Practice Transformation
Optimizing medication use for rural vets
The current issue of The Rural Connection includes an article on leveraging clinical pharmacists to increase rural veteran access. It reports on the success of the Clinical Pharmacy Practice Rural Veteran Access (CRVA) initiative—a veteran-centric, whole-health comprehensive medication management initiative to ensure medication optimization is prioritized in primary care, pain management and mental health practice areas. Among other areas, the effort had particular success supporting veterans with substance use disorders. (The Rural Connection)
Evidence & Innovation
Incentivize PCPs to participate in clinical trials
It’s time to include more primary care physicians in clinical trials, according to a commentary published in Newsweek. Physicians in academic medical centers play an outsized role in enrolling their patients in clinical trials. This can lead to disparities in access to innovative drugs. “Expanding access to clinical trials information in diverse settings through incentivizing physicians will help community rooted physicians stay up to date on the newest scientific developments, better enable patients to access the most groundbreaking treatments and enable trusted physicians to serve as public health information mediators.” (Newsweek)
CMM’s benefits “without debate”
A piece in the Journal of American Health & Drug Benefits authored by leaders of the Get the Medications Right Institute, articulates the value of comprehensive medication management. Unlike medication therapy management, which traditionally focuses on the disease state, “CMM provided by a pharmacist working with the patient in a team-based care model takes a holistic approach to developing a medication regimen that is individualized, effective, and safe.” They conclude, “The benefits of including CMM in the services provided to primary care patients are without debate. […] It is time for the widespread inclusion of CMM services in healthcare coverage for patient care.” (American Health & Drug Benefits)
Turning mail carriers into health workers
In a recent commentary, Elisabeth Rosenthal, editor-in-chief of Kaiser Health News, proposes allowing mail carriers to conduct home visits and basic health checks on the frail and elderly. “Why not instead redeploy some of the U.S. Postal Service’s vast supply of human resources to deliver a service our aging population — and our country — desperately needs?” It’s being done successfully and profitably in other countries, including France and Japan. She’s not alone: The USPS Office of Inspector General suggested it in March. (Kaiser Health News)
Policy Solutions
What constitutes a religious exemption? It’s complicated
Some city and state workers around the country have already begun to resist workplace vaccination rules on religious grounds. Soon those rules will be the norm in the private sector too. In this audio piece, NPR correspondents Andrea Hsu and Shannon Bond explain what the law says about religious exemptions to vaccine rules in the workplace. (NPR)
More insurers sue Merck over generic delay
Humana and Centene filed separate lawsuits earlier this month claiming Merck’s “pay-for-delay” tactics caused them to overpay for cholesterol medications Vytorin and Zetia by hundreds of millions of dollars. The complaints come just three months after the Kaiser Foundation Health Plan sued Merck, accusing the company of breaking antitrust laws in multiple states by delaying the launch of lower-cost generic drugs. (Modern Healthcare*)
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In Case You Missed It!
The first GTMRx Physician Advisory Taskforce meeting was held on September 30, 2021. The goal of the Physician Advisory Taskforce is to provide leadership guidance and recommendations that will enable broad practice adoption of a systematic approach to medication use (CMM) throughout the continuum of care. This will be achieved by physician advisor evaluation, review and ongoing recommendations. It is chaired by GTMRx President Paul Grundy, MD and GTMRx Board Member Ira Klein, MD. You can find all of the physician advisors who are taking part here.
As a leader in the health care field, your opinion on serious issues facing the field today is crucial to the work we do. We’ve developed a quick five-minute survey to gather feedback on issues in health care and the pharmaceutical world today and where they’re headed; we’d be grateful for your participation.
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.
- GTMRx September 13, 2021 comments on Medicare Physician Fee Schedule Letter to CMS about Payment Mechanisms for Medication Management Services through the proposed Medicare Physician Fee Schedule (CMS-1751-P)
Leadership from GTMRx’s PGx Payment and Policy Taskforce and Payment and Policy Solutions Workgroup have created 5 policy recommendations on PGx + CMM that policymakers should consider to ensure that patient medications are managed safely and effectively based on the unique characteristic of an individual patients’ genetic profile, including:
- Add the assessment of patient medications and drug-gene interactions to Medicare (Welcome to Medicare visit) and Medicaid benefits,
- Require CMS to reimburse preemptive multi-gene panel testing as one single test with one standard compensation code,
- Require CMS to reimburse members of the care team trained to evaluate/manage all medications based on patient’s genotype, multi-drug interactions, Rx metabolism, etc.,
- Direct the National Quality Forum (NQF) to review and make recommendations on drug-gene interaction efficacy and safety checks prior/post admin of drugs within CMM,
- Recommend the U.S. Preventive Services Task Force evaluate evidence of PGx testing and CMM, for drugs with known drug-gene interactions, as a preventive health care practice that addresses patient outcomes/medical expenditures and that should be covered by ACA plans.
In addition to development of Vaccine Confidence Leagues (VCLs) and community-building activities, the task force’s recommendations include:
- Accelerated approval of vaccines
- Public education
- Payment reform
- Improved vaccine access for primary care practices
- More effective immunization information systems (IIS)
- No cost-sharing for certain patients
- Enhanced diversity, inclusion, and equity
Find the report Frequently Asked Questions here.
Read the report here.
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