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The Pharmacist’s News Source
pharmacypracticenews.com
CLINICAL
13 16
Pharmacists seek bigger role in cancer survivorship care. Hospital-based pharmacogenomics: Are we there yet?
POLICY
25
Transforming health care payment: IPPS in 2016
OPERATIONS & MGMT
28 30 32
How to become a powerful and intentional leader. Hospitals that save millions—and show pharmacists’ worth. Building an outpatient pharmacy for workers and patients.
TECHNOLOGY
38
OIG Investigates Skyrocketing Gen Drug Prices
A
Volume 42 • Number 6 • June 2015
The New Track and Trace Law Places Hospitals on High Alert A
s soaring prices of certain widely prescribed generic drugs continue to challenge both community and hospital outpatient pharmacies, the Department of Health and Human Services’ Office of Inspector General (OIG) has begun an investigation into the impact of the increases on the Medicare rebate program. The OIG investigation was announced in a recent letter to Sen. Bernie Sanders (I-Vt.) and Rep. Elijah E. Cummings (D-Md.), who have been waging a months-long campaign to find a solution to the generic price problem, which they told the Health and Human Services Secretary, Sylvia Burwell, in an earlier letter was “affecting the pocketbooks and health of millions of Americans.” The two lawmakers have also introduced a bill that would compel generic drug makers to increase the rebates they pay to state Medicaid programs whenever the prices of their medications exceed inflation rates.
s a metaphor for change, “a perfect storm” may be overused. Still, for health systems, it is an apt descriptor, given the flood of disruptive events on the horizon. The transition to ICD-10 diagnostic codes, the explosion of risk-sharing models of care and looming biosimilars approvals are just a few of the key trends that promise to shake up pharmacy operations. Now, crystal ballers are saying it’s time to add one more disrupter to the mix: the Drug Supply Chain Security Act (DSCSA). The legislation, which kicks into high gear this summer, is designed to protect the U.S. drug supply against counterfeiting, diversion and other criminal acts that pose a perennial threat to patient safety. DSCSA achieves some of that protection by requiring proof of an electronic transaction when a product changes ownership as it travels through the supply chain. Hospitals will have to satisfy that requirement—and that’s where some of the operational burdens come in. Beginning July 1, 2015, pharmacists must maintain all the chain of custody information
see PRICE HIKES, page 21
see TRACK AND TRACE, page 24
ADCs can help thwart drug diversion.
EDUCATIONAL REVIEW
Novel Oral Anticoagulants Strategies for Optimizing Patient Outcomes See page 8.
A coalition for compliance
Treatment delays, cost burden cited
Dusting Off Drug Libraries Yields Smarter IV Pumps
Genentech Expansion of Specialty Distribution for Ca Drugs Still Stings
Annapolis, Md.—Partnering with nurses, conducting rounds on inpatient floors and continually educating staff are all ways that hospitals can improve drug library compliance for smart pumps, panelists said at a kick-off meeting for the National Coalition for Infusion Therapy Safety. This is an initiative by the Association for the Advancement of Medical Instrumentation (AAMI) Foundation see DRUG LIBRARIES, page 36
W
hen Genentech announced late last year that it would begin shipping its three workhorse cancer drugs through the specialty distribution channel, hospital pharmacists worried that the move would increase their costs and the time they spent ordering and handling the products, while negatively affecting patient care. Genentech, a Roche company, said the move to deliver bevacizumab (Avastin), rituximab (Rituxan) and trastuzumab (Herceptin) through the specialty distribution channel was a proactive one to improve drug
New Product Teva introduces Argatroban Injection 250 mg/250 mL. See page 40
delivery, while ensuring that hospitals and patients received a quality product. Now, several months later, pharmacists said the move led to shortages of these important cancer drugs for the first time, as well as a host of other problems. “In the history of Genentech, there isn’t one pharmacy director who would have told you he or she experienced a shortage—not one. Now, because they have moved to the specialty distribution channel, we have actually experienced shortages,” said Niesha see DISTRIBUTION, page 26
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