Public and private payers seemingly intent on wringing the last bit of profit from drug distribution have forced pharmacy to a "critical juncture," according to Bruce Roberts, R.Ph., executive VP/CEO, National Community Pharmacists Association. He believes that if the profession is going to survive, let alone thrive, it must erect a new model built around paying pharmacists for providing face-to-face medication therapy management (MTM) services.
Recent years have seen dramatic growth in the specialty pharmacy market, a segment of the industry addressing the needs of patients with chronic illnesses such as cancer and HIV. Sales of specialty medications-though expensive, often injectable, and typically requiring more patient education-have trended upward at more than 25% annually for the past five years. Industry experts forecast annual increases of more than 30% through the rest of this decade, according to Armada Health Care, a specialty pharmacy group purchasing organization in Short Hills, N.J.
A late September hearing saw patients and advocates telling the government that people are dying due to lack of access to intravenous immune globulin therapy (IVIG). It also recorded allegations about suspected artificial shortages, federal foot-dragging, and supplies directed to less-deserving patients. The "town hall" meeting, held recently in Arlington, Va., took five-minute statements from about three dozen witnesses as part of an independent study the Department of Health & Human Services (HHS) contracted for. Patients have been unable to get IVIG, get it in the best setting, or get the brand that works for them.
There will be no doctor to hide behind. You are going to be, in effect, the prescriber. You are going to be the one to question the woman about when the event took place. It could be a mother or sister, maybe the father of a girl under 18. You are the one who will counsel about the correct usage.
Very few drug plan providers left the Medicare market in 2007, but their offerings have shifted. There are fewer plans offering basic coverage and more offering enhanced coverage. Beneficiaries in most states have 50-60 prescription drug plans to consider including 15 or 16 that offer partial or complete coverage in the donut hole.
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.
Patients infected with gram-negative organisms are in trouble. "Drugs that used to be very effective against gram-negative infections no longer work," Johnson & Johnson research fellow Karen Bush, Ph.D., warned the 46th Interscience Conference on Antimicrobial Agents & Chemotherapeutics, held recently in San Francisco.
A diagnosis of metastatic colorectal cancer is not one that a patient wants to hear. It has historically been one of the most difficult cancers to treat, associated with mediocre responses and short survival periods. According to 2006 estimates from the American Cancer Society, colorectal cancer is now the second- and third-leading cause of cancer deaths in men and women, respectively, in the United States. Now a new treatment option is available for patients with metastatic cases that are refractory or intolerant to traditional agents. Enter panitumumab (Vectibix, Amgen).
The quivering and ineffective pumping of the heart during atrial fibrillation (AF) is associated with twice the mortality of persons with normal sinus rhythm. This statistic is one reason revised guidelines on how to treat the condition were recently released by the American College of Cardiology (ACC), the American Heart Association (AHA), and the European Society of Cardiology (ESC). "Guidelines for the Management of Patients with Atrial Fibrillation" was published in the Aug. 15 issue of Circulation. While the 2001 guide placed greater emphasis on using patient characteristics such as age, gender, and heart disease risk, the new guidelines highlight stroke risk as the primary means to determine the need for anticoagulants.
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.
Pharmacists should actively participate in medication therapy management systems. That's one of 30 safe practices the National Quality Forum (NQF) has just endorsed. Of the remaining safe practices, at least 10 are drug-related. They include calling for establishing a computerized prescriber order entry system and a list of abbreviations that should not be used. NQF is a voluntary consensus standard-setting organization whose goal is to improve the quality of health care.
Notwithstanding its concerns about the safety of Alaris SE infusion pumps, the Food & Drug Administration is not requiring manufacturer Cardinal Health to recall the 140,000 pumps in use in thousands of hospitals around the country.
Tracking and locating lost medications is a chronic problem for many hospitals. When a medication gets lost, there are so many different places it can be, including the several different drop-off points along the way before a drug reaches a patient.
Tracking medication errors in an inpatient hospital setting is fairly common. But what about errors that occur when patients self-administer, or when parents administer drugs to their children at home? Who checks to see if patients are being compliant, or if prescribing errors have been made? Did the family members who are charged with dispensing to children understand the instructions? Or are they doing things doctors and pharmacists are not expecting them to?
