Drug Topics - April 14, 2008 - (Page HSE13)

HSE 13 Business/Management Pharmacy outsourcing still much in use by hospitals Fred Gebhart M cKesson Co.’s recent exit from hospital on a permanent basis. Retaining the hospital pharmacy outsourcan outside problem solver as a permanent ing business has turned the spotpharmacy manager could be good for the light on this field. Does it make sense for hospital, but it left the outsourcing firm hospitals to use pharmacy outsourcers and short handed. “I don’t know that manageis outsourcing a good business to be in? ment or operations outsourcing is all that The picture is mixed. For hospitals that profitable any longer,” Roux said. “You are still using outsourcing, they like this still have to deal with the same problems service. That’s the view from the execuas in-house staff in terms of recruiting, tive suite, where many pharmacy direc- Steven Adams of retention, and quality control.” Cardinal says outtors see outsourcing as an alternative to sourcing appeals That may be one reason McKesson developing expensive programs on their to rural and other dropped out of the business. Or perhaps own. According to Ryan Roux, director hospitals it was trying to avoid future problems asof inpatient pharmacy for Harris County Hospital sociated with outsourcing of pharmacy operations. District (HCHD) in Houston, Texas, “It can be much A neonatal death at Summerlin Hospital Medical more cost effective to buy outside expertise than to Center in Summerlin, Nev., in late 2006 was blamed develop it in-house, especially if you need something on errors in pharmacy and nursing. Summerlin Hosimmediately.” pital reached a financial settlement with the parents Just how many hospitals outsource part or all of and pointed the finger at McKesson, which had run their pharmacy operations is not clear, said Edward the hospital pharmacy before the error occurred. Stemley, director, ASHP’s section of pharmacy prac- McKesson also had problems with pharmacists stealtice managers. Roux said HCHD is currently out- ing narcotics at another Nevada hospital pharmacy sourcing three key functions: sterile compounding, it operated in 2006. McKesson declined to discuss 340B program drug pricing, and patient assistance these incidents because its outsourcing business is program management. Sterile compounding is likely being divested. to move back in-house as soon as an extensive facilThe other two biggest drug distributors, Ameriity renovation is complete and HCHD can meet sourceBergen and Cardinal Health, continue to prothe revised U.S. Pharmacopeia guidelines on sterile vide various aspects of hospital pharmacy operations compounding and sterile compounding facilities. and management. HCHD uses Pharmacy Healthcare “Outsourcing our sterile compounding provides ben- Solutions, an AmerisourceBergen unit, to manage efits like longer dating,” Roux said. “If we continued its patient assistance programs. Cardinal has manto do sterile compounding in-house, we’d have to aged hospital pharmacies for more than 40 years, make smaller batches more often because of facility said president of pharmacy services Steven Adams in constraints.” It is those kinds of practical operational response to written questions. The company employs constraints that drive outsourcing, Stemley said. 1,000 pharmacists nationwide and hires about 200 But while outsourcing is growing overall, the kinds hospital pharmacists annually. of services involved may be shifting. For hospital Hospitals outsource operations for a variety of reapharmacy, outsourcing traditionally meant using an sons, Adams said. Cardinal manages more than 200 outside firm to provide pharmacy management staff hospital pharmacies. Operations are almost equally and sometimes an entire pharmacy operations pack- divided between small rural hospitals that have trouage, Stemley said. ble attracting qualified managers, hospitals with In many cases, outside pharmacy directors and budget problems, and hospitals with quality or acupper managers would be brought in to turn around creditation issues, he said. “The scale of our pharmacy problems in pharmacy operations and quality. Once management operations can bring capabilities and the problems were solved, the outside staff would levels of expertise that are difficult for individual hoseither move on or, more frequently, be hired by the pitals to develop on their own,” he said.

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Drug Topics - March 14, 2008 Contents Latebreakers Letters: Students Need Grounding in Chemistry Pharmacy Directors Wary of Heparin Shortages Some E-prescribing Standards are Ready to Go, Others are Not News Briefs Nanotechnology: Big Stakes in a Small World Pay for Performance is Coming to Pharmacy Patient Safety Organizations Still Very Much in Planning Stage Reconciling Medications in Specialty Patients Poses More Challenges Pharmacy Outsourcing Still Much in Use by Hospitals Studied Extensively, New Drug-Eluting Stent Said to be Very Safe Prevention is Key in Treating C. Difficile Infections E-prescribing Grows in Massachusetts, but Other States Lag Behind Active Metabolite Gives New Life to Antidepressant NSAIDS not Recommended for Long-term Use in Osteoarthritis This Time R.Ph.s and States Are Ready for Tamper-Resistant Rx Pads Cardinal Caught Between DEA and Pharmacies over Diversion Control Medicating Kids: Still More Questions than Answers Schnucks Pharmacy: Drug Topics' Chain of the Year Panel Will Ask for a System for R.Ph. Practice Across State Lines FDA Safety Page: How to use Fentora Safely The Shining OTC/HBC Stars of 2007 Take a Look at These OTCs for Eye Health Technology Update: Google Offers a Sneak Peak at its Electronic Records Initiative Recent Advancements in HIV/AIDS Treatment New Products Advertisers Index Classified Viewpoint: Are State Boards of Pharmacy Abusing Their Power?

Drug Topics - April 14, 2008

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