Brevard
County
Pharmacy Association Online Newsletter
July
2005
P.O.
Box 10054 Port St.John, Florida 32927 Tel:
VM 321-633-9579 www.brevardpharmacy.com
Officers:
Executive Committee:
President….…..…..Karen
Bills
Chairman…
Kas Ghayal
Member….Theresa Tolle
Secretary………….Jamie
Wilson
Member…. Kathy Petsos
Member…..Deborah Ledoux
Treasurer………….Jeff
Broxson
Member……Val Ingoldsby
Member…..Jim Dale
Newsletter……….Kim
Giacomelli
Member……Chris Lent
and Jamie Wilson
Member……Mike Edwards
Program
Chair……Maggie Daly
Continuing
Education
July
31-
Dr. Nikhita Druv will present COMPLICATIONS OF DIABETES, hosted by Novonordisc
representative Marshall Rice. Registration 6pm, program start at 6:30pm.
Followed
by: Maggie B. Daly, Pharm D., and
Director of Sea Pines Rehab. Hospital
Pharmacy
will give a one hour lecture on MEDICATION ERROR entitled, ARE
ADVERSE
DRUG INTERACTIONS DRUG ERRORS, DRUG-DRUG INTERACTIONS AND THE PROBLEMS
UNCOVERED WITH SCIENCE, REFERENCES AND COMPUTER SYSTEMS THAT REPORT THESE
REACTIONS. The meeting will close at 8:30.
In
This Issue
·
Pharmacy Benefit Managers: Cost-effective?
·
Florida
Pharmacy Association Annual Meeting July 6-10,
Marco
Island
·
If you have not checked the website recently
you may be missing great information!
·
To keep informed of important and up to date
changes involving your profession visit the Florida Pharmacy Association
website at www.pharmview.com
or our own Brevard County Pharmacy Association website at www.brevardpharmacy.com
If
you are having problems receiving your newsletter by e-mail or mail please
contact Kim Giacomelli at kgiaco@earthlink.net
or 321-242-2996 or 321-508-2742 or Jamie Wilson at FLASUNLVR@aol.com
or 321-242-2996
Laughter
is the best medicine
Actual Medical Chart Notes
Patient
had waffles for breakfast and anorexia for lunch.
Between you and me, we ought to be able to get
this lady pregnant.
She is numb from her toes down.
While in ER, she was examined, x-rated and sent home.
The skin was moist and dry.
Cost
Savings?
U-M's
Changes Cut Drug Expense
Source:
Detroit
Free Press
Publication
date: 2005-05-18
May
18--The University of Michigan has discovered a startling fact: The companies
that tens of thousands of employers have hired to help them hold down the
ever-rising cost of prescription drugs, can actually drive them up.
U-M,
like many employers, had hired companies called pharmacy benefits managers to
encourage the use of lower-cost drugs and negotiate with drug companies and
pharmacies to get the best price possible for the prescriptions of the
university's 80,000 employees, retirees and dependents.
But
to the school's chagrin, it found that the companies:
--Encouraged
doctors to use high-cost, brand-name drugs even when less-expensive generic
drugs or lower-cost, brand- name drugs were available.
--Took
money from drug companies to include their products on the list of approved
drugs the university would pay for -- even if they were more costly than
effective, competing medicines.
The
Ann Arbor
University dropped the five benefit managers it had been working with, hired a
single new manager that has less control over how the drug plan is
administered and imposed strict new rules. These changes enabled U-M to hold
its drug spending to $43 million in 2003, or $8.6 million less than it would
have paid and held down costs for employees. Thanks to the plan, begun in
2003, co pays at U-M have stayed flat for three years and the member share of
the pharmacy premium, 17 percent, is at the lowest level in five years,
officials said this week.
