PHARMACY

NACDS to House committee: Pharmacy can help prevent, curb Rx drug diversion

BY Antoinette Alexander

ALEXANDRIA, Va. — The National Association of Chain Drug Stores submitted on Thursday an official statement to the House of Representatives Energy and Commerce Subcommittee on Commerce, Manufacturing and Trade, highlighting pharmacy’s commitment in partnering with law enforcement agencies and other stakeholders to help prevent and combat prescription drug diversion and misuse.

"Chain pharmacies participate in state controlled substance prescription drug monitoring programs. In addition, we are devoted to important initiatives to improve patients’ adherence to their prescribed medications," NACDS wrote in its statement, which was submitted for the subcommittee hearing, "Warning: The Growing Danger of Prescription Drug Diversion."

"Chain pharmacies and their pharmacists work with their patients daily to provide them with information and counseling on the proper use of their prescription medications and the importance of adhering to their prescription drug treatment," NACDS added.

The statement also laid out specific recommendations to federal policymakers, including strengthening state-level prescription drug monitoring programs, compensating pharmacy-provided medication therapy management services and shutting down illegal online drug-sellers.

"Further, NACDS and our member companies support policies that work to prevent illegitimate Internet drug sellers from selling or offering to sell drugs to U.S. consumers in violation of federal and state laws. We also support efforts to provide patients with means for disposal of their unwanted medications that are authorized by law enforcement," the statement continued.

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FDA: Certain TNF blockers could be linked to rare cancer

BY Alaric DeArment

SILVER SPRING, Md. — The Food and Drug Administration has received reports of a rare and usually deadly cancer in patients using a class of biotech drugs to treat autoimmune and inflammatory diseases, the agency said Thursday.

The FDA warned that some patients taking tumor necrosis factor blockers had developed hepatosplenic T-cell lymphoma, or HSTCL, a fast-spreading cancer of the white blood cells. Most of the cases were in adolescents and young adults using TNF blockers to treat Crohn’s disease and ulcerative colitis, but cases of patients treating psoriasis and rheumatoid arthritis had emerged as well.

TNF blockers include Remicade (infliximab) and Simponi (golimumab), both made by Johnson & Johnson, Abbott’s Humira (adalimumab), UCB’s Cimzia (certolizumab pegol), and Enbrel (etanercept), made by Amgen and Pfizer. The agency said some cases also had emerged in patients taking azathioprine and mercaptopurine, immune-suppressant pharmaceutical drugs available as generics, alone and in combination with the TNF blockers. However, the agency also said that patients with the diseases those drugs treat are at higher risk of developing lymphoma than the general population.

Over the years, the FDA has received a number of reports of patients developing cancers or deadly viral infections like progressive multifocal leukoencephalopathy after taking immune-suppressant drugs for autoimmune and inflammatory disorders, though such cases are rare enough that the FDA generally has recommended that the drugs stay on the market.

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CVS Caremark to implement new management service for PBM, specialty pharmacy clients

BY Antoinette Alexander

WOONSOCKET, R.I. — CVS Caremark has unveiled a new medical benefit drug management service for its pharmacy benefit manager and specialty pharmacy clients.

According to the company, the offering is the first of its kind to provide a comprehensive management solution for the buy-and-bill drug model currently used by physicians — whereby the physician purchases specialty medications, administers them to the patient and directly bills the payer. The payer-centric offering will employ both prospective and retrospective drug utilization management strategies to drugs billed under the medical benefit, while ensuring minimal disruption to the physician’s workflow and facilitating the delivery of evidence-based care.

CVS Caremark stated that it will work with New Century Health, a specialty care management company, to offer its clients integrated evidence-based medicine, treatment care pathways, quality improvement programs and peer-to-peer review through an innovative Web-based decision support platform.

This offering broadly will be available to CVS Caremark customers for implementation beginning Jan. 1, 2012.

Management of specialty drugs under the medical benefit poses a significant challenge to health plans and employers today. In fact, more than 50% of specialty drugs are billed under the medical benefit, many of which are administered in a physician’s office. Payers are less able to identify and apply effective clinical and cost-management strategies, similar to those applied to specialty drugs billed under the pharmacy benefit, because of current medical claims, processing limitations and limited visibility to its clinical applications, according to CVS Caremark.

Through analysis of CVS Caremark data, the company found that among its PBM clients, cancer and associated supportive care specialty drugs — such as hematopoietics for anemia and neutropenia — accounted for approximately 53% of the total specialty drug spend billed to the medical benefit. As a result, CVS Caremark’s new offering initially will focus on improving the quality, safety and management of oncology drugs billed under the medical benefit. Estimated savings of up to 15% of a payer’s oncology spend are expected.

"This offering will enable CVS Caremark to identify the unrecognized specialty pharmacy spend currently billed through the medical benefit for oncology patients," stated Per Lofberg, president of CVS Caremark’s PBM business. "By systematically tracking and analyzing this activity, we can provide our clients with an opportunity to better manage these expensive drugs while also improving the quality of care for their members."

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