In Volusia County, Florida a newly hired pharmacy tech was arrested for stealing more than a dozen bottles of prescription drugs. This is the second drug arrest in three weeks, with the first arrest made on May 25, 2018.
Last January 12, 2018, a Houston man was convicted by a Fort Bend County jury of felony misapplication of fiduciary property. Jorge Alberto Perez was caught stealing from the pharmacy when an internal audit showed a shortage of prescription drugs in the period of 2009 to 2010.
These cases of theft cost pharmacies major losses. In 2011, the cases of employee theft total an average of $996.
But with the outrageous prices of prescription drugs and the lure of controlled substances, pharmacy theft is a potential risk in a pharmaceutical business.
Pharmacy personal steal because of:
According to a study conducted by the Auburn University's Harrison School of Pharmacy, approximately 10% of pharmacists become chemically impaired at some point in their career.
A survey conducted by the University of Georgia also showed that:
These numbers show that the issue of internal theft should be addressed once and for all. It is the best way to prevent business loss and ensure theft doesn't go unchecked.
How to Prevent Pharmacy Internal Theft
Vet employees thoroughly
Didn't they say that prevention is better than cure? Before you take anyone on board, it is important to conduct thorough reference and background checks. Due to lack of prosecution, embezzlers and thieves often move from one practice to the next. Don't be the next victim.
Treat your staff well
They will think twice about stealing from you if they have competitive salaries, benefits, and other perks. Combine that with consistent coaching and feedback and your staff would feel as much a part and accountable with your pharmacy as you are.
Implement accounting controls
Financial transactions should be carried out by trusted individuals.
Different people should handle different financial transactions—review of electronic transfers, prepare checks, sign checks, and regular EHR reconciliation.
In addition, appoint partners to conduct periodic spot checks and hire an independent accountant to review the financial records of your pharmacy.
Implement point-of-sale (POS) solutions
This is one way to ensure that there is no conflict of interest to your practice. Thieves and embezzlers are capable of many things, including fabricating vendors. So make sure that you verified vendors and run a thorough check.
Theft of any kind is often a combination of motive and opportunity. So make sure that your pharmacy leaves no opportunity for employees to steal from you. Set up the security measures listed above to deter and prevent internal theft.
Disease management aims to prevent or minimize the effects of a disease through integrated care. This involves disease management programs that are designed to improve the quality of life and health of persons with chronic conditions and to reduce healthcare costs associated with complications that are completely avoidable.
The idea is to treat chronic conditions more quickly and more effectively so disease progression can be slowed down.
Disease management uses a system of coordinated health-care interventions and one that empowers individuals to work with different health care providers to prevent complications and manage the disease. It operates on the basis that educated individuals are better able to manage their disorder because they know where to seek and receive better care.
A comprehensive disease management program comes with more benefits.
Furthermore, it enhances the efforts of healthcare providers to improve the healthcare programs offered on a population basis. Care coordination is one of the primary concerns of these providers and an integrated multidisciplinary disease management program is the solution.
One of the members of the multidisciplinary team of providers are pharmacists who play a role in assisting individuals in managing their conditions.
What is their role in disease management programs exactly?
Pharmacists in Disease Management Programs
A pharmacist deals with both patients and health care providers, making them a link between the two even when the interaction is not linear.
Trained pharmacists, for example, can evaluate medication therapies and identify drug-related problems, enabling them to help patients manage these problems.
On the other end of the spectrum, a pharmacist can educate physicians about treatment guidelines based on outcomes research conducted.
This is why pharmacists have a significant impact on the development and implementation of disease management programs. Whenever improvements are needed, they can also provide expert information, especially on medications and pharmacotherapy.
In a published study entitled Pharmacist-Led Chronic Disease Management: A Systematic Review of Effectiveness and Harms Compared to Usual Care, increased involvement of clinical pharmacists are encouraged.