The
university's findings call into question just how effective pharmacy benefit
managers are at holding down drug costs -- one of the biggest contributors to
rising health care costs that are straining employers. It also shows how
difficult it is to hold down drug costs -- a major reason employers are
raising employees' co pays and insurance premiums so that they can continue to
offer health-insurance coverage.
The
university started questioning its pharmacy benefit managers when its drug
costs continued to rise between 15 percent and 25 percent a year in the late
1990s and early 2000s.
The
school found that the companies took administrative fees from health plans and
employers. They also received money from drug companies when they were able to
increase the use of their brand- name drugs. "In one case, they sent
letters to patients on generic statins, cholesterol-lowering medications,
saying a recent study suggested better" results "from a brand-name
statin," said Dr. John Billi, associate dean for clinical affairs at the
U-M Medical School. When university experts reviewed the available research,
they disagreed that one drug had significantly better results than the other.
What was significant, however, was the difference in price. The brand-name
cholesterol drug cost $124 per month. The generic cost $20 to $40 per month,
depending on the dosage. That wasn't an isolated incident, Billi said, it
happens throughout the benefit management industry and with all categories of
drugs.
According
to the Henry J. Kaiser Family Foundation, a
California
organization that studies health care costs, benefit managers boost market
share in two major ways: adding drugs to the list of medicines employers pay
for and encouraging doctors to use those drugs, even if they are more
expensive.
The more sales grow, the more drug companies pay the benefit
managers.
Kaiser
and the California HealthCare Foundation report that pharmacy benefits
managers -- called PBMs in health- speak -- are often able to secure rebates
of 5 percent to 25 percent for brand- name drugs.
The
PBM industry reports that most of that rebate is passed on to the customer.
But employers and state governments have argued that it's not clear how much
of that is passed on.
A
spokesman for the Pharmaceutical Care Management Association, the Washington,
D.C., organization that represents benefit managers, declined to comment
Tuesday on industry practices.
When
the university got rid of its old pharmacy benefits managers, it negotiated a
new contract with Caremark Rx Inc. of
Nashville
. But the school imposed a new and unusual set of rules on Caremark. The
school, not the benefit manager, would decide which drugs the U-M's pharmacy
plan would pay for and advocate. And Caremark is not allowed to send letters
to doctors without university approval. That would put an end to letters
encouraging higher- cost drugs when less expensive equivalents were available.
The
only reason the university kept a PBM at all is that PBMs have
incredible
bulk- buying power. PBMs can negotiate a better price than a health plan can
for prescription drugs, Billi said. Approximately two-thirds of all
prescriptions written in the
United States
are processed by a PBM, according to the Kaiser Family Foundation. "The
PBMs get a better price than a health plan could negotiate for the
drugs," Billi said, "but part of the reason they get the better
price is because they agree to steer market share to those drugs."
Caremark
spokesman Gerard Carney declined to comment on industry standards
or
whether the U-M plan is unusual. "Caremark works with all of our clients
to ensure cost-effective, efficient service with a focus on high-quality
care," Carney said.
Mike
Deskin, president of the Pharmacy Benefits Management Institute Inc. in
Tempe
,
Ariz.
, said: "The
University
of
Michigan
plan is rather unique among businesses." The Pharmacy Benefits Management
Institute provides information about PBMs to health plans and employers. The
institute honored the UM pharmacy plan with its 2004 Rx Benefit Innovation
Award last month for demonstrating the value of consolidating drug benefit
management services across all of its health plans and using internal clinical
resources to manage its plan. As employers recognize how pharmacy benefits
managers make money, Deskin said, he expects more businesses to incorporate
aspects of the university's new pharmacy benefits into their own plans. The
university hasn't calculated total dollar savings for 2004 yet, but it
estimates that its pharmacy costs went up an average of 9.3 percent per member
compared with a national increase of 12.9 percent per person.
-----
To
see more of the Detroit Free Press, or to subscribe to the newspaper, go
to
http://www.freep.com
Copyright
(c) 2005,
Detroit
Free Press
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