SOLUTIONS
INJECTABLES IN ACTION
An inside look at the opportunity of long-acting antipsychotic medications
W
hile pharmacists continue to wait for provider
several of his patients were looking for a place to get their
status, states continue to expand their scope
injections, he started carrying them. ″They used to pick up their
of practice one service at a time. In most cases, an
injection from Walgreens and CVS, and they didn't know what to
expansion of scope means an expansion of profit, and by
do with it. And they go to the doctors, and the doctors are busy,″
now most pharmacies have taken advantage by offering
he said. ″So patients approached us and we thought this would
nontraditional services like immunizations and point-of-
be a good opportunity.″
care testing. But pharmacies are still catching up on one
As with many other services, reimbursement varies across
overlooked opportunity to expand their scope and profit.
health plans, whether it's Medicare, Medicaid, or private insurers.
But in all, Zaibak said that the reimbursement for these drugs is
Recently, states across the country have
authorized the administration of long-acting
better than traditional prescription medications.
injectables (LAIs), which mostly comprise
antipsychotics such as Invega, Abilify, Aristada,
count, sometimes by a large margin. ″That patient doesn't just
and Risperdal. For patients, the ability to get these
give us their injectable prescription,″ Zaibak said. ″When they
Just as important, offering LAIs helps increase your total script
injections at the pharmacy can be life changing.
transfer it to us, they transfer their whole profile.″
Pharmacies are easily accessible and help increase
In addition, you can earn an administration fee for each
adherence, which is essential for patients on
injection, paid for by a manufacturer or by the patient. Bremo and
antipsychotic meds.
Hayat both have patients who pay the fee out of pocket if they
aren't able to get patient assistance from the manufacturer.
″I feel it's important for pharmacists to be
involved with mental healthcare services,″ said Leighton N. Mascari, pharmacist at Bremo Pharmacy, which has served the Richmond, Virginia community since 1976. ″We've been able to offer different services to patients just by having them come through our doors and connecting them to care.″
Bremo Pharmacy has offered LAIs
for more than 20 years, when Virginia
Bremo Pharmacy is exploring alternative ways to get paid for the service. It recently established a collaborative practice agreement with a provider so the pharmacists can bill for their time. So far, this seems to be the best approach not only because it provides payment for the administration,
first gave pharmacists authority to
but also because it has
administer the drugs. The majority
opened the door for further
have been given at their long-term
services, like measuring
care location, where there has
blood pressure, weight,
always been a clear need. But
and waist circumference.
during the pandemic the retail
″That's really important for
location saw a large influx of LAI
the administration of LAIs
patients when psychiatric offices
because they can create a lot
stopped allowing patients to come
of metabolic effects,″ Mascari
in for administration. The pharmacy
said. ″And the providers have
now administers up to 25 LAIs a month on average.
Hashim Zaibak, owner of Hayat
Pharmacy, has provided LAIs for about three
been very excited that we do that.″ They also perform Abnormal Involuntary Movement Scale (AIMS) assessment to monitor for extrapyramidal
years and is already administering up to 30
side effects and involuntary movements that
injections every month. After discovering that
can occur with the long-term use of LAIs.
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