It is believed that their role in patient care will enable patients to have access to primary care services and improved health care.
This was backed by the H.R.592 - Pharmacy and Medically Underserved Areas Enhancement Act that was recently introduced in House. The bill aims to improve access to health care through the patient care services offered by pharmacists.
It will also help established two things:
It is clear that pharmacists must be involved in disease management programs. Their involvement varies depending on each practice setting.
Different Pharmacist Interaction with Patients with Different Diseases
According to the US Preventive Services Task Force's (USPSTF), screening for depression can help reduce or eliminate depression symptoms, something that pharmacists can help with.
As a member of a collaborative care team, a pharmacist can:
Blood glucose testing and other routine and simple tests are offered in pharmacies. For diabetes patients who do not have an established relationship with a primary care physician, this option provides a more accessible and less-expensive alternative.
These tests are then used by pharmacists to identify those with potential diagnosis and to help them find appropriate medical attention. As the most accessible healthcare provider, pharmacists are key in the betterment of diabetes patients’ health.
Pharmacists not only provide asthma patients with the medication they need but also valuable resources to help them understand pharmacological agents for treating and managing their disease.
Their knowledge about the disease and recommended medication are valuable and beneficial to patients. Recent studies show that increased awareness about asthma reduced the numbers of asthma-related missed days at school and work, hospitalizations, emergency department visits, and deaths.
Hypertension and Cholesterol
When the American Heart Association released its new guidelines that specify 130/80 is the new high, many people found themselves with high blood pressure. This added 30 million people to the nearly half of Americans that have hypertension.
While the new guidelines spelled bad news for patients, it offers independent community pharmacies an opportunity to further serve them and boost business at the same time.
Disease management programs are an opportunity to improve patient outcomes. But it can only be achieved with complete commitment from the members of the multidisciplinary team. In terms of collaborative development and the implementation and improvement of disease management programs, the pharmacist has the leadership role.
Darshan Kulkarni Pharm.D, MS, Esq.
Amazon has made several recent moves including hiring new health IT experts, and physicians to make a big foray into health. Their recent disclosure that they want to enter the pharmacy world and their recent acquisition of PillPack makes pharmacists go - what does this mean for me? Will there be a reduced need for pharmacists?
As Global Positioning Satellites (GPS) became increasingly popular, the demand for cartographers dropped significantly. Digital maps created and updated in real time compared an individual’s current location to their desired location and told the individual how to get to the final location. Cartographers began to worry about their jobs and livelihood. Amazon’s overtures into pharmacy have similarly concerned pharmacists. However, since the concerns are similar, maybe the results will be too. There is a projection that between 2016 and 2026, the demand for cartographers will increase by 19%. This is attributed to an increased use of maps by government planning such organizations and the realization that there are some responsibilities that cannot be automated and delegated away. Similarly, pharmacists who hope to operate like they did 20 years ago are unlikely to survive. However, those who adapt, would likely be very much in demand.
Amazon has rarely been a manufacturer. Amazon typically connected businesses with potential clients and served as a marketplace. The marketplace originally started as being a place for them to sell their wares, but eventually expanded to become the Amazon Marketplace where anyone can use Amazon as a virtual store and sell their goods. As most know, goods sold by sellers on Amazon often compete against goods sold by Amazon itself, and the orders may often even be fulfilled by Amazon. Amazon has been happy to do this because they still make a profit with such an arrangement. So, one must wonder whether the pharmacy of the future will become a competitor to PillPack or will instead partner with them.
Accordingly, pharmacists may be able to compete or deal with a post-PillPack pharmacy in one of the four following ways:
Competing against PillPack in the near future will likely require demonstrating specialization and knowledge. Cartography grew because of the creation of Hyper-Local Communities (HLCs), These HLCs looked at the location of the nearest Dairy Queen but also looked for shops surrounding the Dairy Queen? This was unable to be achieved by large mapping companies. In the case of pharmacy, pharmacists could develop a specialization by connecting with unique providers or providing unique services or simply products that cannot be easily mailed. This may include veterinary prescriptions, schedule II drugs, specialty drugs, emergency antibiotics, compounding or providing uniquely personalized care.
