Friday, October 18, 2013

Major Changes to Express Scripts Formulary Will Affect Many Asthma and Allergy Patients

I just received notice that as of January 1, 2014, the Express Scripts formulary will be removing a number of medications from its repertoire of covered drugs. This means that patients under the Express Scripts plan will have NO COVERAGE for these prescriptions, and will be required to pay full price at the pharmacy. The list is long, and heavy on medications commonly used by patients with asthma and allergies:

Asthma medications:

Advair diskus
Advair HFA
Alvesco HFA
Flovent Diskus
Flovent HFA
Maxair Autohaler
Proventil HFA
Xopenex HFA

Allergy medications:

Auvi-Q
Beconase AQ
Omnaris
Rhinocort Aqua
Veramyst
Zetonna

As insurers continue to seek ways to cut costs and boost the bottom line, they will negotiate with pharmaceutical companies to obtain lower pricing. Those companies that play ball get to keep their drugs on the formulary. Those that don't, get dropped. The losers are the patients who will be required to switch from medications they have been taking successfully.

If you or a loved one are taking any of the medications on the above list, I would encourage you to schedule an appointment with your Board-Certified Allergist to discuss a trial of a covered alternative medication well in advance of January 1st. Your physician may have a sample of the new medicine that you can "try before you buy". You don't want to be in the position of being forced to switch before you've determined which alternative works for you. You may also want to take advantage of 90 day supplies of medication before the year ends and your coverage expires. Some of the soon to be excluded medications currently have manufacturer's coupons that will be valid through the end of the year.

Talk to your doctor -- we're here to help you navigate through the complex state of medical affairs.

Friday, September 20, 2013

Your Chance to Weigh In On Stock Epinehprine Legislation (Courtesy of AANMA)

I am proud to be from Illinois, where we already have excellent guidelines in place for the protection of food allergic children, and also have a stock epinephrine law on the books. I am also so pleased that my state's U.S. Senators have teamed up to co-sponsor a bipartisan bill designed to keep the children of America safe from severe allergic reactions. Read on to learn more!


Your Chance to Weigh In On
Stock Epinephrine Legislation

The School Access to Emergency Epinephrine Act, which would encourage states to require that schools keep lifesaving epinephrine on hand, is now in front of the U.S. Senate, bringing it one step closer to passage. You can make a difference by contacting your Senators today to ask for their support.

S. 1503 was introduced by Sens. Richard Durbin (D-Ill.) and Mark Kirk (R-Ill.) and co-sponsored by 23 other senators. The companion bill, sponsored by Rep. Phil Roe, MD (R-Tenn.) and House Democratic Whip Steny Hoyer (Md.), was approved by the U.S. House of Representatives on July 30.

The School Access to Emergency Epinephrine Act would provide incentives for states to adopt laws requiring schools to have "stock" epinephrine auto-injectors, which is epinephrine that is not prescribed to a specific student but can be used for any student or staff member in an anaphylactic emergency. Between 20-25% of life-threatening allergic reactions happen at school without prior knowledge of allergies.

Now is your chance to help.

Call or email your Senators today. Find contact information here.

Suggested talking points:
  • S. 1503 -- Sponsored by Senators Durbin and Kirk, the bill would encourage epinephrine auto-injectors be stocked in schools.
  • As a [parent of a child at risk of anaphylaxis] [constituent] [school nurse/teacher/other], urge them to cosponsor S. 1503.
Twenty-eight states already have laws or guidelines in place allowing schools to stock undesignated epinephrine auto-injectors. Check AANMA's USAnaphylaxis™ Map (www.aanma.org/USAnaphylaxis) to see the status of laws in your state.

Questions? Contact Kimberly Turner, kturner@aanma.org.

Wednesday, June 19, 2013

Generic Epinephrine Autoinjector Authorized (once again!) - What Does It Mean For You?

