Viewpoint: Three ways to fight reduced reimbursement
February 5th 2007Independent and chain drugstore pharmacists have had to address a significant number of new issues during 2006, such as the launching of the Medicare Part D program and new demands on their professional time to assist customers. Perhaps the single most pressing issue facing R.Ph.s, however, is reimbursement. No other issue ignites more debate than how an insurance plan, government program, or patient reimburses pharmacists for their products/services. A growing number of pharmacies across the country are falling into debt, laying off workers, and facing closure due to inadequate reimbursement levels and slow payment. This article summarizes the reimbursement plight pharmacists find themselves in and reviews three attempts under way to help resolve this issue.
Viewpoint: A new view of Alzheimer's disease
January 22nd 2007I know the jury is still out on this issue, but I firmly believe mercury exposure is to blame for Alzheimer's disease (AD). It's a subject I feel strongly about because my grandmother is a victim of this horrible condition. I can see firsthand the toll it takes on patients and their families. Even though my grandmother is still alive at 89 years old, she is often so disoriented and confused, it's almost as if she's not here.
Viewpoint: Can independents survive Part D?
November 20th 2006Decades ago, when there were no pharmacy benefit managers and pharmacists were fondly called Doc and sold only medication, pharmacists were respected for the tireless care they gave patients. Over the past 20 years, PBMs working for insurance companies and government agencies have gradually disconnected the care from health, treating pharmacy like a commodity business. Because of PBMs' steady ratcheting down of reimbursements, pharmacists now barely make 1% to 2% profit margins on dispensing prescriptions for private and government plans.
Viewpoint: Many drug errors can be prevented
November 6th 2006Medication safety has always been an important issue, but the Institute of Medicine's (IOM) recent report showing that preventable medication errors injure at least 1.5 million Americans annually illustrates the seriousness of this predicament. The authors of the IOM report, Preventing Medication Errors: The Quality Chasm Series, even acknowledge that this is likely a conservative assessment of drug safety gaps. The report noted that each year 530,000 preventable adverse drug events-injuries due to medication-affect outpatient Medicare patients, 380,000 to 450,000 occur in hospitals, and another 800,000 in long-term care facilities.
Viewpoint: Is pharmacy a profession or a trade?
October 23rd 2006How many times have you gone to see your doctor and, while addressing your medical concerns, he is also on the phone with an insurance carrier trying to rectify a claim or at the receptionist's desk trying to collect payment from another patient? Although you probably have not witnessed this in a doctor's office, it is a common occurrence in community pharmacy.
Viewpoint: Free to a good home-e-technology
September 18th 2006How would you like to receive free e-prescribing software? Or maybe a state-of-the-art medical records software package, complete with Internet connectivity and help desk support? Well, get ready, because some gifts may be coming your way! On Aug. 8, the Department of Health & Human Services, through its CMS and Office of Inspector General, published parallel final rules allowing certain healthcare groups to donate e-prescribing and electronic health record (EHR) technology to physicians, pharmacies, and others. And, better yet, the final rules are broader and more practical than those proposed back in October 2005.
Viewpoint: Pharmacists really are the drug experts
September 4th 2006I was jolted out of a sound sleep at around 2:00 A.M. The pain across my upper chest radiated from shoulder blade to shoulder blade. It was like nothing I had ever experienced before. Then the pain in my jaw began, like a box cutter slicing me from ear to ear. I could feel my heart beating faster. I felt nauseated and little lightheaded. But most of all, I felt an overwhelming sense of doom. I woke up my wife and told her what was happening. She took one look at me and said, "Pick your ER." The expression on her face confirmed what I already knew. I was having a heart attack.
Viewpoint: OBRA has made you targets for lawyers
August 21st 2006It used to be that if pharmacists dispensed the right drug and right dose and gave the right directions to the right customer, we were free of liability. Thanks to the Omnibus Budget Reconciliation Act (OBRA), however, this is no longer the case. As a result of the OBRA counseling provisions, our profession has succeeded in tremendously increasing the risk of liability for frontline pharmacists. We now have to contend with aggressive lawyers who charge us with these three words: failure to warn.
Viewpoint: It's time for healthcare for everyone
August 7th 2006The United States will spend more than $2 trillion on health care this year, which is more than enough to pay for comprehensive health care for everyone. That includes $200 billion (10%) on prescription drugs. Yet we will continue to see adverse health outcomes, including death, because millions are finding that health care is simply unaffordable. It is a national disgrace that people will die merely because they could not afford to purchase their prescriptions and other essential care, even though we are spending enough to provide for them.
Viewpoint: Out of Africa: My six years in Tanzania
July 24th 2006As a missionary and pharmacist, I have spent many years providing pharmacy care in developing countries all over the world. For instance, I have served in Honduras, Mongolia, Kenya, and most recently in Tanzania. In Tanzania, I served for six years, from 1998 to 2004, as the director of pharmacy and as administrator of 85 Tanzanian employees in Kigoma Baptist Hospital, a 45-bed medical/surgical hospital with an active outpatient clinic. This article will cover the last year I spent there.
