Generics may dampen pharmacy sales for drug stores, but they sure help patients
WHAT IT MEANS AND WHY IT’S IMPORTANT CVS Caremark made a major push to showcase the tools it uses to curb costs as it revealed a study indicating that more lax generic regulations could save states millions of dollars, not to mention that its annual insights report revealed an increase in generic dispensing rates.
(THE NEWS: CVS Caremark study: Less restrictive generic laws could curb state Medicaid costs. For the full story, click here)
The study looked at the generic substitution of simvastatin for cholesterol brand drug Zocor over six quarters beginning June 23, 2006, when Zocor’s patent expired. It examined how quickly Medicaid recipients moved to the generic equivalent medications under three different state statutes — mandatory versus permissive substitution, with and without prior authorization, and with and without requiring patient approval for substitution. Based on the findings, CVS Caremark estimated that changing generic substitution laws in favor of less-restrictive regulations could save states struggling to pay for increasing healthcare costs through their Medicaid programs more than $100 million over the next several years. That’s a significant savings at a time when budgets are strained.
This announcement came as the company unveiled the findings of its annual insights report, which revealed an increase in generic dispensing rates in 2009, as plan member contributions declined.
The reason all of these initiatives are important is because patient nonadherence to essential chronic medications is a barrier to improving public health and a source of rising medical costs. Past studies showed one-quarter of people receiving prescriptions never fill their first prescription, and patients with such chronic diseases as diabetes and coronary artery disease adhere to their ongoing medication regimen about half of the time, according to CVS Caremark data. Nonadherence to essential medications is a frequent cause of preventable hospitalizations and patient illness, with costs to the U.S. healthcare system estimated at about $300 billion annually.
NCPA urges delay of PECOS changes that could deter community pharmacy industry
ALEXANDRIA, Va. Fearing that the implementation of an electronic provider enrollment program for Medicare Part B in its current form by the Centers for Medicare and Medicaid Services could disrupt Part B beneficiaries’ ability to obtain access to their services and supplies, the National Community Pharmacists Association is hoping that the CMS will delay its implementation and make other changes.
The provider enrollment, chain and ownership system is an online system that Part B providers can use instead of paper enrollment so that they can sell durable medical equipment, prosthetics, orthotics and supplies, also known as DMEPOS.
The CMS originally had planned to roll out PECOS on Tuesday, but it announced June 30 that while the original implementation date would still be effective, it would “not implement changes that would automatically reject claims based on orders, certifications, and referrals made by providers that have not yet had their applications approved by July 6, 2010.” The NCPA had asked the CMS to delay implementation until Jan. 3, 2011.
Other recommendations made by the NCPA included requiring pharmacy access to nightly provider-referrer enrollment updates to PECOS and removing requirements to include the teaching physician as the ordering or referring supplier and the legal name of the physician or eligible provider on the claim.
“Community pharmacies appreciate and support the PECOS program’s effort to reduce waste, fraud and abuse in Medicare,” NCPA acting EVP and CEO Douglas Hoey said. “However, the slow pace of enrollment and database updates, along with other deficiencies, creates headaches for community pharmacies and could limit access to Medicare Part B medical supplies for seniors, especially in underserved areas.”
Merck announces global consolidation plan
WHITEHOUSE STATION, N.J. Merck will close down eight of its research and development sites and eight of its manufacturing sites as part of a global consolidation plan, the drug maker said Thursday.
The plan will result in around 15% of the company’s staff being laid off as Merck seeks to create a “flexible” research and development organization that focuses on innovation, external collaboration and growth in the company’s product pipeline.
“Today’s announcement is another important step as we successfully integrate our global operations on schedule and move forward with Merck’s strategic priorities,” chairman and CEO Richard Clark said. “These changes are crucial to drive future growth and realize the promise of being a global healthcare leader for the long term.”