Drug Topics - October 22, 2007 - (Page 9)

www.drugtopics.com OCTOBER 22, 2007 DRUG TOPICS 9 Letters Lesson from patient death: Stay vigilant n your Sep. 17 issue, I read with sadness and dismay funny how this never happens with a cash customer. It a report about the death of a child at Rainbow Ba- seems to happen only with third-party plans. We defibies & Children’s Hospital in Ohio as a result of er- nitely need transparency and we know that the CMSroneous administration of a super-hypertonic and con- proposed AMP model is a potential catastrophe. centrated (23.4%) sodium chloride solution, instead Mr. Rupp’s proposed model of Payment = Product of 0.9% sodium chloride as a base solution for a cost + Cost to provide drug + Fee for services + Perforchemotherapeutic medication. With sadness, because mance incentives might improve quality of care, ena precious life was lost due to an avoidable administra- sure a pharmacy profit, and ensure patient access to tion of a potent and fatal solution; with dismay, be- that care. But, I don’t think it goes far enough. cause the manslaughter charge of the pharmacist inThe problem lies in the product-cost part of the volved in the case (if there was no equation. It’s why CMS’ AMP forclear intent) would not be a determula fails to work. Everyone has a rent of future similar mishaps. On Strict adherence to different product cost. Mail order, the contrary, as correctly pointed the VA, nonprofit hospitals, big out by Michael Cohen, such indict- preventive regulatory drug chains, and even other counment may “discourage others from guidelines plays a tries like Canada have been able to reporting errors” of similar or less negotiate discounts, rebates, or consequential nature for fear of le- pivotal role in patient kickbacks that make their product gal punishment. cost far different from what the avsafety. There is obviously no easy fix for erage small town independent potential medication errors. For the most part, they are pharmacy can obtain. a result of systemic deficiencies. From the broad public If we’re going to overhaul the system, let’s eliminate point of view, in addition to the legal ramifications, sen- all of these discounts and implement a one-price-fortinel events of such fatal magnitude may tarnish, per- all system. Whether you are the VA, hospital, a mailhaps unwarrantedly, the image of not only a particular order facility, chain drugstore, or independent pharhealth worker, be it a pharmacist, a physician, or a nurse, macy, you purchase drugs at the same price as all of but also a whole profession, a healthcare institution, and the others. Level the playing field for everyone! by extension the very core of the healthcare delivery sysLocal pharmacies could easily compete with out-oftem. That is precisely why strict adherence to preventa- state mail-order plans if their drug cost was the same. tive regulatory guidelines plays a pivotal role in patient Even the 90-day supply at retail programs would be fisafety. The whole mechanism of patient safety is a con- nancially feasible. Patients would flock to the pharmatinuum, an ever-evolving process, especially as health- cies that provide the best care since pricing issues care delivery becomes more complex. This sad case be- would be negligible. People would be content to utilize hooves all healthcare workers to always be vigilant, even one pharmacy for all of their medicine rather than sacin the face of “rush” and emergency. rifice safety for the incentive of lower prices or co-pays Fekadu Fullas, R.Ph., Ph.D. elsewhere. Why, quality of care would actually imSioux City, Iowa prove, wouldn’t it? FeFuBal@aol.com Sounds like a pipe dream, doesn’t it? The skeptic in me fears there are too many entities with their powerWe need one price for all ful hands in the cookie jar to see this happen in my I agree with Michael Rupp (Viewpoint, Sept. 3) that it lifetime. But if we’re ready for a complete overhaul, is time to overhaul our drug reimbursement system. why not go all the way? Douglas Heidbreder, R.Ph. Since Medicare Part D has been implemented, the Onsted, Mich. number of times I’ve been forced to fill a prescription rph007@comcast.net at below my acquisition cost has gone up by 700%. It’s I Letters (including e-mail) should be as brief as possible and sent with the writer’s name, address, daytime phone number, and date of the issue you are referencing to: Editor, Drug Topics, 123 Tice Boulevard, Woodcliff Lake, N.J. 07677-7664. E-mail address: drugtopics@advanstar.com. Correspondence may be edited for length and clarity. http://www.drugtopics.com

Table of Contents Feed for the Digital Edition of Drug Topics - October 22, 2007

Drug Topics - October 22, 2007 Contents Latebreakers Legislative Victory Builds Momentum for Pharmacy Month Letters Health-System Edition R.Ph.s Brace for Payment Denial for Hospital-Acquired Conditions Topical Human Thrombin Helps Arrest Bleeding FDA Panels Fail to Set Target Levels for Renal Patients’ Hemoglobin Warning Letters Raise Patient Safety Concerns for Fentora Ending/Reversing Weight Gain Man Given Fatal Drug Overdose at Staten Island Hospital Pharmacists Playing More Important Role in Dialysis Treatment AHA President R.Ph.'s Here's How You Can Increase Your Value Premier Launches Comprehensive Quality Improvement Project FDA Approves Dexrazoxane for Treatment of Extravasation New Federal, State Reforms to Ease Disaster Relief Kinks 150 Years of American Pharmacy Ten Tips for MTM Success Independent Superstars: The Ones to Watch The New Dynamic Duo A Parkinson's Disease Primer Classified New Products Advertisers Index Viewpoint

Drug Topics - October 22, 2007

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