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NCPA independent pharmacist survey challenges abusive auditing practices

BY Michael Johnsen

ALEXANDRIA, Va. — Abusive auditing and unfair reimbursement practices harm community pharmacists’ ability to provide critically needed patient counseling and care to seniors, according to a new survey released Tuesday by the National Community Pharmacists Association.

NCPA polled more than 350 community pharmacists about their recent experience with audits conducted by pharmacy benefit managers and other Medicare Part D plan intermediaries. The survey also asked about generic drug reimbursement caps known as maximum allowable costs (MACs). 

Among the findings:

  • 96% stated that a typical PBM contract has minimal or no transparency on how generic pricing is determined or what the reimbursement rate will be;

  • Almost 50% of respondents said that more than 10% of the time, PBMs set MAC reimbursement for generics below the pharmacy’s cost of simply acquiring the drug, much less dispensing and overhead costs; In addition, 92% said payments are not increased promptly to reflect a drug’s rising market costs;

  • 3-in-4 pharmacists said audit requirements across Medicare Part D plans are not consistent, increasing their compliance burden; and

  • Nearly 87% stated that PBM reimbursement and auditing practices are “significantly” or “very significantly” affecting their ability to provide patient care and remain in business.

When asked which drugs had MAC limits set below the pharmacy’s cost of acquiring the product, more than 600 drugs were identified, including budesonide (for asthma); atorvastatin (cholesterol); clarithromycin (antibiotic); fentanyl patches (pain); hydrocodone (pain/inflammation); and methylprednisolone (steroid for allergic reactions, skin conditions and breathing disorders).


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LoyaltyOne: Consumers less willing to share personal information with companies

BY Allison Cerra

CINCINNATI — Consumers continue to be cautious about sharing their personal information, according to an online survey conducted by LoyaltyOne, a global provider of coalition loyalty, customer analytics and loyalty services.

Among 1,000 respondents surveyed, LoyaltyOne found that 78% of them do not feel they receive any benefit at all from sharing information, up from 74% in 2011; less than half feel that companies use their personal data to better serve the consumer, an 11% slip from 2011; and 62% said they would share more personal data if it meant receiving relevant product and service offers, down from 66% in 2011.

"These responses point to an unmistakable trend. Marketers’ efforts to create relevant customer experiences through data need to be re-addressed or they run the risk of their efforts not resonating with customers," LoyaltyOne president Bryan Pearson said. "Consumers are disappointed. For years they’ve provided their valuable information and they’re not realizing something of suitable worth in return. If businesses don’t act quickly to demonstrate they have the consumer’s best interest at heart, they risk an erosion of the business-to-consumer relationship."

The survery also found that only 50% said they’d be willing to give a trusted company their religious affiliation, followed by their political affiliation and sexual orientation (both 49%), health information (36%), mental health information (26%), browsing history (24%) and smartphone location and number of sexual partners (tied at 15% each). Last on the list was their social security number (11%).

For detailed results of the report, click here.

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Healthcare reform: All in favor say ‘aye!’

BY Antoinette Alexander

The interest in healthcare reform has reached a new high, especially in light of the decision by the U.S. Supreme Court to uphold the Patient Protection and Affordable Care Act, yet there’s no denying that consumers are still unclear as to the impact on their personal healthcare and insurance issues. That being said, Americans see a need for change as they battle rising costs and a lack of access to care, and many are saying "aye" to healthcare reform, according to the most recent Patient Views infographic. To be specific, two-thirds of respondents say they support healthcare reform, according to an exclusive survey of nearly 800 patients conducted by AccentHealth and DSN in late July and early August.

Meanwhile, a separate study recently released by TNS underscored these findings and also found that, while few understand the personal implications of healthcare reform, Americans generally agree on the end goals for health reform — appropriate and effective patient care, lower costs and easier access to coverage for all.

To see more Patient Views, click here.

Patient Views is a new, exclusive consumer insights feature that will be appear in every edition of DSN magazine and the daily e-newsletter DSN A.M. If you could ask 4,000 patients anything at all, what would it be? Send your questions to reder@lf.com.

Are you in favor of healthcare reform?

Source: AccentHealth. To view the methodology, click here.

 

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