New Survey: Pharmacists Report Patients Do

Not Treat Cold and Flu Symptoms Early Enough

A recent national survey of 505 pharmacists found that nine out of 10 pharmacists believe it is important for a patient to seek treatment early to help shorten the duration and severity of a cold. And 75 percent of pharmacists say most patients should purchase over-the-counter (OTC) cold and flu products at the first sign of symptoms, while only 26 percent of their patients take this proactive approach.  

According to the survey, (National Pharmacist O.T.C. (Observations on the Treatment of Colds)” sponsored by Matrixx Initiatives Inc. an OTC healthcare company)

pharmacists are increasingly playing a more prominent role in patient care due to the anticipated severity of the upcoming cold and flu season and the current state of the economy. The survey also showed 87 percent of pharmacists anticipate an overall increase in the number of cold and flu patients seeking their counsel and 85 percent agree that the economic downturn will specifically lead more patients to first come to their pharmacist rather than a physician.  

“Early preparedness is going to be more important this cold and flu season; however, even with the threat of stronger, more virulent infections, pharmacists note that patients oftentimes delay treatment allowing a virus to live longer,” said Dr. Fred Eckel, professor of Pharmacy Practice and Experiential Education at the University of North Carolina Chapel Hill Eshelman School of Pharmacy. “Pharmacists are the most accessible health care provider for patients with cold and flu symptoms and the survey findings emphasize the important role of the pharmacist in educating patients with information about early treatment to shorten the duration and severity of a cold.” 

Other key findings from the survey include: 

u  Eighty-five percent of pharmacists agree the economy has increased the number of patient questions about OTC products.   

u  Eighty-one percent of pharmacists agree that more patients are opting to purchase OTC medications versus filling prescriptions due to the economic downturn. 

u  Eighty-one percent of pharmacists report making five or more recommendations per day for OTC cold and flu products. 

Conducted in September 2009, the survey was based on a nationally representative random sample of 505 pharmacists working in independent and chain pharmacies. The sample frame was developed using Medical Marketing Service Inc.'s pharmacies list, that includes more than 68,000 pharmacies and is updated monthly. Only one pharmacist was allowed to respond per pharmacy. Richard Day Research Inc. was responsible for survey design, data analysis and reporting.

03/04/10

NABP Commends Google's VIPPS-Accreditation

Requirement for Internet Pharmacy Advertisers

Rogue Internet drug outlets will soon find it more difficult to advertise to unsuspecting consumers, thanks to Google's decision to require VIPPS (Verified Internet Pharmacy Practice Sites) accreditation, according to the National Association of Boards of Pharmacy (NABP) which recently commended Google for the new restrictions the company has placed on Web sites selling prescription drugs that are seeking to advertise in the United States through Google AdWords. 

"For too long, rogue Web sites posing as legitimate pharmacies have continued, unabated, to peddle substandard, tainted, and counterfeit drugs to unwitting patients," says NABP president Gary A. Schnabel, RN, RPh. "Google's policy change is a major step toward ridding the Internet of these operations, and we applaud Google's commitment to patient safety." 

On February 9, 2010, Google announced in its Inside AdWords blog that the company will accept ads only from Internet pharmacies in the United States that are accredited through the VIPPS program, and from Internet pharmacies in Canada that are accredited by the Canadian International Pharmacy Association. The revised policy allows Internet pharmacies to target ads only to patients in the country in which the pharmacies are accredited. 

The AdWords blog indicates that, once the policy change went into effect later in February 2010, ads for Internet drug outlets that are not accredited by VIPPS or CIPA will no longer appear in Google's sponsored search results. 

Since the advent of its VIPPS program more than a decade ago, NABP has been working to protect patients from rogue Internet drug outlets that circumvent pharmacy laws and practice standards established to protect patient health. In February 2008, NABP began an intensive study of Web sites selling prescription drugs and has found that, of the more than 5,000 Internet drug outlets NABP has reviewed, 96 percent appear to be out of compliance with pharmacy laws and practice standards. These sites dispense dangerous prescription drugs to patients without a valid prescription or medical oversight. The drugs are often unapproved for sale in the United States, or any other developed country, and are often substandard, contaminated, or counterfeit. 

