Maine Pharmacy Association

DHHS shared guidance documents for e-prescribing and opioid dispensing

DHHS shared guidance documents for e-prescribing and opioid dispensing.  Notably, “A pharmacist is NOT required to verify that a practitioner has a waiver of the requirement to electronically prescribe…” To review the official documents, please click on the links below. Electronic-Prescribing-Clarifications Opioid Dispensing Clarification    

E-Prescribing Grace Period Notice and Chapter 488 User Guide

The deadline for mandatory e-prescribing of opioids was rapidly approaching on July 1st. However, the State sent the following communication announcing a 31 day grace period for enforcement of the penalties for violating the e-prescribing provision.  This is good news and will give prescribers and dispensers a little more time to prepare. DHHS provided material on other provisions in Chapter […]

2017 Scholarship Golf Scramble

Join us for our 2017 Scholarship Golf Scramble ! Where: Val Halla Country Club When: Saturday, August 12, 2017 Shotgun start 1pm Includes 18 holes of golf on a championship course, golf cart, BBQ dinner at Rachel’s on the Green! Cost: Single Golfer: $110.00 Foursome: $400.00 Dinner Only: $35.00 Corporate or personal hole sponsorship: $75 […]

Pharmacists from across Maine convene in Augusta to advocate for profession and patients

Pharmacists and pharmacy students from across the state convened in Augusta on May 30th to advocate for LD 572.   Update: Senate passes LD 572; now on to the House!  LD 572 specifies in statute that the “Practice of Pharmacy” is “the provision of health care services” and that “Pharmacists” are “providers of health care services”. […]

LD6 and LD44 Are Successfully Moving Through the Legislative Process

Good news!!  Two bills, LD 6, an “An Act to Prohibit Insurance Carriers from Retroactively Reducing Payment on Clean Claims Submitted by Pharmacies” and LD 455, “An Act Relating to the Provision of Smoking Cessation Services by Pharmacists” are moving through the legislature process. LD 6, an “An Act to Prohibit Insurance Carriers from Retroactively Reducing Payment on […]

A new study was recently published online in NEJM (that compares the efficacy of trivalent, Fluzone HD directly to trivalent, Fluzone vaccine in adults 65 years or older. Over 30,000 patients were randomly assigned to double-blind treatment with either HD or standard Fluzone.  In the intention-to-treat analysis, 228 participants in the Fluzone HD group (1.4%) and 301 participants in the Fluzone group (1.9%) had laboratory confirmed influenza caused by any viral type associated with influenza-like illness (the primary endpoint), relative efficacy 24.2%; 95% CI, 9.7 to 36.5).


Notable limitations: You’ll hear that Fluzone HD is 24% more effective than Fluzone in adults 65 and older.  That’s true, but there are some limitations. First, the absolute difference in efficacy is 0.5%.  So, the NNT is 200.  Which means you need to vaccinate 200 adults over 65 with Fluzone HD rather than Fluzone to prevent one case of influenza.  Also, patients had a mean age of 73.3 + 5.8 years (which means very few people in the study were over 85 and thus the results are generalizable to 65 to 85 year old patients).


Bottom Line: The published results are so recent, that the CDC ACIP hasn’t made a recommendation yet.  According to the current CDC recommendations for adults, the best flu shot is the one you get.  However, both Fluzone and Fluzone HD are covered on Medicare.  Thus, I will be recommending Fluzone HD to adults over 65 unless the HD vaccine is unavailable at my pharmacy/clinic.  Whether the vaccine is cost-effective remains to be determined.

-Mac McCall, PharmD

Leave a Reply

You must be logged in to post a comment.