PHARMACY

NACDS evaluates CMS’ proposed rule for pharmacy progress

BY David Salazar

The Centers for Medicare and Medicaid Services recently shared its proposed changes to Medicare Part D, and it includes several measures that the industry has been seeking. The proposed rule includes changes regarding e-prescribing and medication therapy management, addressing opioid abuse and building pharmacy access, the National Association of Chain Drug Stores said.

“NACDS was pleased to see progress on several important issues in CMS’ proposed rule – including pro-patient and pro-pharmacy approaches on which NACDS has advocated,” NACDS CEO Steve Anderson said. “NACDS will remain engaged on these topics and will issue further comments as CMS continues its work on this proposal, particularly where there are opportunities to shape policies to achieve even better results for Medicare beneficiaries and for the pharmacies that serve them.”

Among the measures in the proposed changes are implementations of guidelines from the comprehensive Addiction and Recovery Act of 2016, which treats a pharmacy with multiple locations that share real-time electronic info as a single pharmacy. By treating multiple locations as a single “locked-in” pharmacy — from which patients at risk for prescription drug abuse or misuse are required to pick up their medication by their plan sponsor, it allows for patient convenience, NACDS said.

CMS also is proposing the adoption of an official electronic prescribing standard for sharing electronic prescriptions and related information. The agency proposes adopting the National Council for Prescription Drug Programs SCRIPT Standard for electronic prescribing.

The proposed changes also take into account reimbursement for pharmacy services. It would classify MTM programs as a quality improving activity, rather than an administrative function — confusion over which NACDS said leads MTM to get included in an area on which Medicare Advantage plans limited spending to 15%. CMS also is clarifying that Part D plan sponsors can’t exclude pharmacies with innovative or unique models because they don’t fit the correct pharmacy type classification for contracted pharmacy networks.

Additionally, CMS is soliciting comments on potential policies relating to direct and indirect remuneration, or DIR, fees. NACDS said it would continue to push CMS to issue guidance calling for increased transparency on DIR Fees, particularly with regard to timing and consistency.

“NACDS will remain vigilant on the numerous, complex and highly consequential policies that ultimately affect pharmacy operations and pharmacy patient care. We will continue to articulate a pro-pharmacy and pro-patient voice as CMS advances its consideration of these issues, and we appreciate the progress that CMS is proposing on diverse and critical topics,” Anderson said.

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Walgreens study finds results from pharmacy, specialty clinic collaboration

BY Michael Johnsen

A recent Walgreens Center for Health and Wellbeing Research study assessed a collaboration between Piedmont Healthcare’s Hepatitis C specialty clinic and a Walgreens local specialty pharmacy and showed that a high proportion (94%) of Hepatitis C patients who were prescribed direct-acting antiretrovirals were able to achieve the primary outcome goal, sustained virologic response, even though many patients had advanced liver disease, previous treatment failure or previous liver transplants.

“Collaboration between pharmacists and providers is key to optimizing patients’ response to treatment,” stated Shauna Markes-Wilson, study author and local specialty pharmacist for Walgreens, a Deerfield, Ill.-based retail pharmacy operator. “Pharmacists provide high-touch support to overcome treatment challenges such as insurance prior-authorization and high copays.  We ensure patient safety through drug interaction screening and patient education,” she said. “We communicate regularly to ensure that patients are adherent to their care plans and address any side effects, while keeping our providers in the loop.”

“Our providers and nursing staff at Piedmont Transplant had known that a collaborative approach with the Walgreens specialty pharmacy was improving access to expensive but highly curative hepatitis C medications, but we had never examined the data to quantify the benefits,” added Lance Stein, hepatologist, of the Piedmont Transplant Institute. “By combining our patient level data we now can quantify this collaboration’s benefits in expediting access to medications, lowering costs and still achieve the high rates of cure seen in DAA clinical trials.”

The descriptive, retrospective study, which published in the Journal of the American Pharmacists Association,  used a joint clinical and pharmacy database of patients who were prescribed DAAs.  Outcomes assessed included time-to-therapy, SVR, insurance appeals and copay assistance amount.

In addition, Hepatitis C patients managed jointly by this clinic-pharmacy collaboration had a shorter average prescribed time-to-therapy and lower copays compared to other published studies. After insurance appeals and financial assistance, patient copays were reduced to less than $20 per month for the majority of patients.

Walgreens has nearly 100 Hepatitis C specialized pharmacies across the country where trained pharmacists and pharmacy staff collaborate with Hepatitis C medical providers to ensure timely and affordable access to potentially life-saving treatment, the company reported.

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Perrigo launches 2 generics

BY David Salazar

Perrigo has introduced two products, a generic of Mycolog II Cream (nystatin and triamcinolone acetonide cream, 1 mg/gram) and the Exalgo (hydromorphone HCl) extended-release tablets.

The Dublin, Ireland-based company’s Mycolog II Cream generic is indicated to treat cutaneous candidiasis. The drug had annual generics sales of $81 million for the 12 months ended September 2017, according to IQVIA data.

Perrigo’s Exalgo generic will be available in 32-mg dosage strength, and is indicated to treat severe pain in opioid-tolerant patients who require around-the-clock pain relief over an extended period of time. The drug had brand and generic U.S. sales of $32 million for the 12 months ended September 2017, according to IQVIA data.

"This launch is another example of the team's hard work in advancing our new product pipeline,” Perrigo executive vice president and president Rx pharmaceuticals John Wesolowski said. “This commitment is driving value for patients by delivering generic products in important treatment categories at more affordable prices.”

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