By contrast, VIPPS-accredited pharmacies have undergone and successfully completed the thorough NABP accreditation process, which includes a thorough review of all policies and procedures regarding the practice of pharmacy and dispensing of medicine over the Internet, as well as an on-site inspection of all facilities used by the site to receive, review, and dispense medicine. For this reason, NABP recommends that patients use VIPPS-accredited Internet pharmacies when buying medicine online. 

"Google's policy revision sets an important precedent in the international push to curb the proliferation of rogue Internet drug outlets," NABP president Schnabel notes. "We encourage other search engines to follow Google's lead and take a stand for patient safety."

More information on the VIPPS program, along with a list of VIPPS-accredited pharmacies, is available under Accreditation Programs on the NABP Web site, www.nabp.net/.

03/04/10

NCPA Commends Senators Baucus, Grassley

for Urging Discretion in Enforcement of

Medicare DMEPOS Accreditation Requirement  

Senate Finance Committee chair Max Baucus (D-MT) and Ranking Member Charles Grassley (R-IA) have sent a letter to Health and Human Services (HHS) Secretary Kathleen Sebelius urging “administrative discretion” in the enforcement of the Medicare Part B Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) accreditation requirement for pharmacies. In response, National Community Pharmacists Association (NCPA) executive vice president and CEO, Bruce T. Roberts, RPh, issued the following statement: 

“Two top Senators sent a bipartisan message to HHS Secretary Sebelius: Avoid disrupting seniors’ ability to purchase essential durable medical equipment. 

“The Senators recognize the DMEPOS accreditation requirement is onerous, expensive, and duplicative for community pharmacies. Even those pharmacies that completed this initial round of accreditation face another round in a few years. Worst of all, the requirement singles out pharmacists while exempting 17 other medical professionals.  

“Senators Baucus and Grassley are part of a large, bipartisan consensus in Congress supportive of exempting pharmacies. Such a provision was included in both the Senate and House health care reform bills. Congress also overwhelmingly approved separate legislation to extend the deadline for accreditation from October 1 of last year to January 1 of this year in anticipation of Congress working its will in this matter.  

“Efforts to find a solution continue, which is why the letter’s message remains critical to ensuring seniors don’t lose access to supplies that help improve their health.” 

The final two paragraphs of the Senator’s letter succinctly make the argument:  

“Absent the use of administrative discretion in implementing the accreditation requirement, Medicare beneficiaries could lose access to diabetic test strips, canes, walkers, nebulizers, wound care, and other vital medical products. Beneficiaries in rural and underserved areas are particularly at risk for experiencing a reduction in access to these medical supplies.   

“We therefore respectfully request that you use discretion in implementing the accreditation requirement for pharmacies in a manner that preserves beneficiaries’ access to medical supplies and equipment while Congress considers the best approach for addressing this issue.”  

The National Community Pharmacists Association (NCPA) represents America's community pharmacists, including the owners of more than 22,700 independent community pharmacies, pharmacy franchises, and chains. Together they represent an $88 billion health-care marketplace, employ over 65,000 pharmacists, and dispense over 40 percent of all retail prescriptions. To learn more go to www.ncpanet.org or read NCPA’s blog, The Dose, at http://ncpanet.wordpress.com.

02/24/10

Statement from the CHPA on Mississippi Bill

That Seeks to Make Cold, Allergy Medicines

Containing Pseudoephedrine Prescription-Only

The following is a statement by Linda A. Suydam, DPA, president of the Consumer Healthcare Products Association (CHPA):

"Today (January 28), the Mississippi House of Representatives passed a bill without listening to any testimony that, if it becomes law, will greatly limit how cold and allergy sufferers access some of their medicines. The legislation would require law-abiding families to obtain a doctor's prescription for pseudoephedrine- (PSE-) containing medicines rather than simply asking for these medications at the pharmacy or service counter. Mississippi lawmakers seem prepared to impose this burden on Mississippians, even though there is a better solution. 

"Mississippi's voters agree this is not the right way to address meth. As states continually find themselves in dire financial situations, policy makers must balance efforts to regulate ingredients used to create meth with the public health and economic consequences of restricting access to important cold and allergy medications. Electronic tracking is one such solution that eight other states have adopted to fight domestic meth production while maintaining consumer over-the-counter access to these products. 

