QS/1, CoverMyMeds partner on prior authorization automation
SPARTANBURG, S.C. – Pharmacy technology provider QS/1 has entered a contract with CoverMyMeds to automate a process often required by insurers to dispense specialty drugs.
QS/1 said it entered a partnership with CoverMyMeds to automate the prior-authorization process, required for 90% of specialty drugs on the market.
"A pharmacist can spend a lot of time cutting through the red tape to get these prescriptions filled," QS/1 pharmacy market analyst John Frady said. "CoverMyMeds helps cut down on that work load by automating the process."
CoverMyMeds allows physicians and pharmacists complete prior authorization and other insurance coverage determination forms for any drug and most drug plans, developing online and phone-based systems that make the process faster and easier.
"The best thing about this plan is, it doesn’t cost the pharmacies a penny to use," Frady said.
FDA accepts application for GERD drug in children
WOODCLIFF LAKE, N.J. — The Food and Drug Administration will review an acid-reflux drug made by Eisai for use in children, the drug maker said.
Eisai said the FDA accepted its application for AcipHex delayed-release sprinkle capsules in the 5-mg and 10-mg strengths for healing of gastroesophageal reflux disease, and maintenance of healing of GERD and improvement of symptoms in children ages 1 year to 11 years.
The FDA expects to have the application reviewed by March 27, 2013. The drug is currently approved in the 20-mg strength for adolescents and adults.
Surprise! Rx medicines lower overall health costs
Amid the glacial pace of change in government and health policy, congressional number crunchers have finally acknowledged an indisputable fact long known to health and pharmacy experts: prescription medicines save money.
It seems obvious enough. But it was only last week, near the end of November, that the Congressional Budget Office unveiled the results of a new study showing that greater prescription drug access and utilization can reduce health care costs in other areas, including hospitalizations.
To put it in the CBO’s own words, “Greater prescription drug use by Medicare beneficiaries reduces Medicare’s spending for medical services.” Researchers based that conclusion on a review of dozens of recent studies of the impact of prescription drug therapy on hospitalization rates and other outcomes.
Better late than never. The CBO’s report, “Offsetting Effects of Prescription Drug Use on Medicare’s Spending for Medical Services,” is a step beyond previous CBO studies “that found insufficient evidence of an ‘offsetting’ effect of prescription drug use on medical services spending,” says Drug Store News reporter Alaric DeArment in a Nov. 30 report.
The savings found in the CBO study aren’t much. “CBO estimates that a 1% increase in the number of prescriptions filled by beneficiaries would cause Medicare’s spending on medical services to fall by roughly one-fifth of 1%,” the agency reports. But its findings are based on only a narrow set of criteria tracking the correlation between increased drug utilization and overall medical savings. And as independent pharmacy leader Doug Hoey noted last week, “CBO’s new analysis represents the tip of the iceberg in terms of the savings independent community pharmacists can produce for Medicare and other health plans.
"CBO examined only the quantity of prescriptions filled, not the qualitative benefits of strong patient-pharmacist relationships in helping patients take their medication appropriately,” said Hoey, CEO of the National Community Pharmacists Association.
I’d like to hear other examples of how prescription drug therapy and medication therapy management – delivered in person by pharmacists – is helping patients lead healthier lives and stay out of the hospital. Please share your experiences and your thoughts about the validity and scope of the CBO’s findings.