PHARMACY

MTM fights diabetes on the front lines

BY Alaric DeArment

The number of patients with diabetes is not decreasing any time soon, and one of the most important fronts in the battle lies at the pharmacy counter.


Medication therapy management, one of the most effective ways that pharmacists can help patients manage their diabetes, got a major boost last year with the introduction of H.R. 891, the Medication Therapy Management Benefits Act, which would allow elderly people with at least one chronic condition to access Medicare Part D coverage for MTM; currently, only those with more than one condition are eligible. At press time, the bill’s sponsors — Reps. Mike Ross, R-Ala., and Cathy McMorris Rodgers, R-Wash. — were looking for cosponsors for the bill.


In the meantime, a number of retailers have taken the lead in providing care and services for diabetes patients. Kerr Drug, for example, a longtime leader in MTM, recently launched the “Just Ask” campaign in stores and across various marketing channels, focusing on 11 conditions, including diabetes. Also, Safeway joined the UnitedHealth Group’s Diabetes Prevention and Control Alliance and began offering the DPCA diabetes control program at Tucson, Ariz., area stores, with plans to extend it to Seattle-area stores. Other retailers in the program include Winn-Dixie, Walgreens, Albertsons, Kroger and Rite Aid.

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PHARMACY

Bydureon takes on diabetes

BY Alaric DeArment

The market for drugs to treat diabetes — especially Type 2 diabetes — has shown quite a bit of activity lately. At the end of January, the Food and Drug Administration approved Bydureon (exenatide), a once-weekly version of the drug Byetta, which was originally developed by Alkermes and subsequently developed further under an alliance between Amylin Pharmaceuticals and Eli Lilly that the two companies formed in 2002. In November 2011, however, Amylin and Lilly terminated their alliance in the wake of an announced diabetes drug partnership between Lilly and Boehringer Ingelheim. Still, Amylin and Lilly agreed to share profits from exenatide drugs, and Amylin will make a $150 million milestone payment to Lilly if the Food and Drug Administration approves a once-monthly formulation of the drug.


The Lilly-Boehringer Ingelheim partnership also has been fruitful. In May 2011, the FDA approved Tradjenta (linagliptin), subsequently approving Jentadueto (linagliptin and metformin) tablets in January 2012.


According to some analysts, Bydureon could achieve annual sales of $1 billion. A Decision Resources study, released last month, found that surveyed endocrinologists would prescribe Bydureon to one-fifth of patients. “We expect Bydureon will displace Victoza (liraglutide) and will earn our proprietary gold-standard status for Type 2 diabetes in 2015,” Decision Resources analyst Christine Helliwell said.


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PHARMACY

NACDS expresses pharmacy’s commitment to patient safety in House Panel testimony

BY Antoinette Alexander

ALEXANDRIA, Va. — Written testimony submitted by the National Association of Chain Drug Stores underscored chain pharmacies’ commitment to patient safety as part of the next Prescription Drug User Fee Act reauthorization, and emphasized that community pharmacist-provided services help improve health outcomes without the introduction of unproven technologies.

NACDS submitted the testimony to the U.S. House of Representatives Energy and Commerce Subcommittee on Health ahead of Thursday’s hearing, titled “FDA User Fees 2012: Hearing on Issues Related to Accelerated Approval, Medical Gas, Antibiotic Development and Downstream Pharmaceutical Supply Chain.”

NACDS supports several drug safety reforms included in the proposed PDUFA reauthorization, including the use of drug industry fees to review drug applications for sound-alike proprietary names and factors that could contribute to the likelihood of medication errors, such as unclear label language or package designs.

NACDS also supports the proposal to standardize Risk Evaluation and Mitigation Strategies and further incorporate these risk mitigation plans into the healthcare system. As Congress considers the REMS program, the U.S. Food and Drug Administration should include the development of methodologies to assess the effectiveness of REMS and obtain pharmacy input, as these strategies could impact drug store operations, according to NACDS.

“NACDS and the chain pharmacy industry are committed to partnering with policy-makers and the supply chain stakeholders on viable effective strategies to enhance the safety and security of the U.S. prescription drug distribution supply chain,” NACDS stated in the written testimony for the hearing record. “Our members have invested significant resources and efforts toward this goal, including changes in purchasing practices and actively supporting state legislation that strengthened the supply chain integrity. Nothing is more important to our industry than the health and safety of our patients.”

NACDS emphasized in the testimony that the U.S. drug supply chain is proven safe — if not the safest in the world. Chain pharmacy has supported the development of state-level chain of custody “pedigrees” for medicines distributed outside normal distribution channels, which have demonstrated some marked improvements in supply chain security. However, premature drug “track and trace” models unnecessarily would increase healthcare costs while imposing burdensome technologies that have not demonstrated an ability to enhance supply chain security, NACDS noted.

“As lawmakers, we urge you to consider approaches that are feasible and workable for the supply chain, and to recognize the importance of not requiring untested costly mandates such as a prescription drug ‘track and trace’ system for supply chain stakeholders,” NACDS stated in the written testimony. “Such requirements would add billions in additional costs to the healthcare system and take time and resources away from pharmacies’ ability to provide pharmacy services to their patients.”

Underscoring NACDS and chain pharmacies’ commitment to drug safety, NACDS and several of its members joined the Pharmaceutical Distribution Security Alliance and support many of its policy recommendations, including the adoption of uniform federal wholesale drug distributor licensure requirements to help ensure consistency in regulations across the country and prevent bad actors from avoiding stringent laws by crossing state lines. NACDS also supports the PDSA proposal to implement lot-level tracing, and is providing recommended edits to the alliance’s policy Discussion Draft to address various concerns.

Separately, community pharmacist-provided medication therapy management services help patients understand their medications and avoid costly complications. Proper reimbursement of pharmacists for providing MTM services could further incorporate this counseling into the healthcare delivery system to improve patient safety while reducing costs.

NACDS also supports the development of a registry of safe online pharmacies to help consumers distinguish between legitimate pharmacy websites and illegitimate drug dispensers that often provide adulterated medicines to patients.

Further, NACDS supports the FDA’s development of a “one document solution” to replace the multiple existing drug information inserts, which are duplicative, incomplete and difficult to understand. The creation of a single patient medication information document, which NACDS had called for, could help ensure that an accurate, comprehensible and balanced assessment of drug risks and benefits are communicated to patients, NACDS stated.

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