PHARMACY

NACDS urges Congress to consider role of pharmacy in ‘Fiscal 2015 Budget’

BY Antoinette Alexander

ARLINGTON, Va. – Citing pharmacist-administered medication therapy management, recognition of pharmacists as healthcare providers, the need for fair and accurate pharmacy reimbursement in state Medicaid programs and other pharmacy services, the National Association of Chain Drug Stores has sent a statement to lawmakers urging them to consider pharmacy provisions within the “Fiscal 2015 Budget,” released by the administration last week.

NACDS submitted a statement to the House Budget Committee and House Ways and Means Committee as each begins review of the “Fiscal 2015 Budget” during hearings this week.

“Community pharmacies and pharmacists provide access to prescription medications and over-the-counter products, as well as cost-effective health services, such as immunizations and disease screenings,” NACDS stated in its comments. “Through personal interactions with patients, face-to-face consultations and convenient access to preventive care services, local pharmacists are helping to shape the healthcare delivery system of tomorrow — in partnership with doctors, nurses and others.”

In its statement, NACDS cited public and private studies showing the health benefits and cost-savings as a result of pharmacist-provided MTM services, including a 2013 report by the Centers for Medicare & Medicaid Services, which found that Part D MTM programs improved medication adherence and quality of prescribing for evidence-based medications for beneficiaries with congestive heart failure, COPD and diabetes.

“Moreover, policymakers have begun to recognize the vital role that local pharmacists can play in improving medication adherence.  Congress has recognized the importance of pharmacist-provided services, such as MTM, by including it as a required offering in the Medicare Part D program,” NACDS stated in its comments.

Highlighting pharmacists’ ability to provide services that lead to better clinical outcomes and lower healthcare costs, NACDS urged the “implementation of budget proposals that allow all healthcare providers, including retail pharmacists, to practice to their maximum capabilities, working in partnership to provide accessible, high-quality care to patients.”

Focusing on patient access to care, NACDS expressed its opposition to the Department of Health and Human Services proposal within the FY2015 Budget to exclude brand and authorized generic drugs from the calculation of average manufacture price, thereby calculating Medicaid Federal Upper Limits based only on generic drug prices.

“While the goal of this provision may be to decrease Medicaid costs, we believe it may, in fact, reduce access to prescription drugs and pharmacy services for Medicaid patients, resulting in increased overall healthcare expenditures,” NACDS stated in its comments.

NACDS’ recent analysis, indicated that approximately 35% of the draft FULs are below National Average Drug Acquisition Cost.
 
“This analysis confirms that additional efforts by CMS are necessary to ensure that pharmacies are not reimbursed below their costs using the reimbursement formula created by the Affordable Care Act. We urge CMS to utilize the rulemaking process to implement the Medicaid pharmacy provisions in a manner consistent with congressional intent, rather than pursuing policies that would further cut pharmacy reimbursement,” NACDS stated in its comments.

NACDS also stressed the implications on patient care if CMS pursues changes to Medicaid reimbursement of durable medical equipment specifically for diabetes testing supplies.

“Reducing Medicaid reimbursement for DTS to match the Medicare rate could similarly produce hardships for Medicaid beneficiaries in terms of reducing access to needed supplies and threatening the health of an already fragile population.

In its statement, NACDS also expressed support for provisions to increase the utilization of generic drugs, which help control prescription drug costs, and stressed cautious support for efforts by HHS to reduce waste, fraud and abuse in the Medicare and Medicaid programs, but in a manner that does not to disrupt beneficiary access or jeopardize beneficiary health.

“We look forward to working with policymakers and stakeholders on these important issues,” NACDS concluded in its statement

 

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PHARMACY

Study: Point-of-care access to generic Rx samples boosts initiation, adherence rates

BY Antoinette Alexander

SAN DIEGO — New research presented at the World Congress Summit to Improve Adherence and Enhance Patient Engagement by researchers from the University of Pittsburgh School of Pharmacy, finds that the MedVantx MedStart Connect generic medication sampling program implemented in the primary care physicians’ office, led to significantly increased patient initiation of new prescriptions (primary adherence) as well as continued use of the medications (secondary adherence), and could possibly lead to savings for health plans.

The study was sponsored by MedVantx and independently conducted by Janice Pringle, principal investigator and director of the program evaluation and research unit at the University of Pittsburgh School of Pharmacy.

"Primary medication non-adherence is an under-addressed problem in health care.  The simple fact is that medications don’t work if patients don’t get them," Pringle said. "The results of this study show a substantial benefit of a unique adherence intervention that not only addresses primary non-adherence, but also proves to be of value over time in improving secondary adherence to medication."