While Amazon has excelled at delivering goods, it has not demonstrated expertise in delivering services. As a result, CVS and Walgreens are looking to capitalize by partnering or hiring nurse practitioners or other mid level professionals and enabling them to engage with patients. Because these providers may be more likely to educate their patients at the pharmacy, diagnosed patients may find fulfilling their prescriptions on site to be more convenient.
Pharmacists traditionally think of Prescription Benefit Managers (PBMs) as their enemies. However, despite PBMs and Group Purchasing Organizations (GPOs) who are all supposed to theoretically help patients by keeping costs down, pharmacists feel squeezed and don’t have enough of a margin. With a new Amazon entrant, a pharmacy may now effectively assert that PBMs, GPOs and Pharmacies are likely to perish if they don’t survive together. Accordingly, this may enable better pricing opportunities and better opportunities for patients.
Being a pharmacist in the Amazon Marketplace may enable prescription fulfillment across the state if not the country. Amazon Marketplace may enable a pharmacist sitting in New York City to sell a prescription to a patient in Albany. In some cases, the pharmacy itself may deliver to the new patient, or create a new category of “celebrity pharmacists” who simply are trusted to provide appropriate care, while a PillPack may do the actual fulfillment and delivery of the prescription.
While Amazon’s entry may provide interesting partnering opportunities, it is important that pharmacists consider relevant laws. The stark, anti-kickback, False Claims Act and civil monetary penalties law will each come into play. Accordingly, pharmacists hoping to partner with other providers, but should be careful with such endeavors since it may expose them to potential legal liability.
It seems likely that a push by Amazon into pharmacy may impact individual pharmacists who may see a decrease in patient volumes. This is likely to scare pharmacies and pharmacists. However, it seems like this may be a temporary situation and lead to more opportunities in the future.
If you are interested in hearing more about how Amazon affects pharmacists, the implications of an Amazon Pharmacy and patient centricity, or how Amazon’s Prime membership discounts might work with medications, search for the Pharmacy Podcast Network wherever you listen to your favorite podcasts or reach out to me directly on Twitter (@DarshanTalks).
10 Pharmacy Startups and Innovators
For a long time, the pharmacy space was dominated by big and long-established pharmacies. There was a major lack of startups and innovators were also lacking.
It was only recently when there was a rapid growth in pharmacy startups that areas in the pharmacy space, that have remained untouched for a long time, were disrupted. These include medication dispensing, delivery, cost-savings, prescribing, information, storage, vitamins and supplements, and specialty pharmacy services.
Below is a list of startups that have excelled in one or more areas of the pharmacy industry that are in need of improvement.
DeliverCareRx takes medication delivery to another level. Not only does the pharmacy offer free home delivery for more than three prescriptions per month but also synchronizes your prescription needs. This means your prescriptions are delivered to your door at the exact time that you need to replenish your supply.
This makes prescription acquisition convenient and timely. You never have to miss a refill for any reason. This also saves you money from fare or gasoline.
DeliverCareRx also offers free prescription management. No need to go to the doctor's office and visit your insurance provider because they will handle the scripts/paperwork for you.
ZappRx offers patients a quick and easy way to process the specialty drug orders through the ZappRx digital platform. You can order specialty medications online quickly and easily.
Considering that specialty prescribing takes time, the shortcut that the pharmacy offers makes a huge difference. Apart from streamlining the process of specialty med ordering, ZappRx also helps with the communication between providers.
NowRx hand delivers your prescription medication the same day you place your order. Since you only need to use an app to place an order, you can skip the long queues and have your prescription filled without leaving home.