The following message is courtesy of the American Academy of Allergy, Asthma & Immunology. A formerly available epinephrine auto-injector (Adrenaclick) is back on the market, as is an authorized generic for this specific device. It is likely that insurance companies and pharmacies may encourage substitution with this generic product, as a way to decrease expenses for both insurers and patients. Please read the message, and be alert to the possibility of device substitution.
_________________________________________

Be Aware of Authorized Generic Epinephrine Autoinjector


Dear Colleagues:
It has come to our attention that Lineage Therapeutics, Inc. recently launched an authorized generic version of Adrenaclick® under the name epinephrine injection, USP auto-injector. This product being marketed as a generic epinephrine autoinjector is an “authorized generic” of the Adrenaclick autoinjector only.
We want to make you aware because the availability of this product may result in substitution for other epinephrine autoinjectors at the pharmacy, which could lead to patient and caregiver confusion.
Epinephrine autoinjectors look and function differently from one another, and they have different instructions for use and require different training. You may have trained your patient for the administration of one type of injector, and the pharmacy may provide another type on which the patient has not been trained. During the stress of an anaphylactic reaction, this may be confusing to a patient and could result in the delay or perhaps an error in the administration of the drug.
When having a prescription filled, patients or caregivers should reinforce with the pharmacist the importance of getting the specific epinephrine autoinjector their physician prescribed and that they are trained to use.
You can view each type of epinephrine autoinjector and the instructions for administration at the respective product websites: www.epinephrineautoinject.comwww.adrenaclick.comwww.auvi-q.com andwww.epipen.com.
Sincerely,
Linda Cox, MD, FAAAAI
AAAAI President
president@aaaai.org

_________________________________________________________

Bottom line? 

As proper use of autoinjectable epinephrine is dependent on training and familiarity with the device, generic substitutions for one device should not replace a prescription for a different device. If cost concerns require you to consider a generic, please first visit your doctor's office to be trained on the device you will be receiving. This will allow you to ensure that you and your family are comfortable with the device to be dispensed.

Friday, February 15, 2013

Be a Star! Submit your video to AANMA's "Why see an Allergist?" campaign!


Allergy & Asthma Network - Mothers of Asthmatics (AANMA) is partnering with the American College of Allergy, Asthma & Immunology (ACAAI) to produce six video vignettes on "Why see an Allergist?" and they need your help! AANMA is looking for people who fit the following criteria and are willing to participate:
  • Newly diagnosed or undiagnosed patients with symptoms of allergy and/or asthma 
  • Patients diagnosed with at least one of the following conditions: 
    • Children with seasonal allergies 
    • Food allergy 
    • Pregnancy and asthma 
    • Teenager with asthma 
    • Pet allergies 
    • Rhinitis 
  • Required to send a homemade, 60-second video of your story to AANMA by March 15, 2013 
  • Willing to participate in a pre-interview via telephone with video production agency 
  • Able and willing to participate in a one-day commercial video shoot in downtown Chicago in April 2013 
The video vignettes will be utilized in social media outlets to raise awareness and educate the public on the role of an allergist in a comprehensive, collaborative care model.

Please contact Tonya Winders at twinders@aanma.org or 703-641-9595 should you have any questions regarding this opportunity.


Thursday, February 14, 2013

Fun With Daisy Scouts!

As a mother of 2 boys, I sometimes feel outnumbered. Therefore, I was delighted to be invited by the local Daisy Scouts to a meeting which focused on being kind and considerate. Using the topic of food allergy as an example, we were able to address the issues of safety, inclusion/exclusion, bullying, how to be a good friend, and more. The girls offered up a whole host of ideas about how to celebrate special events without being food-centric, just in time for Valentine's Day!

In this one group of Daisy Scouts, there were allergies to milk, egg, peanuts, tree nuts and fish! It was lovely to see the girls talk about how they pack special lunches so they can sit with their food-allergic friends and how they don't ever share food. One adorable little one demonstrated, arms outstretched, how she would come between a bully and her food-allergic pal! We did a drill of how to call for help if a friend is experiencing an allergic reaction, and familiarized ourselves with autoinjectable epinephrine.

