PHARMACY

Elimination of Saturday mail delivery could complicate mail-order business

BY Alaric DeArment

Eighty-eight members of the House of Representatives fired off a letter Monday to postmaster general and CEO of the U.S. Postal Service Patrick Donahoe urging the agency not to eliminate Saturday delivery of mail, saying it would impede the ability of people who depend on mail-order pharmacies to receive their medications.

It’s no secret that the retail pharmacy industry and pharmacy benefit managers don’t always see eye-to-eye, with the latter being the main provider of mail-order pharmacy services in the country and often touting them as an alternative to going to the drug store, while the former emphasize the face-to-face interaction with pharmacists not usually possible with mail-order. But between the back-and-forth, millions of patients still depend on mail order pharmacy, and the cost effectiveness that mail-order pharmacies frequently promote themselves as offering could be at risk if they must use more expensive delivery methods.

Many patients don’t have the option of going to pharmacies because of old age, disability or because they live in isolated, rural areas without convenient access to a pharmacy. In 2009, CVS Caremark delivered 50 million prescriptions through the mail, according to an op-ed by SVP mail pharmacy operations Kenneth Czarnecki that appeared in the Chicago Tribune in 2010. For many of those patients, particularly those living with chronic conditions and disease states that require precisely timed dosing, running out of medication and missing doses could have serious, long-term consequences.

As an alternative to shutting down Saturday delivery entirely, the representatives suggested exempting medications and allowing them to continue to be delivered then. Barring that, however, mail-order pharmacies would be forced to either make do with a five-day schedule or, the representatives wrote, use other, possibly more expensive delivery methods.

That could be a problem for a channel that has long promoted itself as a cheaper alternative to brick-and-mortar pharmacy retailers. In late 2012, specialty pharmacy patients – most of whom had conditions like HIV, cancer and autoimmune disorders – covered by Anthem Blue Cross started receiving letters from the insurer stating that their drugs would only be covered if they obtained them through CuraScript, Express Scripts’ mail-order specialty pharmacy business. A spokesman for Anthem told Drug Store News at the time that the move was intended to cut costs, though specialty pharmacies that had treated the patients balked, saying it would threaten continuity of care. In addition, according to experts, missing doses of some drugs, such as those that treat conditions like HIV, can cause the virus to become resistant to them.

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PHARMACY

Pharmacy ideal for proactive health interventions

BY Michael Johnsen

A smoking cessation program developed by the University of California San Francisco School of Pharmacy will be deployed through Safeway pharmacies, the university announced. As part of the program, Safeway pharmacists will receive special training in counseling techniques. 

It’s one of the first partnerships of its kind and another example of how community pharmacy will be stepping into a more preventive healthcare role. You can expect to see more types of these smoking cessation programs along with other proactive health interventions tackling weight loss and encouraging healthier behaviors. 

That’s not a hard prediction to make — pharmacists are the most accessible healthcare provider out there. And the environment in which they operate is not only similarly easy to access but also can be loaded with technology-driven interactive tools.

Health kiosk developer SoloHealth recently partnered with the William J. Clinton Foundation’s 2013 Clinton Health Matters Initiative on building and distributing a tobacco-cessation education module across its SoloHealth Station kiosks, which should number 4,000 by the end of the year. 

The next preventive health arena where pharmacists can play an increasingly important role is weight loss. Remember, it wasn’t too long ago there was an initiative featuring a retailer/health insurer partnership that worked toward encouraging healthier food shopping behaviors. 

First, this will be an active area because tackling weight loss as a preventive healthcare initiative will deliver a greater disease-prevention yield. According to the National Center for Health Statistics, obesity is not only tied to increased morbidity, but also an increased risk of heart disease, stroke, some cancers, diabetes, osteoarthritis and disability.  

Second, there are a lot of Americans who are considered obese, and a disease-prevention program operating out of a convenient pharmacy setting will reach more people. Between 1988–1994 and 2009–2010, the prevalence of obesity among preschool-age children 2–5 years of age increased from 7% to 12%, NCHS noted. And the prevalence of obesity among school-age children and adolescents increased from 11% to 18%, respectively. 

From 1988–1994 and through 2007–2010, the percentage of adults 20 years of age and over with grade 1 obesity (a body mass index between 30 and 34.9) increased from 14% to 20%. Those with grade 2 obesity (BMI of 35–39.9) nearly doubled, from 5% to 9%, and those with grade 3 or higher obesity (BMI of 40 or higher) rose from 3% to 6%.

 

 

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W.Va. senators, representative introduce prescription drug abuse bill

BY Alaric DeArment

WASHINGTON — Two Democrats from West Virginia are sponsoring legislation in the House and Senate to combat prescription drug abuse.

Sen. Jay Rockefeller announced that he and Rep. Nick Rahall had introduced the bills, both called the Prescription Drug Abuse Prevention and Treatment Act, due to a dramatic increase in deaths and overdoses from prescription drugs in their state; the two originally introduced the bills in 2011, and Sen. Joe Manchin, D-W.Va., also is cosponsoring the new bill. Rockefeller said West Virginia has one of the highest rates of drug overdose deaths in the country, and 90% of drug-related deaths result from misuse and abuse of prescription drugs, particularly opioid painkillers.

With 22 million people abusing painkillers since 2002, prescription drugs are second only to marijuana among the most widely abused drugs, according to the Substance Abuse and Mental Health Services Administration.

"I’ve reached out to West Virginians — healthcare providers, schools, pharmacists — asking for new ideas on how to reduce prescription drug abuse," Rockefeller said. "This legislation reflects that real, on-the-ground feedback from West Virginia."

The bills include new training requirements for healthcare professionals before they can be licensed to prescribe these drugs; consumer education on the safe use of painkillers and preventing diversion and abuse; basic clinical standards for safe use and dosage of pain drugs; increased federal support for state prescription drug monitoring programs; and comprehensive reporting of opioid-related deaths to help guide solutions.

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