You can send your prescription to them or have your doctor send it directly to the pharmacy. So after your checkup, you can go straight home instead of going to the pharmacy to purchase your prescription because your doctor can send the prescription on your behalf.
Upon fulfillment, you will receive a notification. Your card will be charged automatically.
You also have an option to video chat with your pharmacist for consultation and for whatever queries you might have.
4. Blink Health
Blink Health lets you buy your prescription meds at a more affordable price. They guarantee the lowest drug prices on all generic medications.
This is one of the startup drug companies dedicated to providing patients with medication cost savings. Unlike other pharmacies offering the same service, Blink Health does not require membership fees or coupons.
You can also pick up your prescription medication at local pharmacies near you. Just pay online and your order will be ready for pick up. Enjoy an average of 70% cost saving per prescription filled.
Run by Specialty Medical Drugstore, a full-service pharmaceutical provider based in Greater Cincinnati, GoGoMeds offers low-cost prescription medications and other specialty pharmacy services.
You can have your prescription filled without the need to leave your home. Just send your prescription via mail or have your doctor fax it directly to specialty medical drugstore.
If you want to transfer from one pharmacy to GoGoMeds, just provide the name and phone number of the pharmacy when you process your order. Upon fulfillment, your medicine can be shipped to you directly or delivered according to your instructions.
6. Alto Pharmacy
Alto Pharmacy fills your prescription and delivers your meds for free. The pharmacy stocks all common medication and specialty treatments and sells them to you at the best price. With the same copay and free delivery, you're sure to achieve medicine cost savings.
With the acquisition of Round Health, Alto Pharmacy helps ensure people actually take their medicine. The reminder app not only takes note of your schedule for taking your medication but also the patterns and rhythms of your life. This allows the app to remind you of your medication more effectively.
You also have the option to have your prescription refilled at a specific schedule and right on time.
Fast and reliable medication dispensing is what NimbleRx is all about. They offer fast delivered pharmacy services that ensure patients get their prescription on time.
Delivery is always free, and you get to choose when and where you want to receive your prescription. Just have your doctor send your prescription directly to the pharmacy and they will take care of the rest.
If you need to manage your refills, just use the Nimble Pharmacy app. It's easy to manage and will speed up purchase and delivery services.
MedAvail has created medication pick up points, self-serve pharmacy kiosks where patients can pick up their prescriptions and over-the-counter medications.
The MedCenter, as the kiosk is called, is remotely controlled by a pharmacist who interacts with clients through audio and video network connection. Think of it as an ATM that dispenses medication on the spot instead of notes.
You can choose from over 500 medications through this 24-hour, on-the-spot pharmacy.
With the outrageous costs of drug prices, pharmacy start-ups that offer medication cost savings will save patients from financial worries. GoodRx is one of the drug coupon companies that provides patients with information as to where they can buy the prescription medication for the lowest price.
Using coupons, clients can save so much more.
Through GoodRx, you can compare drug prices from over 60,000 pharmacies in the US, print free coupons, and save up to 80% on your medication. You can also save a copy of the coupon on your phone and show it to partner pharmacies.
With Capsule, your prescription can be filled right from the doctor's office. Just tell your doctor that your pharmacy is Capsule and wait for a text with a checkout link. Here, you can place your order and schedule same-day delivery.
You can go home right after your checkup and then wait for your prescription to be delivered right at your doorstep.
But their pharmaceutical services don't stop there. You have the option to transfer a refill from your old pharmacy, have capsule take care of your refills, and ask questions related to your prescription.
Where are the Top 5 Medical Tourism Destinations?
More and more people are traveling abroad to seek medical care. They do so not for a less expensive healthcare but because some countries offer better medical services than what they would find in their own country.
According to the Medical Tourism Association, approximately 14 million people in the world go on a medical tourism annually.
A report by McKinsey and Company outlined what patients seek when traveling abroad to receive medical treatment.