The girls were great listeners and participants, and they presented me with a lovely card and a copy of the story they read aloud earlier in the meeting. It's called "The Bugabees - Friends with Food Allergies".

Thanks for inviting me, girls!

This story about friends with food allergies was a wonderful companion piece to the meeting about being kind and considerate.

Wednesday, February 13, 2013

My Son, Future Immunologist?

The other day, my 7 year old son came home from school excited to tell me about his day. His second-grade class had just begun a unit in science about the human body. As an introduction to the unit, his teacher asked the students to name organ systems.

One child called out, "the gut", and another, "the lungs".

But not my child. No, my kid offered up "the immune system"!

Here's the book he took from my office to read to his class:
http://primaryimmune.org/wp-content/uploads/2011/04/Our-Immune-System.pdf

"Our Immune System", by Sara LeBien

Obviously, I'm biased by both genetics and profession. But I couldn't be prouder. :-)

Monday, October 8, 2012

Peanut Allergy "Patch" Study Now Recruiting in Chicago!

A new treatment option for peanut allergy is currently being studied in Chicago!

This treatment modality is commonly referred to as the "peanut patch", and aims to induce tolerance to peanut protein by delivering small amounts of peanut allergen to the immune system through the skin. This is similar in concept to oral and sublingual immunotherapy for foods. However, in the case of the patch, the mode of delivery is hoped to result in fewer reactions during treatment, as the allergen will not be ingested. It is certainly an interesting development, which may hold promise in the treatment of food allergy. This study is recruiting children as young as age 6 years, so it may be an option for those children who are not old enough to qualify for the Food Allergy Herbal Formula study.

Please read the memorandum below for further details:
--------------------------------------------------------------------

...I would like to share with you the exciting new peanut allergy clinical trial we will be starting this fall called A DOUBLE-BLIND, PLACEBO-CONTROLLED, RANDOMIZED TRIAL TO STUDY THE VIASKIN® PEANUT’S EFFICACY AND SAFETY FOR TREATING PEANUT ALLERGY IN CHILDREN AND ADULTS (VIPES STUDY). 
 
The VIPES study is a 12 month, multi-center trial examining Viaskin© Peanut as a potential immunotherapy treatment of peanut allergy in participants aged 6 years and older. Viaskin© Peanut is an allergen extract of peanut administered daily using the Viaskin© epicutaneous delivery system.
 
The goal for this study is to determine the efficacy of several doses of Viaskin© Peanut to significantly desensitize peanut allergic subjects, and to evaluate the safety of long term epicutaneous immunotherapy with Viaskin© Peanut.
 
You may always find the most up-to-date information about our food allergy research studies by visiting our website at www.chicagochildrensresearch.org/allergy. You may also find a current list of all the Division of Allergy & Immunology’s clinical trials at www.chicagochildrensresearch.org/clinical_trials/allergy.

The Viaskin Peanut Patch

Monday, September 17, 2012

Neglected Child's Eyes Well Up, AllergistMommy's Priorities Get Shaken Up

It's been a crazy few months...

My micropractice is now a little over a year old, and I've been blessed with a growing patient base. However, with more patients comes MORE WORK! I love the patient care part - could do that all day. However, I could do without some of the paperwork, data entry, inventory, etc. I pretty much stopped sleeping.

So the time came to add someone to my team. The search for someone who can channel my vision for the practice into their everyday activities was not an easy one. Resumes, essay exams (yes, I actually had candidates complete an essay exam!), interviews, math quizzes, background checks... phew! Adding employees also means adding an employee handbook, policies and procedure manual, compliance programs, payroll, worker's insurance. Wait a minute - I thought getting help was supposed to reduce my workload?

So, no one would blame me if I haven't been scrapbooking, right? Wrong. My 4 year old blames me, and rightfully so.

