Local pharmacy goes extra mile for patients

Bryon Glathar, Herald Managing Editor
Posted 6/15/18

City Drug provides overdose anti-dote that saves life

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Local pharmacy goes extra mile for patients

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EVANSTON — From saving customers a few bucks (or hundreds) to working behind the scenes to get lifesaving medications in the hands of patients — sometimes for free — City Drug is working hard to serve its customers in the community.

Pharmacy technician Stephen Cannon didn’t have to spearhead a project that provided about 100 local residents naloxone auto-injectors last year — at least one of which ended up saving a life. And owner Andrew Cannon certainly didn’t have to front about $30,000 to the manufacturer while City Drug received the money back in chunks as rebates were fulfilled. But they did. They did those things because they care about the community.

Naloxone is an opioid blocker that’s proven to reverse overdoses caused by opioids. It’s been available in a few different forms, including nasal sprays and injections. But pharmaceutical manufacturer Kaléo has been producing Evzio, a naloxone auto-injector — a preloaded cartridge, which comes with audio instructions, that’s easy to inject into muscle tissue. The only problem is … the cost is outrageous — sometimes around $3,500 per dose, Stephen Cannon said.

So when Andrew Cannon heard about a grant that helped make Evzio available for free, his brother Stephen got the ball rolling to help take advantage of the program.

Opioid overdoses have been on the rise, and many organizations, including the USDA, the Surgeon General’s Office and the University of Wyoming are taking aim at the opioid epidemic. 

According to the Wyoming Department of Health, Uinta County is the only county that fills more prescriptions for opioids than the number of people residing in the county. The Wyoming State Hospital, however, might skew that a bit, the health department notes. 

For Stephen, the opioid crisis is more personal.

“My wife’s biological father died of an accidental overdose when she was 8,” he said, adding how a loss like that can affect countless lives. “But also, I know all these people,” he said of his customers.

Dealing with opioids, such as oxycodone, hydrocodone and morphine, can sometimes be like walking a tight rope.

“There’s such a taboo about it,” Stephen said, “because healthcare professionals are under so much pressure … trying to give people the care they need while realizing there’s a lot of people abusing the system — sometimes to their own detriment, sometimes to the detriment of other people.”

Even as a proven antidote for opioid overdoses, naloxone wasn’t an easy sell, Stephen said, even when the costly auto-injectors were offered free to patients.

“It was a difficult conversation when it was absolutely free,” he said. “Now that it might cost the patient (even with insurance) $50 or $100, that conversation is even harder.”

Even given the tough sell, City Drug went above and beyond to make the process simple for those 100 or so patients who received naloxone injectors between April and September of last year. The first sell was the doctors.

“[Customers] would bring in a prescription [for an opioid],” Stephen said. “When we got it, we could call the doctor and ask if we could add this (Evzio) as a prescription and have it for [the patient].”

If the doctor approved it, City Drug would have the auto-injector ready when the patient picked up his or her opioid prescription. But some doctors in town wouldn’t approve it, Stephen said.

“Say, for instance, if someone were coming out of anesthesia and for some reason thought they needed this shot,” he said. “It could bring them immediately out of anesthesia and they could possibly go into shock. … In our opinion, though, the benefit outweighed the risk.”

That proved true in at least one case.

“We did hear back from a nurse here in town who had to use one on one of his patients who stopped breathing after taking a dose of his medication,” he said, adding that the particular auto-injector used was one that was provided free from City Drug. “It’s cool to see it come back and save someone’s life.”

Of course, City Drug isn’t only charged with saving lives, the pharmacy also works to improve the lives of its patients.

“One thing that we work on in particular is called therapeutic optimization,” Andrew Cannon said. He defined the term as “getting the patient the best care for the best price without insurance.”

He said he also works to get patients on medications that have fewer side effects. One prescription that treats high cholesterol, he said, is the medication that is by far the most subscribed in its family, but it’s also the medication with the most side effects. Since it’s an older medication, there are lots of generic options, which makes it inexpensive and frequently prescribed.

However, Andrew said, there are newer medications to treat high cholesterol that have fewer side effects. City Drug works with manufacturers to lower the prices of the newer drugs so they’re more affordable for patients. He said if a certain manufacturer won’t help, he works to get vitamins for the patients to counter what a prescription might have depleted.

“We’re just trying to make the lives of our patients easier,” said.

He said that’s why the pharmacy offers free delivery to patients. It also offers compliance packaging — separating doses by day or week — for those who need it.

“The kids of some of these elderly patients can have a hard time getting all of [the prescriptions] lined up and taking them on the right days and the right time,” he said. “It’s confusing to us, let alone for them, so we package them into weekly packages, so they know what to take each time.”

Andrew takes pride in going the extra mile.

“I feel like we’re the best in the business as far as working with manufacturers,” he said, “and we’re always working with our colleagues to get the medication for the least cost to our patients.”