PHARMACY

Is Humana’s new Rx price tool a game changer?

BY Michael Johnsen

LOUISVILLE, Ky. — Pharmacy/physician collaborative practice models may have just gotten a shot in the arm with the announcement Thursday morning that Humana, which will cover a projected 13.1 million lives following its acquisition by Aetna, will be launching a real-time prescription drug benefit service that gives doctors information about their Humana patients’ drug coverage, pricing and network pharmacy options all while the patient is in the exam room.
 
Delivered to physicians through DrFirst’s myBenefitCheck, the IntelligentRx service provides doctors with patient-specific prescription price information at the time the prescription is being written. The service is expected to reduce the impact of cost on medication access and adherence by helping doctors and patients consider medication cost as part of their drug therapy regimen, the company said. 
 
DrFirst’s medication management technology is integrated with the electronic medical records used by many doctors during patient visits. When a doctor chooses a medication to prescribe, they are presented with information from Humana through DrFirst’s e-prescribing interface, including drug coverage and cost, potential alternative therapies and nearby retail pharmacies and mail order pharmacies in the patient’s network. Drug and allergy alerts are also presented during e-prescribing, helping reduce potential adverse drug events.
 
Humana Pharmacy president William Fleming says helping doctors make more informed prescribing decisions is key to medication access and adherence, and therefore critical to improving clinical outcomes.
 
“This is a big step forward in closing the gaps in the health care system, using transparency and technology to create a better health care experience,” Fleming said. “Real-time information provided by the IntelligentRx service is a perfect example of how we can help doctors proactively deliver better care, more affordably, to their patients.”
 
“The cost of medications is a known contributor to patient medication non-adherence,” DrFirst president Cameron Deemer said. “With myBenefitCheck, it’s as if the doctor is going along with the patient to the pharmacy, helping to select the best medication and pharmacy for patients based on their prescription drug coverage. This technology helps doctors choose the best course of action to support medication adherence and patient outcomes.”
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Rite Aid, Rx orgs make case for expanded MTM

BY DSN STAFF

WASHINGTON — On Wednesday the U.S House of Representatives’ Committee on Energy and Commerce Subcommittee on Health convened a hearing called “Examining Medicare Part D Medication Therapy Management Program.” The hearing was aimed at figuring out the best ways to strengthen MTM model as the Centers for Medicare and Medicaid roll out an overhaul of it. Among those testifying was pharmacist and Rite Aid’s director of field clinical services Jesse McCullough, who spoke in favor of expanding MTM to include more patients. 

McCullough focused on how MTM services aid in senior health care and highlighted recent efforts to expand the program, which include the introduction of a bill in the senate, the Medication Therapy Management Empowerment Act that would increase access to MTM for patients with such chronic conditions as diabetes, cardiovascular disease, high cholesterol and COPD. McCullough also noted that, given community pharmacist’s unique role as an easily accessible healthcare provider, they could be at the center of the expansion of MTM programs.

“Rite Aid has participated in MTM programs since their inception, and we have helped thousands of patients get more out of MTM to optimize their medication therapy,” McCullough said. “The fact of the matter is that we can do more.”

McCullough also spoke about the potential savings to the healthcare system that an MTM expansion would provide — especially given that “poor medication adherence alone costs the nation approximately $290 billion annually — 13 percent of total healthcare expenditures — and results in avoidable and costly health complications.”

In light of the hearing, both the National Association of Chain Drug Stores and the National Community Pharmacists associations submitted statements to the subcommittee calling for an expanded MTM model for Medicare patients.

“NCPA believes that prevention is the best medicine, and whether it's catching a medication error before it leads to a hospitalization or effective chronic disease management, MTM services present an opportunity to improve patient care while providing greater efficiencies within the health care system,” NCPA CEO B. Douglas Hoey said. “NCPA strongly supports Medicare's recent efforts to improve MTM services and will continue to work with Medicare officials and Congress toward that end.”

Similarly, the NACDS emphasized the role MTM can play in improving patient outcomes and called for expansion.

“Pharmacist-provided services such as MTM are important tools in the effort to improve medication adherence, patient health and healthcare affordability,” the statement said. “Reforming the Medicare Part D program should be accomplished through efficiently targeting beneficiaries who can most benefit from the services that will improve medication adherence and overall program effectiveness. … We urge Congress to build on this earlier action and strengthen the MTM benefit in Medicare Part D.”

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Anderson: Events with Obama, Burwell highlight NACDS’ focus on drug abuse, access issues

BY Steve Anderson

This week, the White House and the Administration invited representatives of the NACDS membership to two separate events. Drug abuse and access issues emerged as key topics of discussion at both of them, and it is clear that the need remains for pharmacy to keep urging a 100-percent commitment to patient care, amid a zero-tolerance for drug abuse.

By now, you have seen that President Obama traveled to West Virginia on Wednesday to announce “public and private sector efforts to address prescription drug abuse and heroin use.” NACDS was mentioned in a White House release about this event, with a description of NACDS’ educational initiatives related to opioid overdose and the anti-overdose medication naloxone. NACDS chain members were in attendance. Certainly, NACDS as an association and NACDS member companies are working partners toward a solution for drug abuse.

Earlier in the week, on Tuesday, a cross-section of NACDS members also was invited to meet with Health and Human Services Secretary Sylvia Burwell, with the 2016 enrollment period for the Health Insurance Marketplace topping the agenda. I was invited by the Secretary as well to represent NACDS. At that meeting, we also raised with the Secretary the need for continued efforts to bring a united effort – including health and enforcement authorities alike – to address simultaneously the challenges of prescription drug abuse and legitimate prescription drug access. It is important to emphasize at every opportunity the need for true collaboration to ensure all aspects of these issues are addressed effectively.

NACDS opinion research – conducted in July of this year – shows that likely voters are understanding the complexity of these issues, and the need to address all sides of them. Nearly 8-in-10 agreed (and more than 4-in-10 strongly agreed) with the statement that “pharmacies have a dual role when it comes to battling prescription drug abuse; they have to be part of the solution by working with law enforcement officials to stop prescription drug abuse, but they also have to maintain their responsibilities to patients by making sure they receive the medications they legitimately need."

Given the state of these issues right now, 32 percent of respondents in the research commissioned by NACDS feel there needs to be more emphasis in our country placed on cracking down on the abuse of prescription pain medication by establishing stricter guidelines and rules for how this medication can be dispensed; 49 percent of respondents feel there needs to be more emphasis on ensuring that the patients who legitimately need prescription pain medications are still able to easily get them when they need them; and 19 percent feel the nation has reached a reasonable balance when it comes to this issue.

NACDS.org includes more information about NACDS’ consistent focus on prescription drug abuse and access issues. In reviewing the information, you will be struck by NACDS’ discipline in maintaining focus on the “abuse” and “access” aspects of these complicated issues. It is NACDS’ mission to inject that comprehensive focus at every opportunity and among all stakeholders. 

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