PHARMACY

NCPA survey: Drugs often don’t make it to patients’ hands due to efforts to combat prescription drug abuse

BY Alaric DeArment

ALEXANDRIA, Va. —Vulnerable patients, including seniors and cancer patients, suffer from lack of access to needed painkillers as efforts to combat diversion and misuse of controlled substances often result in drugs not getting into the hands of those who need them, according to a new pharmacist survey by the National Community Pharmacists Association. 

The NCPA surveyed more than 1,000 pharmacists, finding that some of the most vulnerable patients struggle to obtain medications prescribed to alleviate pain, and surprise disruptions in the supply chain can make it impossible for many pharmacists to assure patients their prescriptions for controlled substances will be filled the following month.

About three-quarters of respondents experienced three or more delays caused by stopped shipments of their orders for drugs over the past eight months, with 55 patients per pharmacy affected. Meanwhile, 89% of pharmacies received no advanced notice of the delay and found out only when their order arrived and did not contain the controlled substances they had ordered, with 60% saying delays in receiving the medications lasted at least one week.

"Vulnerable patients are increasingly and tragically becoming collateral damage in the country’s battle against the abuse of prescription drugs, particularly narcotic painkillers," NCPA CEO B. Douglas Hoey said. "In the survey, community pharmacists cited having their supplies or shipments of controlled substances abruptly shut off by their wholesalers, which may have done so due to perceived pressure, intimidation or a lack of clear guidance from law enforcement officials such as the Drug Enforcement Administration."

Most respondents reported having to turn away patients and refer them to competitors. In response, the NCPA has advocated such efforts as electronic prescription drug monitoring programs and tracking systems, more effective education of prescribers, shutting down rogue pain clinics and offering more disposal options for excess medications and more scrutiny of controlled substances delivered by mail-order pharmacies.

"It’s a shame to watch an arthritic 85-year-old do without," one pharmacist wrote in an open-ended section of the survey. "We try to scrutinize all controlled substance prescriptions but are made to feel like criminals when trying to service our patients," wrote another.

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Surescripts CEO Harry Totonis to step down

BY Alaric DeArment

ARLINGTON, Va. — The head of the country’s largest e-prescribing network is stepping down, the company said Thursday.

Surescripts announced that president and CEO Harry Totonis would leave the company in March. Totonis began with the company following its 2008 merger with RxHub.

Surescripts’ board of directors is retaining an executive search firm to find a successor, and a spokeswoman for the company told DSN that it was actively looking for a replacement with Totonis’ help, and did not have plans to appoint an interim CEO at this time.

"Harry is a visionary, responsible for the transformation of Surescripts into the nation’s leading clinical network that is shaping how health care connects and communicates by expanding capabilities to enable interoperability between health systems, physicians and pharmacists," Surescripts co-chairman Steven Miller said. "We are extremely pleased with what Harry has accomplished and believe the company is well-positioned for continued success."

The company has grown rapidly under Totonis’ leadership, today connecting more than half a million prescribers, 94% of retail pharmacies, pharmacy benefit managers, hospitals and others, allowing the transmission of e-prescriptions, immunization records, continuity of care documents and referrals. The company also acquired data encryption firm Kryptiq in 2012.

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Creating generic powerhouses

BY Alaric DeArment

A deal announced last month between CVS Caremark and Cardinal Health created a joint venture that the companies said would be the largest generic drug sourcing entity in the United States.

Each company will have a 50% stake in the joint venture, contributing its respective sourcing and supply chain expertise. The deal also included an extension of Cardinal Health’s existing pharmaceutical distribution agreement with CVS Caremark through June 2019.

McKesson’s purchase in October of a majority stake in German drug distributor Celesio resulted in the two having a combined generic purchasing power of between $9.5 billion and $11.5 billion, according to an analysis by FBR Capital Markets. McKesson announced last month a bid to buy up the rest of Celesio, though hedge fund Elliott Management, which has a stake in Celesio of more than 25%, is trying to block the deal.

A similar analysis of the respective purchasing power of CVS Caremark and Cardinal Health means their deal will create a combined purchasing power of between $9.5 billion and $11.5 billion. According to FBR, the Walgreens-Amerisource-Bergen-ABC Consortium has about $12 billion in combined generic purchasing power. Pembroke Consulting president Adam Fein described McKesson-Celesio, Walgreens-AmerisourceBergen-ABC and now CVS Caremark-Cardinal Health as “King Kong vs. Godzilla vs. Mothra.”

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