PHARMACY

NCPA survey: Closed-door LTC pharmacies dispense meds at 25% higher cost vs. retail

BY Michael Johnsen

ALEXANDRIA, Va. — Long-term care pharmacies incur dispensing costs that are 25% higher than those of traditional retail pharmacies and provide additional services to meet the unique health needs of LTC residents, according to the findings of a new survey released Friday by the National Community Pharmacists Association Long-Term Care Division.

"As payers consider new payment models — such as average acquisition cost, or AAC — it becomes even more vital that they account for the escalated costs of serving LTC patients," noted Douglas Hoey, NCPA CEO. "In addition, while short-cycle dispensing is considered as a means to reduce wastage of expensive medications, this survey is a reminder that consecutive 14-day prescriptions may result in higher dispensing costs that must be factored into pharmacy reimbursement models."

A typical independently owned, closed-door LTC pharmacy incurs dispensing costs of $13.54 per prescription for a 30-day supply, according to the survey. For retail pharmacies, the dispensing costs are estimated at $10.64 by the State of Alabama and $10.72 by Oregon in their respective analyses. 

Compared to their retail counterparts, closed-door LTC pharmacies incur additional dispensing-related costs to serve residents’ needs, including such services as specialized packaging, 24-hour on-call pharmacy services and providing deliveries to LTC facilities several times a day on most days of the week.

Shorter-cycle medication supplies result in LTC dispensing costs that may be lower per prescription but higher overall for a 30-day supply. A 14-day supply of medication resulted in an average dispensing cost of $11.63 per prescription. However, dispensing two 14-day cycles incurs nearly twice the costs of dispensing a one-month supply causing costs rise to $23.26, NCPA noted. 

The results are available in a new report titled "Analysis of Costs to Dispense Prescriptions in Independently Owned Long-Term Care Pharmacies" that is available free-of-charge to NCPA LTC Division members, NCPA noted.

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Mylan ships cholesterol drug

BY Alaric DeArment

PITTSBURGH — Mylan has begun shipping a generic drug for cholesterol, the company said Monday.

Mylan said a subsidiary had started shipping fenofibrate capsules in the 43-mg and 130-mg strengths. The drug is a generic version of Lupin Atlantis Holdings Antara, used in combination with diet to reduce elevated bad cholesterol and other blood lipids and increase beneficial HDL cholesterol in patients with primary hypercholesterolemia or mixed dyslipidemia.

Various versions of the drug had sales of about $60 million during the 12-month period that ended in September 2012, according to IMS Health.

 

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Innovative pharmacy services promote improved patient care, life quality, NACDS head writes

BY Alaric DeArment

ARLINGTON, Va. — The head of a trade organization for retail pharmacies critiqued the conclusions of an op-ed published in the Wall Street Journal that cast doubt on some of the potential benefits of accountable care organizations.

In the op-ed, published Tuesday, the "father of disruptive innovation," Harvard Business School professor and Innosight Institute founder Clayton Christensen and two colleagues wrote that ACOs would not succeed without major changes in the behavior of doctors and patients and would not save a significant amount of money.

"On the one hand, their recommendations for healthcare ring truer than true – they can and should guide the successful implementation of reform," National Association of Chain Drug Stores president and CEO Steve Anderson wrote in a letter to the WSJ in response to the op-ed. "Yet it does not follow, as they suggest, that these recommendations have not already taken root to some extent in the early stages of ACOs, and among other efforts to advance healthcare delivery."

Christensen and his colleagues urged policymakers to “consider opportunities to shift more care to less-expensive venues” like retail clinics; to “consider regulatory and payment changes that will enable doctors and all medical providers to do everything that their license allows them to do”; to “consider changing anticompetitive regulations and licensure statues that practitioners have used to protect their guilds”; and to “make fuller use of technology.”

"While community pharmacies are best known for helping patient use medicines safely and stay healthy, innovative services of pharmacies and co-located clinics do even more to improve patient health and quality of life," Anderson wrote. "These services include vaccinations, health screenings and education and more."


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