Viewpoint: This drug should be OTC
July 10th 2006There has been extensive publicity about the possibility of an influenza pandemic, and this is a valid concern that requires high-priority attention. However, there is an existing pandemic that is apparently sufficiently acceptable that the attention to addressing it pales in comparison to the magnitude of the problem. This pandemic is, of course, smoking and the deaths of more than 440,000 Americans each year as a result of smoking-related illnesses.
Viewpoint: This drug should be OTC
July 10th 2006There has been extensive publicity about the possibility of an influenza pandemic, and this is a valid concern that requires high-priority attention. However, there is an existing pandemic that is apparently sufficiently acceptable that the attention to addressing it pales in comparison to the magnitude of the problem. This pandemic is, of course, smoking and the deaths of more than 440,000 Americans each year as a result of smoking-related illnesses.
Viewpoint: How independents can beat the chains
June 19th 2006Local pharmacies have a special place in American society. Neighborhood pharmacists provide expert medical advice and often inexpensive prescription drugs, and they add to a greater sense of community in residential areas. But, in recent years, the neighborhood drugstore has come under increasing attack by national pharmacy chains, which have gobbled up market share in many areas across the country.
Viewpoint: How you can extend HIV help abroad
June 5th 2006Treating HIV patients has always been a passion of mine. At ourpharmacy in the Bronx, N.Y., we've been able to achieve 85% to 90%monthly refill rates on the HIV patients we treat. With thisexperience under our belts, I wanted to apply the techniques I havegained to HIV patients in other countries as well. This was whatbrought me to Rwanda last year.
Viewpoint: Make the most of life's adventures
May 22nd 2006It's one of the things I've always dreamed of doing and Iaccomplished it last October, two months before I turned 60. As anadmitted adventure travel junkie, I reached the summit of MountKilimanjaro in Africa, the world's highest freestanding mountain.
Viewpoint: Start charging for your services now
May 8th 2006The handwriting is on the wall. With pharmacy being reimbursed at alow and slow rate under Medicare Part D and severe cutbacksexpected in the payment for generic drugs under Medicaid, communitypharmacy will need a new business paradigm in order to survive andgrow into the 21st century.
Viewpoint: Don't forget to give out MedGuides
April 3rd 2006Since 1998, the Food & Drug Administration has had theregulatory authority to require pharmacies to distribute MedicationGuides to patients getting certain high-risk drugs. MedGuides,which provide written information to patients on their Rxs, areprepared by drug manufacturers and approved by the FDA. To date,the FDA lists more than 75 drugs on its Web site that require thedistribution of a MedGuide from a community pharmacy or uponhospital discharge. They include antidepressants, nonsteroidalanti-inflammatory drugs (NSAIDs), and others. Manufacturers ofthese high-risk drugs are responsible for ensuring that asufficient number of MedGuides are available in pharmacies.
Viewpoint: Qui tam suits and you
March 20th 2006Two married pharmacists working for one of the largest PBMs,Caremark, filed a qui tam lawsuit in 2004 against their employer.They alleged Caremark had defrauded a Florida health plan forretired state workers by switching Rxs to higher-priced drugswithout permission and failing to give the health plan credit fordrugs that were returned unopened by customers.
Viewpoint: Consider homeopathy for your practice
March 6th 2006It's well known that many people are skeptical about the value ofhomeopathy. In fact, homeopathy is a medical science with more than200 years of documented clinical efficacy. Homeopathic remedieshave to go through rigorous regulatory review before they can makeit to market. Much of the lay public equates vitamins and herbalsupplements with homeopathy. Actually, the two categories are quitedistinct in both their legal status and therapeutic modalities.
Viewpoint: Pharmacist's role in long-term acute care hospitals
February 20th 2006Having worked as pharmacists at a long-term acute care hospital, we know that the concept of LTACH is widely misunderstood. Long-term acute care hospitals are not skilled-nursing facilities, acute rehab institutions, or short-term acute care hospitals. LTACHs offer different services from those of the other facilities, and clinical pharmacists who practice at LTACHs are required to have a high level of clinical and critical care skills.
Viewpoint: Why a kiddie corner makes sense
February 6th 2006It is a familiar scene in America's pharmacies—a parent carrying a sick child who is screaming his head off. To get them out of the pharmacy as quickly as possible, we zip into high gear and mix that amoxicillin up at a pace like no other. As a mother, I feel the pain of the parent and child. The reality is that many local pharmacies I have encountered are missing one crucial element, something so sought after by parents to give them peace of mind that you would think every pharmacy in the universe would be equipped with it. No, I'm not talking about a fully stocked liquor cabinet, but close! The answer is quite simple: a children's play area.
Viewpoint: Help your patients see their meds
January 23rd 2006As owners of independent pharmacies, we are constantly seeking newservices to make things easier for our customers. This is why wewere instantly receptive to a suggestion that was brought to us bythe Macula Vision Research Foundation (MVRF), a nationalorganization based in West Conshohocken, Pa. MVRF approached eachof us to suggest that we offer large-print labels for prescriptionmedications.
Viewpoint: Can CAP program survive?
January 9th 2006The new competitive acquisition program (CAP) for Medicare Part Bdrugs aims to realign the market forces shaping the distribution ofdrugs and biologics that doctors administer in their offices. Butif it is to survive, CAP must balance market conditions affectingphysicians, vendors, and manufacturers. We believe it does not doso per the implementing regulations published in the Nov. 21Federal Register.