HEALTH

Gallup study shows clinics know how to ‘Take Care’

BY DSN STAFF

CONSHOHOCKEN, Pa. —Take Care Health Systems, which is owned by Walgreens, built its retail-based clinics around a patient-centric model, and the success of that model is evident in the results of recent Gallup research.

The research on customers and customer engagement found that Take Care Clinics ranked among the top 10% of all organizations that Gallup measures globally in engaging their patients and customers. The research is based on a measure of customer engagement Gallup has developed that quantifies the strength and nature of a customer’s connection to a company. Gallup’s metric assesses the emotional bonds of confidence, integrity, pride and passion that reflect a company’s customer relationships. Gallup has found that without a strong emotional bond, satisfaction is meaningless.

The data found:

Take Care Clinics received the highest satisfaction ratings from more than 9-out-of-every-10 patients, compared with the typical company in Gallup’s database that receives the highest satisfaction from just 1-in-every-3 customers;

More than 9-out-of-every-10 patients strongly felt that the nurse practitioner or physician assistant spent enough time with them, and a similar number strongly felt that the nurse practitioner or physician assistant carefully listened to them and explained things in a way that was easy to understand; and

Take Care Clinics strongly engaged more than 3-outof-every-4 patients. The typical company in Gallup’s database strongly engages less than 1-in-5 customers.

The results of the study are important for several reasons. In today’s consumer-driven healthcare environment, simply satisfying a patient is not enough. Patients want to feel a personal connection; they want to be engaged. Furthermore, the role of retail-based clinics will become increasingly important since healthcare reform means that about 30 million people who currently are uninsured will have health-care coverage, and this comes against the backdrop of a physician shortage and overflowing emergency rooms.

The opinions of more than 50,000 Take Care Clinic patient respondents have been captured to date via on-site kiosks at more than 350 clinic locations. Gallup validated these results through a nationwide, random outbound phone study. Results of that study indicated that the on-site kiosk data provided an accurate portrait of Take Care Clinics’ patient-engagement performance.

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Sorry, FTC: ‘Pay-for-delay’ isn’t going away

BY Alaric DeArment

WHAT IT MEANS AND WHY IT’S IMPORTANT This week’s decision by the U.S. Second Circuit Court of Appeals could make political efforts to ban generic-branded patent settlements a lot more difficult.

(THE NEWS: Appeals court upholds decision to OK ‘pay-for-delay’ deals. For the full story, click here)

The Federal Trade Commission in particular, not to mention some members of Congress like Sen. Herb Kohl, D-Wis., has fought hard against so-called “pay-for-delay” settlements between branded and generic drug companies, contending that they delay patients’ access to generic drugs and cost consumers billions of dollars every year.

The concerns of opponents are understandable. Because generic and branded drug makers are supposed to be competitors, what seem on the surface like sweetheart deals must look positively Faustian to many people. But the judges in the appeals court affirmed that whatever their appearance, patent settlements don’t violate antitrust laws.

And the facts seem to support that decision. According to a report released in January by RBC Capital Markets, generic drug companies prevailed in 76% of cases that included settlements, but only in 48% of cases that went to trial. Meanwhile, according to a report released the same month by securities and investment banking firm Jefferies & Co., on average, patent settlements result in generic launch three years before patent expiration. Legally, a generic drug company must launch its version of a drug before or at the time of patent expiration.

While patent settlements often involve some type of monetary transaction, in many cases, the “pay” is in the form of a promise by the branded drug company not to launch an authorized generic, which is the branded drug sold under its generic name at a lower price. Under the Hatch-Waxman Act, the first generic drug maker to launch a knockoff of a branded drug is entitled to six months in which to compete directly with the branded version, but the authorized generic allows the branded drug maker to undercut the generic drug maker by marketing a supposedly “generic” version of its own.

Authorized generics have seen a bit of a pickup as well, and more activity on that front can be expected. On Tuesday, Greenstone, the generics arm of Pfizer, announced that it would create a new business called the Authorized Generics Alliance in order to market authorized generics under the Greenstone label.

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Medicaid plans to end onerous AMP rules

BY Jim Frederick

WHAT IT MEANS AND WHY IT’S IMPORTANT It’s about time.

(THE NEWS: NACDS, NCPA in joint statement praise CMS’ move to withdraw provisions of AMP rule currently blocked by injunction. For the full story, click here)

The White House, or more specifically the Centers for Medicare and Medicaid Services’ division of Health and Human Services, announced in recent days that it plans at last to scrap its controversial and burdensome pricing policies for generic drugs bought by retail pharmacies to dispense to Medicaid patients. If CMS’ newly proposed rule goes through, it will mean the end of the current, much-disputed provisions that define the average manufacturer price of Medicaid me-too medicines.

The proposed rule, to quote the National Association of Chain Drug Stores, calls for “the withdrawal of existing provisions that define AMP, that determine the calculation of federal upper limits [FULs], and that define ‘multiple source drug.’”

As currently defined, Medicaid’s payment model for reimbursing pharmacists to dispense generics is based on a flawed formula for determining what retail pharmacies pay for those medicines, as determined by a set of controversial market metrics.

The current AMP policy almost is a guarantee that retail pharmacies would lose money on nearly every Medicaid generic prescription they dispense. It’s only a temporary court injunction that has thus far kept that new formula from being imposed.

Thus, CMS’ turnabout marks a real victory for the chain and independent pharmacy lobby, which has bitterly contested the AMP reimbursement formula since it was made policy by the Bush administration more than three years ago. But the plan to withdraw the current AMP model doesn’t end the long battle by pharmacy for a fair payment policy for dispensing generic drugs to Medicaid beneficiaries.

What the pharmacy industry –– and the U.S. healthcare system itself, for that matter –– need is a permanent solution to the Medicaid reimbursement mess. And that solution can only be achieved by congressional action and enactment of a new law governing Medicaid.

The 2010 health-reform law goes part way toward that solution, by holding the line on pharmacy cuts and setting the FULs on Medicaid prescription payments at no less than 175% of cost. It also includes what NACDS president and CEO Steve Anderson calls “a much-improved definition and calculation method for AMP” that will “better approximate pharmacies’ costs for purchasing generic drugs.”

Anderson said the injunction lawsuit filed in 2007 by NACDS and its independent pharmacy counterpart, the National Community Pharmacists Association, has saved pharmacy more than $5.3 billion in cuts since a federal court blocked the imposition of the new AMP formula in January 2008. It also may have prevented the closing of more than 11,000 community pharmacies that otherwise would have been forced to dispense Medicaid scripts at a loss or stop serving lower-income patients.

“When we filed the lawsuit in 2007, we knew that patient care was at stake,” Anderson asserted.

The bottom line is that the White House and Congress need to establish a federal payment system that rewards –– rather than penalizes –– pharmacies for dispensing lower-cost generics that provide the same safety and efficacy profiles as higher-cost pioneer medicines. Such a permanent fix would be a win both for the pharmacy industry and the American taxpayer, by saving tens or even hundreds of billions of dollars over the long term in federal health costs.

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