Small Doses: News for Pharmacists in June

Outpatient Clinic Drug Spending to Soar

Prescription drug spending at outpatient clinics is expected to grow by 11% to 13% this year. “National Trends in Prescription Drug Expenditures and Projections for 2018,” published in the May 2018 AJHP online, also predicts that spending on prescription drugs at nonfederal hospitals will remain unchanged or rise up to 2%.

Overall, national spending on prescription drugs this year is predicted to increase by 3% to 5% compared to 2017. “Clinics’ [spending increase] has to do with the continued movement of care from inpatient to outpatient settings. It also has to do with the fact that most of the really expensive medications are used in clinics,” says lead author Glen T. Schumock, PharmD.

Grocery Chains Partner with Specialty Pharmacy

Southeastern Grocers, the parent company of Winn-Dixie, BI-LO, and other supermarket chains, has partnered with Pathstone Health Services to offer personalized specialty pharmacy services to patients. Specially-trained pharmacists offer personalized check-ins, reminders, and advice on medication side effects and potentially conflicting medications, Southeastern says. The service is designed to help patients with complicated medical conditions that are often chronic in nature such as cancer, hepatitis, multiple sclerosis, and Crohn’s disease.

Deaths, Injuries from Tainted Synthetic Cannabinoids

Hospital pharmacists in Illinois are on high alert after an outbreak of severe bleeding and death among users of tainted synthetic cannabinoid products. Health officials say the outbreak appears to be linked to the presence of brodifacoum, a rodenticide, in the synthetic cannabinoid products, ASHP reports. There have been 151 cases of severe bleeding, including three deaths, as of late April.

Otherwise healthy patients present with spontaneous bleeding from the gums, vomiting of blood, blood in the stool, and nosebleeds. Ahmed Mahmoud, PharmD, critical care and emergency pharmacist at Northwestern Memorial Hospital, tells ASHP that his chief concern is having an adequate supply of medications to achieve normal hemostasis.

Vaccinations at Pharmacies Lower Healthcare Costs

Increasing the number of vaccinations performed at pharmacies could significantly lower healthcare costs. Studies show that pharmacies “tend to be more effective, lower-cost providers of vaccinations,” said Pacific Research Institute in the report, “Promoting Access and Lowering Costs in Healthcare: The Case of Empowering Pharmacies to Increase Adult Vaccination Rates.”

In a 2014 study, for example, researchers found that the average direct costs paid per adult vaccination were lower in pharmacies compared with physician offices by 16% to 26%, and by 11% to 20% lower in other medical settings. “Pharmacists provide vaccinations at lower costs, and with greater convenience, for many patients,” the report states.

How Community Pharmacy Can Use Technology to Help Patients

The combination of physical community pharmacies, telepharmacy, and technology can improve patient outcomes and lower costs -particularly those with chronic conditions. In a keynote address at HLTH 2018, Troyen A. Brennan, MD, CVS’s chief medical officer, outlined how data-driven insights and community- based retail healthcare can provide a highly personalized healthcare experience that supports the patient-centered medical home.

Initial CVS Health pilot programs exploring this idea will focus on three target groups of patients: those with five common chronic diseases (diabetes, hypertension, hyperlipidemia, asthma, and depression), fragile patients, and patients transitioning from a hospital setting.

Albertson’s Pharmacies Offering Genetic Mental Health Testing

Over two dozen Albertsons, Jewel-Osco, and Acme pharmacies are now offering a genetic test for patients with mental health issues. The test is the Genecept Assay from Genomind. The test identifies genetic markers that indicate which treatments are likely to work as intended, have no effect, or cause adverse effects for a specific patient. Specially trained pharmacists may decide to counsel a patient about the test if they see a pattern of the patient having unsuccessful experiences with medications prescribed for several mental illnesses.

“Up to half of all patients respond poorly to the first psychiatric medicine they try because everyone’s body is different,” states Genomind.