PHARMACY

Patients look to pharmacists for POC testing

BY Richard Monks

With the United States expected to face a growing shortage of primary care physicians over the next decade, support for point-of-care testing in community pharmacies is growing.

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“While patients continue to look to their pharmacist as a steward of medication safety and effectiveness, more and more patients are looking to their pharmacists to provide innovative services that further help maintain their health-and-wellness, including point-of-care testing,” National Association of Chain Drug Stores president and CEO Steve Anderson said this spring after the association kicked off its Community Pharmacy-Based Point-of-Care Testing certificate program.

According to a study published last year in the Journal of the American Pharmacists Association, one of the most immediate impacts that point-of-care testing in pharmacies can have is helping prevent and treat such infectious diseases as influenza, group A streptococcal pharyngitis, HIV and hepatitis C.

Proponents of point-of-care testing in pharmacies said providing these services could help ensure a bright future for pharmacies across the country.

“It’s a matter of being prepared to meet the opportunities presented to us,” said Stephanie Klepser, clinical director at the specialty pharmacy Optimed LLC; Michael Klepser, Ferris State University College of Pharmacy professor; and Emily Burley, a PharmD candidate at the school, in a story in the group’s journal Michigan Pharmacist. “A pharmacy work force skilled in physical assessment and use of POC tests, and that is eager to enter in to collaborative disease management programs with physicians, is just what the profession needs.”

However, those pushing for more point-of-care testing in pharmacies admit that there are hurdles to be cleared before testing in pharmacies can become widespread.

Regulations concerning testing vary from state to state and are often vague, experts said. Only eight states address point-of-care testing in their pharmacy practice acts, and only five of those specify which tests pharmacists are allowed to perform.

Data from healthcare researchers suggested, however, that a growing number of community pharmacies are finding ways to offer point-of-care testing. Since 2004, for instance, the number of pharmacies with a certificate to offer services waived under the Clinical Laboratory Improvement Amendments of 1988 — including point-of-care testing — has nearly tripled.

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PHARMACY

Minorities impacted most by pharmacy deserts

BY DSN STAFF

After so called food deserts — communities that lack access to fresh produce and other healthy foods — led some retailers to develop stores to fill this gap, the existence of a new type of desert with an equally devastating impact on the health of those living there is starting to emerge.

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Known as pharmacy deserts, these pockets in some major U.S. cities are characterized by the lack of drug stores, causing residents in these areas to have to travel much farther than others to get prescriptions filled, buy over-the-counter medications or visit the steadily increasing number of urgent care clinics found inside stores.

Researchers at the University of Illinois at Chicago, who last year identified the first of these areas, said pharmacy deserts are con tributing to health disparities that jeopardize many people’s well-being. For the most part, they said, those impacted by the dearth of pharmacies are minorities.

While their research focused solely on Chicago, where more than a million people are affected by the lack of pharmacies, the team said it had no doubt that the situation is the same in other areas.

Writing in the journal Health Affairs, the research team led by assistant professor Dima Qato said the emergence of pharmacy deserts poses a potential threat to public health and suggested that governments and the private sector explore ways to remedy the situation.

“Incorporating pharmacies in community health centers is one potential solution,” Qato wrote in an op-ed piece in the online publication Chicago Reporter a few weeks after his findings were published. “Another is to increase governmental oversight in the distribution of pharmacies across communities in the United States.”

In addition, he said, state and federal agencies could require pharmacy organizations to ensure that residents in every neighborhood have access to pharmacies, and the same analysis of local needs that is used to approve the construction of new hospitals should be extended to decisions about where to locate pharmacies.

“To overcome objections about excessive regulation, tax or other market-based incentives might also be used to encourage pharmacies to locate in underserved areas,” Qato said.

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Generic price hikes expected to continue

BY Richard Monks

The dramatic increase in the price of generic drugs last year is expected to continue for the rest of 2015 and even into next year, according to those who closely monitor the market.

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Financial analysts and other industry watchers stress that the rate of inflation and the number of price hikes will likely be slightly below the nearly 400 increases in 2014 that resulted in overall costs rising more than 6%. A Morgan Stanley report released in January put the generic inflation rate at between 5% and 6% for the next 12 months to 18 months.

The same issues that led to last year’s spike in prices — increased demand, short-term market exclusivity for some new single-source generics and higher manufacturing and raw materials costs — have not gone away, industry watchers said. In addition, increased regulatory obstacles, supplier consolidation and the increasing complexity of generic drug production also are expected to drive up prices going forward.

Some said they expect the ongoing generics inflation could lead retail pharmacies to rethink the way they market these products. A report earlier this year by The Lockton Benefit Group, a provider of employee benefits to companies around the world, predicted that some of the highest-priced generics will begin to disappear from community pharmacies’ low-cost drug lists.

“Some PBMs are even recommending moving certain generics into a higher co-pay tier,” the report said.

While the spike in the price of generics has provided many pharmacies with higher top-line growth, it also has driven down bottom-line profitability and led consumers and plan payers to shy away from some generics.

“Overall increases in the amounts we pay to procure generic drugs … could have a significant adverse effect on our profitability,” a spokesman for Walgreens Boots Alliance said. “In addition, our gross profit margins would be adversely affected by continued generic inflation to the extent we are not able to offset such cost increases.”

Like other community pharmacies across the country, Walgreens said it is hoping to combat the price hikes through changes in its procurement procedures and revamped contracts with suppliers and payers.

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