"An e-tracking system is a tool that law enforcement and pharmacists can put in place to stop the sale of illegal amounts of PSE as set forth by the Combat Meth Act. With this real-time tracking system, states can also link up with other states to track cross-border sales. For instance, neighboring Louisiana has plans to implement e-tracking starting in March. Additionally, e-tracking would be implemented at no cost to the state; the makers of PSE-containing products would purchase and maintain the system for Mississippi. 

"A CHPA-sponsored survey conducted by David Binder Research last month found that almost two-thirds of Mississippi voters surveyed (N=350) feel making common cold and allergy medications containing pseudoephedrine available by prescription only would be a big mistake, placing a heavy and unnecessary new burden on law-abiding people, significantly increasing consumer costs, and hurting the state's own finances at the worst possible time. 

"Among other findings: 

u  61 percent of those surveyed would oppose laws that would require these medications be sold only by prescription. 

u  74 percent of those surveyed agree that an Rx-only requirement would create an 'unnecessary burden' for law-abiding citizens; and  

u  59 percent of those surveyed indicate they feel the legislative train is speeding forward too fast, agreeing 'before my state's lawmakers enact a new law, they should study the economic impact and societal burden a prescription law would pose.' 

"This House bill was passed before hearing any testimony or listening to the concerns of constituents. We urge the state legislature to assess the deep burdens of this bill and the proven alternative of e-tracking before placing such serious and costly restriction on law-abiding Mississippians."

CHPA is the 129-year-old-trade association representing U.S. manufacturers and distributors of over-the- counter medicines and nutritional supplements. 

02/24/10

NCPA Backs Bill to Improve Federal Employees’

Drug Benefit; Offers Changes to Legislation  

In a letter to Rep. Stephen Lynch (D-MA), the National Community Pharmacists Association’s (NCPA) Bruce T. Roberts, RPh, executive vice president and CEO, offered support and recommendations for improving the recently introduced bill, H.R. 4489, The FEHBP Prescription Drug Integrity, Transparency and Cost Savings Act. Lynch’s bill expands the Office of Personnel Management’s (OPM) oversight capabilities for the Federal Employees Health Benefits Program (FEHBP), which includes prescription drug services. Rep. Lynch also chairs the subcommittee with jurisdiction over FEHBP, and in the last year has held hearings on the effectiveness the program.   

In the January letter, Roberts commends Lynch for including the following four provisions designed to create greater transparency that could lead to savings in the program: 

· Giving OPM access to data from drug manufacturers and pharmacy benefit managers (PBMs) on deals to promote the usage of certain drugs over others, and forcing the PBMs to “pass through 99 percent of rebates earned on behalf of plan sponsors” as opposed to keeping those resources to themselves.  

· Exposing mechanisms that reveal PBMs’ manipulation of the pricing structure “by using different reimbursement bases for prescriptions dispensed by mail order pharmacies compared to retail pharmacies,” which benefits PBMs since they own mail order pharmacies.

· Assuring that patients “receive the prescription drug actually prescribed by their physician,” which would end the PBM drug switching unless “approved by the provider and results in actual savings to the plan”.  

· Prohibiting PBM ownership of retail pharmacies to “eliminate the conflicts of interest that are inherent when a manufacturer exerts a controlling interest in a PBM or when a retail pharmacy owns a controlling interest in a PBM”.  

If these provisions were enacted they would represent a breakthrough at the federal level by mitigating some of the more egregious PBM business practices and help create momentum for more sweeping reform, explained Roberts. However, H.R. 4899 has other provisions that should be amended to prevent unintended, but possibly deleterious, consequences to pharmacies and their patients. Roberts explains in the letter: 

“There are several areas of the bill which we would encourage be modified. The current language establishes that the amount that the carrier plan may pay a PBM for a prescription drug may not exceed the drug’s average manufacturer price (AMP). The use of AMP as a pricing benchmark for the carrier, and in turn the pharmacy provider, is problematic unless AMP were to be significantly redefined or increased in such a way that truly reflects the retail pharmacy acquisition cost of a prescription drug, which is higher than a drug’s current AMP. Moreover, use of AMP would be inappropriate to pay for generic drugs because of the need for reimbursement policies to encourage the use of generics.

“In addition, the definition of AMP in the legislation is not appropriate because it includes mail order sales. It should only reflect sales to retail pharmacies. Without modification of these provisions, community pharmacy participation in the program would be threatened, reducing patients’ access to prescription medications.”

02/24/10