PHARMACY

Independent pharmacy group NCPA unveils marketing center for members

BY Jim Frederick

ALEXANDRIA, Va. Adding to a growing arsenal of services to help small business owners who operate independent pharmacies, the National Community Pharmacists Association today unveiled a new program in partnership with Pharmacy Development Services to help them compete more effectively.

The new NCPA/PDS Marketing Solution Center will provide independent pharmacy owners with marketing strategies, tools and resources “to stay ahead of the competitive curve and effectively reach new and current customers,” NCPA announced. It will be operated by Pharmacy Development Services, a pharmacy marketing and business development company. 

The Solution Center is a web-based marketing tool, according to PDA. It’s designed to help pharmacies increase sales from their existing customers, attract new shoppers, and track and measure their advertising.  

“As independent pharmacy owners, sometimes we spend more time working in our businesses than working on our businesses to help them grow,” said NCPA president Holly Henry. “I’ve worked with PDS for years and I’m glad to say they’ve given me the freedom to step back and market my business and see great success.” 

NCPA said the new offering is part of a membership campaign launched in June, with the goal of reaching every independent pharmacy owner in the U.S. The center is part of the association’s recently announced Ownership Academy, a resource for NCPA members in all phases of community ownership.

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Diabetes medicines most expensive prescription drugs

BY Michael Johnsen

ROCKVILLE, Md. Diabetes medicines ranked No. 1 in total expense for prescription drugs in 2006 — $38.1 billion — according to a report published by the Agency for Healthcare Research and Quality, a division of the Department of Health & Human Services, last month.

The diabetes medicines, as a class, includes lipid-lowering drugs like Pfizer’s Lipitor.

Medicines for treating heart disease ranked No. 2 with $33.1 billion, followed by central nervous system agents ($28.2 billion), psycotherapeutic agents ($17.5 billion) and hormone replacement therapies ($14 billion).

Overall, the top five classes of drugs account for 62.8% of total prescription drug expenditures of $130.8 billion — diabetes drugs alone accounted for 18.3% of prescription-drug spending.

Psychotherapeutic agents and diabetes medicines were the two highest therapeutic classes with a mean expense per prescription of $91.54 and $86.90, respectively. Average per person expense per prescription in these two categories was higher than the average expense for the remaining three classes in the top five: central  nervous system agents ($62.59), hormones ($48.15) and cardiovascular agents ($46.54).

The estimates in the brief were derived from the Household Component of the 2006 Medical Expenditure Panel Survey, the agency stated. Only prescribed medicines purchases in an outpatient setting are included in the estimates. Insulin and diabetic supplies and equipment are also included in MEPS prescribed medicines estimates. Over-the-counter medicines are excluded from these estimates as are prescription medicines administered in an inpatient setting or in a clinic or physician’s office.

Therapeutic classes were assigned to drugs using Multum Lexicon variables from Cerner Multum, the agency noted. The therapeutic class of central nervous system agents includes the large subclass of analgesics; the therapeutic class of psychotherapeutic agents includes the large subclass of antidepressants; and the therapeutic class metabolic agents includes the large subclasses of antihyperlipidemic agents and antidiabetic agents. 

Sales of lipid-lowering drugs had been initially been captured as part of its own therapeutic class in the 2003 and 2004 data, but were reclassified as a therapeutic subclass of the new therapeutic class, metabolic agents, in 2005 and 2006 data. 

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HIT: The $20 billion needle in the haystack

BY Rob Eder

Dear Mr. President,

In my first letter to you (see Drug Store News, Dec. 9, 2008, “Dear Mr. President-Elect,” page 12), I implored you to make fixing the U.S. healthcare system the enduring legacy of your presidency.

That’s why I applaud the $87 billion Congress has built into the most recent version of the economic stimulus package to beef up Medicaid and extend COBRA health benefits for the millions of unemployed Americans who have lost their jobs in recent months, as just about every sector of our economy continues to wrestle with the worst slowdown since The Great Depression.

