/publications/issue/2008/2008-09/2008-09-8679

News Capsules

Author:

Copayments Reduce Rx Adherence...

Findings from a recent study appearing in the Journal of General Medicine show that when prescription copayments rise, medication adherence drops—especially among low-income patients.

The multiyear study followed 29,764 diabetes patients and 13,081 patients with congestive heart failure (CHF). Researchers found that for each medication class, individuals in high-income areas were consistently more adherent, compared with their low-income counterparts. For both diabetes and CHF, a notable decrease in medication adherence occurred across all drug categories in response to a 10% copayment increase. Adherence to statins was particularly sensitive to income, the study found.

"Based on our analysis, it is likely that increased copayments, intended to control costs, will exacerbate the disparities seen across socioeconomic groups," noted study coauthor Michael Chernow, PhD, professor, Department of Health Care Policy, Harvard Medical School.

The current study, funded by GlaxoSmithKline, complements earlier studies from its Health Management Innovations team, which indicate that barriers to medication access should be removed to improve adherence, better manage chronic conditions, improve health, and lower health care costs.



...As 79 Million Struggle to Pay Medical Bills

A new study from The Commonwealth Fund has found that 79 million Americans are having medical bill problems or paying off medical debt. The proportion of working- age Americans in this situation increased from 34% in 2005 to 41% in 2007. The study also found that more working-age adults are delaying or avoiding needed medical care, such as skipping doses of medication or not filling prescriptions, because of health care costs. One third of working-age adults spent 10% or more of their income on out-of-pocket medical expenses and health insurance premiums in 2007, up from 21% in 2001.

The data come from the national Commonwealth Fund Biennial Health Insurance Survey (2007). More information on the study can be found at www.commonwealthfund.org.



Aetna Launches Pharmacists' Web Site

Aetna recently announced the launch of AetnaPharmacists.com, a secure Web site designed to provide its >59,000 network pharmacists with quick and convenient access to up-to-date formulary, claim, and other prescription information online.

"This new tool will help pharmacists quickly access information related to members' prescriptions and help manage their pharmaceutical needs," said Joseph C. Zavalishin, who heads Aetna's Pharmacy Management Network. The site features drug pricing information, a Provider Services manual, and the latest information on whether a specific drug is included in the Aetna formulary.

Pharmacists can register for the new Web site at www.aetna.com, where they should click on the "For Health Professionals" link and then on "Pharmacy."



CVS Acquires Longs Drug Stores

In a $2.9-billion deal, CVS Caremark Corp will acquire Longs Drug Stores Corp, expanding the retail giant's position as the number-1 provider of prescriptions in the United States. The purchase will bring CVS' total operations to approximately 6800 drugstores in 41 states and the District of Columbia.

The acquisition includes Longs' 521 retail drugstores in California, Hawaii, Nevada, and Arizona. CVS also will have a leading position in Hawaii, where it currently does not have a presence. In addition, the retail chain is acquiring Longs' Rx America subsidiary, which offers prescription benefits management (PBM) services to >8 million members and prescription drug plan benefits to approximately 450,000 Medicare beneficiaries.

With an enhanced national reach, CVS will be in a stronger position as it rolls out its new suite of offerings under the Proactive Pharmacy Care model, taking advantage of its retail and PBM services.



NCPA Foundation to Award Scholarships

The National Community Pharmacists Association (NCPA) Foundation announced the recipients of 31 pharmacy student scholarships for 2008-2009. The scholarships, totaling $63,000, will be awarded at NCPA's 110th Annual Convention and Trade Exposition next month.

The award recipients include:

Cassandra Shields, from the University of Missouri, was named the 2008 recipient of the Willard B. Simmons Sr Memorial Scholarship and will receive $2500. The scholarship is awarded to a student who has demonstrated exemplary interest in pharmacy management.

Todd Mattingly, from the University of Kentucky, was named the 2008 recipient of the J.C. and Rheba Cobb Memorial Scholarship and will receive $2500. This award is presented for exemplary interest in civic and government affairs.

Ellen Smith, from the University of Washington, is the first recipient of the new Neil Pruitt Sr Memorial Scholarship and will receive $2500. This award is based on leadership, academic achievement, and interest in entrepreneurism.

The NCPA Foundation also awarded its 2008 Presidential Scholarships to 18 pharmacy students who will be awarded $2000 each. The winners are chosen on the basis of academic achievement, leadership qualities, interest in independent community pharmacy, and extracurricular accomplishments.

The 10 award recipients for the 2008 Partners in Pharmacy Scholarships will each receive $2000 scholarships. The scholarship recognizes academic achievement, community service, and a demonstrated interest in independent pharmacy.



