Reid Paul

At the 15th annual Murray and Bernard Schuss Memorial pharmacy lecture, Edith Rosato, R.Ph., argued that community pharmacy must unite and work together to confront a range of challenges. Rosato, senior VP of pharmacy affairs for the National Association of Chain Drug Stores, addressed an audience of more than 200 students and faculty at the Arnold & Marie Schwartz College of Pharmacy & Health Sciences, Long Island University. NACDS interim president and CEO Robert Hannan was originally scheduled to deliver the lecture.

As reimbursements for drugs keep falling, chains must fill more prescriptions-and apply even more pressure on their pharmacists to dispense quickly-to make up for their loss. But pharmacists claim this is leading to more drug errors.

If there is a lesson from the last election, it may be this: Beware of seniors bearing donuts. Pennsylvania Representative Melissa Hart, a Republican from the southwestern part of the state, certainly should have. Instead, just two weeks before the mid-term elections, Hart called the police to handle a group of 40 Association of Retired Americans (ARA) activists who brought donuts as a demonstration against the donut-hole gap in coverage in the Medicare Part D benefit. Hart, who was leading in polls at the time, went on to lose the election.

So you've decided to provide medication therapy management (MTM) services to your Medicare Part D patients. Which technological product should you use to document and bill for these services? "Technology plays a very significant role," commented Stefan Merlo, Pharm.D., manager of pharmacy practice and operations at the National Association of Chain Drug Stores. "If pharmacies are not able to properly document and bill for their services, the process is not going to work."

When First DataBank agreed to settle a lawsuit last month and pledged to stop publishing AWP (average wholesale price) data in two years, it sent ripples through the pharmacy industry. AWP has long been a key measure for determining pharmacy payments, and there is no easy answer for how to replace it. As John Rector, senior VP and general counsel at the National Community Pharmacists Association, cautioned, "This is the very beginning of what will probably be a very lengthy process."

The position of pharmacy technician has grown and evolved dramatically over the past 11 years. And, as technicians grow in importance at many chain and independent pharmacies, so too has the technician certification exam.

While technology solutions to help flag potential drug-drug interaction problems have been around for years, they are becoming increasingly powerful and refined. One such resource developed by NeoFax tackles the problem by focusing on two specific areas where many errors take place: neonatal drug dosing and parenteral nutritional ordering. The NeoFax WebApp is a browser-based software application that provides up-to-date information as well as customizable tools.

Even as pharmacists are still divided on whether the profession should have moved to the Pharm.D. degree, there are some industry insiders who believe that an eight-year entry-level degree is in the offing. Fueling this belief is the fact that a majority of students today enter pharmacy schools with several years of undergraduate education and many expect that a prior B.S. (or B.A.) degree will be a requirement in another 10 years.

Squeezed by low and slow reimbursement from Medicare Part D, independent pharmacists have certainly taken their lumps this past year. But they still managed to eke out some victories, according to leaders of the National Community Pharmacists Association, which held its annual meeting in Las Vegas last month.

For the fifth consecutive year, consumer satisfaction with pharmacies has risen, according to the 2006 Pharmacy Satisfaction Digest. Ninety-eight percent of respondents reported that they were either highly satisfied or satisfied with their pharmacy, up from 95% in 2002. Moreover, the number of respondents indicating that they were highly satisfied rose to 58%, a gain of 5% over the 2005 results and 13% higher than the 2002 results.

When Gov. Jon Corzine recently signed the New Jersey Prescription Drug Retail Price Registry bill into law, he hailed it as a "significant step toward making health care more affordable." The law creates a database of prices for the 150 most common prescription drugs. Consumers will be able to access the database via a toll-free telephone number or search it on-line. Despite the Governor's optimism, however, many pharmacists doubt the law will have much impact on either pharmacists or consumers.

With conflicting statements from the Food & Drug Administration, Centers for Medicare & Medicaid Services, and a Federal District Court judge, the definition and legality of pharmacy compounding once again seems headed to the Supreme Court or Congress for sorting out.

Sometimes the best defense is a good offense. While many pharmacists have been vocal critics of the role of pharmacy benefit managers and the growing use of mail-order pharmacies, much of the focus has been on passing legislation to protect pharmacists or restrict PBMs. Taking a different approach, the Georgia Academy of Independent Pharmacy (AIP) has developed a multitiered plan to compete directly with the PBMs.

The Food & Drug Administration recently issued letters to three pharmacies warning them to "stop manufacturing and distributing thousands of doses of compounded, unapproved inhalation drugs nationwide." The three named companies, RoTech Healthcare, CCS Medical, and Reliant Pharmacy Services, were all warned that if they did not comply, they risked injunctions and the possible seizure of their products in question.

As more and more companies develop systems for electronic prescription systems, Sen. Hillary Clinton (D, N.Y.) recently called for national legislation to develop a uniform national e-prescription standard. The Pharmaceutical Care Management Association applauded the effort, noting that the standard is long overdue.