Top 5 Medical Tourism Destinations
When it comes to advanced care and cosmetic surgery and dentistry, Mexico takes the top spot. Tijuana, in particular, is a hotspot for cosmetic procedures.
The country has 98 hospitals accredited by the Federal Health Ministry and 7 hospitals accredited by the Joint Commission International (JCI).
With low-cost medical treatments that save patients up to 60% the prices in the US and Europe, it's not a surprise that many people travel to Mexico for medical tourism.
2. Costa Rica
In the last few years, Costa Rica has consistently ranked high in dentistry and cosmetic surgery above Canada and the US. It is also making vast improvements in the fields of bariatric surgery, cancer therapy, and eye surgery.
Compared to the US, healthcare services in Costa Rica is 45% to 65% lower.
The CheTica Ranch in San Jose offers medical tourists a unique ranch-style recovery retreat where patients enjoy amenities that rival a hotel and the care of well-trained nurses.
According to the Medical Tourism Global Market and Figures 2018, Canada highly excels in stem cell treatment at a cost that is more affordable than in the US. In 2016, it was considered a world leader in health tourism according to an index developed by Fetscherin & Stephano.
With medical tourism considered one way for the country to create another source of revenue, expect more medical treatments to be added into Canada’s medical tourism.
Healthcare costs in India will save patients 65% to 90% of similar services in the US. The country also uses cutting edge-technology in healthcare delivery. This is why it is one of the key players in the medical tourism industry.
Many of its hospitals are accredited by the Joint Commission International and the National Accreditation Board for Hospitals and Healthcare Providers. Some private hospitals offer health care packages for foreign patients that include airport-to-hospital pickups, private chefs, and free in-room Wi-Fi.
Some of the more popular procedures include eye surgery, orthopedic surgery, bone transplants, and heart bypass surgery.
Chennai currently ranks number one as the ultimate health care tourism destination in India.
In Latin America, Brazil is the best in healthcare delivery as noted by the World Health Organization. It is home to some of the world-renowned surgeons and has 43 JCI-accredited hospitals.
Brazil offers high-quality cosmetic and plastic surgery services that cost about 30% to 50% lower than in the US. This shouldn’t come as a surprise as cosmetic treatments are considered the norm in the country.
The Ivo Pitanguy Clinic in Rio de Janeiro is well-known for performing more cosmetic surgeries than other places in the world.
These are the just the top 5 medical tourism destinations in the world. This means you have more options when seeking medical treatments abroad if you look long and hard. What is even better is that you’re not just paying for lower costs but excellent medical care as well.
For the content
The Right Ways to Deal with a Disgruntled Former Employee Online and Offline
Firing an employee has its consequences. And a disgruntled former employee has the ability to destroy your company's reputation by badmouthing or spreading rumors. With the thought that they have nothing to lose or they simply want to exact vengeance, they can be quite vindictive.
What can you do to minimize the damage? How should you react so as not to worsen the situation?
What you do and how you react depends on the channel used. However, the premise behind the actions you take is the same.
On social media
What better way for a former employee to speak negatively about your company to a bigger audience than through social media?
Because anyone can say anything about everyone in such platforms, the damage can be catastrophic. Imagine if partners, vendors, and prospective clients get to read a disgruntled employee's negative comments?
Your company is sure to be fodder for wild speculations and bad talks.
How you handle the situation can douse the fire or fuel it. Because everyone is watching, you need to tread carefully.
Address the former employee directly
This is the most practical approach, with the situation discussed between the parties involved and no one else. There are different ways to do this.
Pursue legal action
This especially applies to the private sector where an employer is within their rights to sue a foul-mouthed former employee. You can send a cease and desist as a scare tactic. Or file a suit when the former doesn't work.
Issue a public statement
Most of the time, if you don't react to someone's negative comments, many would speculate that the accusations are true. If dealing with a problem privately doesn't work, issue a statement that denies all allegations and expresses regret that the former employee refused to deal with the matter privately.
