PHARMACY

University of Nebraska Medical Center implements outcome-oriented treatment model with Walgreens

BY Michael Johnsen

KEARNEY, Neb. — In collaboration with Walgreens, the University of Nebraska Medical Center on Wednesday unveiled a new treatment model to help positively impact clinical outcomes for hypertension and Type 2 diabetes patients through a program made possible by a National Association of Chain Drug Stores Foundation grant. 

“This collaboration takes the clinical and practical relationship to a whole new level by helping to create a key communication stream,” stated Donald Klepser, assistant professor of pharmacy practice at UNMC, and the study’s primary investigator. “It’s a more economical utilization of healthcare resources — and takes better advantage of a pharmacist’s expertise.” 

UNMC approached Kearney Clinic because of its innovative approach to care with electronic medical record technology and a patient-centered medical home model. Typically, patients are seen once every six months. To help gain a better understanding of what happens after seeing a doctor or being prescribed medication, the pilot will track select patients’ activity and progress. “It’s research like this that will inform and shape how we practice,” commented Ken Shaffer, pediatrician at Kearney Clinic.  

Walgreens pharmacists will fill participants’ prescriptions, and provide a comprehensive medication review to address any patient questions or concerns, identify possible interactions and help improve adherence. In addition, pharmacists will offer free blood pressure testing each time medications are picked up, tracking results for each patient. If refills are late or never picked up, that information will be shared with the clinic for follow-up by a physician. The project will utilize the Nebraska Health Information Initiative, a statewide bilateral information sharing portal, which will allow physicians and community pharmacists to safely and easily share data across clinical settings.   

The two-year initiative begins April 1 and is focused on increasing communication between community pharmacists and physicians to help improve patient care and medication adherence. Potential candidates for the program are currently being enrolled.

Walgreens is working with UNMC, Kearney Clinic, Blue Cross and Blue Shield of Nebraska and Nebraska Health Information Initiative, Nebraska’s statewide health information exchange, on introducing the program.

The NACDS Foundation awarded UNMC a $369,000 grant to study the potential impact on patient health by incorporating community pharmacy-provided medication management strategies into existing patient-centered care teams, such as medical homes and accountable care organizations. 

 

 

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NACDS responds to WSJ article citing cynicism, inaccuracies

BY Antoinette Alexander

ARLINGTON, Va. — A recent Wall Street Journal article, “10 Things Drugstores Won’t Tell You,” has caught the attention of National Association of Chain Drug Stores president and CEO Steve Anderson, who responded to the article by saying that it put sensational headlines and statements ahead of the facts, thus depicting pharmacies inaccurately.

The original article was published in the March 17 edition of WSJ that was distributed through other regional and local newspapers. The WSJ does not publish letters to the editor regarding articles distributed in this format. However, at the suggestion of a WSJ editor, NACDS was encouraged to engage in the dialogue online, and therefore, NACDS posted its comments online in response to the article.
 
The text of the response is below:
 
The “10 Things Drugstores Won’t Tell You” might make a good headline, but this cynical piece incites an inaccurate portrayal of pharmacies, rather than emphasizing how they can help patients improve their quality of life.  
 
One blatant inaccuracy is “Pharmacists at the clinics … provide services people once turned to their primary care physician for,” such as physicals. Fact: Clinics provide patient services that are administered by nurse practitioners or doctors — not pharmacists.

What is probably another eye-catching headline is just another falsehood: “You say cold symptoms? We say meth addict.” This assumption is irresponsible and erroneous. Fact: Pharmacies are subject to federal and state laws in selling pseudoephedrine (PSE) products. They do not assume their patients are “meth addicts.”
 
Consumers are “better off” when they work with their pharmacy to help stay healthy. Fact: A well-researched “10 Things Drugstores Do for Patients Every Day” would better serve patients instead of snappy headlines and unsubstantiated assumptions.
 

Commenting further on the matter, Anderson stated, “It is unfortunate that this article undervalues the important role of pharmacies when so many patients rely on them to stay healthy and make their health care more affordable. As the face of neighborhood health care, pharmacies help patients use medicines safely, as well as providing vaccinations, disease testing and other patient care services. Every opportunity a pharmacist has to interact face to face with a patient is an opportunity to help a patient feel better or live better. There is no substitute for that personal interaction.”

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Va. governor signs first state bill to limit biosimilars

BY Alaric DeArment

WASHINGTON — Gov. Bob McDonnell of Virginia has signed into law the first bill that could limit the reach of follow-on biologics, though the bill includes a two-year sunset clause, meaning it will expire in 2015.

McDonnell signed House bill 1422 and the identical Senate bill 1285, which would prevent a pharmacist from dispensing a biosimilar to substitute for the original, branded biologic if the prescriber indicated that substitution was not allowed or if the patient insisted on receiving the branded product.

It would also require the pharmacist to inform the patient before dispensing and record the name of the product and its manufacturer on the dispensing record and prescription label. In addition, pharmacists would be required to provide cost information for the reference product and the biosimilar to the patient.

While praising the bill’s sunset clause, saying it meant the bill would likely expire before any Food and Drug Administration-approved biosimilar became available, the Generic Pharmaceutical Association, a trade group that represents generic drug companies, criticized the bill.

“The law signed today in Virginia to allow for the substitution of biosimilars in that state, while well intentioned, is pre-emptive, and carries burdensome administrative ‘red tape’ that threatens the positive impact biosimilars will have in Virginia," GPhA president and CEO Ralph Neas said.

Similar laws have been working their way through the legislatures of other states, such as Colorado and Florida, and could stand in the way of full implementation of the biosimilar approval pathway that passed as part of the Patient Protection and Affordable Care Act. While the healthcare-reform law created the conditions for an abbreviated pathway for biosimilars, similar to the one created for generic drugs with the Hatch-Waxman Act of 1984, it is up to the FDA to create the specific regulations, which the agency is still in the process of doing.

Biotech companies have supported the state laws, saying they are necessary to promote patient safety. They say that unlike generic drugs, which are required to be identical to their branded counterparts, slight changes to a biologic drug — such as generic differences between the cell lines used by the creator of an original biologic and those used by the creator of a biosimilar — can dramatically change its properties and therefore its safety and efficacy profile.

But generic drug companies, which strongly backed the abbreviated pathway for biosimilars, dispute the biotech industry’s view.

"The push for these new measures has nothing to do with safety and everything to do with Amgen and Genentech, two biotech Goliaths, trying to thwart competition," Neas said. 

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