News Capsules

Copayments Reduce RxAdherence...

Findings from a recent study appearingin the Journal of General Medicineshow that when prescription copaymentsrise, medication adherencedrops—especially among low-incomepatients.

The multiyear study followed 29,764diabetes patients and 13,081 patientswith congestive heart failure (CHF).Researchers found that for each medicationclass, individuals in high-incomeareas were consistently more adherent,compared with their low-incomecounterparts. For both diabetes andCHF, a notable decrease in medicationadherence occurred across all drugcategories in response to a 10% copaymentincrease. Adherence to statinswas particularly sensitive to income, thestudy found.

"Based on our analysis, it is likely thatincreased copayments, intended to controlcosts, will exacerbate the disparitiesseen across socioeconomic groups,"noted study coauthor Michael Chernow,PhD, professor, Department of HealthCare Policy, Harvard Medical School.

The current study, funded byGlaxoSmithKline, complements earlierstudies from its Health ManagementInnovations team, which indicate thatbarriers to medication access shouldbe removed to improve adherence, bettermanage chronic conditions, improvehealth, and lower health care costs.

...As 79 Million Struggle to Pay Medical Bills

A new study from The Commonwealth Fund has foundthat 79 million Americans are having medical bill problemsor paying off medical debt. The proportion of working-age Americans in this situation increased from 34%in 2005 to 41% in 2007. The study also found that moreworking-age adults are delaying or avoiding needed medicalcare, such as skipping doses of medication or not fillingprescriptions, because of health care costs. One thirdof working-age adults spent 10% or more of their incomeon out-of-pocket medical expenses and health insurancepremiums in 2007, up from 21% in 2001.

The data come from the national CommonwealthFund Biennial Health Insurance Survey (2007). Moreinformation on the study can be found at www.commonwealthfund.org.

Aetna LaunchesPharmacists' Web Site

Aetna recently announced the launch ofAetnaPharmacists.com, a secure Website designed to provide its >59,000networkpharmacists with quick andconvenient access to up-to-date formulary,claim, and other prescriptioninformationonline.

"This new tool will help pharmacistsquickly access information related tomembers' prescriptions and help managetheir pharmaceutical needs," saidJoseph C. Zavalishin, who heads Aetna'sPharmacy Management Network. Thesite features drug pricing information, aProvider Services manual, and the latestinformation on whether a specific drugis included in the Aetna formulary.

Pharmacists can register for thenew Web site at www.aetna.com,where they should click on the "ForHealth Professionals" link and then on"Pharmacy."

CVS Acquires Longs DrugStores

In a $2.9-billion deal, CVS Caremark Corpwill acquire Longs Drug Stores Corp,expanding the retail giant's position asthe number-1 provider of prescriptionsin the United States. The purchase willbring CVS' total operations to approximately6800 drugstores in 41 states andthe District of Columbia.

The acquisition includes Longs' 521retail drugstores in California, Hawaii,Nevada, and Arizona. CVS also will havea leading position in Hawaii, where itcurrently does not have a presence. Inaddition, the retail chain is acquiringLongs' Rx America subsidiary, whichoffers prescription benefits management(PBM) services to >8 million membersand prescription drug plan benefits toapproximately 450,000 Medicare beneficiaries.

With an enhanced national reach, CVSwill be in a stronger position as it rollsout its new suite of offerings underthe Proactive Pharmacy Care model,taking advantage of its retail and PBMservices.

NCPA Foundation toAward Scholarships

The National CommunityPharmacistsAssociation (NCPA) Foundation announcedthe recipients of 31 pharmacystudent scholarships for 2008-2009. Thescholarships, totaling $63,000, will beawarded at NCPA's 110th Annual Conventionand Trade Exposition next month.

The award recipients include:

Cassandra Shields, from the Universityof Missouri, was named the 2008 recipientof the Willard B. Simmons Sr MemorialScholarship and will receive $2500. Thescholarship is awarded to a student whohas demonstrated exemplary interest inpharmacy management.

Todd Mattingly, from the University ofKentucky, was named the 2008 recipientof the J.C. and Rheba Cobb MemorialScholarship and will receive $2500. Thisaward is presented for exemplary interestin civic and government affairs.

Ellen Smith, from the University ofWashington, is the first recipient of thenew Neil Pruitt Sr Memorial Scholarshipand will receive $2500. This award isbased on leadership, academic achievement,and interest in entrepreneurism.

The NCPA Foundation also awardedits 2008 Presidential Scholarships to 18pharmacy students who will be awarded$2000 each. The winners are chosen onthe basis of academic achievement, leadershipqualities, interest in independentcommunity pharmacy, and extracurricularaccomplishments.

The 10 award recipients for the 2008Partners in Pharmacy Scholarships willeach receive $2000 scholarships. Thescholarship recognizes academic achievement,community service, and a demonstratedinterest in independent pharmacy.

