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Survey Showcases Pharmacists’ Role in Cutting Care Costs
Despite an economic landscape that has resulted in declining prescription drug reimbursements and rising expenses, independent community pharmacies “remain a viable small business model,” according to a new survey from the National Community Pharmacists Association (NCPA). The 2011 NCPA Digest, sponsored by Cardinal Health, focused on the actions that community pharmacists are taking to overcome financial challenges and continue to provide patient care.
“Community pharmacists continue to play a vital role in improving health outcomes while reducing costs,” said B. Douglas Hoey, RPh, MBA, NCPA executive vice president and CEO. Two areas in which community pharmacists made a significant mark in 2010 were in “promoting the appropriate use of lowercost generic drugs” and “providing critical, face-to-face patient counseling on the proper use of medications.”
Key findings from NCPA Digest, now in its 79th year, are as follows:
• The average amount of prescription drugs dispensed declined slightly, from 64,635 to 64,169; however, the number of refills increased slightly.
• The generic dispensing rate among independent community pharmacies increased from 69% to 72%.
• The number of prescription drugs dispensed under the Medicare Part D program held steady at 30%. The number of Medicaid prescription drugs dispensed rose from 14% to 16%.
• Home delivery and compounding remained among the most common niche services offered by independent community pharmacies.
• Disease state management services were offered by 78% of pharmacies.
The survey, according to Hoey, “offers further proof of the adaptability and innovation of independent community pharmacists as they try to overcome significant challenges to keep serving patients.”
Comparative Effective Research Efforts Falling Short
A study of 7 state Medicaid programs found that although states desire comparative effective research (CER) to establish their pharmacy policies, current public CER efforts aren’t meeting their expectations. Despite an influx of federal dollars to generate more CER, states are using resources to contract with private organizations to produce CER information on their behalf.
“There is growing pressure on state Medicaid programs to bring prescription drug costs under control and provide high-quality care, even as the Medicaid population expands,” said Jenny Gaffney, the study’s lead author. “Although a range of organizations are trying to fill key evidence gaps, these efforts have lacked the timeliness and relevance needed to inform day-to-day complex decisions on what drugs to cover and for whom.”
The study, which was completed by researchers from Avalere Health and the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured, found that state Medicaid programs defaulted to using the net price of drugs to refine preferred drug lists (PDLs) due to a perceived lack of compelling evidence of comparative clinical benefit. Research also indicated that a majority of states rely on a single pharmacy benefit management company to help with the decision- making process for pharmacy benefits, and that states do not use publicly available sources of CER because of the lack of cost information, and the length and timing of the analyses.
Although the majority of states participating in the study previously provided open access to mental health drugs, many now restrict access to drugs in these classes through the PDL, researchers found. To view the report, visit www .kff.org/medicaid/8233.cfm.
Congress Considering Drug Shortages Bill
In light of the increasing number of drug shortages that have been reported in recent years, the US House of Representatives and the US Senate are considering a bill proposing that prescription drug manufacturers warn the FDA early about potential situations.
The early notice by drug manufacturers of a discontinuation or interruption in the manufacturing process would enable the FDA “to work with other manufacturers to ramp up production,” according to a statement by the American Society of Health-System Pharmacists (ASHP). If adopted, the legislation—entitled the Preserving Access to Life-Saving Medications Act—would amend the Federal Food, Drug, and Cosmetic Act.
In September, the Subcommittee on Health held a hearing to examine the increase in drug shortages. Howard K. Koh, MD, MPH, assistant secretary for health, US Department of Health and Human Services, discussed the importance of increased and earlier communications about drug shortages, according to a report from the American Pharmacists Association (APhA). Dr. Koh pointed out that the number of shortages rose from 61 in 2005 to 178 in 2010, with the majority involving generic medications and generic sterile injectables, including oncology drugs.
Representing ASHP at the hearing, Kevin J. Colgan, MA, FASHP, corporate director of pharmacy at Rush University Medical Center in Chicago, told the subcommittee, “I am here today because I cannot serve my patients or their caregivers due to shortages of medications, some of them critical to patient care.” ASHP, he noted, supports the drug shortages legislation.
In addition, the APhA House of Delegates Policy Committee is proposing drug shortages as an issue for 2012. PT