Pharmacy Newsroom is AAP's information resource for independent community pharmacies. We highlight news about new medications, pharmacy legal issues and tips to grow your independent pharmacy business.
The Medicare Open Enrollment period is a critical time for patients and pharmacists alike. As more Baby Boomers become eligible for Medicare, the beneficiary population is expected to increase from over 65 million beneficiaries today (as of March 2023) to over 80 million beneficiaries by 2030. Now more than ever, pharmacists must take an active role during Open Enrollment by offering services that help patients understand their plan options. Equipping yourself with the right knowledge could mean a tremendous amount of money saved for both your pharmacy and patients. As you plan to help your patients with navigating their options for the coming year, here are a few things to know:
National and state news affecting independent pharmacies
National Pharmacy News
This week, PBM’s were in the spotlight at the Capitol. During the House Committee on Oversight and Accountability hearing about PBMs, lawmakers from both sides of the aisle agreed that PBMs have too much power and very little transparency.
“Instead of fierce competition, now just three PBMs control 80% of the market, and each of the three major PBMs is owned by a major health insurer and owns or is owned by a pharmacy,” stated committee Chair James Comer (R-Ky.). “This means that when they negotiate with a health insurer, they are either negotiating with themselves or one of their direct competitors. The committee has made it a priority to expose the anticompetitive tactics by PBMs that are increasing healthcare costs for Americans and harming patient care.” Read more about the hearing.
State Pharmacy News
Florida: Florida lawmakers approved the rules to implement several provisions of the Prescription Drug Reform Act (SB 1550). The rules increase accountability among PBMs. They include all application forms for PBMs seeking to operate in Florida in 2024. Any PBM that attempts to continue operating in Florida next year, and has not been approved as an insurance administrator, can be fined up to $10,000 per violation per day. Read more.
Washington: The Washington State Pharmacy Association (WSPA), NCPA, and NACDS are celebrating a settlement of a six-year lawsuit with the state of Washington. The state agreed to these terms among others:
Conduct a cost of dispensing study to move to cost-based dispensing fees
Provide more than $60 million in retroactive payments to pharmacies in Washington State’s fee-for-service Medicaid program
Use, for now, Oregon’s cost-based dispensing fees and tiers from July 1, 2023, going forward, until a new cost-based dispensing fee obtains necessary state and CMS approval.
Registration is now open for the 2024 AAP Annual Conference. All independent and community pharmacies are invited.
Join us in “America’s Finest City”- San Diego, April 4-6.
Springboarding off last year’s hugely successful event, the 2024 AAP Annual Conference is built around YOU! Our goal is to make sure you increase your knowledge, develop new strategies and learn useful tips you can use when you get back to your store. Our program features an informative lineup of speakers from across the country, educational CE sessions and a diverse collection of exhibitors.
And new this year, you have a chance to win $10k, $15k or $25k in API Warehouse credit! Details can be found here.
The 2024 AAP Annual Conference will be hosted at the Town & Country Resort. This stylish mid-century themed hotel is centrally located to all that San Diego has to offer.
The property is adjacent to luxury shopping and golf, and within minutes of the airport, beautiful beaches, hiking, biking and world-class attractions.
With five lively restaurants and a lounge, three pools, Twister the 4-story waterslide, sand volleyball court, and fire pits, you will have plenty to do during your downtime.
FDA approved updated versions of the Covid-19 vaccines made by Moderna and Pfizer as hospitalizations rise.
The vaccines are approved for those 12 years and up and are authorized under emergency use for those six months and up. A different vaccine made by Novavax is currently under review with the FDA for use in ages 12 and up.
Health experts will meet this week to discuss recommendations for using the new vaccines and are expected to be available by mid-September.
For these shots to reach the public, the CDC has to make an official recommendation, which could come as soon as Tuesday.
In June, US health officials told drugmakers to reformulate shots in time for fall that would protect against the XBB.1.5 subvariant that accounted for about 40% of Covid infections at the time.
Pfizer and Moderna have both said their updated shots also protect against EG.5, currently the most widely circulating variant.
In a plan to reduce costs, Reuters is reporting that Walmart is asking some of its 16,000 pharmacists across the country to voluntarily take pay cuts and reduce their work hours. The cuts, which are aimed at pharmacists in higher wage brackets, show how current demand for expensive weight loss GLP-1 medications, coupled with Walmart’s $3.1 billion opioid settlement, are adding to the company’s financial woes.
Walmart states that it was reducing the number of hours it was offering some pharmacists, claiming a drop-off in demand for medications during the summer and requests from pharmacists for a less demanding job. Read more.
CMS selects first drugs for Medicare price negotiation
The Centers for Medicare & Medicaid Services has released the first ten drugs that will be available for price negotiation under Medicare Part D. Under the Inflation Reduction Act, Medicare will be able to negotiate the prices of prescription drugs with participating drug companies beginning this year and in 2024, which will become effective in 2026.
HHS officials call for reclassification of marijuana to Schedule III drug
Bloomberg is reporting that officials with the U.S. Department of Health and Human Services are recommending easing restrictions on marijuana and reclassifying it under the Controlled Substances Act. A top official with the department wrote a letter to a Drug Enforcement Agency administrator saying that marijuana should be classified as a Schedule III drug, which means it has a low potential for abuse. Marijuana is currently a Schedule I drug, meaning it has no medically accepted use and a high potential for abuse. The decision to reclassify marijuana resides with the DEA, which could take months to complete its evaluation.
The Food and Drug Administration has issued a one-year delay on the final enhanced drug distribution security requirements under the Drug Supply Chain Security Act (DSCSA). Those requirements were set to take effect in November. The new date will be Nov. 27, 2024.
The decision to delay the DSCSA requirements was made after several advocates warned the FDA that the supply chain was not ready to comply. The extended time aims to allow each sector of the pharmaceutical supply chain time to develop the systems and processes necessary for efficient transactions. Read more.
According to the Centers for Disease Control, new COVID vaccines are expected in September. Vaccines from Moderna, Pfizer and Novavax will be designed to target omicron subvariant XBB.1.5.
Those vaccines still need approvals from the Food and Drug Administration and the CDC, which will form eligibility guidelines.
The arrival of updated vaccines offers some peace of mind to Americans as the U.S. sees an increase in COVID cases and hospitalizations. The current surge appears to be fueled by newer strains of the virus like EG.5, or Eris, an omicron subvariant that accounted for 17.3% of all cases as of last week, according to the CDC.
But the efficacy of the new COVID vaccine boosters is unknown against another new omicron strain of the virus called BA.2.86, which has been identified in a very small number of cases in the U.S., U.K., Denmark and Israel. Read more.
To order your vaccine program supplies from API Warehouse, like gloves and syringes, click here.
After announcing last week that it was selling off Winn-Dixie and Harveys Supermarkets to Aldi, and Fresco y Más to an investment company, the news broke this week that Southeastern Grocers is selling the pharmacy business to CVS and Walgreens.
According to internal emails obtained by the Tampa Bay Times, Southeastern Grocers told its pharmacists that it will sell all of its Winn-Dixie and Harveys pharmacy business by the end of the year.
