'PALM' PILOT NEBULIZER; Duval Pharmacy Leads Test Treatment for Cystic Fibrosis

By Turner, Kevin | The Florida Times Union, June 20, 2008 | Go to article overview

'PALM' PILOT NEBULIZER; Duval Pharmacy Leads Test Treatment for Cystic Fibrosis


Turner, Kevin, The Florida Times Union


Byline: KEVIN TURNER

Jacksonville pharmacy owner Greg Carter says the answer to cystic fibrosis sufferers' long, twice-daily home treatment times can fit in the palm of your hand.

The eFlow is a small electronic nebulizer that converts liquid drugs into a thick mist that can be inhaled. It gives the patient more medicine in less time and reduces treatment times from three hours a day to an hour or less, Carter said.

Doctors and patients agree it's better than clunky, tubes-and-compressor nebulizers, but it will be a while before everybody who takes inhaled medicines can get one.

Carter is leading a pilot program for the device and is the exclusive provider of the machine to Florida CF patients on Medicaid.

"It's an extremely tough disease to manage," said Carter, who owns Carter's Pharmacy on Corinthian Avenue in Ortega and Carter's Park and King Pharmacy at King and Park Streets in Riverside. "And if they don't do it, they're in the hospital."

About 1,200 Floridians have the chronic, inherited disease that clogs lungs, causes life-threatening infections and interferes with the operation of the pancreas.

Device manufacturer PARI Pharma of Munich, Germany, chose Carter's pharmacy over others. Large, chain pharmacies don't generally custom-compound drugs, so they're not in the eFlow pilot and trial programs, he said.

Medicaid officials have agreed to fund nebulizer medicine that Carter's pharmacy makes for the eFlow because it cuts today's costs in half, said state Sen. Stephen Wise, who helped Carter promote the plan.

"It will save the state money. Why would they not want to do that?" he said.

Under the pilot program, Carter's employees compound the antibiotic Tobramycin - FDA-approved for injection - into doses for eFlow use.

Those doses are half doses of Tobi, a version of the drug for use with conventional nebulizers, he said.

Half-dosing Tobramycin and other drugs can save Medicaid up to $1,600 a month, Carter said. The state is using $250 a month of the savings to lease the eFlow device for patients in the pilot.

Three other pharmacies in the country have delivered the eFlow to about one-fifth of the 30,000 Americans who have CF and use Tobramycin, Carter said. He's brought eFlows to 25 Floridians since Jan. 31, but none in the Jacksonville area.

Asthmatics and other people with lung conditions who want an eFlow will have to wait. …

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