It is important that, when dealing with this kind of situation on social media, you remain diplomatic and in control. Never stoop to a disgruntled employee’s level.
Given this kind of possibility, it is better to be proactive and take steps to ensure that terminating an employee will not result in a social media circus. Create a social media policy that outlines rules of engagement for employees.
In the real world
Regardless of the method that a former employee uses in harassing your business, follow the same approach as you would on social media.
Reach out privately first.
If this doesn't work, focus on what matters most—your company and your active employees.
To keep the boat from rocking too much, so to speak, you should:
It is not enough to deny accusations. You should also show everyone that you operate by principles and sway public opinion in your favor.
In the event that harassment takes physical form and your employees are in danger, take steps to protect them. Report any threats made and, when a former employee shows up at your place of business angry, contact the proper authorities.
Remember to document everything. This will prove handy when you have to pursue legal action.
How Pharmacy Benefit Managers Impact Drug Pricing, Hospital and Patient Care, Payers, and More
In the United States, the cost of diabetes-related drugs, such as insulin or Victoza, cost 10 times as much than if you were to buy them outside the US. Price inflation of prescription drugs are not new but it is a unique problem for the United States.
Who's to blame for the skyrocketing costs of prescription drugs?
Pharmacy benefit managers (PBMs)
They may not be the only culprit, but they contribute largely to the problem. Competing drug companies buy access to PBM formularies so their products will be chosen as the recommended choice.
By paying rebates and other fees to a PBM, a drug manufacturer can take a bigger piece of the sales pie. To recoup the large rebates and other fees paid to the PBMs, drug manufacturers have to increase the list price of drugs.
The result is skyrocketing drug prices.
But the cost of prescription drugs is not the only thing that PBMs can impact in both negative and positive ways.
How Pharmacy Benefit Managers Work
Historically, PBMs act as middlemen entities that process prescription medication claims and plan sponsors for a small fee. They provide services and educational programs to aid patient. They also serve as an intermediary between insurers and other healthcare members. This allows them to negotiate large customer contracts and for pharmaceutical companies and pharmacies to get the best rate.
What PBMs do
The role was clear-cut and clean until they leveraged their position as middlemen to impact nearly every aspect of the prescription drug marketplace. Even an independent pharmacy is not spared from the impact that PBMs make.
Impact of PBMs on hospitals and patient care
PBMs are exploiting a Medicare provision that allows them to charge remuneration fees directly and indirectly to pharmacies within their network. To price out the competition, particularly a local independent pharmacy where patients have a personal relationship with pharmacists, they increase the fees for using in-house and member pharmacies as part of Medicare reimbursement.
With the way the incentives are structured, PBMs retain more of the discounts and fees, driving up costs on Medicare. Since the pricing model used is fiercely guarded, pharmacy benefit managers continue to hide the costs paid by health insurance companies, patients, and the government.
Impact of PBMs on American Health Care
PBMs generate revenue in three ways—administrative fees, pharmacy spread, and rebates.
All these resulted in high prescription drug prices, restricted patient access to pharmacies, and the negative impact of limited formularies.
Impact of PBMs on employers/payers
Payers can benefit from a PBM through management of prescription drug benefits for members. Because the contracts are often one-sided and complex, partnering with PBMs often results in limited savings.
Only 30% of employers understood the clauses of their PDM contracts, according to a study by the National Pharmaceutical Council.
Research from Cigna showed that employers sponsoring their own health plans can save annually with integrated medical and pharmacy benefits. They can also bolster member patient care and self-management.
Although tackling prescription spending without the help of a PBM is beneficial, employers/payers still need to weigh the pros and cons of partnering with PBMs.
Lack of Regulation and Transparency
Through all these scenarios, a commonality is the lack of federal regulation and transparency that allowed PBM practices to take advantage of their role in the healthcare marketplace and make money at the expense of patients, payers, and pharmacies.