140,000 ED Visits for Antibiotic Reactions

Researchers looking at recent national adverse drug event surveillance data estimate that >140,000 emergency department (ED) visits each year can be attributed to an allergic reaction or other drug-related adverse event in patients taking systemic antibiotics. Antibiotics were implicated in 19.3% of all ED visits for drug-related adverse events, according to the study, which appears in the September 15, 2008, issue of Clinical Infectious Diseases.

The researchers noted that although the risk of an ED visit for an antibioticassociated adverse event is small for an individual patient, the overall burden on the population increases when antibiotics are commonly prescribed for indications for which they have no benefit. They suggest that communicating the risks of antibiotic- associated adverse events should become an important strategy in efforts to promote judicious antibiotic use.



Part D Web Site Confuses Seniors

Medicare.gov is apparently not as userfriendly as some might hope, in helping even those seniors with basic computer skills to understand the Part D prescription drug plan, according to a recent study of seniors living in Miami, Florida.

Well-educated adults with computer experience reported difficulty using the Web site to determine eligibility for services and enroll in the drug plan. Participants also reported problems navigating within the Web site and locating information. The University of Miami researchers note that it is likely that persons with less computer experience would have even greater difficulty and suggest that more input from individuals be used in the Web site design.

The findings were reported in the August 20, 2008, issue of the Journal of the American Medical Association.



Initiative Launched for HIV/AIDS

Mirixa Corp and Ramsell Pharmacy Solutions have launched a pharmacistdelivered medication therapy management (MTM) initiative for individuals with HIV/AIDS.

The program will enable retail pharmacists to provide coaching and education for AIDS Drug Assistance Program patients across the country and to promote quality medication-related care, proper adherence, and education regarding HIV/AIDS. The services will be delivered via MirixaPro, the company's' medication care management system, which is used by Mirixa's network of retail pharmacies. In addition to each state ADAP organization, the same services will be offered to state Medicaid plans.

Programs delivered through the initiative will involve the electronic delivery of patient cases to community-based pharmacies. The pharmacists then invite patients to engage in protocol-driven confidential face-to-face education sessions, which are designed to improve medication-related care and increase treatment adherence, benefiting patients and lowering health care costs.



"PRO(TECH)T" Bill Jumps Ahead

The House Energy and Commerce Committee recently approved a bill to promote faster adoption of electronic health records (EHRs). In a unanimous vote, committee members approved HR 6357, the Protecting Records, Optimizing Treatment, and Easing Communication Through Health Care Technology Act of 2008 or "PRO(TECH)T."

The legislation promotes the nationwide adoption of a health information technology (HIT) infrastructure and would establish incentives for doctors, hospitals, insurers, and the government to exchange information electronically.

"Your grocery store automatically knows what brand of chips you bought last year, but your cardiologist doesn't automatically know what prescriptions your family doctor prescribed for you yesterday. That's problematic for health care quality and costs," said Rep John Dingell (D, MI), committee chair. Some concerns have been raised about EHR implementation costs to physicians, as well as the need for privacy protections, however.

The legislation is also under review in 2 other House committees—Small Business and Ways and Means. In a statement to the Ways and Means Subcommittee on Health, which recently held a hearing on the bill, the National Association of Chain Drug Stores (NACDS) reiterated its support for a "robust and standardized" HIT system.

"It is critical that communications between the prescriber, the pharmacist, and the patient not be hampered, while assuring adequate safeguards for protected health information," said NACDS President and Chief Executive Officer Steven C. Anderson, IOM, CAE.



Rite Aid Offers Incentive to Patients

Rite Aid is running a "Fill Up & Fuel Up" program—individuals who transfer a prescription immediately receive a $30 gift card and remain eligible for $2600 gas gift cards which will be given to 31 winners. The incentive program runs through January 10, 2009.



Crosswalk Tool Available for Sterile Compounding

Baxa Corp is now offering a crosswalk tool for understanding the compliance requirements for sterile compounding and the United States Pharmacopeia (USP) 797 compliance. The tool offers statespecific guidelines on professional licensing and training requirements, State Board of Pharmacy harmonization with USP 797 guidelines, and sterile compounding laws.

The interactive reference map was developed by ClinicalIQ, CriticalPoint LLC, and the National Association of Boards of Pharmacy. Baxa Corp markets the CriticalPoint compliance training modules as part of its Productivity and Compliance Tools product line, which includes the Skills, Training, Academics and Resources Center classroom-based training for USP 797 compliance and aseptic compounding.