The study compared the prescription initiation and refill histories of a patient population who received in their doctors’ offices an initial 30-day sample of generic medications for treatment of chronic diseases including high blood pressure, high cholesterol, and diabetes, to a group of patients receiving only electronic prescriptions. All of the patients receiving the MedVantx samples were able to start therapy, while only an average of 60% of patients in the e-prescribing group went on to fill a prescription to initiate therapy. The study also found that 73% of patients receiving a MedVantx sample went on to fill their first prescription to obtain a second month of therapy after finishing their 30-day sample.

To determine the program’s potential impact on secondary adherence rates, researchers analyzed pharmacy claims data provided by health plans for filled prescriptions at 90, 180, and 365 days after the point of care generic sampling event. Over this time period, patients who received MedVantx samples continued to fill prescriptions for these medications at each time point, obtaining 53 more days of medication during the course of one year.  At each time point, the proportion of days covered was also higher for the MedVantx point-of-care generic sample group, with a difference of 42% at 90 days, 26% at 180 days, and 15% at 365 days. In addition, researchers found that the percentage of patients who were highly adherent (had medications 80% of the defined time frame or PDC80%) was also statistically significantly higher at each time point in the MedVantx sampled group versus the control group.

The researchers also sought to establish if the adherence achieved through the point of care generic sampling program resulted in reduced overall health care costs for those patients. They found results that were strongly suggestive of real cost savings, including an average overall health care cost reduction per sampled patient of $201 to $291 the year after sampling.

 

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Study: Pharmaceutical companies prioritizing healthcare IT investments

BY Michael Johnsen

PARSIPPANY, N.J. — Three-in-four pharmaceutical companies are looking to derive greater value from the influx of healthcare information that includes anonymized electronic medical records and other real-world data, according to a report issued by the IMS Institute for Healthcare Informatics on Wednesday. New investments in a range of commercial operations applications — such as customer relationship management, social media or integrated multi-channel marketing solutions — were cited by more than 70% of respondents as a priority.

“Realizing the full benefit from new technologies will be a high priority for all life sciences companies as commercialization approaches are revised amid changing customer demands and a growing need for efficiency,” stated Murray Aitken, executive director of the IMS Institute for Healthcare Informatics. “Applications that are healthcare-specific, cloud-based, integrated, secure and analytically powerful will yield tremendous advantage to these organizations, and ultimately to patients and the health system overall.”

The study — Riding the Information Technology Wave in Life Sciences: Priorities, Pitfalls and Promise — found that pharmaceutical companies are aggressively shifting their technology-based approaches to align cross-functional activities, optimize their organizations and improve the effectiveness and agility of commercial teams. In addition, new investment is being focused on enabling greater patient engagement.

The report cites findings from an IMS Institute survey of decision makers in IT, marketing, sales, operations and management from 70 organizations who were asked about their current and planned use of new IT solutions. Overall, respondents expect continued cost reductions across the industry, and 40% pointed to planned cuts of more than 10% in their organizations during the next three years.

Accordingly, the largest global pharmaceutical companies will need to reduce combined operating costs by $36 billion annually through 2017 to maintain their operating margins and current levels of R&D activities. Pressure on operating margins is expected to grow as companies face rising costs at the same time drug prices are being constrained or reduced. With an estimated R&D cost inflation rate of 5% annually, organizations will need to reduce other operating costs to maintain margins. While the source of cost cutting will vary by company, a primary focus likely will be on sales, marketing and administration costs, which amount to nearly 30% of net sales. Of those surveyed by the IMS Institute, 87% indicated that their commercial organizations are being optimized through a range of approaches, including selective insourcing and outsourcing, resource shifting and implementation of previously unavailable technology-based solutions.

Integrated systems, cited by 85% of survey respondents as a need for optimizing their commercial organizations, are increasingly viewed as a means to improve workflow speed, eliminate conflicting data interpretations across departments, and reduce the cost of vendor teams managing manual data handoffs.

Life sciences companies are shifting their primary data storage to the cloud, and investing in new sales and marketing-related applications. Due to the sensitive nature of healthcare data, the adoption of remote, cloud-based technologies by pharma companies has been slow compared to other industries. Organizations are embracing efforts by cloud providers to accelerate progress in establishing and maintaining secure and compliant environments for the collection and storage of health information. As many as 70% of participants expressed a need to utilize third-party, cloud-based applications.  

And new mobile applications for both patients and physicians are seen as increasingly important for strengthening healthcare engagement. Nearly 60% of survey respondents rated patient apps as extremely or very important to address commercial challenges, while 69% similarly rated investments in physician apps.

The full version of the report can be downloaded as an app via iTunes. The study was produced independently as a public service, without industry or government funding, IMS Institute for Healthcare Informatics reported.

 

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