NCPA addresses CMS around AMP impact on community pharmacy
ALEXANDRIA, Va. — The National Community Pharmacists Association on Wednesday offered federal Medicaid officials a number of suggestions to address methodology that, if left in place, would result in what the NCPA couched as "potentially devastating cuts" in Medicaid pharmacy reimbursement for a wide range of common, generic prescription drugs.
In a letter to the Centers for Medicare and Medicaid Services, NCPA detailed a number of issues with the average manufacturer price data on which CMS is relying to calculate new caps on Medicaid pharmacy reimbursement, known as federal upper limits, for multiple source, generic prescription drugs.
“Independent community pharmacies are the backbone of the Medicaid drug benefit,” stated NCPA CEO Douglas Hoey. “These small-business pharmacists are often located in underserved rural and inner-city locations and care for twice as many Medicaid patients compared to national chain pharmacies," he said. “However, the newly proposed limits published by federal Medicaid officials would reimburse independent community pharmacies at rates that are below even the pharmacy’s acquisition costs for hundreds of products.”
In the letter, NCPA explains the following concerns and recommendations:
The AMP data on which CMS is relying does not accurately reflect acquisition costs for community pharmacies. Even at the reimbursement baseline established in the ACA, or Affordable Care Act (175% of the weighted average AMP), there are hundreds of products on CMS’ proposed list with FULs that are below an independent community pharmacy’s acquisition costs;
Inconsistency among drug manufacturer practices may contribute to the below-market FULs. The lack of guidance from CMS to manufacturers in terms of fully defining AMP has resulted in widely varying manufacturer practices in calculating AMP values. This, in turn, may contribute to the inadequate FULs proposed by CMS. Consequently, the new AMP regulation should be finalized before any AMP values are used to set FULs;
Insufficient manufacturer data. The FULs are based on one month’s AMP data, without regard to the statutorily required “smoothing process” to help avoid wild fluctuations that could occur from month to month;
CMS should recognize independent community pharmacies’ higher drug acquisition costs. Despite aggressive efforts to negotiate lower prices, community pharmacies’ acquisition costs are often 25% to 50% percent higher than those of publicly held chain pharmacies. The ACA granted CMS the flexibility and authority to set the FULs at a higher rate to account for that difference and to help preserve patient access in underserved rural and inner-city communities; and
CMS should fully resolve these and other issues before publishing its final, revised FULs. The publication by CMS of below-market reimbursement caps, such as those initially proposed, could result in additional health plans adopting a flawed reimbursement standard and further reducing the ability of independent community pharmacies to continue serving patients.
“The best way to lower health costs associated with prescription drugs is through the appropriate use of generic drugs and greater adherence, which helps prevent complications," Hoey added. “Medicaid patients rely on clinically trained pharmacists for counseling, which could be jeopardized if CMS doesn’t ultimately arrive at a more practical approach.”
Friskies, Pet Acoustics develop cat tracks
ST. LOUIS — A cat food brand has partnered with a company that develops music specifically for pets.
Friskies and Pet Acoustics said they will create six musical tracks that inspire cats to play. Two of the tracks, Friskies Paws for Treats and Friskies Purrfect Day, feature elements of percussion made by Friskies toys, food and treats, while also including stimulating frequencies that inspire a playful response in cats. As part of the partnership, Friskies will release two new tracks quarterly now through June 2012, which exclusively will be available online at Friskies.com.
"Partnering with Pet Acoustics was a natural fit for Friskies," Friskies assistant brand manager Alison Coburn said. "We’re always looking for unique ways to enhance cat play. Friskies recently created tablet games and phone apps for cats; and now we’re adding music. It’s one more way Friskies can help encourage people to try new and easy things to enhance their cats’ playtime."
USC School of Pharmacy to double presence in safety-net clinics
LOS ANGELES — The School of Pharmacy at the University of Southern California announced on Wednesday that it will double its presence in clinics and medical homes that deliver healthcare services to the uninsured, the poor and the homeless.
The school began providing clinical pharmacy services in safety-net clinics in 2002 and currently is a key partner with 12 such clinics in Southern California. The new USC Medication Therapy and Safety Initiative aims to increase the school’s coverage to 24 clinics and medical homes by 2013.
"The USC School of Pharmacy’s work in safety-net clinics enables us to have a direct and positive impact on the city’s most at-risk residents," stated R. Pete Vanderveen, the school’s dean. "And since these economic problems face the entire country, we are urging our fellow pharmacy schools to increase their outreach efforts as well."
This increased commitment to community is desperately needed, with the continuing economic crisis making these clinics even more vital to meeting the health needs of underprivileged communities, as demand increases and public funding decreases, the school noted. New census statistics show that more than 15% of Americans live below the national poverty level. In California, more that 16% are in poverty and nearly 20% lack health insurance. Los Angeles County alone is home to more than 2.7 million uninsured.
A USC clinical study demonstrated that integrating pharmacy services into safety-net clinics and medical homes results in measurable improvements in care. For example, hypertension patients had reduced blood pressure, and patients with diabetes showed improvements in blood-glucose control. The launch of this new initiative coincides with American Pharmacists Month, which recognizes the profession’s role in improving patient care.
"Staff pharmacists, working under protocols, adjust prescribed therapies and provide patient education to help ensure that each patient reaches treatment goals safely and effectively," stated Steven Chen, associate professor of clinical pharmacy and one of the school’s leading faculty serving in safety-net clinics.
The improved patient outcomes and cost savings that occur when pharmacists are part of patient-centric healthcare teams have been shown in clinical settings ranging from hospitals to the Department of Veterans Affairs. A healthier population, in turn, should help drive down healthcare costs by keeping patients healthier and out of the emergency room and hospital. Furthermore, having a pharmacist manage medication therapy for the most complicated patients increases access to health care, as it frees up the physician to see more patients.
Pharmacy students and residents benefit from the program as well, since the clinics provide training for a diverse population and a wide range of diseases and conditions. For the faculty members who provide services, the clinics also offer opportunities for research and to collect crucial data regarding health outcomes, medication safety, health literacy and cultural competency that ultimately will lead to further advances in care.
Increasing the number of clinics and medical homes where students and residents are trained also is important because the more exposure they gain to such facilities, the more likely they’ll choose to dedicate their careers to helping people in these settings, according to Vanderveen.