Pharmacists comment on security, behind-the-counter drugs, and other issues.
Regarding your online question in January about whether specialty pharmacy is a field still open to community pharmacies, I believe that pharmacies with the traffic, such as ours in an oncology facility, should become specialty pharmacies and be allowed to participate by the payors. As far as I can tell, the title of "specialty pharmacy" is being used by pharmacy benefit managers to route prescriptions that cost more to their own mail-order pharmacies. If a community pharmacy sees the patient population, the pharmacists certainly can do a better job at counseling patients face-to-face than a mail-order pharmacy can over the phone. I have had patients come to my pharmacy to learn how to take chemotherapy agents dispensed by a mail-order pharmacy. Their insurance company required them to use the mail-order pharmacy. This can be life threatening when oral chemotherapy agents are involved, not to speak of the inappropriate use of healthcare dollars if these agents aren't taken at optimal doses and times.
Let's get rid of drug samples
Of course, if these patients were indigent, then I might not be so deeply offended. However, the luxury cars they get into (which I can also observe) lead me to believe that poverty is not an issue with these patients. The physicians or the office staffs of the physicians become the good guys by giving out the free samples. Who wants to pay for drugs when they can be obtained free? In addition, how many samples are taken (diverted) by physician office personnel, some without any medical background, and distributed to Aunt Mary or Grandma? The possibility of serious problems with this practice and many others related to samples is obvious. In the event that indigence is an issue, patients should use the voucher system at their local pharmacy and take advantage of the best safety net available-the local pharmacy.
I propose that we take Russ Lazzaro's position one step further: Why limit the distribution of samples only in New Jersey? It's time for a nationwide adoption of a voucher system for the distribution of pharmacy samples. Patient safety and good medical practice demand it! What do you think?
Ronald Melaragni, R.Ph.
East Lansing, Mich.
Not ready for DMEPOS accreditation
Let's look at this great new idea from the government-the accreditation of providers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). First the competitive bidding part means that you will be reimbursed at cost but more than likely below cost. Then you wait up to six months for your money. Sound good so far? Then we can pay these certification agencies upwards of $5,000 to tell us what we already know and have been doing for 30 years. I can understand why the mail-order outfits are jumping at this because they will have all the business in a few years anyway.
So I asked the fourth graders next door what they thought about this and they told me, "Gee Mr. Christensen, if it was us, we'd just soon take a vacation with that money and at least have a good time!" Out of the mouths of babes! Sounds reasonable to me. Got to love the government...it taxes you so it can turn around and put you out of business.
Irvin Kim Christensen