“Prior to the closing of the proposed merger agreements recently announced, Southeastern Grocers has entered into agreements to transfer prescription files to certain CVS Pharmacies and Walgreens,” confirmed Southeastern Grocers communication director Meredith Hurley in an email. Read more.
AAP is helping our Members prepare for the 2024 DIR Fee Hangover
According to a survey by NCPA, approximately 98 percent of pharmacists are concerned about the upcoming 2024 DIR fee hangover and the impact it could have on their pharmacies. Many are even worried that it could lead to pharmacy closures. So, the time to prepare is NOW!
Here are five useful tips to help you prepare.
#1. According to NCPA, the first tip for preparing for the DIR fee hangover is going back to your accounting basics and understanding your cashflow.
There are many key performance indicators, or KPIs, in pharmacy. One cash flow KPI is the Current Ratio, which is current assets divided by current liabilities. How you classify those current assets and liabilities is vital to an accurate ratio. The industry average is around 2.5 to 1, so $2.50 of cash, receivables and inventory for every $1 of current debt. It is wise to know your ratio and aim for a 3 or 3.5 to 1 current ratio going into 2024. This would give you a cash flow cushion to hopefully weather any DIR unknowns.
#2. Our second tip to help you thrive during the 2024 DIR hangover is by increasing your gross margin. The average pharmacy gross margin is anywhere from 23-24%. Increasing this margin will go a long way to improving your cash flow.
One way to increase revenue is to find niches markets, such as women’s health, travel vaccines, pet meds, or nutritional supplements, to fill the holes in your community’s healthcare. Offering unique services to your patients will go a long way to improving your gross margin.
#3. You can find our third tip in the EnlivenHealth DIR Fee Hangover Playbook. To predict the DIR fees that PBMs will attempt to collect in the first quarter of 2024, look at the DIR fees collected from the same timeframe in 2023. (This should be easy to do in your third-party reconciliation platform.) Once you have that number, set it as your savings benchmark. That’s the amount of cash you need to set aside by the beginning of 2024 to avoid the sting of the DIR Fee Hangover.
#4. Our fourth tip is keeping your expenses in check. Your expenses are one of the most important factors to your cash flow and bottom line. When you are trying to figure out the best ways to combat the DIR hangover, your time is best spent focusing on the expenses that will make a big impact: cost of goods sold and wages.
Maximize your PVA
Make sure you are maximizing your purchasing with your Prime Vendor Agreement (PVA). AAP now offers multiple options for stores to help create a buying plan to fit your needs. A good PVA can increase your margin percentage. Contact our team to see which PVA option is right for you.
Keep wages in check
Technology and automation are two ways to help run payroll effectively. Check out the AAP Preferred Partners to see if any of them can help with your store’s needs.
#5. Our fifth tip is to open a business line of credit. If you are worried about cash flow next year, it can be a useful tool to have available for short-term cash flow issues.
Funds are typically drawn from the line of credit by using a business checking account, a small business credit card or even a mobile banking app.
But a word of caution, these can be dangerous cash flow tools in a pharmacy because they are NOT free money. Lines of credit are usually higher-interest debt. These are not mid- or long-term debt cash flow solutions for a pharmacy, and you shouldn’t rely on them for those needs.
Any time access to a line of credit is utilized, there must be a plan in place on how and when it will be paid back. Long-term cash flow issues within a pharmacy should not be addressed with short-term debt solutions such as a line of credit.
If we learned anything from the COVID-19 pandemic, it’s that independent pharmacists are innovators. Preparing now will help you thrive in 2024.
The Teamsters Union members voted to approve the tentative contract agreement reached last month, ending contentious labor negotiations that threatened to disrupt package deliveries for thousands of pharmacies nationwide.
The Teamsters said in a statement that within the highest voted election ever, 86% of the votes casts were in favor of ratifying the contract.
The union ratified more than 40 supplemental agreements except for one that covers about 170 members in Florida. The national master agreement will go into effect as soon as that supplement is renegotiated and ratified, it said.
UPS said voting results for contracts covering employees under two local unions are expected soon. The new contract sets a new standard for pay and benefits.
“Our members just ratified the most lucrative agreement the Teamsters have ever negotiated at UPS,” Teamsters General President Sean M. O’Brien said in a statement. “This contract will improve the lives of hundreds of thousands of workers.” Read more.
Moderna’s updated COVID-19 vaccine is effective against Eris variant
In this Weekly Rx Roundup, Moderna reports an initial study data showed its updated COVID-19 vaccine to be effective against the “Eris” and “Fornax” subvariants in humans.
The company expects the updated shot to be available, pending approval from the FDA, in the coming weeks for the fall vaccination season.
Pfizer has reported that its updated COVID-19 shot showed success at neutralizing activity against the Eris subvariant in a study conducted on mice. Pfizer has yet to complete its study in humans.
Eris, the nickname for EG.5, is a sub-lineage of the still-dominant Omicron variant. EG.5 accounted for about more than 17% of COVID-19 cases in the U.S., according to the latest government data. Infections from Fornax, officially known as FL 1.5.1, are also rising across the country.
Two big PBM stories in this Weekly Rx Roundup
Shares of CVS Health plunged 8% on Thursday after Blue Shield of California said it will drop the company’s pharmacy benefit management services and instead partner with Mark Cuban’s Cost Plus Drugs company and Amazon Pharmacy to save on drug costs for its nearly 5 million members.
The announcement hints at the potential for health insurers to abandon the traditional pharmacy benefit manager, or PBM, system and sent shares of other companies that offer PBM services lower.
CVS Health’s Caremark has been Blue Shield’s PBM partner for more than 15 years.
The other big story is that the United States Tenth Circuit Court of Appeals on Tuesday issued an unfavorable decision in the Pharmaceutical Care Management Association (PCMA) v.Mulready appeal.
The decision overturns Oklahoma’s effort to regulate pharmaceutical benefit managers (PBMs) – and likely would have implications for other states as well. The ruling allowing PBMs to escape certain state regulation by hiding behind the alleged preemption of that law by federal ERISA and Medicare Part D laws.
“The Tenth Circuit decision is inconsistent with what other federal courts have decided, and it departs from the Supreme Court’s unanimous Rutledge decision, which clearly held that PBMs can’t hide behind ERISA. It must be overturned,” said B. Douglas Hoey, CEO of the National Community Pharmacists Association.
AAP is following this story closely and will keep you updated as it unfolds.
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Micro Merchant Systems is a pharmacy technology company that has been providing exceptional management solutions to the Independent Pharmacy Market for 30 years. Thousands of pharmacies throughout the U.S trust their PrimeRx™ system to manage their Retail, Long-Term Care, Specialty, Compounding, 340B, Mail order, Physician’s office, Hospital & Health System Outpatient, and Hub Service Pharmacy technology needs.
Micro Merchant Systems Windows-based PrimeRx™ Pharmacy Management System serves as a local or hosted platform for their innovative solution offerings. At Micro Merchant Systems, they offer products, services, APPs, APIs, and vendor interfaces to keep the pharmacy running at the peak of performance.
