Practice Transformation
Lessons from COVID: Curbing antibiotic overuse
From April to December 2020, antibiotic prescriptions for children declined by 73% compared with the same months in 2019 for primary care practices in the Philadelphia region, according to research published in Pediatrics. Antibiotic prescriptions for respiratory tract infections (RTI) saw an even steeper decline. This suggest reducing viral RTI transmission through social distancing and masking corresponds with a reduction in antibiotic prescribing, according to the researchers. “Because many antibiotic prescriptions related to viral RTI are inappropriate, this further emphasizes the importance of judicious prescribing for RTIs and the need for antimicrobial stewardship in this setting to mitigate both short- and long-term adverse effects of antibiotic overuse in children.” (Pediatrics; MedPage Today)
For some drugs, Cuban’s pharmacy saves over $100
Mark Cuban Cost Plus Drug Co. online pharmacy went live last month. The company produces low-cost versions of high-cost generic drugs. Its website currently offers 100 generic drugs to treat an array of illnesses, including diabetes, asthma and heart conditions. The company doesn’t partner with PBMs, and it does not accept insurance. However, its cost-saving model means patients are often offered prices lower than what most health plans’ deductible and copay requirements would total, according to the company. Becker’s Hospital Review provided a list of the 27 medications for which pharmacy offers a savings of $100 or more. (NPR; Becker’s Hospital Review)
Evidence & Innovation
Gene variant may protect against severe COVID-19
A human genetic variant that appears to protect against severe COVID-19 infection, according to research published in Nature Genetics. It could serve as a target for drug development. Earlier work identified the OAS1/2/3 gene cluster as a risk locus for severe COVID-19 among mainly individuals of European ancestry. “This study shows how important it is to include individuals of different ancestries. If we had only studied one group, we would not have been successful in identifying the gene variant in this case,” says the study’s corresponding author Hugo Zeberg, assistant professor at the Department of Neuroscience at Karolinska Institutet. (Reuters; Nature Genetics; announcement)
An insulin saga: Hours of time wasted
Bram Sable-Smith, who writes for Kaiser Health News almost didn’t get his insulin prescription filled. The problem: His new insurance refused to cover his ongoing prescription without prior authorization–and then rejected the brand he’d been using. “It feels like a lot of paperwork to confirm something we already know: Without insulin, I will die.” It wasn’t just his time that was wasted: “The time wasted by me, the pharmacists, the nurses and probably some insurance functionaries is astounding and likely both a cause and a symptom of the high cost of medical care.” (KHN)
Policy Solutions
Vaccines: For Black patients, the issue may be access
Black and white people had similar levels of hesitancy in getting COVID-19 vaccines when they first became available, but Black Americans appear to have overcome hesitancy more quickly, according to research published in JAMA Network Open. The study suggests that access, not hesitancy may be the main driver behind comparatively low vaccine uptake in the Black community. “This research underscores the importance of ongoing research and practical efforts to ameliorate a range of barriers to receiving the COVID-19 vaccine.” (Medscape; JAMA Network Open)
AMA: The Great Resignation is coming to health care
If you think the health care staffing shortage is bad now, just wait. One in five physicians and two in five nurses intend to leave their current practice within two years, according to AMA findings published in Mayo Clinic Proceedings: Innovations, Quality & Outcomes. Additionally, about a third of physicians, advanced practice providers and nurses expect to work fewer hours in the next 12 months. If clinicians follow through, it will have “significant implications for the future healthcare workforce,” write the authors. (Fierce Healthcare; Mayo Clinic Proceedings: Innovations, Quality & Outcomes)
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In Case You Missed It!
IMPORTANT: CMMI seeking a clinical pharmacist as part of the Seamless Care Models Group
DH Announcement (Direct Hire – Open to all U.S. Citizens):
Announcement number: CMS-CMMI-22-11350740-DE
Title, Series, Grade: Pharmacist, GS-0660-14
Close date: Tuesday, February 8, 2022
Link to announcement: https://www.usajobs.gov/job/633098700
This position is being announced by the CMS Center for Medicare and Medicaid Innovation (CMMI), Seamless Care Models Group (SCMG).
*You will lose consideration for the position if you do not submit the required documentation with your application. Please reference the Required Documents section in the announcement for further information.
Job summary:
- Lead the design, development, implementation of innovative Part D pharmaceutical models with payment or service-delivery implications.
- Provide recommendations to leadership on implementing innovative pharmaceutical payment models that improve access to critically needed drugs with a reduction in out-of-pocket costs for beneficiaries and reduce federal government spending.
- Lead CMS coordination with national professional organizations, private insurers, and pharmaceutical industry representatives on innovative pharmaceutical payment and care models.
- Translate the results of Medicare Part D pricing studies into actionable policy and program recommendations that inform CMS Medicare Part D policies and processes with consideration of policy impacts, economic viability and technical feasibility.
- Lead interpretation and analysis of pharmacy administrative claims and plan-reported data concerning drug coverage, pharmacy services and drug utilization patterns.
SEE THE EVIDENCE | The Outcomes of Implementing and Integrating Comprehensive Medication Management in Team-Based Care: A Review of the Evidence on Quality, Access and Costs
Learn about the peer-reviewed evidence showcasing the value of CMM, through improvements in access to care, provider work life, outcomes and patient satisfaction as well as a reduction in costs. These findings, updated in December 2021, outline the CMM team-based care process that can be implemented in a variety of health care systems to ensure positive patient outcomes.
SEE THE GUIDANCE | The Integration of Telehealth Delivery within a Comprehensive Medication Management Practice
Considering the advantages of telehealth and the future direction of health care, it is no longer a question of if telehealth needs to be implemented into practice; rather, it is a question of how to integrate telehealth and CMM services. Core to a plan is a patient care team that works together to achieve a goal of enhancing patient-centered care and medication optimization. Outlined are essential steps to integrating telehealth services and CMM practice: define what telehealth means for your practice, secure stakeholders, develop a team, equipment and software needs; assess costs and financial stability, educate staff, patients and caregivers, develop a workflow, measure health care outcomes and meet with your team regularly.
SEE THE GUIDANCE | Value Framework for Providing CMM in Telehealth
The escalation of telehealth has shed light on the opportunities that exist to increase patient access to care through virtual visits that extend beyond the traditional in-office visit. Included as an opportunity for telehealth is comprehensive medication management (CMM). This value framework, intended for health care team members, payers for health care services and health care policy makers, proposes a guide for providing CMM services via telehealth. Although obstacles to telehealth delivery of CMM exist, the benefits to providers, patients and payers outweigh the barriers. For sustainability of telehealth and CMM provided via telehealth, effort from multiple stakeholders is needed to address the challenges that exist.
Join us to be part of meaningful change
Irma, like many others, struggles as a result of our current trial-and-error approach to medication. That is why we advocate for a new, comprehensive approach to medication use and prescribing. As a non-profit 501(c)(3) and 501(c)(4) organization, the GTMRx Institute and Foundation relies on funding from our supporting members. We ask that you consider becoming a Supporting Signing Member so we can continue to provide relevant, timely resources to get the medications right!
If you’re interested in supporting the Institute or Foundation at a higher level, please contact us. Your dollars will bring about meaningful change for people like Irma.
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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.
