The Federal Trade Commission has issued an advisory opinion questioning a proposed New York State law intended to make it easier for neighborhood drug stores to compete with mail-order pharmacies. The opinion was quietly released on Monday and has stirred up a storm of protest from local pharmacists, who contend that they can provide drugs as cheaply as, if not cheaper than, mail-order pharmacies do, while offering a higher level of customer service.
The FTC had been investigating a number of complaints of alleged anticompetitive practices by CVS Caremark, many, but not all, of which focus on dealings between CVS Caremark’s Pharmacy Benefit Management (PBM) business and its retail pharmacy business. These complaints include allegations that the PBM steers business to the pharmacy, that the businesses share competitively sensitive information and that the company engages in predatory pricing. While some of the allegations are unique to CVS Caremark, others challenge practices common in the PBM industry. More broadly, these complaints attack business practices common in vertically integrated businesses.
In a press release regarding the FTC settlement, CVS Caremark announced “[t]here were no allegations of antitrust law violations or anti-competitive behavior related to CVS Caremark’s business practices or its products or service offerings.
Increased competition from the Internet has raised a concern of product quality for online prescription drugs. The Food and Drug Administration (FDA) prohibits the importation of unapproved drugs into the US and the National Association of Boards of Pharmacy (NABP) emphasizes their illegality and cites examples of unsafe drugs from rogue pharmacies. An investigation by the Department of Justice (DOJ) revealed that Google was allowing unapproved Canadian pharmacies to advertise on their search engine and target US consumers. Because of heightened concern to protect consumers, Google agreed to ban non-NABP-certified pharmacies from their sponsored search listings in February 2010 and settled with the DOJ in August 2011. We study how the ban on non-NABP-certified pharmacies from sponsored search listings affects consumer search on the Internet.
The Federal Trade Commission (“FTC” or “Commission”) is an independent agency responsible for maintaining competition and safeguarding the interests of consumers. Congress has charged the FTC with enforcing the FTC Act, which prohibits unfair methods of competition and unfair or deceptive acts or practices in or affecting commerce. Pursuant to its statutory mandate, the FTC seeks to identify business practices and government regulations that may impede competition without offering countervailing benefits to consumers. Competition is at the core of America’s economy, and vigorous competition among sellers in an open marketplace gives consumers the benefits of lower prices, higher quality products, and greater innovation.
Because of the importance of health care competition to the economy and consumer welfare, anticompetitive conduct in health care markets, including pharmaceutical markets, has long been a focal point of FTC law enforcement, research, and advocacy.
Study Shows PBM Ownership Does Not Result in Higher Costs for Consumers
The Albuquerque location will become the fourth medical cannabis dispensary in that city, and its opening signals the Company’s intent to serve the New Mexico market.
Good luck with that…
It looks like the problem of shortages has been “solved” by the Producers, including the opinion that new producers aren’t needed. Is anyone surprised?
From New MexiCann newsletter for the week of 10/19/14 (by Len Goodman):
As you probably know, all Licensed Non Profit Producers turn in a very extensive report to the Dept. every three months. The report covers total yields, average yield per plant, on-hand inventories, sales by product category, compensation to employees, number of unique Patients served, total number of transactions, sales by county, transfers between LNPPs, etc.
After we filed on Friday, I went back to 2012 and 2013 to compare our cultivation yields. I knew New MexiCann was getting better all the time, but had lost track of how far we had come. Carlos and Jennifer and their crew are doing an absolutely amazing job and thought we might be interested in these numbers. I ignored 2010 when our plant count was only 95 plants and 2011 since it was not until the last quarter that we were fully built out to handle the increased plant count of 150 total plants.
Average Ounces per Harvested Plant
Reporting Quarter, 2014, 2013, 2012
January – March: 13.2, 10.9, 6.6
April – June: 15.1, 11.7, 6.7
July – September: 16.3, 11.5 , 8.3
October – December: N/A, 10.7, 10.7
When the Dept. received the results from the independent Supply Survey it had ordered, an enormous Supply Shortage was uncovered. As Producers, we all knew how quickly we were running out of Medicine. The yield reports used for that survey were based on early 2013 reports to the Dept. Since then, the shortage, while still real, is much less than it was. We run out far less frequently.
I think that New MexiCann is not alone in its 50% increase in yields since the Survey. [Unless I’m reading this chart wrong, I believe the 50% figure is incorrect. It looks like New MexiCann’s yields have mostly doubled since 2012, but the survey was done in 2013. So the increase from 2013 to 2014 (so far) looks to be around 30%.]
Many Producers have greatly improved their techniques and yields and are experiencing similar increases. With the Dept.’s proposed increase in plant count to 450 – coupled with Producers increased skills, I expect that there will no longer be a shortage of Medicine by mid 2015. It will take a while for LNPPs to build out and take advantage of three times as many plants as we are currently allowed to grow.
As the number of NM MCP Registered Patients increases, we may someday need more Licensed Producers, but with the coming plant count increase, that day is quite some time away. I doubt if new LNPPs will be needed until the number of Registered Patients get to at least 18-20.000.