For more information, please email Micro Merchant Systems at sales@micromerchantsystems.com or call (866) 495-3999 to set up a PrimeRx™ Demo. Visit online at www.micromerchantsystems.com.
The Food and Drug Administration approved the first-ever pill for postpartum depression. In trials, the treatment improved depression symptoms among new mothers as early as three days after they started the medication.
The medication, called zuranolone, is taken daily for two weeks. In clinical trials involving women who experienced postpartum depression, the drug improved symptoms — such as anxiety, difficulty sleeping, loss of pleasure, low energy, guilt or social withdrawal. Read more.
By understanding the independent pharmacy business, we can work to make the most of our distinct advantages to meet consumer needs
McKinsey & Company conducted a consumer survey of more than 1,000 people and leads us to better understanding the independent pharmacy business in the U.S. They published their findings in this article, laying out how the retail pharmacy landscape has changed over the years, how consumer preferences have evolved, and how different types of retail pharmacies may respond as a result.
The U.S. retail pharmacy landscape faces saturated retail locations, ongoing labor shortages, inflationary pressure and a leveling-off of generic drug penetration. To effectively compete in this environment, all independent and community pharmacies can strive to better understand and adapt to changing consumer preferences.
This study gives us a snapshot of the market, where we are trailing the big chains and where we can make substantial gains.
How the retail pharmacy landscape has evolved
Over the past two decades, the retail pharmacy landscape has evolved substantially. This survey breaks down the retail pharmacy sector into four categories: retail chains, regional pharmacies such as mass retail and grocers, independent pharmacies, and mail-order and online pharmacies.
According to McKinsey & Company, the number of independent pharmacies has decreased by nearly 50 percent since 1980, leveling off at about 20,000 locations since 2000. While filling about 48,000 prescriptions a year, independent and community pharmacies remain viable through effective collaboration with other independents and wholesalers. This cooperation has taken the form of support from wholesalers like API Warehouse, pharmacy service administrative organizations, and group-purchasing organizations like AAP.
Understanding the independent pharmacy business in the U.S. is key for retail pharmacies. We can ensure we understand and meet consumers’ needs so we are a preferred destination. Click here to read the full report and gain more insight to understanding and improving your pharmacy’s business.
Schedule meetings with your local policymakers during the August legislative recess
The August legislative recess is here. This is the perfect time to invite your local state and federal policymakers to your store and explain how they can help your business.
With the flurry of activity this year on Capitol Hill lawmakers looking to hold PBMs’ feet to the fire, AAP and NCPA members have testified before the House Oversight and Accountability Committee and the Ways and Means Health Subcommittee, as well as the Senate Commerce Committee.
Additionally, the Drug Price Transparency in Medicaid Act, was unanimously advanced out of the Energy and Commerce Committee to the House floor as part of the PATIENT Act. These are all encouraging developments, but we need to keep the pressure on policymakers to finish the job and send a comprehensive PBM reform bill to the president’s desk.
This can best be accomplished by hosting members of Congress and candidates in your pharmacy for one-on-one meetings, giving them a firsthand look at the important role you play in your community and in helping your patients, and highlighting the harm abusive PBM practices have on both your pharmacy and your patients. If you aren’t sure how to contact them, you can look up their information here.
During the August legislative recess, members of Congress are usually home meeting with constituents. This is a very opportune time to host your legislators in your pharmacy.
We need all community and LTC pharmacists to participate in this important month of action and keep the pressure on our elected officials to take strong legislative action.
When you do host your local lawmaker, let AAP know. Send us an email and pictures so we can share with our other Members on social media and in our weekly newsletter.
Take advantage of this great opportunity to promote yours and every independent and community pharmacy.
As you know, there has much information and talk about LTC Pharmacy at Home. The need for better pharmacy care for people who are homebound or need assistance with activities of daily living (ADLs) is a reality with the increasing elderly population. According to projections in a new report from the Population Reference Bureau (PRB), the aging of the baby boom generation (those born between 1946 and 1964) could fuel a 75 percent increase in the number of Americans ages 65 and older requiring nursing home care, to about 2.3 million in 2030 from 1.3 million in 2010. New facilities are not being built today to accommodate people with institutional needs.
Those numbers stress the need to find new ways to administer care and pharmacy services to aging adults with medical conditions and impairments limiting their ability to care for themselves. Long term care (LTC) pharmacy at home is a new way for LTC pharmacies to care for people needing institutional care but who desire to stay in their home or are financially unable to be admitted into a facility.
Many of these people are participating in a home and community-based waiver (HCBS) program from their state where Medicaid pays for institutional care in their home, or they are homebound and need assistance with two or more ADLs (activities of daily living) or IADLs (instrumental activities of daily living).
While the definition of pharmacy services required to be provided to people qualifying for LTC pharmacy services, a new coalition and others in the industry are providing clarity on these needed services. The independent community LTC Pharmacy, whether in closed door pharmacy or in a combination pharmacy (retail and LTC), is the best solution in providing pharmacy care to these patients and to assist in decreasing hospitalizations and emergency department visits. We know that people who do not take their medications correctly – too much, too little, wrong time, wrong dose – frequently have complications that result in ER visits and hospitalizations. A new coalition, the Alliance for LTC Pharmacy at Home is developing strategies to define, promote and get these services paid by insurers (https://www.pharmacyathome.org/).
Join your colleagues all over the country for NCPA’s Month of Action and get the attention of the people whose vote matters to your pharmacy’s future. Invite your Congressional rep or Senator for visit while they are form for the August recess. Make sure they understand how important it is to keep pressure on PBMs and fight for a competitive and fair business environment.
Pressure is working. In the past week, Senate Finance Committee approved legislation that includes strong PBM reforms, passing the Modernizing and Ensuring PBM Accountability Act by a vote of 26-1. Now it’s on the way to the full Senate before it can proceed to the House of Representatives. Keep the momentum going by contacting your lawmaker today and getting them to visit your pharmacy. The fight isn’t over, so let’s put the action in Month of Action.
Pfizer’s New Migraine Treatment Now Available in U.S. Pharmacies
After FDA approval in March, Zavzpret is now available in U.S. pharmacies. The medication is the first and only calcitonin gene-related peptide (CGRP) receptor antagonist nasal spray for acute migraine treatment in adults. For the nearly 40 million Americans living with migraines, this approval provides an alternative option for relief, especially for those who have contraindications or poor responses to triptans and other acute migraine medications. Read more.
Breaking News: PBM reform bill advances in Senate vote
More good news for independent pharmacies – a PBM reform bill advances in Senate vote. On July 26, the U. S. Senate voted 26-1 to advance the Modernizing and Ensuring PBM Accountability Act to a vote of the full Senate. This vote is a big step for independent pharmacies because this PBM reform package contains several provisions to enhance transparency into PBM-insurer operations, improve patient access to community pharmacies, and ensure fair pharmacy reimbursements that are based on actual acquisition and dispensing costs.
After a full U.S. Senate vote, the next step would be a vote in the House of Representatives. No date has been set for that, however.
