Briefs of interests to pharmacists

CVS Health Corp. unveiled an initiative aimed at improving the management of chronic kidney disease (CKD).  CVS’s program incorporates a focus on early disease identification, patient education and a comprehensive home dialysis program that includes a clinical trial for a home hemodialysis device that CVS Health plans to submit to the FDA for market clearance.   The device has been designed with features to make home hemodialysis simple and safe for patients, in order to facilitate longer, more frequent treatments.  The program expands CVS’s enterprise assets, including home nursing, long-term care centers, pharmacy locations and payer relationships.

FDA has approved tolvaptan (Jynarque–Otsuka Pharmaceutical) to slow kidney decline in patients with autosomal dominant polycystic kidney disease.  The progressive genetic disorder causes fluid-filled cysts to develop in and damage kidneys.  In 2013, FDA rejected tolvaptan but the agency approved it after Otsuka completed an additional study.  The one-year study found the drug on average slowed kidney function decline about 35% more than placebo.

As evidenced by recent deals and partnerships, the health insurance industry’s interest in home care is heating up.  Industry officials say there will be a change in the way care is delivered.  “The end game is to have facilities care only for those in need of ICU-level care.  Almost every other type and level of care can and will be delivered in alternative settings — primarily the home,” said Joe Paduda, principle of Health Strategy Associates, LLC.   Example: Starting June 1, Blue Cross and Blue Shield of North Carolina will bring in-home medical care services to about 6,500 patients to one provider of in-home, risk-based medical care.

Legislation requiring pharmacists and pharmacy technicians in South Carolina not providing critical care in hospitals to take a 30-minute break during a 12-hour shift has passed a legislative committee.  Pharmacists had testified that they are often fatigued from working long hours and that could lead to errors that may impact patient health and safety.

Drug manufacturers are pushing back against one of the Trump administration’s major proposals to bring down drug prices: a proposal to shift chemotherapy drugs and others administered in the hospital into a different part of Medicare.  The idea would give insurance companies and pharmacy benefit managers new power to negotiate discounts on some of Medicare’s costliest drugs.  That could mean big savings for the Medicare program itself, which might be passed on to consumers.

Illinois’ Medicaid managed-care program has accelerated the financial crisis for owners of independent and small-chain pharmacies, says the Illinois Pharmacists Association.  Many pharmacies are being paid less than acquisition cost of the medicines they dispense Medicaid patients.   Their dispensing fee has declined from $5.50 for generics and $2.40 for brand-name to 45 cents per prescription.   PBMs are responsible for the cuts, said the Association.

Anticoagulant drugs are expected to become a part of life for many aging adults at greater risk for blood clots.  While many people taking blood thinners take warfarin, which has been in commercial sue since the 1950s, four newer oral anticoagulants have come along in the past 8 years and have been increasing in use  These new drugs start working faster; however, they still carry a risk of bleeding.