Practice Transformation
Telehealth may hinder identification of drug misuse
Most of physicians (67%) fear they missed signs of drug misuse during the pandemic, according to a new Health Trends report from Quest. Telehealth may be a culprit: 75% said telehealth visits limit the ability to determine if patients are at risk for or are already misusing prescription drugs. Moreover, 91% of physicians said they feel confident they can recognize the signs of prescription drug misuse during in-office interactions with patients, but only 50% report the same confidence via telehealth visits. (Modern Healthcare*; report)
Lack of interoperability sustains the fax machine
At least 70% of health care providers still exchange medical information using a fax machine, reports Bloomberg Law. Reliance on faxes is particularly strong in sectors of the health care system where EHR adoption has lagged. For example, skilled nursing facilities and behavioral health providers didn’t receive federal funds for EHR adoption through the HITECH Act. However, hospitals and providers outfitted with the latest EHR technology still use them to exchange information. Why? Lack of interoperability. (Bloomberg Law)
Evidence & Innovation
Unsupported drug price hikes cost $1.67B in 2020
In 2020, drug makers raised prices on seven widely used medicines by substantial amounts without any new clinical evidence to justify the increases. This led patients and health insurers in the U.S. to spend an additional $1.67 billion last year, according to a new analysis by the Institute for Clinical and Economic Review. Much of the added spending was due to one drug: AbbVie’s Humira. The price rose by 9.6%, after rebates and discounts, which led to an extra $1.4 billion in spending. (STAT News; Institute for Clinical and Economic Review)
US drug spending outpaces the world
The US spent $464 billion on prescription drugs in 2018. That’s $133 billion more than is spent by 32 Organization for Economic Co-operation and Development countries combined. Yet, US sales represent fewer than 25% of drug sales; this suggests that drug prices, not utilization, explain the higher spending. For example, brand-name prices in 2018 were nearly 3.5 times more in the US than in other high-income countries. This creates financial burdens for patients, employers and state and federal governments, according to the Commonwealth Fund. (Health Payer Intelligence; Commonwealth Fund)
Federal jury: Pharmacies culpable in opioid crisis
CVS, Walgreens and Walmart recklessly distributed massive amounts of pain pills in two Ohio counties, a federal jury ruled last week. “The law requires pharmacies to be diligent in dealing drugs. This case should be a wake-up call that failure will not be accepted,” said Mark Lanier, an attorney for the counties. In some cases, retailers were alleged to have instructed pharmacists that they should not refuse a doctor’s prescriptions even if red flags were triggered. “These allegations indicate an increased focus upon the interactions and communications between supply chain participants,” Linda Clark wrote in an August 2020 issue of America’s Pharmacist. (AP; America’s Pharmacist)
Policy Solutions
Rule: Health plans must report drug costs
The recently issued Prescription Drug and Health Care Spending Interim Final Rule requires health plans to report prescription drug and health coverage costs. They must submit information on prescription drug and other health care spending annually. Costs must be broken down by type such as hospital care, primary care or specialty care. Health plans and insurance issuers must submit the 50 most frequently dispensed brand prescription drugs, the 50 costliest drugs by total annual spending and the 50 prescription drugs with the greatest increase in plan expenditures from the previous year. (Becker’s Hospital Review; Rule)
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In Case You Missed It!
GTMRx Membership Spotlight | Shawn McFarland, , Pharm.D., FCCP, BCACP
This month, we would like to recognize Shawn McFarland from the Veterans Health Administration. He is the co-lead of the Evidence-Based Resources Subgroup of the Practice and Care Delivery Transformation Workgroup and co-author of two important papers: “Assessing the Impact of Comprehensive Medication Management on Achievement of the Quadruple Aim Review” and “Medication Optimization: Integration of Comprehensive Medication Management into Practice.
The GTMRx Institute is comprised of over 1500 members, many of whom are champions in the world of CMM. They lead our workgroups, serve on our taskforces, publish CMM evidence and research, and guide and support our work. Our members are crucial to the work we do to advocate for a better medication management system. As a thank you, we will be starting a new membership shoutout series to highlight members and their many accomplishments. So on behalf of the Institute and those who benefit from CMM, thank you Shawn!
ICYMI | New Issue Brief: More than a theory: Putting CMM in practice, Annie Ideker, MD, & Mary Roth McClurg, Pharm.D., MHS
We need a better way to manage medications. Medicine is the main way we treat illness, but it’s also the source of avoidable misery.
Health care delivery has long been fragmented, and the growing shortage of primary care clinicians is compounding the problem. There is also a lack of communication. “We have not closed the feedback loop between specialists, primary care providers and pharmacists relating to medication use.” Adding to the problem is the aging population. More people are living longer. They have chronic diseases, and they’re taking more medications. This alone adds so much complexity to one’s ability to manage medications. At the same time, more medicines are available to take, and prescription drug costs are rising. Read on for more.
CMM IN ACTION | 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.
Advocacy in Action
GTMRx is pleased to announce that we have launched our Advocacy Letters and Policy Documents page on the GTMRx website. Advocacy is a core component of the GTMRx Institute’s mission, and our policy positions are aimed at advancing acceptance and recognition of the importance of creating a systematic, evidence-based approach to medications and their rational use through CMM in practice. To advance our efforts, comments are submitted to the Centers for Medicare and Medicaid Services (CMS), members of Congress, the Administration, and other public sector payers (OPM) as appropriate.
This toolkit explores the benefits of CMM for individuals and for the employers who pay for benefits. Research published in March 2018 reveals the waste to the system when the wrong drugs are prescribed, drugs are skipped or drugs make people sicker which in turn leads to an estimated 275,689 deaths per year. In financial terms, there’s also a $528 billion price tag attributed to non-optimized medication use. This toolkit was developed with guidance and support from the GTMRx Employer Toolkit Taskforce.
Use this toolkit to work with your:
- Pharmacy Benefit Managers (PBMs)
- Medical carriers
- Benefit consultants
- Solution providers (PGx, others)
- Employees
Read the report here.
Additional resources:
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.