The package also contains language from two other bills: the Drug Price Transparency in Medicaid Act (S. 1038), which creates a fairer reimbursement rate for pharmacies operating in Medicaid managed care, and the Protect Patient Access to Pharmacies Act (S. 2052), which reforms Medicare Part D by clarifying and providing enforcement tools for the any willing pharmacy law. NCPA has more details about the PBM reform bill that advanced in Senate vote
The agreement was announced Tuesday, the first day that UPS and the Teamsters returned to the bargaining table after negotiations broke down earlier in July.
Negotiators for UPS and the Teamsters Union had already reached tentative agreements on several issues, including cameras and air conditioning in the delivery trucks. But clashes continued over increasing pay for part-time workers, who make up more than half of the UPS employees represented by the union.
Teamsters will begin voting on the new five-year contract Aug. 3 and concludes Aug. 22.
Another blow to was dealt to the PBM industry last week. Federal Trade Commission voted unanimously to warn that some of its previous advocacy statements related to PBMs no longer reflect current market realities. The decision effectively removes a major line of defense for the PBM-insurers in litigation, arbitration, and lobbying against state and federal reforms.
Our friends at NCPA were instrumental in persuading the commissioners to reconsider the agency’s prior statements and ultimately bring it to a vote. Read more on NCPA.org.
The AAP is in Boston this week at RBC. Come meet with our team and get updates on the AAP Prime Vendor Agreement, ProfitAmp, AlignRx and more. Plus, relax and enjoy some fun with Virtual Reality, cornhole and a golf putting green!
New Jersey joins in the fight against PBMs
New Jersey Governor Phil Murphy signed three bills to help make prescription drugs more affordable for New Jerseyans. The three bills will work together to cap certain out-of-pocket costs, establish greater oversight of Pharmacy Benefit Managers, and promote transparency across the pharmaceutical supply chain. Read more.
Birth control goes OTC
The U.S. Food and Drug Administration approved Opill (norgestrel) tablet for nonprescription use to prevent pregnancy. Opill is the first daily oral contraceptive approved for use in the U.S. without a prescription. Approval of this progestin-only oral contraceptive pill provides consumers a choice to purchase oral contraceptives without a prescription at independent and community pharmacies. Read more.
To prevent a repeat of last winter’s “tripledemic” of respiratory illnesses, Americans will be encouraged to roll up their sleeves not just for flu shots but for two other vaccines, one of them entirely new.
The three shots — flu, Covid and R.S.V. — may help to reduce hospitalizations and deaths later this year. But there are uncertainties about how the vaccines are best administered, who is most likely to benefit, and what the risks may be.
For older and immunocompromised Americans, all three vaccines are vital. Yet it’s unclear how many Americans will opt for the shots. 71% of adults ages 65 and older got a flu shot this past winter, but only about 43% chose to get the Covid booster.
The misery of the past winter may help change minds. The flu may have led to as many as 58,000 deaths, peaking in December, according to the C.D.C. Covid claimed roughly 50,000 lives between November and March.
R.S.V. kills up to 10,000 people each year, most of them older. Infections this year peaked in November and resulted in about twice as many hospitalizations, including children, as in prepandemic years.
Only the Covid and flu vaccines were available last fall. The R.S.V. vaccines for adults are new, and in clinical trials proved to be highly effective against infection of the lower respiratory tract, which includes the lungs.
FDA approves Alzheimer’s drug Leqembi
The Food and Drug Administration fully approved the Alzheimer’s treatment Leqembi, which will expand access to the expensive drug for older Americans.
Medicare announced shortly after the FDA approval that it is now covering the antibody treatment for patients enrolled in the insurance program for seniors, though several conditions apply.
Leqembi is the first Alzheimer’s antibody treatment to receive full FDA approval. It is also the first such drug to receive broad coverage through Medicare. Read more.
Five Adalimumab biosimilars launched on July 1 in the U.S.
July 1 marked the launch of five different adalimumab (Humira) biosimilars, setting off the first round of therapeutic alternatives into the market, including adalimumab-abdm (Cyltezo), adalimumab-aqvh (Yusimry), adalimumab-bwwd (Hadlima), adalimumab-adaz (Hyrimoz), and adalimumab-fkjp (Hulio). These medications join adalimumab-atto (Amjevita), the first adalimumab biosimilar that launched earlier this year.1Read more at Drug Topics.
CMS issues revised guidance to Medicare Drug Price Negotiation Program
CMS recently issued revised guidance to Medicare Drug Price Negotiation Program. CMS noted that the majority of the comments received from supply chain entities on this topic, including manufacturers and pharmacies, supported the use of a standardized, published pricing metric to calculate the refund due from the manufacturer to the pharmacy for the pass through of the maximum fair price as required under the program. Read more.
The NCPA Annual Convention will be held October 14-17 in Orlando. Make plans now to join. And AAP members will receive $100 off your registration when using the promo code “Buy100.”
The Protect Patient Access to Pharmacies Act (S. 2052) was introduced this week to the U.S. Senate. This bill addresses the abusive business practices by pharmacy benefit managers (PBMs) that have resulted in the growth of pharmacy direct and indirect remuneration (DIR) fees and have led to pharmacy closures.
The bill, supported by NCPA and APhA among others, will help to secure Medicare patients’, who are typically seniors, freedom to receive medications and care from the pharmacy of their choice by improving enforcement of the “any willing pharmacy” law. This law is intended to prevent the exclusion of pharmacies from Part D plan networks.
The Patient Access Act is only the most recent effort working toward DIR fee relief as the Centers for Medicare and Medicaid Services’ (CMS) proposed rule made in early 2022 goes into effect in the beginning of 2024. CMS’ proposed rule will work to reduce the financial burden on independent pharmacies and increase transparency in the PBM industry. Read more.
Approval for GLP-1-based weight loss pills on the FDA horizon?
The buzz about Eli Lilly’s experimental pill for weight loss is growing. Retatrutide helped people lose an average of 15% of their body weight after 36 weeks on the highest dose in a mid-stage trial, and as much as 24% of their weight over 48 weeks — the biggest reduction reported to date in clinical trials of a new class of obesity treatments. These results are rivaling what’s seen with currently approved injectable therapies like Wegovy over longer durations.
The drug, orforglipron, had similar side effects as others in the class, known as GLP-1 receptor agonists: primarily gastrointestinal events like nausea, constipation and vomiting, researchers reported in a study published in the New England Journal of Medicine. Read more.
AAP Member Greg Mitchell sat down with Drug Topics to discuss the importance of being connected to your community when running a rural pharmacy. You can listen to the entire podcast here.
FDA Committee Recommends Development of Monovalent, XBB-Containing Vaccines for the Fall
The FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) has unanimously recommended that COVID-19 vaccines being developed for this fall should only include protection against the XBB variant.
Trial results showed that among 101 participants who had previously received 4 doses of a COVID-19 vaccine, an XBB-containing vaccine was more effective against the currently circulating XBB variants. Read more.
ACA preventive care mandate maintained, for now
A federalappeals court maintained a freeze on a ruling that struck down the Affordable Care Act’s mandate that employers and insurers fully cover preventive health services while a legal challenge to the rule continues to wind through the courts.
