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Attempts continue unabated in the courts and state legislatures this year to make the dealings of pharmacy benefit managers more transparent, to make the organizations personally liable as "fiduciaries" under the Employee Retirement Income Security Act (ERISA), or to otherwise regulate them.

The Centers for Medicare & Medicaid Services is designing a comprehensive Medicare information Web site for pharmacists, as well as a pharmacy kit. The agency will also be sharing more information through continuing education and special pharmacist outreach events.

If a vote were held tomorrow on whether to unionize their workplace, 18% of nonunion staff pharmacists would say Yes, according to a six-state study by researchers at Midwestern University Chicago College of Pharmacy.

The American College of Physicians (ACP) recently issued guidelines for the management of obesity. Prepared by ACP's clinical efficacy assessment subcommittee, the paper was published in the April 5 issue of Annals of Internal Medicine.

New evidence-based guidelines for the treatment of cancer pain were presented at the 24th Annual Scientific Meeting of the American Pain Society (APS) in Boston last month. The meeting was designed to help clinicians and patients better control the pain associated with the disease. According to APS, approximately 1.2 million people are diagnosed with cancer each year. While effective treatment for pain exists, studies have reported significant undertreatment.

How do we improve medication-error rates? Indeed, how do we even set up systems to know whether med-error rates are improving? Should reporting of errors be voluntary or mandatory? And should agencies that receive such reports give the public information on them?

You might see specialty pharmacies compete tooth and nail under a new Medicare Part B program proposed by the Centers for Medicare & Medicaid Services. Under the proposal, physicians can continue buying Part B drugs on their own. Under this scenario, their reimbursement switches from average wholesale price (AWP) minus 5% to average sales price (ASP) plus 6%. Or physicians can opt into a competitive acquisition program (CAP).

Pharmacists who want to transfer their licenses to another state can now download the application directly from the Web site of the National Association of Boards of Pharmacy.

This month a jury in the Circuit Court for the Sixth Judicial Circuit in Champaign County, Ill., is expected to hear a countersuit that was filed by Bruce Kelle, R.Ph., against Albertson's, doing business as Osco, for sign-on bonus breaches.

Will pharmacies see more drug shortages and price increases as a result of a new way of doing business for wholesalers? That's what some experts have warned.

The administrator of the Centers for Medicare & Medicaid Services, Mark McClellan, is in a big hurry. A telltale sign is the rapid-fire way in which he spoke before pharmacists at the American Pharmacists Association annual meeting in Orlando last month. McClellan knows there are still many plans to be laid in the remaining months before Medicare Part D can be rolled out next January. But on schedule it will be, he vowed repeatedly at APhA's opening general session.

The National Home Infusion Association (NHIA) held an audio conference recently to alert home infusion providers to the challenges they may face when the new Medicare Part D prescription drug benefit is implemented on Jan. 1, 2006.

Medco Health Solutions, one of the nation's largest pharmacy benefit managers, has joined forces with the University of Medicine & Dentistry of New Jersey (UMDNJ) to study major public health issues and their effects on prescription utilization and healthcare costs.

You might see specialty pharmacies compete tooth and nail under a new Medicare Part B program proposed by the Centers for Medicare & Medicaid Services. Under the proposal, physicians can continue buying Part B drugs on their own. Under this scenario, their reimbursement switches from average wholesale price (AWP) minus 5% to average sales price (ASP) plus 6%. Or physicians can opt into a competitive acquisition program (CAP).

A California hospital recently lost its accreditation from the Joint Commission on Accreditation of Healthcare Organizations, and another one is at risk of losing it. In both cases, medication-related problems accounted for part of the reason for their predicament. Their experience could signal a tougher approach by JCAHO.

Health-system pharmacists are taking a wait-and-see attitude about proposed rule changes for hospitals' conditions of participation (CoPs) in Medicare that were announced recently by the Centers for Medicare & Medicaid Services. When the feds first proposed these rules eight years ago, it provoked a firestorm of protest from R.Ph.s.

For the third year in a row, a record number of pharmacists had their licenses transferred to other states in 2004, according to an annual year-end review by the National Association of Boards of Pharmacy.

Sensing that the time has come for the profession to take responsibility for policing what many view as a pharmacist"s cherished prerogative—compounding—Kenneth Baker has accepted the job of implementing a way for compounding pharmacies to earn a stamp of approval from the Pharmacy Compounding Accreditation Board (PCAB).

One percent of the world's population has rheumatoid arthritis, accounting for more than nine million physician visits and 250,000 hospitalizations in the United States annually. Abatacept, the first in a new class of agents called selective T-cell co-stimulation modulators, is in development by Bristol-Myers Squibb for the treatment of this joint disease.

The Food & Drug Administration recently approved entecavir (Baraclude, Bristol-Myers Squibb) for the treatment of chronic hepatitis B virus infection in adults with evidence of active viral replication and evidence of either persistent elevations in serum aminotransferases or histologically active disease. Entecavir Tablets are currently available in U.S. pharmacies. Entecavir Oral Solution will be launched at a later date.

The Food & Drug Administration recently approved mometasone furoate 220 mcg once-daily inhalation powder (Asmanex Twisthaler, Schering-Plough), the first inhaled corticoste-roid to receive clearance for once-daily initiation therapy. Asmanex is approved for first-line treatment of asthma as preventive therapy in patients 12 years of age or older. It is also approved for patients on bronchodilators alone or who require oral corticosteroid therapy, when adding Asmanex may reduce or eliminate the need for oral corticosteroids. Schering plans to launch the product in the fall of 2005.

The next time patients pick up a prescription at a Target pharmacy, they will receive their pills in a newly designed bottle, thanks to Deborah Adler, a graphic designer for Milton Glaser in New York City. Called ClearRx, the new system features a flat Rx bottle with colored rubber band rings that come in six colors and fit around the neck of the bottle.

Perhaps nothing is as professionally frustrating to today's health-system pharmacists as the gap between the promise and reality of computerized physician order entry (CPOE). Concern may have risen to a new level in March with publication of a report in the Journal of the American Medical Association that said CPOE could cause as many medication errors as it prevents. Add that to a growing awareness among R.Ph.s that many physicians hate the systems and the fact that most hospitals can't afford them, and CPOE's promise of improved patient safety seems a dream.

The Centers for Disease Control & Prevention recently released detailed recommendations to state health departments that are considering mandatory public reporting of healthcare-associated infections (HAIs). "HAIs are a major public health problem in the United States," said Patrick Brennan, M.D., chairman of the CDC's Healthcare Infection Control Practices Advisory Committee (HICPAC), which wrote the document.

How do you increase the dispensing rate of generic prescription drugs in a state that's in the backyard of some of the largest name-brand pharmaceutical companies? That was the dilemma facing Horizon Blue Cross Blue Shield of New Jersey and Horizon Healthcare Services Inc., New Jersey's largest health insurer.

As mandatory mail-order pharmacy continues to grow and encroach on the market share of traditional pharmacies, the National Association of Chain Drug Stores met in Philadelphia last month and discussed ways to respond to this competition. Potential solutions included: retail pharmacies' contracting with their own pharmacy benefit managers to service mail-order plans, mounting a public relations campaign to attack the accepted belief that mandatory mail plans save money, and offering alternative 90-day retail programs that provide mail-order savings but retain contact between patient and pharmacist.