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Senators call for oversight on preferred pharmacy networks

BY Alaric DeArment

WASHINGTON — Medicare Part D plans that create tiered networks of pharmacies for beneficiaries need more oversight amid reports that small and medium-sized pharmacies are being excluded from them, several senators wrote in a letter last week to the Centers for Medicare and Medicaid Services.

The letter, addressed to acting CMS administrator Marilyn Tavenner, said that exclusion from the networks meant that the pharmacies were unable to offer comparable costs for seniors to fill prescriptions, raised concerns that the networks could raise Medicare Part D costs and adversely affect beneficiaries’ access to pharmacies, especially in rural areas. CMS is in the process of reviewing Medicare plans for 2014 approval.

"Please review the agency’s plans to ensure preferred networks are implemented in a manner that is consistent with the Medicare Modernization Act," the senators wrote in the letter. "We respectfully request that you inform us of your findings, and of steps that have been put in place to ensure Medicare plans using preferred networks are providing high quality of care for Medicare beneficiaries while maintaining access to prescription drugs and not increasing overall Medicare costs."

Under preferred networks, most pharmacies can participate as "network" pharmacies in order to satisfy Medicare’s geographic access requirements, but only some may participate as a "preferred" pharmacy that can offer the plan’s lowest advertised co-pays, and most plans do not allow independents to participate as preferred pharmacies.

“Momentum continues to build within CMS itself and on Capitol Hill behind the need for increased oversight and scrutiny of preferred networks in Medicare Part D, and we appreciate the work of legislators and agency officials alike who are keeping their eye on the ball of meeting beneficiary needs,” National Association of Chain Drug Stores president and CEO Steve Anderson and National Community Pharmacists Association CEO B. Douglas Hoey said in a joint statement.

In March, 31 members of the House of Representatives — including many representing rural areas in states like West Virginia and Montana — wrote to CMS expressing concern from Medicare beneficiaries and small business owners about Medicare Part D plans featuring preferred networks. Pembroke Consulting president Adam Fein wrote in October that he expected such networks to "make a big splash" in 2013.

Meanwhile, the Pharmaceutical Care Management Association, a trade group representing the pharmacy benefit manager industry, has defended the networks, saying they lower costs, citing data from CMS.

The signatories to the recent letter were Sens. Sherrod Brown, D-Ohio; John Thune, R-S.D.; Tom Coburn, R-Okla.; Thad Cochran, R-Miss.; Richard Durbin, D-Ill.; Michael Enzi, R-Wyo.; Chuck Grassley, R-Iowa; Heidi Heitkamp, D-N.D.; John Hoeven, R-N.D.; James Inhofe, R-Okla.; Tim Johnson, D-S.D.; Amy Klobuchar, D-Minn.; Jeff Merkley, D-Ore.; Jerry Moran, R-Kan.; Jon Tester, D-Mont.; and Roger Wicker, R-Miss.


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Study finds large numbers of students abuse prescription drugs to cope with stress of finals

BY Alaric DeArment

WASHINGTON — Finals can be a stressful time for any college or graduate student, with many hours spent studying and few spent socializing or relaxing. But many students are using prescription drugs to get through finals, according to a new study.

the 621-person study, commissioned by the Digital Citizens Alliance and conducted by Zogby Analytics, found that one-in-three students reported taking prescription drugs to get through finals. The study included two online surveys conducted April 29-30, one with 366 current college students and recent graduates and a margin of error of plus or minus 5.2 percentage points and another with 355 parents of students and recent graduates and a margin of error of 5.3 percentage points. The Digital Citizens Alliance is a Washington-based group whose goal is to educate the public and policymakers on threats to consumers on the Internet.

"It’s the rampant abuse that can cause serious health complications and even death," Digital Citizens Alliance executive director Tom Galvin. "Too many young adults are learning a terrible lesson to self-medicate to get through stressful, challenging moments."

Nearly one-quarter of respondents said they or a friend had shared legally prescribed drugs with someone else and perceived the practice as common; 71% of parents regard it as common as well. Fifteen percent of students have ordered drugs online without a prescription or know a friend who has. More than 40% of parents of current or recently graduated students say law enforcement isn’t doing enough to curb the illegal sale of prescription drugs online, compared with more than 17% who say it is.

 

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Patients under doctor’s care more proactive

BY Jason Owen

Not surprising, the majority of respondents who visit the doctor report that they are proactive about their health, according to an online survey of almost 700 AccentHealth viewers conducted in April. And about one-third of respondents indicated that they were "very proactive" about their health.

To see more Patient Views, click here.

Patient Views is a new, exclusive consumer insights feature that appears in every edition of DSN magazine, as well as the daily e-newsletter DSN A.M. If you could ask 6,000 patients anything at all, what would it be? Send your questions to [email protected].

Source: AccentHealth. To view the demographic breakdown of participants, click here.

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