Even if none of that spending creates one single job or puts one more dollar back into the economy in any kind of way that would please John Keynes, I get it. We can either pay now to make sure these people don’t lose their health insurance or pay more later to cover the upstream costs of the lapse in their coverage today. Making sure that patients see doctors and stay on their meds today is a lot cheaper than paying for otherwise unnecessary surgeries and long-term hospitalizations tomorrow. This isn’t about charity. This is insurance against the higher cost of not having insurance. I get it.

Today, I write about the $20 billion healthcare information technology “needle” buried deep inside that $800 to $900 billion “haystack” of legislation you demanded Congress return to you for your signature in time to make economic stimulus your Valentine’s gift to the nation. As I mentioned in my first letter to you, I truly believe that the widespread adoption of an HIT infrastructure that connects providers throughout the continuum of care is a fundamental and absolutely necessary component of a modern healthcare system.

While others may choose to debate whether ‘tis nobler to cut taxes or spend our way out of our current economic crisis, I am not looking to politicize any of this. I think that the central issue here revolves around concerns of patient privacy, which I believe in this context is less a matter of partisanship than it is a matter of unfounded paranoia. If for some reason the original version of HIPPA isn’t enough to guarantee patient privacy in a world where health information would suddenly be digitized, where are the gaps?

And if there are gaps or areas in which HIPPA might be improved, why are these decisions that are being legislated by a group in Congress that, quite frankly, doesn’t fully understand the issues that surround patient privacy? As community pharmacy leaders have urged, this is clearly a matter best resolved by a process of negotiated rule-making conducted between HHS and the various stakeholders involved.

Because if you really get under the hood and take a closer look at these proposals, you will see that, not only do they stand in contrast to the very concept of economic stimulus, they do even less to promote improved health outcomes for patients.

Take this “Accounting of Disclosures” proposal that was part of the House version of the stimulus bill and, at the end of January, was expected to be part of the Senate’s bill, too. Basically, this would require pharmacies to keep records of each time a patient’s health information was “disclosed” to another “covered entity.” Every day, pharmacies make thousands of these “disclosures” just to process third-party claims and receive payment for the services they provide. Forget the fact that this is a logistical nightmare with the potential to significantly slow healthcare delivery, the cost to house all of that data—literally, billions and billions of transactional records—would be staggering.

Or, how about the “Marketing Issues” provision, which basically would require a patient to opt in to every patient communication that a pharmacy might ever choose to send them. So, let’s say a pharmacy were to receive a first-time prescription for a newly diagnosed diabetic; if the pharmacy wanted to send that patient some information on how to better manage the condition, it would need that patient’s authorization. If you wanted to invite them to take part in a disease state management program that could reduce their long-term healthcare costs by tens, perhaps hundreds of thousands of dollars, you would need them to fill out another authorization form. How about a simple refill reminder? Another authorization.

Each year we spend about $177 billion in direct and indirect costs related to patients not taking their medications as they have been directed to. How does this $20 billion in HIT spending address that, especially considering how much more pharmacy providers are going to have to invest to navigate their way through these new privacy proposals just to get back to the status quo?

What is currently being proposed will force community pharmacy—which clearly, has led the charge on HIT in this country, with more than 95% of all retail pharmacies electronic prescribing-enabled—to either scrap entirely their existing pharmacy systems, which have been programmed to operate according to existing HIPPA requirements, or invest inordinate sums to have those systems completely redesigned to meet the new proposed requirements. This is simply unfair, as a large portion of that $20 billion is going to fund special physician incentives to adopt e-prescribing technology. Why reward one group for being late to the dance and penalize another for arriving early?

HIT is too big and too important to the future of this country and, ultimately, is too expensive an undertaking to get wrong. Right now, it is a $20 billion needle in an $800 billion haystack of economic stimulus measures, and the real point of it all—to improve health outcomes and reduce long-term healthcare costs—is getting lost in all of this.

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