Practice Transformation
Tailored CMM: Different models, same process
Pharmacists are well positioned to collaborate with primary care providers to conduct comprehensive medication management, but different PCP practices require different CMM practice approaches, according to the authors of an Annals of Pharmacotherapy commentary. The authors consider two models — Expanded Care Team Pharmacist Model and Population Health Team Pharmacist Model — and explore how the CMM process works in each. “By tailoring the CMM process to their practice model, pharmacists can follow consistent delivery of CMM services to create a common understanding among patients, PCPs and other care team members.” (Annals of Pharmacotherapy)
Employers lack transparency into specialty drug outcomes
A Pharmaceutical Strategies Group report finds that specialty drugs continue to be a top focus for plan sponsors, at least in part because of costs. As it stands, sponsors don’t have much insight into the impact of such drugs. “More than 80% of plan sponsors have access to reporting on their total healthcare costs,” PSG’s Tracy Spencer said in a prepared statement. “However, clinical outcomes of adherence, persistency and clinical efficacy were reported less often (71% and 31%, respectively). Employee productivity had the lowest reporting rate: 23%.” (Benefits Pro; report announcement)
Senators find common ground grilling PBMs
Pharmacy benefit managers fielded questions from both sides of the aisle earlier this month during a Senate Commerce Committee meeting. The questions were similar to those the industry faced from the FTC, with a heavy focus on anti-competitive practices, including artificially inflating the list prices of certain drugs while collecting a growing portion of rebates and increasing out-of-pocket costs for consumers along the way. One of the witnesses, law professor Robin Feldman, explained how PBMs’ interests are best served when list prices are high. “Everyone is benefiting other than the consumer.” (Endpoints News)
Evidence & Innovation
FDA approves first in vitro diagnostic tool for early AD
The FDA has authorized a test that can detect amyloid plaques in early-stage Alzheimer’s disease without the use of PET scans. The Lumipulse G ?-Amyloid Ratio (1-42/1-40) test is intended to be used in patients 55 years and older. It offers “a new option that can typically be completed the same day and can give doctors the same information regarding brain amyloid status, without the radiation risk, to help determine if a patient’s cognitive impairment is due to Alzheimer’s disease,” Jeff Shuren, MD, JD, director of the FDA’s Center for Devices and Radiological Health, said in a statement. (FDA; MedPage Today)
Prescription rebates plans keep growing
Prescription drug rebates from drugmakers to commercial health plans are steadily increasing, according to a study published in JAMA Health Forum — and this applies to all three types of plans — individual, small group and large group. The rebates can reduce plans’ net costs but not patients’ cost sharing. “We have the sick people paying more than their fair share for the drug and the rebate goes back to the plan to reduce premiums for the healthy,” says co-author Ge Bai, PhD, CPA, a professor of accounting at Johns Hopkins Carey Business School, quoted by Axios. (Axios; JAMA Health Forum)
Policy Solutions
Opinion: Voluntary innovation tests undermine CMMI’s potential
Making innovation tests voluntary undermines the CMS Innovation Center’s potential, according to an opinion piece in STAT News. Voluntary models can create two problems, writes Jesse Gubb. “First, providers can select the program that is most lucrative for them, not necessarily the one that is best for patients or for Medicare or Medicaid spending. Second, it makes potential reforms hard to evaluate, because those who participate may differ from those who don’t.” […] Mandatory, national randomized evaluations ensure that the already significant effort to develop the models will yield the rigorous evidence needed to support decisions on whether to scale and adopt them broadly.” (STAT News)
In Case You Missed It!
GTMRx Workgroup Update
On May 12, Evelyn Hermes-DeSantis, Pharm.D., director of research and publications, phactMI and professor emerita, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, and Jennifer Riggins, Pharm.D., technology and partnership strategist, phactMI and medical affairs consultant, the stem and president, medical affairs and digital, JSR Medical Affairs Consulting, LLC, presented to the GTMRx Employer Advisory Taskforce on consumer surveys conducted by phactMI on medical information (e.g., where consumers search for medical information, preferences for tech platforms, how they use medical information received).
GTMRx Blog: CMMI-funded pilot shows that CMM is scalable, sustainable and successful
Comprehensive medication management embedded within primary care provides a scalable and sustainable way to achieve the Quadruple Aim, says Steve Chen PharmD, FNAP, GTMRx distinguished fellow and associate dean for clinical affairs at USC School of Pharmacy, in a recent blog. He shared the results of a Center for Medicare and Medicaid Innovation (CMMI) Round 1 Healthcare Innovation Award program. “The CMMI funding allowed my team at the University of Southern California School of Pharmacy, in collaboration with AltaMed Health Services, to evaluate the impact of providing CMM services for high-risk patients. It was, in short, a success.”
See more details here.
Celebrating 3 Years of Impact: GTMRx Institute Turns 3!
The Get The Medications Right Institute (GTMRx) is celebrating 3 years of impact and advancement of our goals. Now, more than ever we remain committed and anchored in our mission and goals to:
- A personalized, patient-centered, systematic and coordinated approach to medication use will vastly improve outcomes and reduce overall health care costs.
- We must align systems of care to integrate comprehensive medication management, engaging patients to ensure that they are willing and able to take those medications that are indicated, effective, and safe, to optimize their outcomes.
- We need immediate delivery system, payment, and policy transformation to streamline clinical trials and reduce costs of bringing drugs to market while enabling successful, broad-scale adoption of integrated, comprehensive medication management (CMM) services.
- Appropriate diagnosis and access to advanced diagnostics with companion/complementary and pharmacogenetics (PGx) testing is essential to target correct therapy.
- Success requires team-based, patient-centered care models that recognize appropriately skilled clinical pharmacists as medication experts who work in collaborative practice with physicians and other providers.
Thank you to all who have joined us and aided in our mission to advance personalized, patient centered, team-based care. If you aren’t already a part of the Institute, you can join us by agreeing to our belief statements here: https://gtmr.org/become-a-signing-member/
The Right Drug Dose Now Act Introduced Feb. 28, 2022
On February 28, 2022, the GTMRx Institute issued a letter of support for the Right Drug Dose Now Act which was introduced on the same day. (See the press release from Congressman Swalwell here.)
GTMRx’s Precision Medicine Enablement via Advanced Diagnostics Workgroup invited congressional staff from the Personalized Medicine Caucus to present on draft PGx legislation underway on two occasions. The Personalized Medicine Caucus, co-chaired by Representatives Tom Emmer (R-MN) and Eric Swalwell (D-CA), engages members in a constructive dialogue about legislative and regulatory policies that can help realize the full potential of personalized medicine. The recommendations that came out of these discussions were put into our Letter to the Personalized Medicine Caucus Co-Chairs—Representatives Tom Emmer (R-MN) and Eric Swalwell (D-CA)—on the Right Drug Dose Now Act.
Some of the GTMRx recommendations to the Caucus included:
- Incorporating comprehensive medication management definition and language.
- Combining PGx testing with the CMM process of care.
- Expanding implementation of EHR guidelines, education awareness campaigns, and reporting.
- Clarifying the definition of adverse drug events.
A Comprehensive Overview of the Institute, It’s Vision, Mission and Leadership
The Get the Medications Right Institute is working to decrease misuse, overuse and underuse of medications and avoid waste by advancing comprehensive medication management to ensure appropriate and personalized use of medications and gene therapies. Learn more in this brochure.
Interested in supporting our work?
Please contact Jeff Hanson (e: [email protected])
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.
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.
