PHARMACY

APhA calls for health care reform to better incorporate pharmacists

BY David Salazar
APhA calls for health care reform to include pharmacist clinica 
 
 
WASHINGTON — As the American Health Care Act — the GOP plan to repeal and replace the Affordable Care Act — makes its way through Congress, the American Pharmacists Association is weighing in on what it says would be an ideal addition to any health care reform efforts: patient access to pharmacist-provided services and affordable, safe medications. 
 
“Consistent with our recommendations related to the Affordable Care Act … and other health care reforms, APhA continues to call for policies that support patient access to and coverage of —pharmacists’ patient care services, the pharmacy of their choice, and safe and affordable medications,” APhA EVP and CEO Thomas Menighan said. “An important component to providing access is ensuring adequate reimbursement to pharmacists for their patient care services and to pharmacies for medications and other products. Securing enactment of these policies increases access, improves quality and decreases costs.”
 
Menighan said APhA is calling for a healthcare system that best uses the skills of its practitioners, including pharmacists, to bring patients the best care and bring value to the system. One way to do so is to better incorporate pharmacists and the clinical services they can offer into the healthcare team. One key way to realize where pharmacists can be incorporated into patient care, he said, is to take a less segmented view of what coverage patients need
 
“We encourage Congress, when setting policies, to look beyond isolated components of health care to determine value. Because health insurance coverage is frequently analyzed by the benefit type, such as in-patient, out-patient, and drug coverage, a patient’s overall services, costs and outcomes may never be reviewed comprehensively,” Menighan said. “Congress and other policymakers cannot continue to view drug and medical coverage, and their related costs and outcomes, separately if we are to achieve true value in health care.”
 
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Studies: Esbriet can improve life expectancies for idiopathic pulmonary fibrosis patients

BY Brian Berk

ALEXANDRIA, Va. — Pirfenidone (Esbriet) can improve life expectancy compared with best supportive care and lower the risk of lung function decline for patients with idiopathic pulmonary fibrosis, an irreversible and unpredictable disease of unknown etiology that makes breathing difficult and causes permanent scarring damage to the lungs, according to two studies published in the March issue of the Journal of Managed Care & Specialty Pharmacy.

IPF is has no known cause and is fatal, often resulting in death in two to five years after diagnosis. It affects approximately 100,000 Americans and typically occurs in people older than 50. Historically, more men than women have been diagnosed with IPF. Common symptoms include a persistent dry cough; shortness of breath, sometimes even during normal daily activities; and “Velcrolike” crackles at the bases of the lungs, which a doctor can hear with a stethoscope. IPF is often initially misdiagnosed with other more common diseases such as asthma or chronic obstructive pulmonary disease. It can take months or even years to accurately diagnose IPF because the symptoms of IPF are very non-specific.

The first study, “Predicting Life Expectancy for Pirfenidone in Idiopathic Pulmonary Fibrosis,” revealed the Food and Drug Administration-approved drug, manufactured by Genenetech, can increase life expectancy in patients by 2.47 years compared to best supportive care. This study was funded by InterMune International AG, a wholly owned Roche subsidiary since 2014.

The second study, “Systematic Review and Network Meta-analysis of Idiopathic Pulmonary Fibrosis Treatments,” concluded pirfenidone may reduce the odds of experiencing a decline in percent predicted FVC of ≥10% compared with placebo in the first year of treatment. The results of the analysis also suggest that pirfenidone improves survival. FVC refers to Forced Vital Capacity, which is a measure of breath a person can exhale.

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Northeast Ohio Medical University pioneers Transitions in Care with Ritzman Pharmacy

BY Michael Johnsen

ROOTSTOWN, OHIO – The College of Pharmacy at Northeast Ohio Medical University on Friday launched the College’s first Transitions in Care program through its affiliate, Pharmacy Innovations, and in partnership with Ritzman Pharmacy at NEOMED and Summa Rehab Hospital.

“We hope to decrease re-admissions and increase compliance with patients taking their meds as prescribed,” stated Jeffrey Sanderson, medical director at Summa Rehab Hospital. “While it’s too early to project the long-run, we’ve already seen compliance – with patients getting their initial prescriptions filled – increase from an average 50% to 100% [for those introduced to the program].”

Services through the program, which began Jan. 5. 2017, include concierge service, medication education and discharge counseling – all at no additional charge to the patient.

The unique collaboration responds instantly to a number of critical concerns in health care today: medication adherence, access to quality health care and health literacy and re-admissions.

The process is fluid and begins as patients with varied medical needs are admitted to the Summa Rehab Hospital, a 60-bed inpatient acute medical rehabilitation hospital.  Upon admission, patients are automatically enrolled in the Transitions in Care Program, but they may opt out if desired.  Twenty-four hours prior to discharge, medication orders are sent to Ritzman Pharmacy at NEOMED for preparation.  On the day of discharge the medications are delivered via courier to the Pharmacy Department at Summa Rehab.  The Transitions in Care pharmacist then provides medication education, discharge counselling and discharge medications.

But it’s the direct interaction with pharmacists prior to discharge that’s key to increasing adherence, noted Charles Taylor, dean of the College of Pharmacy at NEOMED and president of Pharmacy Innovations. “Interprofessionally educated pharmacists can play a huge role as part of the care team. We need them to be recognized as providers of care.”

“It makes sense for pharmacist to play a role before discharge," agreed George Glatcz, COO Ritzman Pharmacy. "Usually a patient is sent home with a prescription, no medication education and no medication. It is no wonder that three out of four Americans do not take their medication as directed.”

Transitions in Care programs are on the increase. There are even a handful of residencies for Postgraduate Year Two (PGY2) pharmacists across the country. With health care facing an increased shortage of primary care physicians, medication adherence hovering around 50% and providers striving to reduce readmissions, patients, physicians and providers would all benefit from pharmacists as part of the care team, Glatcz noted.

 

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