140,000 ED Visits for Antibiotic Reactions

Researchers looking at recent nationaladverse drug event surveillance data estimatethat >140,000 emergency department(ED) visits each year can be attributedto an allergic reaction or otherdrug-related adverse event in patientstaking systemic antibiotics. Antibioticswere implicated in 19.3% of all ED visitsfor drug-related adverse events, accordingto the study, which appears in theSeptember 15, 2008, issue of ClinicalInfectious Diseases.

The researchers noted that althoughthe risk of an ED visit for an antibioticassociatedadverse event is small for anindividual patient, the overall burden onthe population increases when antibioticsare commonly prescribed for indicationsfor which they have no benefit. They suggestthat communicating the risks of antibiotic-associated adverse events shouldbecome an important strategy in effortsto promote judicious antibiotic use.

Part D Web Site ConfusesSeniors

Medicare.gov is apparently not as userfriendlyas some might hope, in helpingeven those seniors with basic computerskills to understand the Part D prescriptiondrug plan, according to a recentstudy of seniors living in Miami, Florida.

Well-educated adults with computerexperience reported difficulty usingthe Web site to determine eligibility forservices and enroll in the drug plan.Participants also reported problems navigatingwithin the Web site and locatinginformation. The University of Miamiresearchers note that it is likely thatpersons with less computer experiencewould have even greater difficulty andsuggest that more input from individualsbe used in the Web site design.

The findings were reported in theAugust 20, 2008, issue of the Journal ofthe American Medical Association.

Initiative Launched forHIV/AIDS

Mirixa Corp and Ramsell PharmacySolutions have launched a pharmacistdeliveredmedication therapy management(MTM) initiative for individuals withHIV/AIDS.

The program will enable retail pharmaciststo provide coaching and educationfor AIDS Drug Assistance Programpatients across the country and to promotequality medication-related care,proper adherence, and education regardingHIV/AIDS. The services will be deliveredvia MirixaPro, the company's' medicationcare management system, whichis used by Mirixa's network of retail pharmacies.In addition to each state ADAPorganization, the same services will beoffered to state Medicaid plans.

Programs delivered through the initiativewill involve the electronic deliveryof patient cases to community-basedpharmacies. The pharmacists then invitepatients to engage in protocol-drivenconfidential face-to-face education sessions,which are designed to improvemedication-related care and increasetreatment adherence, benefiting patientsand lowering health care costs.

"PRO(TECH)T" Bill Jumps Ahead

The House Energy and CommerceCommittee recently approved a bill topromote faster adoption of electronichealth records (EHRs). In a unanimousvote, committee members approved HR6357, the Protecting Records, OptimizingTreatment, and Easing CommunicationThrough Health Care Technology Act of2008 or "PRO(TECH)T."

The legislation promotes the nationwideadoption of a health informationtechnology (HIT) infrastructure and wouldestablish incentives for doctors, hospitals,insurers, and the government toexchange information electronically.

"Your grocery store automaticallyknows what brand of chips you boughtlast year, but your cardiologist doesn'tautomatically know what prescriptionsyour family doctor prescribed for you yesterday.That's problematic for health carequality and costs," said Rep John Dingell(D, MI), committee chair. Some concernshave been raised about EHR implementationcosts to physicians, as well as theneed for privacy protections, however.

The legislation is also under review in 2other House committees—Small Businessand Ways and Means. In a statement tothe Ways and Means Subcommittee onHealth, which recently held a hearing onthe bill, the National Association of ChainDrug Stores (NACDS) reiterated its supportfor a "robust and standardized" HITsystem.

"It is critical that communicationsbetween the prescriber, the pharmacist,and the patient not be hampered, whileassuring adequate safeguards for protectedhealth information," said NACDSPresident and Chief Executive OfficerSteven C. Anderson, IOM, CAE.

Rite Aid Offers Incentive to Patients

Rite Aid is running a "Fill Up & Fuel Up" program—individualswho transfer a prescription immediately receive a $30 giftcard and remain eligible for $2600 gas gift cards which willbe given to 31 winners. The incentive program runs throughJanuary 10, 2009.

Crosswalk Tool Availablefor Sterile Compounding

Baxa Corp is now offering a crosswalktool for understanding the compliancerequirements for sterile compounding andthe United States Pharmacopeia (USP)797 compliance. The tool offers statespecificguidelines on professional licensingand training requirements, State Boardof Pharmacy harmonization with USP 797guidelines, and sterile compounding laws.

The interactive reference map wasdevelopedby ClinicalIQ, CriticalPointLLC, and the National Association ofBoards of Pharmacy. Baxa Corp marketsthe CriticalPoint compliance trainingmodules as part of its Productivity andCompliance Tools product line, whichincludes the Skills, Training, Academicsand Resources Center classroom-basedtraining for USP 797 compliance andaseptic compounding.