The decision from the New Orleans-based U.S. 5th Circuit Court of Appeal means that over 150 million people’s health care coverage for certain cancer screenings, behavioral counseling and HIV prevention by the U.S. Preventive Services Task Force will remain in place for the time being.
Biden names Mandy Cohen — former North Carolina health secretary — to lead CDC
President Biden named Dr. Mandy Cohen as the next leader of the Centers for Disease Control and Prevention. Dr. Cohen served in top positions in state and federal government and in the private sector. She served as health secretary in North Carolina, where she worked on expanding access to health care for low-income residents and became the face of the state’s COVID-19 response during the public health emergency. Read more.
Your patients rely on you to dispense the right medication for their unique needs. The same level of care should be taken when it comes to your pharmacy’s financial health. We’ll explore strategic and effective ways to diversify your pharmacy’s revenue and ensure long-term success. So, grab your pad and pen, and get ready to lay a foundation for financial well-being for your pharmacy.
Why Diversification is Crucial:
Diversification is important for several reasons. First and foremost, it helps protect your pharmacy against economic downturns and changes in the industry. By diversifying your revenue streams, you’ll be less reliant on any one source of income, which can help you weather any storms that come your way. Additionally, diversification can help you attract new customers and build loyalty with existing ones. By offering a wider range of products and services, you’ll be better able to meet the needs of your customers and keep them coming back to your pharmacy. Read More >>
We are proud of AAP Member, Kevin Duane, and his fight against PBMs. His advocacy helped pass legislation in Florida and now he’s moved into the national spotlight.
If you didn’t catch his testimony before the bi-partisan U.S. House of Representatives Oversight Commitee, you can watch it here.
FDA approves first oral antiviral for treatment of COVID-19 in adults
FDA gave full approval of the oral antiviral, Paxlovid, for the treatment of mild-to-moderate COVID-19 in adults who are at high risk for progression to severe COVID-19. This includes those at risk for hospitalization or death. Paxlovid is the fourth drug — and first oral antiviral pill — approved by the FDA to treat COVID-19 in adults. The U.S. government will continue to oversee the distribution of Paxlovid, and U.S. residents eligible for the medication will continue to receive the medicine at no charge, according to Pfizer. Read more.
N.Y. federal appeals court clears the way for Purdue Pharma bankruptcy deal
In a landmark ruling Tuesday, a federal appeals court in New York cleared the way for a bankruptcy deal forPurdue Pharma. The deal will shield members of the Sackler family, who own the company, from future lawsuits.
The 2nd Circuit Court of Appeals spent more than a year reviewing the case after a lower court ruled it was improper for Purdue Pharma’s bankruptcy deal to block future opioid-related lawsuits against the Sackler family. The Sacklers earned billions of dollars from the sale of OxyContin and other opioid pain medications.
This latest ruling overturns the lower court’s December 2021 decision and clears the way for a deal hashed out with thousands of state and local governments. Read more.
(Courtesy of NCPA) As part of its ongoing inquiry into pharmacy benefit managers (PBMs) and their impact on the accessibility and affordability of prescription drugs, the Federal Trade Commission issued compulsory orders to two group purchasing organizations that negotiate drug rebates on behalf of other PBMs. The orders will require these entities to provide information and records on their business practices. Having previously issued compulsory orders to the six largest PBMs in the U.S. healthcare industry, the FTC yesterday issued two additional orders to Zinc Health Services, LLC, and Ascent Health Services, LLC.
House panel advances transparency and PBM bills
(Courtesy of Axios) On Wednesday, a House Energy and Commerce Committee advanced a health markup in a unanimous 27-0 vote to:
Codify and strengthen Trump-era rules for hospitals and insurers to make health care prices available and more transparent.
Impose new transparency requirements on PBMs and ban “spread pricing” in Medicaid, where PBMs charge more than they pay for a drug and keep the difference. Read more.
1 in 5 older adults skipped or delayed medications last year because of cost
(Courtesy of NBC News) A growing number of older adults say they can’t afford their prescription medications, a study published Thursday in JAMA Network Open found.
About 1 in 5 adults ages 65 and up either skipped, delayed, took less medication than was prescribed, or took someone else’s medication last year because of concerns about cost, according to the study.
“That was pretty surprising,” said lead study author Stacie Dusetzina, a health policy professor at Vanderbilt University in Nashville, Tennessee. A study published in the journal Medical Care found that in 2016 about 1 in 7 older adults were not taking their medication as prescribed because of cost.
“So a pretty big jump,” Dusetzina said.
The study’s findings were based on a national survey taken by more than 2,000 older adults from June 2022 through September 2022. Read more.
After more than three years, the COVID-19 public health emergency ended Thursday.
While many Americans may not initially notice the sunsetting of the declaration, they are likely to feel it if they come down with COVID-19 or suspect they might have it. They could have to start paying for testing and treatment that they’ve grown used to being free during the pandemic. Just how much depends on the type of health coverage they have. Get the testing and vaccine details here.
FDA Advisory panel votes unanimously in favor of making Opill birth control an OTC
Advisers to the Food and Drug Administration on Wednesday voted unanimously to recommend making a birth control pill available without a prescription.
The 17-0 vote by two advisory panels came despite concerns from agency officials about the quality of the data used to support switching Opill from prescription to over the counter. The agency did not have concerns about the safety and effectiveness of the drug.
The FDA is not required to follow the recommendation but the panel’s opinion will weigh heavily on the FDA’s final decision, which is expected later this summer. Read more here.
FDA approves Rexulti for the treatment of agitation associated with Alzheimer disease dementia (AAD)
It is now the first FDA-approved treatment indicated for AAD in the U.S. According to John J. Miller, MD, Editor in Chief of Psychiatric Times. “Baby boomers are retiring and Alzheimer disease is on the rise, and AAD in one of the most difficult complications of dementia. Meanwhile, the need for treatments of Alzheimer disease and dementia remains huge and largely unaddressed. This approval parallels nicely with recent drug development and research working on decreasing disease progression by removing amyloid plaque with monoclonal antibodies and improving cognitive function.” Read more.
A late-2021 analysis by Deloitte about “the future of the pharmacy” includes what may seem to be an obvious observation, but one that still warrants repeating: “Most people don’t realize that pharmacists can perform a range of complex clinical functions around therapy optimization, not just dispense pills.”
The analysis reaches the conclusion that, while the COVID-19 pandemic provided an opportunity for pharmacists to increase their role in providing hands-on patient care, there was no proportionate reduction in the time required to dispense medications. In fact, the article notes, dispensing demands have only increased, as reduced reimbursement and dispensing fees, along with increased direct and indirect renumeration (DIR) fees have caused many pharmacies to actively look to increase prescription volume.
What do you need to consider when buying an independent pharmacy?
Whether buying your first business or tenth, acquiring an independent pharmacy presents unique challenges. Similar to any retail business, you’ll be performing your due diligence evaluating:
Location: What’s the neighborhood like demographically? What kind of walk-by or drive-in traffic might you expect? What type of competition are you up against?
