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Healthcare is Apple’s next target for disruptive innovation

BY Michael Johnsen

First with its iPod, and then with its iPhone and iPad, Apple has successfully introduced the kind of disruptive innovation that has helped redefine whole industries. Today, Apple continues to help shape the way Americans consume media and communicate with one another. Tomorrow, Apple may help shape how Americans engage health care. According to a Reuters report published last week, Apple is in talks with health providers including Mount Sinai, the Cleveland Clinic and Johns Hopkins around its HealthKit service. 
 
Apple's HealthKit will be used as a health data aggregator — including blood pressure, blood sugar, pulse and weight — that healthcare professionals and caregivers can use to help track a patient's health. In so doing, Apple will become one of the conduits to optimized, patient-empowered healthcare where outcomes based management isn't just a goal, it's a comprehensive, turnkey solution. 
 
Of course, Apple isn't alone. Just about every other major player in telecommunications is staking out a claim on what tomorrow's telehealth will look like, including Verizon's Virtual Visits and Google's Helpouts. Comcast, Time Warner and Cox also are exploring telehealth as a potential lucrative revenue stream. And with good reason, telehealth services are expected to generate $4.5 billion by 2018, according to research firm IHS, with an approximate 7 million patients plugged in, up from less than 350,000 in 2013. 
 
Imagine the possibilities. Devices already exist that can successfully capture health data and wirelessly upload that data to the cloud. With the appropriate patient permissions in place, the next step will be to mine that data for exception reports and place those reports into the hands of retail pharmacists, who in turn can do what pharmacists do best — council patients on their medication protocol and disease state management. 
 
It's a proactive health model that can identify at-risk patients and intercept those patients in an effort to improve outcomes. And it's a model that fully places America's most approachable healthcare professional — the pharmacist — right smack in the middle of some positive disruptive innovation of their own. 
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Amneal expands portfolio with four new generics

BY Ryan Chavis

BRIDGEWATER, N.J. — Amneal Pharmaceuticals announced four new additions to its portfolio of generic drugs, which represent multiple therapeutic categories and account for $900 million annually in U.S. sales, the company said, citing data from IMS Health.

The new generic products are:

  • Acyclovir ointment, USPL: Available in 5% strength and sold in 30-g. tubes. Each gram of ointment contains 50 mg of acyclovir. The Amneal generic is the therapeutic equivalent to Zovirax ointment 5%;
  • Atovaquone oral suspension, USP: The first-to-market generic is available in 750-mg/5-mL strength and comes packaged in 8-fl. oz. bottles. The drug is the therapeutic equivalent to Mepron oral suspension;
  • Clindamycin palmitate hydrochloride for oral solution, USP (dediatric): Available in 75 mg/5 mL reconstituted strength. Mixing the powder with water provides 100 mL of a clear, cherry-flavored solution. The Amneal product is the therapeutic equivalent to Cleocin Pediatric.
  • Oxycodone hydrochloride tablets, USP (C-II): Available in 5-mg, 10-mg, 15-mg, 20- mg or 30-mg strength in 100-count bottles. The Amneal generic is the equivalent to Roxicodone.

“Introducing these four products in the market aligns with our strategic focus on extending our generic offerings across all dosage forms,” said Chirag Patel, co-CEO and co-chairman of Amneal.  “Currently, we have 125 ANDAs filed with the U.S. FDA across numerous dosage forms, including transdermal, oral liquid, topical, injectable, oral solid, ophthalmic and otic.  These new medications will further diversify our expansive portfolio.”   
 

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JAPhA: Medicare annual wellness visits spell opportunities for pharmacists

BY Antoinette Alexander

WASHINGTON — Medicare’s Annual Wellness Visits present potential opportunities for pharmacists based in physician offices, concluded two experience articles published in the July/August 2014 edition of the Journal of the American Pharmacists Association.

The two articles and a related editorial explore the financial and logistical challenges associated with a pharmacist-led AWVs developed and delivered within a physician’s office.

AWVs are an underutilized benefit of Medicare, APhA noted. They are cost- and copayment-free services that keep patients healthy and well. AWV providers must assess medical and family history, risk factors, routine measurements and vital signs, as well as provide yearly immunizations, a complete medication review and cognitive impairment and depression screenings.

The viewpoint article “Medicare Annual Wellness Visits: Patient need and pharmacist patient care services intersect” by Pamela Heaton stated. “Our older patients need the preventive care provided through AWVs, pharmacists are uniquely qualified for providing medication management and other health-and-wellness services, a reimbursement mechanism is available, and we have an ample — and growing — supply of pharmacists. We must play an important role in filling this gap and should now step boldly into this currently available space.”

An analysis of the first experience article, “Development and implementation of a pharmacist-delivered Medicare annual wellness visit at a family practice office,” by M. Thomas and J. Goode, stated, “As the pharmacy profession's role in health care continues to evolve, more responsibilities in primary patient care services are being assumed by pharmacists. However, this growth has been inhibited by minimal cognitive service compensation by payers. AWVs present a new opportunity for pharmacists to provide a financially viable patient care service that is covered for Medicare beneficiaries through the Affordable Care Act. Pharmacists can successfully be integrated into the healthcare team to provide AWVs and thereby enhance the health and wellness of Medicare patients.”

An analysis of the second experience article, “Financial implications of pharmacist-led Medicare annual wellness visits,” by I. Park, et al, stated, “Pharmacists are not currently recognized as healthcare providers under the Social Security Act, which limits reimbursement potential and impedes the ability to establish outpatient clinical pharmacy services. The Affordable Care Act of 2010 presents a unique opportunity for higher reimbursement than that traditionally available via AWVs. By conducting wellness visits, pharmacists can be both valuable assets to the primary care team in practices of varying sizes and generators of revenue to support their positions.”

These experiences conclude that the challenge in expanding this type of service will be in providing a reimbursement mechanism that will enable pharmacists in any setting to develop relationships with primary care providers and offer AWVs. To enable this possibility, pharmacists need be recognized as providers by the federal and state governments and by private payers, APhA stated.

The full-text articles are available on the Journal’s website at JAPhA.org.

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