PBMI’s Specialty Drug Benefit Report benchmarks specialty pharmacy trends
PLANO, Texas — The Pharmacy Benefit Management Institute recently released its Specialty Drug Benefit Report, sponsored by Walgreens Specialty Pharmacy. The 2014 edition highlights trends important to specialty pharmacy, including emerging cost-control strategies and challenges affecting benefit design and patient care.
"I was struck by the results on employer perceptions of pharmacy outlets for specialty drugs," noted Adam Fein, president Pembroke Consulting, in a Drug Channels blog on the release. "Employers think specialty pharmacies provide better pharmacist access and lower costs. However, they also think retail pharmacies are comparable for clinical services — and that surprised me."
Retail drug stores are also seen as better at providing access to copayment programs, Fein noted.
The report is based on survey respondents from 337 U.S. employers, representing more than 14.3 million lives. For the first time, the survey asked questions specifically about medical and pharmacy benefits, including key opportunities and challenges facing specialty pharmacy management. This is important because it reflects rapidly changing site-of-care dynamics and will better enable PBMI to assess and report on future trends.
NCPA applauds proposed legislation to reform pharmacy audits
ALEXANDRIA, Va. — Two Florida lawmakers have introduced legislation in the Florida State Senate and Florida House of Representatives, respectively, that aims to apply standards to pharmacy audits and rein in practices that could negatively impact patient care, small business community pharmacies and state revenue. The legislation has received a nod of approval from the National Community Pharmacists Association.
State Sen. Aaron Bean, R-Jacksonville, has introduced SB 702 and State Rep. Travis Cummings, R-Orange Park, has introduced the Pharmacy Audit Bill of Rights (HB 745).
“With SB 702, there can be clear guidelines of acceptable audit practices of our pharmacies,” Bean said. “I am hopeful these guidelines will result in better health care for all Floridians.”
“I feel it is important that Florida remains a state that champions small business rights by removing unnecessary burdens that could otherwise jeopardize their future and those that use their service,” Cummings said. “The auditing process can be very burdensome and arduous on pharmacies, especially small independent pharmacies. The bill establishes the ‘rules of engagement’ for the auditing process because right now there are none. HB 745 will establish fairness while still maintaining a high standard of service for the consumer, and I look forward to working to pass this much needed legislation in the State of Florida.”
“It should not be a punishable offense when a pharmacist dispenses the right medication as prescribed to the right patient at the right time and for the agreed-upon reimbursement,” stated NCPA CEO B. Douglas Hoey. “Yet across the Sunshine State, pharmacists are struggling with egregious audits focused on hyper-technical clerical issues. These time-consuming reviews limit pharmacists’ ability to care for patients. In addition, auditors seek any excuse, no matter how small, to take thousands of dollars away from pharmacies and local communities and send them out-of-state to Fortune 500 pharmaceutical middlemen.”
“This legislation will allow reasonable pharmacy audits to continue in order to guard against waste, fraud and abuse,” Hoey said. “NCPA is proud to support the work of the Florida Pharmacy Association, PPSC and all Florida pharmacists in this effort. We commend Senator Bean and Representative Cummings for their leadership and encourage their colleagues to support this legislation.”
Rather than using the audit process to guard and protect against fraud, many PBMs view audits as a profitable revenue stream for their company, the NCPA stated. Community pharmacies are often forced to pay thousands of dollars as the result of an audit for nothing more than basic clerical or typographical mistakes, many of which are not the fault of the pharmacist or pharmacy staff. Twenty-nine other states have recently enacted bipartisan legislation similar to the Florida proposals.
Florida is home to more than 445 independent community pharmacies that employ approximately 4,405 residents.
USA Today article highlights scope of service expansion at nation’s pharmacies
The nation’s pharmacies are no longer just for prescription medications and states are proving to be the enablers to a broader the scope of practice.
In light of the evolving healthcare landscape, USA Today published an article on Friday about how pharmacists are increasingly working with doctors to assess patients, identify drug interactions and medication errors and, in some cases, even write a prescription.
Illustrating its point, the article features Diana Arouchanova, who owns Clinicare Pharmacy, who recently discovered that one of her patients had been prescribed by her doctor a dangerous combination of two medications. After discovering the error, Arouchanova got the doctor to change the prescription and started checking her patient’s high blood pressure to ensure it dropped.
As the article notes, several states such as California are giving pharmacists greater flexibility. In October, California Gov. Jerry Brown signed into law a provision that allows pharmacists to perform physical assessments; order and interpret laboratory tests; refer patients to other providers; start, adjust and terminate medications under physician protocol; and work with other healthcare providers to evaluate and manage a patient’s health issues.
Other states, including New Mexico and North Carolina, also allow pharmacists to take on more clinical responsibilities, USA Today noted.
The article also mentions that CVS Caremark is a prime example of how pharmacies are taking on a greater role in promoting good health by deciding to stop selling tobacco products in all of its stores.