PHARMACY

CMS study further proof community pharmacy can improve patients’ lives, says NACDS

BY Jason Owen

ARLINGTON, Va. — National Association of Chain Drug Stores (NACDS) president and CEO Steve Anderson, calls a new study by the Centers for Medicare and Medicaid Services (CMS) “further proof of community pharmacy’s ability to improve patients’ lives while making healthcare more affordable in this country.”

CMS yesterday released “Medication Therapy Management (MTM) in a Chronically Ill Population: Interim Report.” The study describes reduced prescription drug costs and hospitalization costs among patients with congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) who were newly enrolled in a Medicare Part D MTM program in 2010.

MTM is a methodical approach to improving medication use and reducing the risk of adverse events that has been advanced substantially by the increasingly patient-centered focus of pharmacy education and by pharmacists’ increasing recognition for medication expertise.

“This CMS study shows yet again that public and private payers who pursue pharmacist-provided MTM are on the right track for improving the effectiveness, quality and affordability of patient care,” Anderson said. “This is exactly why NACDS has focused on the priority of further advancing MTM through legislation and raising awareness of its value within the private sector. When it comes to patient care and smarter approaches to healthcare, MTM is a winner.”

The CMS study said, “In comparison to Medicare beneficiaries with CHF or COPD who did not receive any MTM services in 2010, those who were enrolled in MTM programs – particularly those who received annual CMRs [comprehensive medication reviews – experienced significant improvements in the quality of their drug regimens.”

In the 112th Congress, NACDS supported legislation to improve Medicare’s MTM benefit, and efforts already are underway to marshal support for such a legislative initiative in the current 113th Congress.

“Community pharmacies are widely recognized for their core function of helping patients use medicines safely and stay healthy,” Anderson said. “Innovative pharmacy services – including MTM – do even more to improve health, quality of life and healthcare affordability. This is particularly true for many Americans in the greatest need.”

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Survey: Part D ‘preferred pharmacy’ provision driving rural seniors away from community pharmacy

BY Michael Johnsen

ALEXANDRIA, Va. — A survey of community pharmacists suggests that "preferred pharmacy" Medicare Part D drug benefit plans may pose challenges for seniors in rural communities. The finding comes shortly after similar questions were raised at the January public meeting of the Medicare Payment Advisory Commission, Congress’ advisory board on Medicare issues, the National Community Pharmacists Association noted Thursday. 

"Any legitimate pharmacy provider willing to accept a health plan’s terms and conditions, including reimbursement, should be allowed the opportunity to serve that plan’s members, including as a preferred pharmacy," stated Douglas Hoey, CEO of NCPA. "Unfortunately, in the current environment, seniors may unwittingly be coerced by co-pays that are only available in ‘preferred’ pharmacies that may be 20 miles away, while much closer, locally owned pharmacies are shut out. In effect, Medicare’s access standard is a double standard — one by which some plans rely on independent pharmacies to meet pharmacy network access requirements while not allowing those same pharmacies to serve patients on equal footing.

Some seniors are surprised to find that they are enrolled in Part D drug plans whose preferred pharmacies offering the lowest, advertised co-pays may be 20 miles or more from the seniors’ home, pharmacists reported. And nearly all community pharmacy owners/operators (91%) said they are not offered the opportunity to participate as a preferred pharmacy.

Approximately 1,800 rural independent pharmacies serve as the only pharmacy provider in their community, with the next closest pharmacy many miles away.

Virtually every pharmacist (98%) said their patients experienced confusion about the difference between preferred and nonpreferred (or "network") pharmacies, with 76% of pharmacists attributing the patients’ confusion to the plan’s marketing activities.

While the Medicare Part D program does require plans to maintain a pharmacy network that meets minimum access standards, these requirements do not apply to the preferred pharmacies designated by the plan, NCPA noted. 

At a Jan. 10 MedPAC meeting, Commission staff said one reason they were "keeping an eye on this trend is because this could have an effect on beneficiaries’ access to medications." In particular, questions were raised at the meeting about preferred pharmacy plans’ potential impact on patient access to medication, beneficiary confusion over the difference between a preferred pharmacy and a network one, and the cost impact of differential co-pay levels. "Access and cost implications of tiered pharmacy networks are not yet known, and we will continue to monitor the plans’ use of tiered pharmacy networks and the effects on beneficiaries’ access to medications," MedPAC staff noted.


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CVS Caremark announces expansion of Pharmacy Advisor program

BY Antoinette Alexander

WOONSOCKET, R.I. — CVS Caremark has announced the extension of its Pharmacy Advisor program to cover an additional five chronic conditions, including asthma, breast cancer, chronic obstructive pulmonary disease, depression and osteoporosis.

The condition-based program alerts pharmacists when patients are not adherent to their medication regimens or have a gap in care, allowing them to intervene with patients and communicate with their physicians in real time.  Before this program extension, the Pharmacy Advisor program had focused on patients with diabetes or cardiovascular conditions, with more than 3.8 million interventions conducted to date.

It is estimated that medication nonadherence costs the U.S. economy nearly $300 billion annually. Studies suggest that poor medication adherence is linked to chronic conditions, and that medication persistence — the length of time a patient continues to take a prescribed drug — tends to be low for those with chronic conditions. Research also suggests that the design of medically appropriate regimens for individual patients can play a role in improving costs and outcomes associated with adherence and that intervention by pharmacists can reduce gaps in care.

"We are delighted to extend Pharmacy Advisor and its benefits to patients managing medications associated with additional chronic conditions," stated Troyen A. Brennan, EVP and chief medical officer of CVS Caremark. "Pharmacists play an important role in the coordination of care for individuals living with chronic conditions and understand how critical medication adherence is in supporting their patients."

In addition to improving medication adherence, Pharmacy Advisor directs members with chronic conditions to existing disease management programs where they can obtain additional support, the company stated.

"Pharmacy Advisor not only improves quality of care for individuals with chronic conditions by providing an additional layer of support, but also addresses the important systemic challenges of healthcare costs related to medication nonadherence," stated Jon Roberts, president of CVS Caremark’s PBM business.  "Extending the program to cover a broader range of chronic conditions expands our ability to support even more patients on their path to better health, while reducing the burden of cost associated with medication nonadherence for patients with these conditions."


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