Drug Topics - June 16, 2008 - (Page 32)

32 DRUG TOPICS JUNE 16, 2008 www.drugtopics.com Cover Story BTC class is created is which drugs are suitable candidates? Zellmer believes that initially a BTC category wouldn’t have a large number of medications. He foresees certain statins,some antihypertensive medications, and the oral flu vaccine as possible BTC candidates. Hogue cautioned that decisions about which drugs should fall under this category need to be made on an individual basis. He gave the example of statins, noting that Crestor (rosuvastatin, AstraZeneca) requires renal and hepatic monitoring. He said that pharmacists may not be capable of conducting this monitoring until more point-of-care testing devices are available that allow pharmacists to monitor these more complex therapies. Hogue also cautioned that certain antihypertensives that affect electrolytes may also not be suitable for BTC because of the level of monitoring and management that is needed. He also advised against moving heart failure and epilepsy drugs BTC. Hogue has proposed to the FDA that vaccines be the first drugs to move BTC. “We can increase access to a preventive therapy that we know works and know can save lives. Pharmacists have proven over the last 12 years to be extremely capable of identifying patients in need of vaccinations and immunizing them appropriately. There is absolutely no reason a patient needs to go to a physician to be vaccinated against a condition,” he said. Hogue also feels confident that nasal corticosteroids and nicotine replacement therapies are suitable BTC candidates. “The management of allergic rhinitis is very straightforward, easy to diagnose, and pharmacists can easily determine dose and identify which corticosteroid to use. Nicotine replacement therapy and other agents used in the treatment of smoking cessation are also excellent drugs to go BTC, said Hogue. Melissa Sherer, Pharm.D., a consultant for Pharmacy Healthcare Solutions, agreed that smoking cessation products, when appropriately monitored, would be effective BTC drugs. Sherer cautioned, though, that pharmacists might need to verify that the patient is over the age of 18 before prescribing these drugs. “We’d probably see a similar age requirement on those types of products that would be more like Plan B in terms of age checking,” she said. Reimbursement issues How will pharmacists be reimbursed if BTC were to come to pass? “The critical thing would be reimbursement for the medicine, but also some payment for the pharmacist’s clinical services,” said Zellmer, adding, “ I don’t think we are talking about a system that would be comparable to an OTC medicine, where the pharmacy derives its margin through a markup on the medicine, but reimbursement by the insurance company for the product and compensation for the pharmacist for his or her professional time.” Hogue suggested that ads for BTC products alert consumers to the fact that they have to pay R.Ph.s for their services. “There needs to be some consumer messaging that is incorporated as part of the release of BTC products to help consumers understand that they won’t have a doctor’s office visit, but they will have to be evaluated by a pharmacist. It may require blood testing and either they or their insurer will have to pay for that,” he said. Harry Hagel, R.Ph., senior VP of government and professional affairs at the American Pharmacists Association, believes that Medicare Part D and MTM have paved the way for pharmacists to get paid for patient care services in a BTC world. “We are seeing some evolution in the business model of pharmacy as we see greater pharmacist/patient interaction and we do have models of payment out there for pharmacists. We have several states that have state-funded programs where they are paying pharmacists for MTM. Profitability is not really the driver. It’s really about the delivery of services we believe will benefit the patient and the healthcare system in general and it’s about a financial model http://www.drugtopics.com http://www.reesepharmaceutical.com http://www.reesepharmaceutical.com

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Drug Topics - June 16, 2008 Contents Latebreakers Letters Latebreakers in Depth Pharmacists Lose in Final ESRD Rule New Drug Helps Palliative Patients on Opioids Take Care of Business Oral Treatment Reduces Multiple Sclerosis Flare-ups Beware of Inflammatory Masses From Implantable Infusion Systems Safer Therapeutic Options Emerging for Atrial Fibrillation Congressional Committee Chair Calls for Action Against Hospital Infections This Software System Helps Hospitals Manage Anticoagulation Therapy Rx Care Community Practice JP at Large Self-Care Cover Story Long-Term Care Chains and Business Technology Technology Update Continuing Education New Products Advertisers Index Classified Viewpoint

Drug Topics - June 16, 2008

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