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Target donates $60K to Texas wildfire relief

BY Allison Cerra

MINNEAPOLIS — Target has assisted Texas wildfire relief efforts by donating $60,000.

Target said that a $25,000 cash donation was made to the American Red Cross with the additional cash and product donations — including 12,000 bottles of water, 3,600 bottles of Gatorade, 500 boxes of snacks, clothing, diapers, toiletries and bedding — made to other nonprofit organizations in the Texas area.

“When disaster strikes, Target listens and acts quickly to donate time, money and essentials to help support the needs of our communities,” Target chairman, president and CEO Gregg Steinhafel said. “Our thoughts are with those affected in Texas and we hope our donation will aid in the community’s recovery.”

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Q&A: Eyeing managed 
 care in ‘HD’ — Mark deBruin, H. D. Smith

BY DSN STAFF

Longtime industry veteran Mark de Bruin in July signed on with wholesaler H. D. Smith as corporate VP managed care. Drug Store News sat down with de Bruin recently to discuss the managed care climate for the independent pharmacy operator and how the business of pharmacy continues to evolve. 


DSN: What are the challenges facing managed care networks today? 


Mark de Bruin: Let me begin by saying pharmacy in general has a tough position in terms of relevance in health care. Pharmacy is typically not thought of the same as the medical profession, and as such, it is not a focal point for healthcare legislation. Secondly, the biggest issue for pharmacy is the reimbursement currently in the marketplace. There’s no recognition of the professional services provided by pharmacy. There is enormous consolidation within the industry, which concerns particularly independent pharmacy but certainly [also] all of pharmacy. … The other concern is just [that] the general business climate for pharmacy is difficult today. The education levels of pharmacists are extraordinarily high; that builds into a factor of tremendous cost for a pharmacy provider. … There is little recognition by the healthcare system about the value that the pharmacist provides. The last concern is that the aggregation of the industry relative to the government … leads to cost pressures for retail pharmacy. That in turn leads to a very difficult business climate.


DSN: The perception of the pharmacist as healthcare provider — is that evolving? Moving forward?


de Bruin: The pharmacist is the best-positioned healthcare professional in the marketplace because of their availability [and] accessibility to the consumer. … The entire economics of pharmacy are based on product delivery. That is not where the value of pharmacy lies; the value of pharmacy lies in the information and the patient care that can be provided. There is very little recognition for that. 


DSN: With your experience at both ends of the spectrum — managed care and pharmacy operations — what are some of the synergies afforded through H. D. Smith?


de Bruin: What is unique about H. D. Smith is their focus on independent pharmacy — the independent healthcare professional, locally based in these communities and towns where health care is less accessible. The aggregation of a network by H. D. Smith to negotiate contracts is important. [For example], we can eliminate the administrative burden, which is an absolute nightmare for pharmacy today, relative to contract administration. We also provide the products and services that are important to independent pharmacy to allow them to compete in the larger landscape [dominated] by the large chains. We have [offerings] like reconciliation, quality control, billing of unique claims [and] the ability to look at a pharmacy’s data and maximize their profit. We provide leverage in the marketplace relative to contract negotiation. Those synergies are very important to the independent pharmacy owner. 


DSN: How many pharmacies are part of the H. D. Smith network?


de Bruin: We have currently right around 1,100 pharmacies. Of those 1,100, they are the best of the best. They are the survivors of a difficult marketplace. 


DSN: How does H. D. Smith differentiate the managed care offering in today’s business climate?


de Bruin: H. D. Smith’s primary focus is on the individual community pharmacy — the local provider on the corner of Main and Main. That focus is considerably different than a focus on the chains. We offer products and services that are not readily available to the individual proprietor. We understand the business. I come from pharmacy; I’ve run pharmacies for a long time. I recognize the challenges. The differentiation comes from understanding the business, from aggregating their volume for negotiating leverage and from providing product solutions that they are unable to obtain themselves.

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Despite options, doughnut hole hurts seniors

BY Alaric DeArment

While it has been a boon to elderly Americans, Medicare Part D includes a complicating factor that has proven to be a headache.


Despite its seemingly charming name, the doughnut hole has proven to be a headache for many seniors. Also known as the Medicare Part D coverage gap, the doughnut hole is when drug costs reach a point when the patient becomes responsible for the entire cost, and Medicare doesn’t pay for them again until they reach the catastrophic-coverage threshold. The hole and threshold change from year to year.


Starting this year, the Centers for Medicare and Medicaid Services introduced a program that offers a 50% discount of branded drugs. But according to a December survey of 1,243 beneficiaries commissioned by the Medicare Today coalition and conducted by KRC Research, only 1-in-5 seniors were aware of the discount.


In many cases, entering the doughnut hole can be avoided or at least postponed by switching from branded drugs to generic drugs, but according to a study conducted by researchers form CVS Caremark, Harvard University and Brigham and Women’s Hospital released last month, Medicare Part D beneficiaries who enter the doughnut hole are twice as likely to discontinue their medications as they are to switch to more affordable or generic medications.


The study, published in PLoS Medicine, examined prescription drug use among more than 660,000 Medicare beneficiaries enrolled in more than 200 Medicare Part D and retiree drug plans in 2006 and 2007. 


“Proponents of the doughnut hole argue the coverage gap benefits the healthcare system by making participants more sensitive to medication costs. There is an expectation that people will seek less expensive drug options when they enter the doughnut hole and that action will result in cost savings both for them and for their health plans,” stated Jennifer Polinski of the division of pharmacoepidemiology and pharmacoeconomics at Brigham and Women’s Hospital and Harvard Medical School, and lead author of the study. “However, our findings show that when beneficiaries have to bear the full financial burden of the cost of their medications, they are twice as likely to stop taking their medications altogether and become nonadherent as they are to switch to more affordable or generic drugs. The resulting decrease in medication adherence could ultimately result in higher medical costs as a result of adverse health events.”


The research team said that approximately one-third of the 663,850 beneficiaries it tracked in 2006 and 2007 reached the doughnut hole seven months into the fiscal year. Other studies estimated between 11% and 14% of Part D enrollees who do not receive a low-income subsidy reach the doughnut hole each year.


“No doubt, this is a difficult area for policy-makers. Taking cost out of the healthcare system is something everyone is trying to achieve,” added Troyen Brennan, EVP and chief medical officer of CVS Caremark, who heads the research initiative that conducted the study. “The Affordable Care Act incrementally eliminates the doughnut hole by 2020, but until that time, program beneficiaries remain at risk of decreased drug utilization because of high out-of-pocket drug costs. A strategy that promotes the use of low cost medications and that keeps people adherent would result in better health outcomes and overall reduced healthcare costs.”


The Medicare Part D study is a product of a three-year research collaboration between CVS Caremark, Harvard, and Brigham and Women’s Hospital that is focused on understanding why many consumers do not take their prescriptions as directed and developing solutions to assist patients in using their medications effectively.

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