Property: Is the building owned or leased? What repairs or renovations will be needed? Can it support the business needs you envision?
Inventory: What OTC, DME, beauty, giftware, or other categories of inventory are currently sold? What is included as part of the sale?
Staff: What are the current staffing levels and related costs? Who are the current team members? What are their skills? Who is essential?
Financial viability: Is the business worth the price?
But when you buy an independent pharmacy, there are more dimensions to understand about each of these elements. They involve additional evaluation, regulation, legal, and financial guidance to determine what may or may not be a good buy for you. Below is a guide to some things to consider as you make your plans. Read More >>
Ordering your most popular items can be done simply with SmartSync, AAP’s customized intelligence-based bulk ordering program. It is available to AAP Members who are opted into ProfitAmp Full Access or ProfitAmp Monthly Assessment, and it is designed to help you save even more on your pharmacy’s most common inventory.
First, AAP analyzes your dispensing data each month to suggest a thirty-day supply bulk order, customized to your store’s needs.
Then, we notify you that your suggested SmartSync order is ready to view on APIRx.com. Your prime vendor GCR and rebate structure are taken into account and API NDCs with the highest-dollar savings are selected.
Next, within three days, you can approve the order as-is or adjust the order based on your current inventory.
And finally, you will receive an extra five percent off the invoice price (minus controlled substances) for receiving your order by ground shipping.
That’s it. Fast and Easy. SmartSync saves you time and money. *
To find out how SmartSync can help you, contact your AAP territory manager today.
*$49 monthly program fee is waived when an order is placed.
Make restocking your shelves fast and easy with Scan & Toss. Available on both Android and Apple devices, shopping from API Warehouse is more convenient than ever.
You now have the freedom to quickly purchase from API Warehouse and AAP’s primary contracted wholesaler, anywhere you go, straight from your mobile device.
You can place your order with just a few taps. You simply scan a product’s barcode to get started, or manually enter an item’s UPC, NDC, API or Cardinal item number, or search by item description.
The app works with Brand Rx, Generic Rx, and even OTC products. It goes wherever you go, allowing you to place and view orders quickly and efficiently, no matter where you are!
Scan & Toss syncs all your data across multiple devices! Plus, you can review past orders right on your phone. And the app’s Message Center delivers your rebate information as soon as your API order is placed.
To get the Scan & Toss Mobile app, you can download it from the Google Play Store on your Android device or the App Store on your Apple device.
Contact your A-A-P territory manager to get started today.
In this pre-recorded webinar, please join Jessica Swicegood and Cole Page from GeriMed to learn more about their program ComboMed™.
ComboMed™ has garnered prominence from independents nationwide for the enhanced revenue ($3-$4 more per script, zero DIR fees) it brings to retail independents servicing LTC. From the traditional SNF setting, to ALF, Group Home, Psychiatric, Correctional, ICF-IDD, Hospice, and the fastest-growing segment in LTC—Medical at Home, odds are you’re likely servicing LTC already and don’t know it. Or if you do know it, you’re not receiving the benefits of this program on your Med D LTC claims.
A group of pricey breakthrough prescription drugs are poised to shake up the market this year — including an Alzheimer’s treatment that could be approved today by the FDA.
Why it matters: Though the drugs offer hope to patients with hard-to-treat conditions like Alzheimer’s or sickle cell disease, or who struggle with obesity, their potentially eye-popping prices are sure to create dilemmas for insurers, government programs and patients themselves.
The big picture: The approvals could fuel already-contentious debates around affordability and equity, giving ammunition both to those who say innovation doesn’t come cheap and others who contend medical advances are meaningless if patients can’t access them.
Although some of the drugs could be transformative, “they will create choices that need to be made and they will also create potential burdens, particularly on the most vulnerable, on people who are the least well-insured and people who live in states or happen to have insurance coverage that is the least generous,” said Rena Conti, a professor at Boston University’s Questrom School of Business.
None of the drugs would be subject to the price controls that congressional Democrats included in the Inflation Reduction Act.
Driving the news: The FDA is expected to today decide whether to approve Eisai and Biogen’s lecanemab, a treatment for Alzheimer’s disease, setting into motion another round of debate over how much the drug should cost and whether Medicare should cover it.
It would become the second FDA-approved Alzheimer’s treatment targeting amyloid plaques that are believed to contribute to the development of the disease. But it isn’t likely to cause as much controversy as Biogen’s Aduhelm did when it was approved in 2021.
Biogen initially priced that drug at $56,000 a year, drawing outrage from critics and presenting big questions about how Medicare could absorb the large spending spike if millions of beneficiaries tried to get it.
If lecanemab is approved, experts will be closely watching both its list price and whether the FDA limits its use to subgroups of Alzheimer’s patients. Both factors will be crucial in determining potential spending on the drug.
A cost-effective price would be between $8,500 and $20,600 a year, the Institute for Clinical and Economic Review said last month.
State of play: The drug pipeline is brimming with other experimental cures that could make headlines this year.
Data for another promising Alzheimer’s treatment by Eli Lilly that is similar to lecanemab is expected midyear, per a recent Cowen research note, and Medicare will almost certainly have to revisit its coverage policy for the entire class of drugs.
Several multi-million dollar gene therapies have already been approved. But this year the pipeline includes two treatments for sickle cell disease, which has a much larger patient population.
Clinical trial results for Eli Lilly’s obesity drug candidate are also expected in April, potentially ushering a new entrant to what could become a booming market. Disputes over coverage of obesity drugs already on the market will almost certainty continue.
Between the lines: Some novel drugs present an inherent dilemma: They’re worth a lot of money because of the way they can dramatically improve patients’ lives. Even so, manufacturers can still price these drugs well above what experts say they’re worth.
Gene therapies may cost millions per patient. Other drugs could cost much less per course, but cater to enormous patient populations or may require long-term use.
In any scenario, the expense could present complex problems to federal and state health programs, private insurers and patients who wind up on the hook for out-of-pocket costs.
“We’re fortunate there are so many treatments in the pipeline that promise to transform the quality of care for people with devastating diseases. While we recognize there are concerns about cost, the facts point to a health care system that can sustain this incredible innovation over the long haul,” said Priscilla VanderVeer, vice president of public affairs at PhRMA.
Yes, but: The final cost burden hinges on several factors, starting with where manufacturers set the launch price.
CMS has issued the final physician fee schedule for CY 2023, which updates vaccine payment information. The CY 2023 payment amount for influenza, pneumococcal, and HBV vaccine administration is $31.14. This amount will be geographically adjusted based upon the fee schedule area where the preventive vaccine is administered. With regard to COVID-19 vaccine administration, for CY 2023 the payment amount is $41.52. This differential will remain in place until the end of the calendar year in which the current Emergency Use Authorization declaration for drugs and biologicals with respect to COVID-19 ends. Thereafter, the payment amount for COVID-19 vaccine administration will be adjusted to align with the payment rate for the other Medicare Part B preventive vaccines. Learn more.
Two of the largest U.S. pharmacy chains, CVS Health and Walgreen Co., announced agreements in principle Wednesday to pay about $5 billion each to settle lawsuits nationwide over the toll of opioids, and a lawyer said Walmart is in discussions for a deal.
