Se ee IMMUNE E GLOBULINS S REVIEW W inserted after page 12
Serving managed care, health system and specialty decision makers Volume 10 • Number 1 • January/February 2021 • specialtypharmacycontinuum.com
Now a CMS requirement
UP FRONT ExceleraRx-Shields merger bolsters health-system stake in SP market ............ 3
OPERATIONS & MGMT Telepharmacy takes hold during COVID-19 ................
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CLINICAL Pharmacists have the skills to administer HIV PrEP ......
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POLICY Some P4P programs may not pay off ................ Inflammatory Rx drives another strong year for specialty ..........
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TECHNOLOGY ICD-10 data help streamline specialty care ...................
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REVIEW ARTICLE
The Role of the Specialty Pharmacist in
Treating Cystic Fibrosis See page 12.
Home Infusion Therapy Accreditation Rolls Out A
s of Jan. 1, 2021, 21, home infusion providers are officially cially required by the Centers for Medicare re & Medicaid Services (CMS) to carry att least one accreditation to bill Medicare re Part B for home infusion therapy (HIT) HIT) services. To make that transition on a success, providers need to consider nsider a number of important factors, rs, according to three organizationss now offering the accreditation. The first is to o know that Medicare HIT accreditation reditation is not necessarily forr everyone, noted Jon Pritchett, tt, PharmD, the program director ctor overseeing pharmacy programs for the Accreditation on Commission for Health th Care (ACHC). “Some places just focus on pediatric diatric infusions, and Medicare dicare may not be a significant icant part of what they do,” he explained. “But But for organizations ns that have a heavy vy Medicare popula-tion and a lot off those medications aare ree covered, then there’s ’ a good d return on investment for this accreditation.” It’s also important to know why HIT accreditation has gained traction. Historically, CMS had not covered the cost of nursing components for administering HIT. The 21st Century Cures Act, enacted in December 2016, established a new benefit for HIT services, including nursing services; training and
An effective tool for non-340B facilities
Specialty Med Committees Drive Savings
D
eveloping a subcommittee to evaluate the use of specialty medications among inpatients helped pharmacists at Bryan Medical Center, in Lincoln, Neb., save nearly $650,000 in the first year alone. This financial boon came from evaluating just four medications, according to a presentation at the ASHP 2020 Midyear Clinical Meeting and Exposition. The work began with an evaluation of andexanet alfa (Andexxa, Portola) in the main Pharmacy and Therapeutics Committee, and an acknowledgment Continued on page 4
MFN Drug Price Plan Frozen By U.S. Courts
C education d i not otherwise h i covered d under d the durable medical equipment benefit; remote monitoring; and other monitoring services. In 2019, CMS set the minimum expectations for home infusion suppliers to apply for and receive reimbursement, including the requirement to be accredited by an approved accrediting organization. Many providers have already met the
ourt injunctions have put the nail in the coffin of the Trump administration’s “Most Favored Nation” interim final rule aimed at lowering prescription drug prices, but experts say this probably isn’t the last we’ll see of international drug reference pricing. The rule, which was set to take effect Jan. 1, proposed to restrict costs for the top 50 physician-administered Medicare Part B drugs—which account for almost 80% of Part B spending—to no more than the lowest price that drug manufacturers receive in other similar countries (bit. ly/3oMqlSv). Specifically, it would have replaced the existing average sales price
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