Letters to the editor: January 8, 2007

I would be interested in reading an article in Drug Topics concerning regulations currently in place to address safety in the workplace. Does the safety of pharmacists have the attention of any national/state pharmacy organizations? If not, what will it take for our safety at work to become a major concern?

Michelle K. Rutledge, Pharm.D.
HSR&D Associate Investigator
James A. Haley VA Hospital
VISN 8 Patient Safety Research Center (118M)
Michelle.Rutledge@va.gov

Thank you for your informative article on the petition calling for acetaminophen labeling (Nov. 20). As an 85-year-old senior and an advocate for consumer/patient education for over 65 years, I strongly encourage more education and information to the elderly through pharmacists, physicians, and healthcare providers on the subject of acetaminophen, Tylenol, APAP, OTC combinations, and Vicodin products when mixed with or without alcohol.

From December through February (the Superbowl/football games), 58% of all alcohol is consumed in the United States. Mixing APAP with alcohol is deadly and is the No. 1 cause of liver failure in the country today.

What seniors need to know is that there are over 200 OTCs containing APAP, including such widely used products as Excedrin Migraine analgesics, Tylenol for Arthritis, Triaminic Cold and Allergy medications, and so on.

I know the holidays will bring many headaches. While it is true that APAP is much safer under a 4-gm dosage per day than NSAIDs, all these medications need to have an FDA warning on their labels.

Robert C. Rodgers President
Professional Pharmaceutical Advocates
Santa Rosa, Calif.

Some MTM providers are being shut out

For those clinical pharmacists who have been doing medication therapy management in clinical settings for the Medicare Part D population, some payers are still shutting us out.

The Humana D program and the CCRX program both refuse to enroll pharmacist providers unless they are part of a drugstore or have a pharmacy affiliation. The directors of these programs fail to understand that MTM, as a medical service, with assigned CPT codes from the American Medical Association, provided by pharmacists, should be billed just like any other medical service. They should let those who use a HCFA 1500 format and follow the guidelines participate in their MTM program.

Instead, those of us who practice in clinical, nondispensing settings are being excluded, punitively, for being ahead of the curve in care.

The program initiated at the Ohio Department of Health (ODH), the Bureau for Children with Medical Handicaps (BCMH), uses the HCFA 1500 format, has an appropriate compensation level, and allows pharmacists (no matter where they practice) to bill ODH. This program was identified for its excellence, and the Minnesota Medicaid program chose to emulate the ODH/BCMH approach.

The entire goal of this exercise was to improve patient care quality of life, improve patient care outcomes, maximize therapeutic decision making, and minimize adverse drug events that increase healthcare catastrophic events and costs.

If state governments are getting the right message, why is private insurance being so recalcitrant? I have contacted multiple local pharmacies in Columbus and no one is willing to let me bill for my services through them.

We need to get this MTM program right. Wake up, Humana and CCRX, and let those who are already in practice into your clubhouse.

Allen Nichol, Pharm.D., Director
Diabetes Management Program
Grandview Family Practice
Columbus, Ohio
allennichol@aol.com