Together, the developments amount to what could be the last round of huge settlements after years of litigation over the drug industry’s role in an overdose crisis that has been linked to more than 500,000 deaths in the U.S. over the past two decades. Read more.
The FDA has issued an emergency use authorization (EUA) for a booster dose of the Novavax COVID-19 Vaccine, Adjuvanted (NVX-CoV2373) in adults aged 18 years and older.1 The booster dose should be administered at least 6 months following the completion of a primary vaccination series with an authorized or approved COVID-19 vaccine. It can be administered to patients who do not have access to an authorized bivalent COVID-19 booster, in whom a bivalent booster would not be clinically appropriate, or who chose to receive the Novavax booster because they would not otherwise receive a COVID-19 booster dose. Read more.
Drug-related deaths are soaring among older Americans, driven by factors including unintentional misuse of prescription medications, self-medicating to treat pain, recreational drug use and social isolation.
In just a decade, the drug-related death rate doubled for those 65 years and older, climbing from 4.2 deaths per 100,000 in 2008-2010, to 8.4 deaths per 100,000 in 2018-2020, according to a report on senior health by United Health Foundation, which is part of UnitedHealth Group, earlier this year. The report drew on statistics from the Centers for Disease Control and Prevention. “It’s a really sad finding,” says Rhonda Randall, D.O., chief medical officer at UnitedHealthcare. “There’s a misperception that seniors may be exempt from this problem.” Read more.
The Food and Drug Administration announced Wednesday that it had granted emergency use authorization for updated COVID-19 vaccine boosters for Americans as young as 5 years old, and the Centers for Disease Control and Prevention officially signed off on their use. The boosters can be given at least two months after their previous shot of the vaccine. Read more.
Your patients are the lifeblood of your business. With an increased number of pharmacy alternatives popping up these days — including mail order pharmacies and online pharmacies — how can you ensure your patients stay your patients?
Did you know you can create a customer retention strategy through Medicare plan consultations that keeps your current customers engaged and happy? You can, and we’ll get to that shortly.
Before we understand how you can improve patient retention, however, let’s first look at what patient retention is and how you calculate your patient retention rate. Read More.
With the adjournment of the California Assembly on August 31, only four state legislatures remain in session for 2022—Michigan, Pennsylvania, Ohio, and New Jersey. (As of this writing, Missouri is in Special Session to deal with state tax issues; a state legislature calendar is available here.) The National Conference of State Legislatures bill tracking database shows that through August, 418 bills had been introduced, in 47 states, directly addressing prescription drug-related issues. Read more.
At last! After nearly a year of committee hearings and political maneuvering, Congress finally has approved legislation to reauthorize FDA’s user fee programs for brand and generic drugs, biosimilars, and medical devices. The current programs expire with the close of fiscal year 2022 on September 30. Reauthorization will enable FDA to continue collecting application and facility user fees from industry for fiscal years 2023 through 2027, a 5-year period that begins October 1. Read more.
A federal judge ruled on September 19, 2022, against a Justice Department antitrust challenge to UnitedHealth‘s $13 billion acquisition of health-technology firm Change Healthcare, rejecting government claims that the deal would unlawfully suppress competition and limit innovation in health-insurance markets.
U.S. District Judge Carl Nichols ruled for the companies in an opinion that he kept under seal for now because he said it “may contain competitively sensitive information.” The judge said he would release a redacted public version of the ruling in the coming days. In a one-page public order, he denied the Justice Department’s request to block the companies from completing the deal. Read more
Starting a new pharmacy can seem like a daunting task, and it certainly is one. However, the road to opening a pharmacy that runs successfully from day one means making the right decisions long before the doors are opened. This article is meant to help independent pharmacists navigate the process of establishing a new pharmacy more easily and successfully.
Create a Business Plan
There’s a well-known adage (often attributed to Benjamin Franklin, though there seems to be no evidence that he ever actually said it) that goes, “If you fail to plan, you are planning to fail.” When starting a new pharmacy, this is especially true. Therefore, the first thing to do is write out a business plan that includes the following items:
The Novavax COVID-19 Vaccine has received an expansion of the emergency use authorization (EUA) from the FDA. The expanded EUA allows the vaccine to be administered as a two dose primary series for children aged 12 through 17. The vaccine was previously authorized under an EUA for adults 18+. Read more about the announcement.
Millions of Americans will soon have access to lower cost hearing aids, thanks to a final rule from the FDA aiming to improve access to them. The rule creates a category of OTC hearing aids, which allows a patient, ages 18+, with mild to moderate hearing impairment to purchase a hearing aid from a pharmacy or online retailer without a medical exam, prescription, or adjustment by an audiologist. Read more.
Under the new law, the U.S. government is now able to negotiate prices on the costliest prescription drugs, cap costs at $2,000 per year for people on Medicare, limit the monthly cost of insulin to $35 for seniors, and extend subsidies for people buying their own health coverage through the Affordable Care Act, also known as Obamacare. The law also provides free vaccines for seniors. Read more.
The US Senate passed the Inflation Reduction Act on Sunday. The bill includes provisions that will impact community pharmacies, like Medicare pricing, drug rebates and insulin copays. Read more about the bill here.
It’s back. Americans who thought they had successfully put COVID-19 in the rearview mirror are slowly coming to realize that the virus is not quite done with them. As of mid-July the Centers for Disease Control and Prevention (CDC) reported a 7-day moving average of 124,000 daily new cases – a 15.7 percent increase over the prior week.
The surge in new cases, driven primarily by the Omicron BA.5 variant, has fueled discussion about reimposing mask mandates, and the possibility of additional booster shots. This, despite evidence the latest variant is more resistant to existing vaccines than previous strains. Read More.
Flu season is fast approaching. And it’s more important than ever for patients, particularly those who are at risk, to be vaccinated against influenza. Adults 65 and older, along with those with severe health problems, people of color and those of lower socio-economic status are at higher risk of developing severe complications from the illness. Getting vaccinated can help protect these vulnerable populations. Learn more about the selected strains, changes to vaccine recommendations and what to expect next.
Humira may face competition from multiple generics in 2023. But, immunology medications aren’t the only biosimilars coming into the market in the next few years. Cardinal Health has compiled a report of more than 40 other biosimilars that we may see by 2030. Read Cardinal’s report here.
Did you know that more than one-third of health care organizations in the United States were hit by ransomware attacks in 2020? Approximately 65% of these attacks were successful, and approximately one-third of the organizations that had data stolen paid up. However, only 69% of organizations that paid ransom actually got their data back. Here are some tips to help you protect your patients’ information. Read more.
With PCMA’s failure to file its appeal by the July 11, 2022 deadline, North Dakota can regulate PBMs as it sees fit. PCMA has exhausted its legal options. So, the ruling in PCMA vs. Wehbi is now the law of the land for the states in the 8th Circuit (Arkansas, Iowa, Minnesota, Missouri, Nebraska, North Dakota and South Dakota). Read more
The Food and Drug Administration on Wednesday authorized a Covid-19 vaccine developed by Novavax, a biotechnology company in Maryland that received significant federal funding to produce the shot.
