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Providing the ‘Rite Care’ for patients

BY Michael Johnsen

CAMP HILL, Pa. —Following its initial test-concept of Rite Care—a reimbursed medication therapy management model pioneered four years ago in the Pittsburgh market—Rite Aid has since expanded those program capabilities across 2,200 Rite Aid stores in virtually all of the markets the company serves through a specially trained MTM workforce comprised of more than 650 pharmacists.

“We’ve evolved from that four-store concept in Pittsburgh,” said Rick Mohall, director of field clinical services for Rite Aid. Today, Rite Aid employs a “hub-and-spoke” method to expand that dedicated MTM offering across its store base. The most significant learning to come out of Rite Care as Rite Aid expanded that functionality across its store base is the significant need for MTM services, Mohall said, “as far as improving the patient’s health and well-being, improving outcomes and quite frankly saving the healthcare system overall dollars spent on those patients.”

And while that need is great, there still is a challenge in effectively marketing that program to the lay consumer; many of Rite Care’s MTM encounters come by way of referral. “Even amongst those who are referred through third-party carriers, we often still have to explain the need and what we can bring to [the table],” Mohall said.

Once patients experience MTM firsthand, its value is relatively easy to grasp, Mohall added. “For the consumers who have actually gone through an encounter, their takeaways are extremely positive,” Mohall said. Those MTM encounters have prompted more than a few patients to transfer all of their prescriptions into the pharmacy where their MTM consultation occurred.

The MTM training delivered to Rite Aid’s pharmacists goes beyond the expertise they develop around medicines in six years of pharmacy school, Mohall noted. “We train [our pharmacists] on the components of an MTM encounter based on the APhA/NACDS white paper.”

The training incorporates more of a disease management approach that couples medication compliance programs with a more holistic approach to health care that incorporates both the doctor and the pharmacist. As a complete healthcare package, MTM programs help to maximize a patient’s therapy. “Physicians find it extremely helpful to see a personalized medication record come out of an encounter,” Mohall added.

The MTM services provided through Rite Care can cost as much as $120 per hour on the initial visit. However, similar to the pharmaceutical business, more than 90% of those encounters are reimbursed by a third party, and the majority of those represent Medicare Part D participants. The average time of an MTM visit falls between 45 minutes and one hour.

Diabetes patients rank at the top of the list for MTM, followed by cardiovascular disease patients. But such MTM programs as Rite Care cut across a broad swath of disease states, including asthma and gastrointestinal disorders.

With diabetes ranking No. 1 across MTM visits, Rite Aid augments those pharmacists trained through the Rite Care program with another group of Rite Aid pharmacists certified as diabetes educators, or Rite Aid Diabetes Care Specialists.

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Washington, Mo., considers repealing recently passed PSE legislation

BY DSN STAFF

NEW YORK The objective here is closing down clandestine methamphetamine labs. The question is: Who is going to bear the cost? And the answer, ultimately, is the consumer.

It seems that one of the primary reasons behind legislation like this, which is also under consideration by the California state legislature as well as several local municipalities throughout Missouri, is cost shifting.

Indeed, one solution that would prevent the practice of “smurfing,” a practice whereby meth addicts exceed their legal purchase limits in pseudoephedrine products by buying across several nearby pharmacies, is electronic logbooking. By granting access to PSE logbooks to law enforcement in real time, law enforcement officers would not only be made aware of a “smurfer” as they were driving between pharmacies, but would also identify who that smurfer was and where they lived.

Setting up that comprehensive electronic logbooking system requires resources, however. State coffers have traditionally been tapped for that purpose, and at least in the case of California, the Consumer Healthcare Products Association has offered to help defray that cost. In the case of Missouri, more than $500,000 has already been earmarked for the implementation of an electronic logbooking system at the state level.

However,  a not-as-much-talked-about cost is also borne by law enforcement, as pointed out by Franklin County Sgt. Jason Grellner in Missouri. After all, it requires additional resources to actually apprehend and prosecute those criminals, he suggested. And a system that better defines who those criminals may be, by his estimation, could cost the state as much as $350,000 per criminal per year.

Therefore, Grellner argues, it’s a fiscal responsibility to take PSE off the OTC market altogether, and require a prescription for the popular decongestant.

That, in a nutshell, is cost-shifting. Because reverse switching PSE translates into less revenue for retailers (and consequently less taxable revenue, as well) for those consumers who choose to forego PSE-provided relief, and for those who don’t, it’s a greater healthcare cost because now consumers have to schedule an appointment with their primary care practitioner and pay the co-pay for that doctor’s visit on top of the cost of the PSE product.

Regardless of how the consumer ultimately pays for the elimination of meth labs — whether through increased taxes to cover escalating law enforcement budgets or through increased personal healthcare costs — there is another argument to be made here. Switching PSE to prescription-only status may result in fewer meth labs busted, but it’s not going to do anything about those meth addicts still on the street. Necessity is the mother of invention, and for addicts, that simply means sourcing their meth from somewhere else.

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