon, and syringe, while only 30.5% dosed correctly using the cup with printed markings, and 50.2% dosed correctly using the cup with etched markings. Limited health literacy was also associated with making a dosing error. The researchers concluded that the study results have important implications for the design of dosing instruments.

FDA Guidance Agenda Released
FDA released a “Guidance Agenda: New Draft Guidances CDER is Planning to Publish During Calendar Year 2010.” Included in the agenda for 2010 are plans to release guidance on the following topics:

  • Good Naming, Labeling, and Packaging Practices to Reduce Medication Errors
  • Drug Names and Dosage Forms
  • Pediatric Information: Incorporating into Human Prescription Drug and Biological Products Labeling

The guidance documents are currently under development.

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