The vaccine will be a new option for Americans as vaccination rates stagnate. The vaccine is authorized as a primary immunization series for adults, rather than a booster. However, the shots can’t be administered until the CDC signs off on the recommendation later this month. Read more.
As expected, Florida Governor Ron DeSantis signed the PBM transparency order. The order is aimed at lowering the price of prescription drugs. AAP Member Ben Levine was at the governor’s side during the signing. Levine calls this order a victory for all Floridians. “This transparency will really help drive down drug prices, and also improve access for patients in our community so that they can go to the pharmacy they choose.” Read more about the executive order.
Florida Gov. Ron DeSantis (R) today announced plans to sign an executive order that would hold PBMs accountable and provide drug cost transparency. Under the order, state agencies will be directed to reevaluate their contracts with PBMs to ensure “that costs to the state of Florida are justified.” Read more about the order.
Thirty years ago, pharmacies were just realizing the opportunities available to them in the long-term care space. At that time, long-term care pharmacy and pharmacists were servicing residents living in nursing homes (SNF) and that was the end of the story. In 2022, the healthcare spectrum has changed. Everyone is looking for a way to decrease healthcare costs and provide better care. Adverse drug reactions account for many hospital admissions – according to a recent meta-analysis, one in ten hospital admissions are for elderly patients.1 This makes pharmacists—more specifically, long-term care pharmacists— part of the solution for both costs and care; especially as the definition of appropriate long-term patients and services continue to be defined. Long-term care pharmacies can be a closed-door pharmacy servicing only long-term care residents or a long-term care pharmacy can be in a “combo” pharmacy where both retail and long-term care pharmacy are being offered under a retail license.
As you know, long-term care pharmacies provide services above and beyond what is delivered at the counter of a typical retail pharmacy for a walk-in patient. The Centers for Medicare and Medicaid Services (CMS) has specific requirements for pharmacies servicing Medicare Part D beneficiaries in long term care facilities2. LTC pharmacies must have the capacity to provide specific drugs in units of use packaging, bingo cards, cassettes, unit dose or other special packaging commonly required by LTC facilities. They must also have services available twenty-four hours, seven days a week for emergency calls. These are but a couple of the services needed to take care of patients in a long-term care setting. Many pharmacies have added other services such as medication reconciliation, medication management, medication regimen reviews (MRRs), etc., in addition to the ones specified by CMS. Read More.
01 March 2022, Berlin: The drug Paxlovid against Covid-19 from the manufacturer Pfizer is lying on a table. Photo: Fabian Sommer/dpa (Photo by Fabian Sommer/picture alliance via Getty Images)
It’s a win for pharmacies, which had been pushing for the FDA to allow them to prescribe the medication, saying that it would ultimately expand access to the antivirals.
Paxlovid is authorized for the treatment of “mild-to-moderate” COVID-19 in adults and pediatric patients that have tested positive and are considered to be at high risk of developing severe disease.
A federal judge on Monday ruled in favor of three major U.S. drug distributors, AmerisourceBergen Drug Co., Cardinal Health Inc. and McKesson Corp., in a landmark lawsuit that accused them of creating a health crisis. Read about the ruling.
California Gov. Gavin Newsom (D) signed the state budget, including a provision that forgives $142 million in Medi-Cal clawbacks from independent pharmacies in the state. Read more here.
Businesses owners, including those who work within the pharmacy industry, often face situations in which legal advice becomes useful. Getting the right legal advice can be pricey, but it can save a lot of time, money and hassle in the long term. Here are some situations where getting good advice is crucial.
Walmart recently announced its plan to raise wages for its more than 36,000 pharmacy technicians working in Walmart and Sam’s Club stores. Additionally, the retail giant plans to hire an additional 5,000 workers in these positions this year. Are you ready to compete for staffing with Walmart? Read the full article from Drug Topics here.
Cardinal Health issued a new alert regarding recently reported fraudulent activity. There are reports of individuals falsely claiming to be representatives from pharmaceutical wholesalers and courier service employees. This is an industry-wide issue, as criminals attempt to place orders and intercept delivery of the product. Be on the lookout, and read the full alert here.
More than 90 percent of people in the United States live within five miles of a community pharmacy. Additionally, patients visit the pharmacy twice as often as they visit their primary healthcare provider. So, your pharmacy can make a significant impact on the lives of your community members, but you must get them through the door first.
One way is standing out from your competition by personalizing your services. From simple handwritten, thank you notes for a new patient to loyalty programs or just recognizing a birthday, the possible ways to connect with patients are endless. To learn more ideas about how to increase your pharmacy customer base, watch the AAP Preferred Partner webinar from TDS here.
Have you ever thought about what it would take for your pharmacy to go green? If you could give your patients their medication information digitally, it would save you thousands of dollars every year in paper and toner costs. Our Preferred Partner, Vuca Health, has an innovative solution called MedsOnCue. Their platform has a library of informational videos about hundreds of medications, in both English and Spanish.
The system can integrate into your pharmacy’s system and deliver the medication information video straight to your patient’s computer, smartphone or tablet. To learn more about MedsOnCue, watch our AAP Preferred Partner webinar from Vuca Health here.
We know that every pharmacy faces different challenges. That is why we partner with a variety of vendors to give you choices that address YOUR business needs. Our Preferred Partner, Rx30, can make your pharmacy faster and more efficient by optimizing your workflow and customizing it around you.
Check out the AAP Preferred Partner webinar about the types of tools they can provide your business. From integrated pharmacy point-of-sale to insurance claim reconciliation or pharmacy inventory management, Rx30 has a solution for you.
Independent pharmacies are the cornerstone of every community. And the role your pharmacy plays in your community is constantly evolving. You are not just filling scripts. You are doing healthcare counseling and testing. In many underserved areas, you are becoming the primary care provider for many patients.
But the question is – how do you bill for all of these services you are offering? In this Preferred Partner webinar, EnLivenHealth explains some of the programs they offer to help you navigate the medical billing system. Watch the webinar here.
Expiring drug products are a problem in every pharmacy. But out-of-date pharmaceuticals don’t have to be an unmanageable business expense. The right business partner can turn expired medications into cash.
Medication returns vendors, more formally known as reverse distribution or reverse logistics providers, manage between 3.5% and 4% of all pharmaceutical sales, according to a 2018 estimate from the Healthcare Distribution Alliance (HDA) Research Foundation. That’s more than 120 million units annually, worth more than $13 billion, based on 2016 pharmaceutical product sales of $450 billion.
“Return Solutions comes to the pharmacy quarterly and goes through our entire stock to pull everything that is expired or set to expire in the next few months,” said Lisa Stahlman, RPh, pharmacy manager at the WellSpan Pharmacy in Dallastown, Pennsylvania. “A few weeks later, we get a check. I’m sure there are plenty of pharmacies that don’t use a returns company, but it’s so much more time-efficient and cost-efficient than trying to keep up with return policies and requirements for every manufacturer on your own.” Read More.