Something needs to be done.
Lawmakers are pushing to fill in what's lacking and make PBMs more accountable.
In California, legislations are being proposed to boost transparency in PBM dealings. One of these legislations require pharmacy benefit managers to provide information about how much they paid for a drug, including administrative fees, acquisition costs, and rebates received.
(Muster, IN) Rxeed.com is a new web-based prescription marketplace, that connects consumers with their neighborhood retail pharmacies, specialty pharmacies and others. In addition, it connects pharmacy owners with top wholesalers, allowing the owner to search inventories of available prescriptions. Finally, it creates a platform for pharmacy owners to reach out to other independent pharmacies and purchase prescriptions for shortage or back-order issues. This type of platform is the first of its kind, to bring together consumers, independent pharmacies and wholesalers in one place.
The website was created by Omar Hassad, pharmacist and local owner of Tinley Park Apothecary in Tinley Park, IL. He developed it after experiencing frustration with negative reimbursement from insurance companies, spending thousands of dollars trying to find new customers, and several hours dedicated to finding the cheapest prices for medications. " I firmly believe that Rxeed platform will forever change the way pharmacies will interact with consumers and wholesalers, " stated Founder and CEO Omar Hassad. Consumers now have the power to choose how much they pay for prescriptions by letting local independent pharmacies bid their lowest price for the medication and required services. Once a bid is accepted, the consumer is connected with their local pharmacy, giving the pharmacy owner an opportunity to gain new customers at a minimal cost. Using the “Locate a Medication” feature, a consumer can easily find which local pharmacies have the medication in stock. This convenient feature saves the consumer time spending hours on the phone, and gets the medication needed in their hands quicker. Consumers also have the option to locate compounding pharmacies and receive a comprehensive medical review.
For the independent pharmacy owner, he or she can purchase prescription drugs at a substantial discount, and in small quantities. This can be for drugs in short supply, a specific patient need, or when there is a public health emergency. There is no charge to join, the only fees are a small transaction percentage when prescriptions are bought and sold among pharmacy owners. For additional information on this new platform, go to www.rxeed.com, or call 1-833-697-9333.
How many times has a patient presented to you a prescription for a “specialty medication" that you are unable to fill? It could be that you are not able to order the medication from your wholesaler. Or worse, the patient’s insurance is mandating a specific pharmacy different than yours. It can be frustrating when a current or prospective customer is coming to you, the pharmacist, for a solution to their chronic and sometimes rare, condition.
There is no finite definition for what qualifies as a “specialty medication". In general, specialty medications are used to treat chronic or complex conditions and usually require special handling or administration and close monitoring of the patient. Sometimes, these prescription medications are indicated for rare diseases, which means that the disease affects less than 10,000 people. And they are therefore given “orphan drug status” under the Orphan Drug Act of 1983. This Act allows for fast-track FDA approval for drugs intended to treat these rare diseases due to limited therapies available on the market. Obtaining fast-track approval allows the medicine to be available as quickly as possible to the patients that need it the most. This also means that the medication does not have to go through as many lengthy clinical studies as the “more” traditional therapies. Often, as a stipulation of being given fast-track approval status, the FDA may require additional aftermarket studies to be completed, meaning that the drug is available to be prescribed but the patients taking the medicine are monitored for safety and efficacy of the therapy. This is referred to as a Phase IV clinical trial. Any pharmacy that dispenses one of these drugs must understand this process and accommodate the patient and drug manufacturer for any required documentation or data.
Some specialty drug manufacturers may limit the number of pharmacies who have access to order their medication. These are deemed “Limited Distribution Drugs,” or LDDs for short. When attempting to order one of these medications from your wholesaler, you may notice that the drug’s name is not listed in the system. Or it may take you straight to a screen that reads, “due to manufacturer limitations, this product is only available through a limited distribution network” and to contact the manufacturer directly. This can be very disheartening for a pharmacist or pharmacy owner.