Perhaps one of the reasons producers are now “running out far less frequently,” is because more patients are leaving the program (and the state) — or are being denied access — than are being added.
7/11/2012, Dry Market
‘[The patients are] in a rat race going from place to place to place,’ Kane tells SFR.
11/19/2013, New Mexico faces medical marijuana shortage
8/31/09, The New Mexico Independent, By Marjorie Childress: “The source for this story, who wished to remain unidentified, told the Independent that if he didn’t have a producers license he’d have to risk buying it on the street — which is legal for him under state law, but dangerous because it forces him to purchase from people working in an underground economy.”
“We are the only State that legally allows Patients to procure meds where they can. SENMMCA supports any method that gets medication to Patients be that through State Producers, PPL’s, Co-ops, black market, import from other legal States–essentially any way to get Patients more meds.” Robert Pack, SENMMCA, 02/18/14
The Lynn and Erin Compassionate Use Act, Page 1: “A qualified patient shall not be subject to arrest, prosecution or penalty in any manner for the possession of or the medical use of cannabis if the quantity of cannabis does not exceed an adequate supply.”
Part of the reason for this rule is because of the continual shortages in this state’s program. Unfortunately, the Department of Health is getting ready to change this rule, so that medical cannabis patients will become criminals again for not purchasing their medicine at expensive dispensaries.
Originally posted 3/25/2014 at 420magazine.com:
I have studied about 25 different test results from four different dispensaries, and if one thing stands out, it is the difference in THC percentages between actual weight and dry weight.
I have corresponded with Jeremy Applen from Page Analytical, and in discussing this issue, he said:
“Because THC content is reported as a percentage of weight by weight (% w/w) the moisture content will definitely affect the value reported. If the moisture content of the product is high, this will cause the reported percentage of THC value to decrease; which is why when you look at results which include the THC % reported both as % dry weight and % actual weight, the actual weight is lower.
When Page Analytical began operations in 2011, there was a lot of dialogue between myself and my first customers as to whether or not the samples should be dried prior to potency analysis. Some labs dry the samples and others don’t.
In order to stay in business, I have since had to allow LNPP’s to choose which tests they would like, and not all choose to test for moisture or microbiological contaminants.”
(Certain punctuation added by me, for easier reading.)
For the 25 test results I have studied, only a few included THC percentages for dry weight and actual weight. The difference between the two is usually around 2 percentage points. And in my opinion, the THC percentage for actual weight is more in line with the strength of a product.
For instance, in March of this year, New Mexicann tested its Medicine Woman strain twice — the first results included moisture content (9.91% moisture, 12.053% potential THC, actual weight); the second test did not (24.677% potential THC, dry weight).
In New Mexicann’s newsletters from March 15th and 19th, Medicine Woman is listed at 15.7% THC, .8% CBDs (don’t know where those figures are from); and for March 22nd, the same strain is listed at 25% THC, 0.1% CBD/CBG. But if you look at the latest test results, you can see that New Mexicann rounded the THC potential from 24.677 to 25 (dry weight), and choose to only report CBD/CBGs at 0.1%, when it’s actually 0.00% CBDs, 0.184% CBNs, 0.716% CBGs, and CBCs at 1.05%.
It sounds like they are talking about two completely different strains here, and this dispensary’s choice in reporting THC/CBD percentages appears to be one of the causes.
So, if you want to use THC percentages as a gauge of potential strength, you will have to ask whether the number indicates dry or actual weight. Since most dispensaries are not choosing to test for moisture content, for THC percentages that are available, patients will need to decrease those reported by about 2% here in New Mexico.
Along with this difference found in reported THC percentages, it appears one must also know if the sample was dried and cured before being tested. Since there doesn’t appear to be an indicator within the test results of what type of sample is being tested, I don’t know how patients are supposed to locate this information. And at this time, I don’t know how much this affects tested THC potential, or how to adjust reported figures to take this into account.
From the Department of Health:
January 2, 2013
To: Licensed Non-Profit Producers (LNPP)
From: Ken Groggel, Manager, Medical Cannabis Program (MCP)
Re: Approved Cannabis Testing Laboratory
We are pleased to announced that Page Analytical has been recognized by the Department of Health as an approved laboratory for testing of cannabis and cannabis-derived products in New Mexico. The Scientific Laboratory Division conducted a review of the laboratory operated by Jeremy Applen and determined that, based on documentation and onsite visits, the analytical test results can be viewed with confidence.
Utilization of Page Analytical for testing of cannabis and cannabis-derived products will satisfy the regulatory expectations of the Department and the requirements agreed to in the Production Standards for Cannabis-Derived Products, effective January 1, 2014. Page Analytical can be contacted at ******.
Regular testing done in a Department approved laboratory is the only acceptable method to determine the quality, purity and consistency of dose required for the sale of cannabis-derived products. Please refrain from labeling any cannabis products with specific quantitative information without appropriate laboratory testing documentation for support.
Thank you for your continued cooperation and support of the New Mexico MCP.
(A copy of this notice was kindly provided to me by Mr. Applen.)
7/10/2014, Now What? DEA Tosses Tramadol in Schedule IV