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Can Advancing Technologies Edge Out the Pharmacist? MCK Mckesson

December 04, 2007 – Comments (1)

I apologize for the length of post ahead of time. But I had to lay some ground works for the questions and thesis. So please take time to try and read it, because I just spent an hour looking stuff up on the net and bringing it here to you fine folks.

Tonight on my local 6 pm news (Pennsylvania Fox 29) They did a health segment of local doctors that are filling the prescriptions they've written to clients. By the use of in office (vending machines) located on the way out the door. Pennsylvania is one state that doctors are allowed to fill their own scripts on premises.
I would imagine if the laws are changed to allow e-prescription to transmit narcotic scripts via the net. That will be what makes this thing take off. Right now the script is entered into the inner office doctors computer system and not over the net (just down the If the laws change. people could then go to machine somewhere else or at a later date. It has many other advantages. From theft or fraud prevention. To your Xanax in the morning out of the coffee machine

First question : ( MCK-MCKESSON CORP) who owns and operates the"RxOBOT" system. that has been in use in hospitals for years, Are they the play on this. And if the laws get in...ESRX (EXPRESS SCRIPTS, INC.)
Second, What does this do for the long term in...CVS (CVS CAREMARK)..WAG (WALGREEN CO)
RAD (RITE AID CP) it Bermuda SHORTS time?

"Senators urge DEA to legalize e-prescribing of controlled substances"- December 4, 2007 6pm

A Democratic senator from Rhode Island was joined by Republican colleagues today in insisting that the Drug Enforcement Administration open the door to e-prescribing of controlled substances.
"Can Advancing Technologies Edge Out the Pharmacist?"

Patent Application

The applicant sought a patent on a mechanical system that would dispense prescription drugs when the patient "swiped" a "smart card" through the device reader. The card would be already encoded with a prescription from a physician's office equipped with a device to write the order onto the card. While similar technologies are already available and subject to other patents, this device was allegedly new and unique (criteria necessary to obtain a patent) because it totally eliminates the need for a pharmacist. The applicant claimed that, as an added benefit, elimination of the pharmacist from the dispensing process would increase confidentiality between the patient and the physician. The United States Patent and Trademark Office Board of Patent Appeals denied the application on the ground that the device failed the "obviousness" test necessary to secure a patent. The Board found that the new device was not distinguishable from other products that had received prior patents. But, more important to pharmacists, the Board ruled that the increased privacy benefits are "illusory" because pharmacists are required to participate in the dispensing process under various state licensing laws"

"From the perspective of most pharmacists, this case is scary for several reasons. Certainly there is some small comfort in the fact that a patent was denied to a system that would eliminate the pharmacist from the dispensing process. But the reason for this denial is disconcerting. If the only thing that supports the need for a pharmacist in the dispensing technology is state laws that mandate a pharmacist, it will not be long before some legislature, especially one facing an impossible prescription drug benefit expenditure in a Medicaid budget, decides it would be a good idea to eliminate the pharmacist mandate from state law. Imagine the logic: if we have the ability to do without the pharmacist, why have the pharmacist? In this regard, what is sad about this opinion is the complete lack of discussion as to the value of the pharmacist in the dispensing process. Perhaps even more worrisome are the medication-dispensing devices and systems already in place that rely on personnel other than pharmacists. One of the articles used in the case to support the patent application refers to an "RxOBOT" (owned by MCK-MCKESSON CORP) system that has been used in "hospital pharmacies to dispense more than 40 million medications, with no reported errors." While the Patent Board correctly noted that "automation reduces human errors" it failed to note how many errors pharmacists prevent by catching both human and mechanical errors committed by others.

The timing of this case is also troubling. As more and more pharmacy and other healthcare groups focus on medication errors and the deaths and related problems caused by drug accidents, this case and the technology it describes has the potential to shift our focus from the humanistic approach of providing medical care to pure economics and business. It is bothersome that devices and databases are presented in this case as having the capability of discovering potentially harmful interactions without a single mention of the discretion necessary to decide if an interaction, a contraindication, or a medical complication is significant enough or important enough to warrant a refusal to fill a given prescription. If these issues are not troubling, consider what happens in all of the technology systems described in this case when a problem is detected: the prescription does not get filled. Period. At least, not until somebody starts the process all over again and a new prescription is electronically issued. When a pharmacist is involved in the process and problems are detected, myriads of alternatives are created, all the way from discretionary evaluations of the potential harm, to phone calls to correct the problem. The very last thing pharmacists do, usually after exhausting all the options, is just refuse to fill the prescription. Pharmacies do not pay the bills by turning down prescriptions, and patients do not heal when the pharmacist just says, "No."

Eliminate the pharmacist? The technology is definitely here to permit it. It seems as though there are plenty of reasons to do it. Even in academic circles there is talk about the value of removing dispensing functions from the pharmacist to permit concentration on more important medication management functions. There is no doubt that the phrase has some "curb appeal": Eliminate an FTE. Eliminate another human being and the costs involved. Eliminate all the headaches of having another employee. Eliminate the potential for human error. The fastest-rising costs in healthcare are associated with prescription drugs, and medication errors that needlessly kill thousands of people every year. Blame the pharmacists; eliminate them. Think of all the costs and problems that would be avoided. The Medicaid budget could be balanced, the HMOs and PPOs and insurance companies could increase their profits and the world would be a safer place.