This morning, he sat on the sofa with his brother after breakfast, leafing through my 7 year old's baby scrapbook. You know, the scrapbook I created when I was a wide-eyed, bushy-tailed new mom, delighted by the thought of documenting first smile, first bath, first solid food, first fill-in-the-blank? The scrapbook that is not only a collection of photographs, but also captions describing baby antics and quotations on boyhood and motherhood? My older son loves looking at this book whenever he gets the chance. Who wouldn't love a book where you're the star, and every photo is flattering, embellished with jungle animals and teddy bears?

The tears in my 4 year old's eyes were like a dagger in my heart. "Mommy, where is MY book?"

I didn't have the heart to tell him, "Honey, your photos are in a couple of albums on Facebook."

So, this week, I have added to the top of my task list:

  • Redeem self in eyes of baby boy. Create best baby scrapbook EVER. You have 2 hours.

I will be needing this...



One day, I will sleep. Today is not that day.

Tomorrow isn't looking good, either. :-)

Saturday, August 18, 2012

A Peek Into the Mind of a 4 Year-Old

Yesterday morning, I asked my younger son to throw his dirty clothes down the laundry chute. What I witnessed shortly thereafter cracked me up:

Son #2: "Bye-bye, underwear! Have a nice trip!"
Son #2 (imitating the "voice" of his dirty underwear): "Nooooo! I don't want to go!"
Son #2 (back to himself): "Sorry, you need to get clean. Now go, and have a nice day!"

It makes me smile to witness my children engaged in imaginative play. In this day of little faces glued to tiny screens, it's so nice to see that creativity and imagination are still the best entertainment.

It's a long trip for a small pair of drawers!

Saturday, July 28, 2012

How My Asthmatic Son Taught Me Not to Underestimate His Potential

My younger son and I both have asthma. Although we are well controlled, we still carry rescue medication with us everywhere. Even well-controlled asthma can flare severely under the right (or wrong) circumstances.

I was especially cautious during a recent family vacation to Colorado. Living in the Midwest, we were unaccustomed to the thin mountain air, and I worried that my 3 year old might have his enjoyment of the trip ruined by asthma symptoms.

So when our agenda was modified to include a steep 1.2 mile hike to view a pristine lake nestled close to the mountaintop, I wondered aloud if we should leave him behind at the hotel with his grandparents. My husband (who does not have asthma) glibly replied, "Relax, he can handle it!".

"Easy for you to say," I retorted. "What are we going to do if he has an asthma attack halfway up the mountain?"

Dear hubby didn't need to reply. My fearless son overheard the conversation and chimed in: "I want to climb the mountain, too! Mommy, are we going to climb the mountain togedder?" Puppy dog eyes looked up at me, awaiting my answer...

One look at his earnest expression, and how could I deny him? After confirming that all our gear was in place (Water bottles? check. Inhaler?check. Spacer? check. Oxygen tank? Chill out, lady. This is Hanging Lake, not Mount Everest.), we set out on our journey.

We took our time, because the climb was rocky and steep, and his little legs didn't allow him to leap up the mountainside like his brother (who arrived at our destination nearly 40 minutes before we did!). However, I was amazed to find my little guy navigating the rocks like a pro! He climbed all the way up on his own power, never once asking to be carried. After a snack at the top, he made it down on his own too! Nearly 3 hours of hiking 2.4 miles at an elevation of over 7000 feet above sea level, all by himself. Thanks to a few puffs of prophylactic albuterol before the climb, no coughing, wheezing or shortness of breath interfered with our fun! All the other hikers stopped to tell him he was doing a great job, and proclaimed, "You must be the youngest hiker on this trail!" He was so proud. WE were so proud.

Having a laugh during a water break.

Waterfalls abound!

My take-away lesson? Well-controlled asthmatics really CAN do anything they put their minds to, even if they're only 3 years old and Mommy is a chicken.

Close to the top... kids are getting hungry.

As parents, we want to protect our kids from the mere possibility of harm. However, we shouldn't shelter them from amazing life experiences just because they carry a modicum of risk. Risk is a part of life. All we can do is give them a healthy foundation and teach them to make good choices... then we need to let them LIVE.


No risk, no reward!