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Practice Transformation

Becker’s Hospital Review asked several experts to describe how pandemic has affected medication adherence. Matthew Pond, Pharm.D., VP of pharmacy services at HonorHealth in Arizona, focused on patient coverage and costs. Losing health insurance “directly impacts patients with conditions requiring medication therapy, and we expect to see these trends continue as increasing barriers to care of outpatient medication adherence.” Related to that is the ability to pay out of pocket. “With the national unemployment rate exceeding 11% and the loss of health insurance, that is a dangerous combination for medication adherence.” Poor adherence and the inability of the patient to afford the medication are two of several other factors contributing to the lack of medication optimization. (Becker’s Hospital Review)
The New York Times asks—and attempts to answer—the question, “Is telemedicine here to stay?” It largely depends on whether Medicare and private health insurers will adequately cover virtual doctor visits post pandemic. To convince insurers they should continue paying for virtual care, doctors must demonstrate they can move beyond treating simple respiratory infections to caring for patients with chronic conditions. And, of course, it must improve patient outcomes. Congress appears willing to take up the issue: Since May, rough 20 telemedicine bills have been introduced in the House and Senate—20 in each. (New York Times)
President Trump issued an executive order last week permanently expanding Medicare coverage of some telehealth services. Examples include emergency room visits, nurse consultations and speech and occupational therapy. A broader expansion would require Congressional action. The order also calls on agencies to work together to build up the infrastructure to support telehealth in rural communities. (AP)

Evidence & Innovation

“Employers are powerful influencers in driving system change, and they can assert that influence to address misaligned incentives within the medication use system,” writes Katherine Capps, executive director of GTMRx Institute. Why should they get involved in medication management reform? She offers several reasons, including the fact that achieving medication optimization will reduce waste in health care spending, ensure appropriate use of medications and decrease low-value care. She offers five tips to help employers become more involved. Among them: Ask vendors and carriers for data and analytics related to how they address medication therapy problems. (Managed Healthcare Executive)
The pandemic has created four interrelated health care crises: loss of insurance coverage, financial losses for providers, racial and ethnic disparities and a crisis in public health, Commonwealth Fund leaders write in NEJM. These crises reveal and compound underlying problems in the health care system, but they also point the way toward reform. “National trauma can change national psychology and create opportunities for major reform. Whether the novel coronavirus will do so remains uncertain, but even if it does not, the pandemic may open the way to meaningful incremental changes that are normally difficult for our highly divided and partisan political institutions to accomplish.” (NEJM)
Even a successful COVID-19 vaccine may not produce an immune response in everyone. However, MIT scientists recently unveiled a machine-learning approach that can predict the probability that a particular vaccine design will reach a certain proportion of the population. In fact, they’ve designed—on the computer—a novel COVID-19 vaccine that has far better coverage than many of those published so far. Many of those in development may protect more than 50% of the population, but “certain individuals and older individuals may not be protected,” MIT’s David K. Gifford tells ZDNet. (ZDNet)
Moderated by CNBC Reporter Meg Tirrell and featuring an interview with Scott Gottlieb, this virtual seminar will convene leaders from the Personalized Medicine Coalition’s board of directors to examine the status of efforts to combat COVID-19 in Europe and the United States with reference to the principles of personalized medicine. Register here. (Personalized Medicine Coalition)

Policy Solutions

Two advocacy groups—Knowledge Ecology International and the Center for Digital Democracy—petitioned the FDA Aug. 3 to ban the use of music in prescription drug commercials during the portion that lists potential side effects. They argue that consumers may be too easily distracted. The groups argued that distracting music leads to viewers comprehending the benefits of drugs more than the risks, which leads to unfair, highly positive views of advertised drugs. “Advertisers’ use of background music is a distraction from the presentation of risks, because the type of music they choose is incongruent with the message presented, and it bombards the viewer with excess stimuli, making it difficult for them to retain the information,” the petition states. (STAT NewsBecker’s Hospital Review)

In Case You Missed It!

GTMRx taskforce update: Employer Toolkit Taskforce
The Employer Toolkit Taskforce had a meeting on Thursday, August 8 to continue refining materials to promote adoption of CMM. They have been making significant progress toward the development of guidance for employers when working with their medical carrier, PBMs and TPAs.
Henry “Mark” Dunnenberger, Pharm.D., director, Personalized Medicine and Pharmacogenomics, Center for Personalized Medicine, NorthShore University HealthSystem spoke to the Precision Medicine Enablement via Advanced Diagnostics Workgroup on Friday, August 7. Dr. Dunnenberger spoke to the following topics: why and how pharmacogenomics phenotype terms were standardized, the process that led to the submission and creation of pharmacogenomics SNOMED-CT terms and a brief overview of CPIC Informatics.
GTMRx Blueprint for Change Available Now!
New report calls for medication management reform with guidance for how medications are managed. 
On July 22, 2020, “The GTMRx Blueprint for Change,” a robust report based on eight months of multi-stakeholder input, was released. The report outlines steps for reform, including an evidence-based process of care – Comprehensive Medication Management (CMM) – that personalizes the approach and leads to better care, reduced costs and improved patient satisfaction and provider work life.
The GTMRx Blueprint for Change includes recommendations to engage everyone involved in patient care—from physicians to clinical pharmacists, health plan sponsors, providers, consumer groups and policymakers. The GTMRx Four Pillars of Medication Management Reform include revamping:
    • How we practice
    • How we pay
    • How we use diagnostics
    • How we integrate technology
  You can download the report here.
Hear more about using a risk stratification process for patient identification to select individuals that benefit most from comprehensive medication management services intended to produce value-based outcomes: economic, humanistic and clinical. There will also be discussion about why it is vital for regulators, care providers and payers to work together to establish standards and best practices to ensure access to clinical information, to include diagnostics, at the point of care. This webinar will also showcase a case example of risk stratification in action with the Teachers Retirement System in Kentucky.
Molly Ekstrand, BPharm, BCACP, AE-C, Consultant with North Star Medication Optimization, LLC, along with Jane Gilbert, CPA, Director of Retiree Health Care, Teachers Retirement System of the State of Kentucky, will offer an overview of how health care IT infrastructure can efficiently enable health systems, payers and purchasers of health care to identify groups of patients who will most likely benefit from comprehensive medication management services.
Find more information here.
Hosted by the GTMRx Institute’s executive director and co-founder, Katherine H. Capps, Voices of Change features leaders who have knowledge, experience and ideas to solve this urgent need to get the medications right. The most recent episode features Amanda Brummel, PharmD, BCACP, vice president, Clinical Ambulatory Pharmacy Services Fairview Pharmacy Services. Past guests include Orsula V. Knowlton, PharmD, MBA, president and chief marketing & new business development officer of Tabula Rasa HealthCare, Inc., Anand Parekh, MD, chief medical advisor, Bipartisan Policy Center and GTMRx President Paul Grundy, MD, chief transformation officer, Innovaccer.
Listen here.
Donate to the GTMRx Foundation through AmazonSmile!
AmazonSmile is an easy way for 0.5% of your qualified purchases go to the GTMRx Foundation at no cost to you. And signing up is simple—go to smile.amazon.com and select “Get the Medications Right Foundation” as your charity of choice. If you prefer to directly donate instead, you can do so here.
Adding the foundation on AmazonSmile will help us continue to provide no cost educational webinars, issue briefs, weekly news briefs and promote the need for transformation of our current system of medication use through social media campaigns.
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