PHARMACY

Report: Catalyst Rx case study justifies Walgreens PBM network inclusion

BY Michael Johnsen

ROCKVILLE, Md. — Catalyst Rx, the pharmacy benefits management subsidiary of Catalyst Health Solutions, on Friday took out a full-page ad in the Wall Street Journal touting the value of a Walgreens pharmacy to a large healthcare payer. Catalyst also released a case study touting that value, according to a DrugChannels.net report.

According to that case study, Walgreens achieved a generic utilization rate of 69% versus 67.7% for all other chains in the area, resulting in a cost-per-script savings of $3.30.

"Excluding Walgreens from the case study client pharmacy network would cause significant member disruption, create potential gaps in patient care and impact costs to the client, its employees, retirees and their dependents," Catalyst Rx stated. "As with all of our participating pharmacy partners, we recognize the services and the value delivered by Walgreens to its local community residents and are pleased to continue to include them in our network in 2012."

For a copy of the case study, click here.

Catalyst Rx in June completed its acquisition of Walgreens’ pharmacy benefit management subsidiary.

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Medi-Cal reimbursement cuts of 10% opposed by pharmacy

BY Michael Johnsen

ALEXANDRIA, Va. — The National Association of Chain Drug Stores and the National Community Pharmacists Association jointly spoke out Friday against cuts to California’s Medicaid program Medi-Cal, which will be retroactive to June 1.

“We are extremely disappointed with the unconscionable Medi-Cal reimbursement cuts proposed by the state and approved by HHS," the associations stated. "If left in place, we believe that these reductions would greatly harm millions of Californians by effectively reducing their access to community pharmacies and the healthcare system as a whole. The impact in terms of compromised health outcomes for patients or delayed access to needed services could be significant."

And that significance will be amplified in 2014, when another 3 million to 5 million Californians are expected to enroll into the Medi-Cal program through the Affordable Care Act. "The cuts approved by [the Centers for Medicare and Medicaid Services] today are a complete contradiction to the ACA and makes you wonder if anybody between the Obama administration and Health and Human Services Agency are talking before these decisions are made,” stated Jon Roth, CEO for the California Pharmacists Association.

Specifically, three proposals expected to save $623 million collectively were approved last week:

  • A 10% provider payment reduction on a number of outpatient services, including physicians, clinics, optometrists, therapists, laboratories, dental, durable medical equipment and pharmacy;

  • A new 10% provider payment reduction for freestanding nursing and adult subacute facilities; and

  • A 10% provider payment reduction and rate freeze for distinct part/nursing facility-B services.

NACDS and NCPA outlined four points as to how the Medi-Cal cuts will generate negative outcomes:

  • First, community pharmacists provide expert medication advice and promote cost-saving generic drugs. … Patient access will likely suffer as many pharmacies may be forced to cease filling prescriptions and providing counseling to these patients for fear of jeopardizing their pharmacy’s financial viability;

  • Second, we believe that the Medi-Cal cuts will mean fewer jobs and local tax revenue at the worst possible time for the state’s economy. Pharmacy reimbursement by public and private health plans has already been declining for many years. These cuts could be the tipping point that forces community pharmacies to scale back operating hours, employee hours or to close altogether;

  • Third, these short-sighted cuts could very well backfire and ultimately increase costs for California and the federal government. Pharmacy services are arguably the best value in health care. As a result of the diminished pharmacy access these cuts will trigger, patients will likely either endure greater and costlier health problems or have to turn to more expensive providers, such as emergency rooms for the medication and counseling they need; and

  • In addition, it is surprising and disappointing that the federal and state officials involved have acted with such disregard to the judicial system, with a related case pending before the U.S. Supreme Court. No one should presume the outcome of the case of Douglas v. Independent Living Center of California and the federal review of California’s proposed cuts should never have been concluded while the case is active.

The Douglas v. Independent Living Center questions whether Medicaid recipients and providers can sue a state that does not pay the reimbursement rate required by the Medicaid Act. The Supreme Court heard oral arguments in that case Oct. 3. A transcript of those arguments are available here.
 
“Community pharmacists can work with states to reduce healthcare costs by eliminating needless medical expenses and increasing appropriate generic drug use," NACDS and NCPA stated. "As state and federal healthcare officials begin to realize the consequences of these actions, it is our hope that they will go back to the drawing board to develop a more practical budget approach.”

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Obama issues executive order to address drug shortages

BY Alaric DeArment

WASHINGTON — President Barack Obama issued an executive order Monday to address the growing problem of drug shortages.

The order directs the Food and Drug Administration "to take action to help further reduce and prevent drug shortages, protect consumers, and prevent price gouging." Specifically, the FDA is directed to broaden reporting of potential shortages of certain prescription drugs and expand efforts to expedite review of new manufacturing sites, suppliers and manufacturing changes. The order also directs the FDA to work with the Department of Justice to find out whether wholesalers and other companies have responded to potential shortages by illegally hoarding medications or raising prices.

Other actions include plans by the administration to send a letter to drug manufacturers encouraging them to report discontinuation of certain drugs to the FDA and notify the agency of potential prescription drug shortages. It will also increase staffing resources for the FDA’s Drug Shortages Program.

"We applaud the president’s initiative in issuing this executive order and believe that through continued multi-stakeholder collaboration, we can put a stop to this problem," GPhA president and CEO Ralph Neas said. "No patient should ever be denied treatment because the needed medicine is in short supply."

Sen. Amy Klobuchar, D-Minn., and Rep. Diana DeGette, D-Colo., recently introduced legislation that would require disclosure of all prescription drug shortages and give the FDA new authority to enforce those requirements.

***This story updates the story posted Monday morning titled "Report: Obama to sign executive order to address drug shortages."


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