While the Food & Drug Administration has always been deeply concerned with drug safety, the organization is taking new and improved measures to pay closer attention to this issue, said Scott Gottlieb, M.D., Deputy Commissioner for Medical and Scientific Affairs at FDA.
As a physician at Eli Lilly & Co., the manufacturer of Xigris (drotrecogin alfa [activated]), I am responding to an article that appeared in your Aug. 21 issue, referencing a pharmacy technician who created a "Xigris calculator."
Drug delivery systems are hot. As they expand into more and more therapeutic categories, they are altering the status quo of drug administration for an increasing number of patients. They are also fueling a need for patient education, a need that is perhaps unobtrusively shaping the face of pharmacy.
In some patients with acute myocardial infarction (MI), the use of sirolimus (Rapamune, Wyeth)-eluting stents drastically reduced the rate of in-stent restenosis at one year, compared with uncoated, bare-metal stents, according to the results of a new study.
The 2006 World Congress of Cardiology (WCC) was host to more than 25,000 cardiologists this year. Noteworthy among the thousands of presentations were several large-scale drug trials, most of which evaluated agents affecting the renin-angiotensin system (RAS).
Medication safety experts nationwide were dismayed but not surprised upon hearing the tragic news that three premature infants died after receiving a fatal dose of heparin at Methodist Hospital in Indianapolis. Three other pediatric patients who also received inappropriate doses of heparin were transferred to Riley Hospital for Children in Indianapolis where they were reported to be in critical condition at press time.
In a recently issued policy statement, the Drug Enforcement Administration proposed a new rule that would ease current restrictions on prescribing Schedule II controlled substances. Under the new rule, doctors will be able to prescribe 90-day supplies of Schedule II medications such as OxyContin (oxycodone, Purdue Pharma), methylphenidate HCl, and codeine. The public can submit comments about the new rules through Nov. 6.
Should pharmacy benefit management programs meet quality standards? URAC, a Washington, D.C.-based healthcare quality group, has formed a Pharmacy Benefit Management Standards Committee to look into this matter. Its goal is to develop an accreditation program for PBMs and health plans alike.
From pills to patches, from implants to Plan B going OTC, women have more contraceptives to choose from today than ever before.
New evidence indicates that traditional diuretics may be more harmful than beneficial for heart failure patients, while some drugs currently contraindicated could be beneficial. These nuggets and more were presented at the Heart Failure Society of America's 10th annual meeting in Seattle last month.
Closing the only pharmacy in Holly Ridge, a small town in eastern North Carolina, was not an easy decision for Randy Spainhour. The 58-year-old pharmacist knew that the closest pharmacy was 15 miles away and that it would put a big strain on many of his customers. "I felt I had no choice," he insisted. "It was either that or going bankrupt."
Invasive fungal infections will have less of a fighting chance now that a new antifungal has been approved by the Food & Drug Administration. Posaconazole (Noxafil, Schering-Plough), available as an oral suspension, is indicated for the prophylaxis of invasive Aspergillus and Candida infections in patients 13 years of age and older who are immunocompromised, such as hematopoietic stem cell transplant recipients with graft-versus-host disease or those with hematologic malignancies with prolonged neutropenia from chemotherapy.
If you want to understand the immediate impact of Wal-Mart's recent announcement that it will charge only $4 per prescription for nearly 300 generic drugs, just ask Nick Patel, R.Ph. Patel's West Coast Pharmacy, Tampa, Fla., is located one block from a Wal-Mart location and suddenly finds itself at the epicenter of a new healthcare debate. "I've had people come in with the list," Patel reported to Drug Topics. "But so far, I haven't lost any customers." Like many in the industry-especially those in the Tampa area-Patel is watching closely to see what happens next.
Specialized Pharmacy Services and its parent corporation, Omnicare Inc., have agreed to pay $52.5 million to settle one of the largest Medicaid fraud cases in Michigan. The company was charged with billing Medicaid for medication dispensed to beneficiaries who were deceased and failing to credit Medicaid for drugs that were not consumed, among other charges. As a result of the settlement, a Corporate Integrity Agreement will be in place for two years; it is designed to improve the company's Medicaid billing practices and to demonstrate the company's commitment to comply with Medicaid pharmacy policy and procedure.