Upon calling the manufacturer, you may find out that in order to gain access to this drug, there are many rigorous requirements to meet first. It is also worth mentioning that all manufacturers are different and have different specifications that must be met. Many require weekly data reports so it would be prudent to know if your pharmacy’s dispensing software can accommodate customized and automatic reports. The manufacturer may also request proof that you, as the pharmacy, have a way to monitor the patient for adherence and therapy response. A common theme among these manufacturers is some sort of “specialty accreditation”. This is often the first step to becoming a Specialty Pharmacy.
Achieving accreditation proves a commitment to quality and standards that are becoming the norm in the specialty space. Accrediting bodies such as the Accreditation Commission for Health Care (ACHC) and the Utilization Review Accreditation Commission (URAC) are arguably the most reputable in the field. Both sets of standards set the stage for core activities such as:
o Patient Care
o Coordination of Care and/or Delegation
o Information Management
o Compliance Program
o Quality Management and Continuous Quality Improvement, etc.
Accreditation is strongly recommended but could become mandatory by payers in the near future in order to ascertain preferred contracts for reimbursement purposes. This means extra revenue for your pharmacy by adding a specialty line of business. The entire process can take up to six months to a year for full accreditation and can be very arduous and labor intensive.
If all of this is intimidating to you, just know that you are not alone. The key is to connect with a professional who has been through the process. Ideally, they should have been able to achieve and has maintained accreditation for some time. Embarking on a project like this size could be overwhelming and a competent expert can guide you through the process.
There are many resources available though, if you choose to take on a project independently. However, there is a lot of competition out there in specialty pharmacy but accreditation can set you apart from others. Visit www.ACHC.org or www.URAC.org to learn more about the various programs in accreditation and visit www.HVRSSolutions.com/services-offered to learn more about guidance through the process. HVRS Solutions provides necessary paperwork required for accreditations such as policies and procedures and staff training documentations and will also assist you in preparing you and your pharmacy staff for on-site surveys. All services are customizable and personalized to your individual business needs.
We recommend using CSI Specialty Group for all of your specialty needs. Click Here
Winners of the 2018 APPA Pharmaceutical Industry Awards
APPA recognizes outstanding performance in the Pharmaceutical Industry
2018 marks a wonderful kick-off to APPA’s fourth anniversary and the alliance is thrilled to acknowledge superior commitment and contribution to the industry.
With twelve categories selected by an industry survey, the awards recognize companies and individuals for their innovation, dedication, and best-in-class service.
The winners, eight companies, one school and three individuals, will be honored at a prestigious awards ceremony - the “Oscars” - for the Pharmaceutical Industry scheduled to take place on June 8, 2018, at the national convention, PharmaCon Expo in Orlando, FL.
Here are the winners of the 2018 Pharmaceutical Industry awards:
• Independent Pharmacy of The Year - Benzer Pharmacy Tampa, FL
• Pharmacy School of The Year - University of Pittsburgh
• Pharmacy Manufacturer of The Year - Merck & Co.
• Pharmacy Technology of The Year - PrescribeWellness
• Secondary Wholesaler of The Year - Republic Pharmaceuticals
• Pharmacy Wholesaler of The Year - McKesson
• Specialty Pharmacy of The Year - PantheRx
• Pharmacy Entrepreneur of The Year - Al Babbington - PrescribeWellness
• Pharmaceutical Representative of The Year - Marc Weiss - AmerisourceBergen, Florida
• Hospital Pharmacy of The Year - Kaiser Permanente Hospitals
• Industry News Provider of The Year - Pharmacy Times
• CEO of The Year - Michael Castagna - MannKind Corp
For more information about the awards: https://joinappa.com/awards
For more information about PharmaCon go to: https://joinappa.com/events
Call, text us at 877-570-2665 or email us at firstname.lastname@example.org.
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