Letters: September 15, 2008


Pharmacists express doubts about PhRMA's new marketing code, e-prescribing, and prompt pay.

Key Points

Regarding your August poll about the new marketing code of the Pharmaceutical Research and Manufacturers of America (PhRMA), I cannot seriously believe that a healthcare professional would be swayed by pens, cups, writing pads, etc. I enjoy discussing clinical data about medications with my colleagues in the industry. They are more knowledgeable about their drugs than anyone else, and I can pick and choose to believe them (or not) and can certainly look up the references they provide to see if they are telling the truth. I haven't been lied to yet. The industry reps whom I have met have been honest and forthcoming, and a pen will not make me "sell my soul." The FDA, PhRMA, and all the others that are behind this restrictive policy need to rethink it. Cutting off communication between industry and professionals is a mistake.

Ellen Sprentall-Nankervis, BS, PharmDenankervis@embarqmail.com

Not sure e-prescribing is a good idea

Kelly O'Neil, RPhjkorun@aol.com

For starters, two questions

On the prompt pay issue, what good is the remittance advice of pharmacy benefit managers (PBMs) that only have the prescription, date, and amount paid? There is an example of a better way from an unlikely source - Medco. Medco provides a statement that has the name of the medication along with the quantity and amount paid. This allows one to quickly look and see if reimbursement is correct, according to the contract. If Medco can do this, why can't all PBMs? Is the Health Insurance Portability and Accountability Act (HIPAA) a privacy law or a cover-up law?

Question No. 2: How come there is such a lag time in our pricing after price increases? Here are three recent examples: diclofenac sodium DR 75 drastically increased in price in May, but PBMs have been very slow to respond. Check cholestyramine light powder packet and orphenidrine/aspirin/caffeine 25/325/30 milligrams (mg) and you will also find large losses in reimbursement. The response to notification about price increases has been no response to a delay of a few days. There is currently a lawsuit on this very practice of not updating prices in a timely manner as a mode of operation to defraud those involved. I have provided three examples for everyone to check and I hope all of us could work together to keep PBMs aware that we know of their tactics.

Craig H. Haslam
Preston, Idaho

Workload and safety

Regarding Joseph Bova's letter in your July issue, there is an apparent conundrum with the New York Board of Pharmacy (and probably others) about limiting pharmacists' workload. While I agree with Mr. Bova that pharmacists should demand extra help, the unfortunate reality is that they have not been able to unify to exert such power. It is apparent that the board of pharmacy is unwilling to pass legislation to require any limit on workload. So if pharmacists can't get it together and there is documentation that certain levels of workload increases errors, then who's responsible for public safety?

Robert Crystal, RPh
Albany, N.Y.

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