Is this the future? Just for a minute. Maybe. Once the curb appeal wears away and rational thought prevails, pharmacists should be safe again. At a time when we are arguably facing the greatest shortage of pharmacists in modern times, of course the profession and functions performed by pharmacists will change in the future; they have undergone dramatic changes already. Not long ago all drugs were manufactured from natural products into medicinal dosage forms. That function has been practically eliminated. The robots are already here; when they come into even wider service they will dramatically alter the dispensing functions of pharmacists. But medication vending machines will never eliminate the need for sound evaluative judgment and the management of medication therapies. Even if machines could do that, there will always be one reason society will need pharmacists: professionals who are not only experts in medication use but individuals who also really care about the health and welfare of our patients. The laws may change and the technology may grow, but the need for caring pharmacists will never be eliminated."

The Pittsburgh, Penn.-based Automated Healthcare, Inc., a subsidiary of McKesson Corp., manufactures and markets pharmacy automation systems used by hospitals to reengineer their medication use process to improve cost savings and quality of care.   [more]



FuelCell Energy Inc. (FCEL)...Wheres the respect?

December 02, 2007 – Comments (0)

(Anyone see the initiated rating by JP today)
Hey Jim Cramer,

I just dont understand, why all this time, you will not even bless FuelCell Energy Inc. (FCEL) as a spec buy. Let alone an outright buy, after all this time I've been binging it to you. It has to be close to 50 in a years time. That is no exaggeration either. I got the post and emails to prove it. And can give ya the 5 dates I was a show caller with them as my stock. ALL DONT BUYS ! gave me. And other callers also. You once told me if oil went to $100,
this stock is then a buy, and will spike up. Anyway, I hope ya got the point of my diligence to this stock. It's all that and then some !
Ya dint even bless it during two "green weeks" ya did over the last year. I have blamed you many time for being bias. Because GE is FCEL's competitor. FCEL is eating GE's cookies Mommy packed in their lunch, in this sector. I think the CNBC brass wont let ya. There's no other logical reason. And I consider myself a pretty logical guy.

So about the company. They're time has come Cramer. It's here. I know you'll say "they haven't made NO money yet". But isn't always about where a stock and company is going, and not where they've been. They are selling product, as fast as they can produce it (hand over fist..Navy They're backlog would also make GE blush. They've sold 7 power plants (thats what they are ya know) just in the last month. In lieu of current market

Ya really cant even compare their valuation within the industry. Because their products and business plan are so unique to it. It doesn't power auto's. It's not NANO tech. It's a cell that charges from other means (wind/solar/existing AC power) to be used at a later date or to lessen grid demand, and even sold back in to it. Hence, when the sun aint shining and the wind aint blowing, power is still there. That's one part. They also have a unit that capture methane and converts it to power. One reason they are selling so much is TAX CREDITS. Many BIG COMPANIES have been buying and installing their fuel cells. Because using fuel cells gets you the lions share of them credits (35%). Google, Ford, Pepperidge Farm, and a rumor that they have a product on the space staion and at NASA HQ. Many municipalities and state funded alt energy programs have been purchasing theirs specifically. just gander at the last two months PR's. And they are also due to report soon. Production margins have always held them back before. They weren't making to many because demand wasn't there. That's changed dramatically recently. They're hiring and working multiple shifts, and built a new factory. I already mentioned the back log. Their products also have lengthy patents. Some 10 plus years.They protect them vigorously also. The stock is also heavily held by some Big Boys also. POSCO Power (Korea power giant), Wells Fargo, TCW, HEARTLAND, Enbridge, TiAA-CREF pension fund. They are a ROW'er. Many project overseas.
GE is going to buy these guys out cramer. FCEL's product is better then GE's (efficiency and cost wise). They're in the same office park in is going to get sick of seeing and hearing about FCEL.
They could scoop them right up. I'm tired of typing. The story and the growth and the fundies are there Cramer.

It was real time when I called in...and you shot them down....the stock went up 30% the next day on the POSCO buy

This is one of my biggest and longest positions. I have for last 22 months traded it around my core position. Sold on the spikes and bought it back lower. It has been an easy stock to do that with. I always hold calls a few months out around certain times.

Come to think of it...they've gone up in your face all along.
How you like them now. oh thats right....wait till the Q comes in and see then. Anticipation is the key to any success. In life and the market.

Asked by StephenGoff - 10 answers - 223 views   [more]



Delek US Holdings Inc. (DK)...Me trying to pick a bottom !

December 02, 2007 – Comments (0)

I really like this company. I had to use a lot of patients, as it pulled back from $30 in mid July. It's been a slow and steady fall from there since. I started buying it at $22. And averaged down once at $18.75 recently.
It trades pretty thinly. It's held 77% by insiders. George Soros being one of the more famous ones. Tax loss sale stock maybe? could that be why it's pulled back significantly? I think come after the New Year this will rebound nicely. they also report another quarter before then. It should be dramatically better then the last. Due to decreasing margins in the crack spread. They own almost a 40% stake in Lion Oil Company. So $100 oil doesn't hurt them as much as one would think. They're also making good change $$$ on the very lucrative convenience store/gas station profit margins. Come on....we've all been traveling on the road and stopped at the rest stop and paid the super marked up prices in them joints. They have almost 500 of the pick pocket They also have gas stations in the same structures. Some stations with their own refined products, some with others products. I also think that Pantry Inc. (PTRY) would make a good acquisition for (DK). It would give them over 1900 stores/gas station in the south east USA. In west Texas, is their refinery, selling approximately 21,000 barrels per day. (it has a rating to due the capacity of 60,000 barrels per day) The company owns 65 miles of pipeline and leases another 36 miles of pipeline. The company's pipeline serves Dyess Air Force Base near Abilene, Texas. Delek US has supply contracts for up to 27,350 barrels per day of refined product.  [more]

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