Bridging the gap between the hospital and post-discharge care
In This Issue Ask the Expert
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For smaller operators, how to get into a limited drug distribution network.
Volume 1 • Number 2 • Spring 2012
Reports from the PBMI conference
Cost Containment In Specialty Pharmacy
Q&A
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Jay Mirtallo, MS, RPh, on why nutrition needs to be a higher priority.
Practice Profile
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The Apothecary Shops applies a personal touch to disease management.
Operations & Mgmt
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New study underscores savings potential of alternate-site infusions.
Clinical
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Anti-EGFRs linked to increased risk for thromboembolic events.
Disease State Spotlight
21
UIC Specialty Pharmacy’s primer on managing hepatitis C patients.
Excelera Eyes Market Growth For Hospitals
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everal health systems have made the foray into the specialty pharmacy market. But with their limited scale and lack of national exposure, it is difficult for them to convince manufacturers and insurers that they can supply medications and patient management programs at a reduced cost, and also deliver the utilization and outcomes data that Pharma needs for research and marketing. Now some health systems are tackling the size challenge. A group led by Fairview Health System in Minnesota and Henry Ford Health System in Michigan has established a national network of hospital pharmacies called ExceleraRx, LLC
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Scottsdale, Ariz.—Specialty pharmacy medications represent a significant source of pharmacy costs for most employers trying to keep their pharmacy benefits in check. Although they make up fewer than 20% of overall prescriptions today, according to Medco Health Solutions’ 2011 trend report, specialty drug spending saw a 22% increase in its total market share between 2008 and 2010 and further growth is predicted for the coming decade. The nonprofit accrediting body URAC has predicted that specialty drugs will make up the majority of new drug approvals in coming years and will account for approximately 40% of a health plan’s drug spending by 2020. With numbers like these, it’s little wonder that specialty pharmacies are emphasizing cost containment initiatives. Such initiatives were key topics in many of the presentations at the Pharmacy Benefit Management Institute’s 2012 Drug Benefit Conference in February. For example, Walgreens has a number of cost containment strategies for its specialty pharmacy program, such as compliance management, divided dispensing and site of care optimization (related article, page 11). Aggressive management of patient compliance/adherence is one such initiative, Michael Einodshofer, director of utilization management for Walgreens Specialty Pharmacy told Specialty Pharmacy Continuum. In addition to influencing patient outcomes (Table, page 11), compliance can have a huge affect on cost. Mr. Einodshofer noted that Walgreens has preliminary results showing that a compliant
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see CONTAINMENT, page 10
Educational Review Medication Errors: A Year in Review by ISMP See specialtypharmacy continuum.com
see EXCELERA, page 8
Breadth of problem is ‘scary’
Do MTX Drug Interactions Fall Below Radar?
A
dangerous interaction between proton pump inhibitors (PPIs) and methotrexate that prompted the FDA to issue a warning late last year represents just the tip of the iceberg of potentially serious interactions that can occur when common medications are given concomitantly with methotrexate. “It’s pretty scary how many of these interactions there are,” said Ali McBride, PharmD, clinical pharmacy specialist at the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital in St. Louis.
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see INTERACTIONS, page 17
The Book Page Fundamentals of Pharmacognosy and Phytotherapy, Second Edition Michael Heinrich See page 27.