Pharmacy Update

The West Virginia Pharmacists Association (WVPA) sent its members copies of new legislation that becomes effective June 6. They include: required reporting of overdoses; prohibited sale of dextromethorphan products; physician assistants prescribing; FQHC funding for rural and primary care; fraud and abuse in Medicaid; PEIA rainy day fund to prevent cuts; conversion of prescriptions; required reporting of drug overdose; fraud and abuse in Medicaid; audit of Board of Pharmacy and sweeping of monies; registration of pharmacy technicians; opioid reduction act revised by lawmakers; pharmacists to dispense tobacco cession therapy; conversions of prescription and authorizing refills; and pharmacy audit integrity act.

Is a pharmacist to call the provider every time a patient has an opioid prescription that reaches or exceeds 90 MME for the care coordination safety alert? NO…According to CMS report sent WVPA.

The provider will be initially contacted by the pharmacist if a patient presents to the pharmacy with a prescription that reaches a cumulative threshold of 90 MME or greater across all of the patient’s opioid prescriptions and triggers the alert at the pharmacy.

Once a pharmacists consults with a prescriber on a patient’s prescription for a plan year, the pharmacist does not have to consult with the prescriber on every opioid prescriptioin written for the same patient after that unless the plan implements further restrictions.

West Virginia and 43 other states have filed an antitrust lawsuit claiming some of the nation’s largest generic drug companies conspired to inflate and manipulate prices, cut competition and restrain trade for more than 100 different drugs.

The federal complaint, which was filed May 10 in U. S. District Court for the District of Connecticut, also lists 15 senior executives as defendants, including Mylan Vice President of Sales James Nesta.

Among manufacturers named in the suit are Mylan Pharmaceuticals, Teva Pharmaceuticals, Pfizer Inc., Sandoz, and Upsher-Smith Laboratories LLC.

The lawsuit claims 20 generic drug makers engaged in a “broad, coordinated and systematic campaign to conspire with each other to fix prices, allocate markets and rig bids for more than 100 different drugs.”

The Trump administration’s point-of-sale rebate proposal would drastically alter the way rebates are delivered, and pharmacy benefit managers are angling for responsibility to distribute the rebates under the new model. PBMs have signaled they could sue the administration if they do not like the way the final rebate rule is structured Pharmacists, on the other hand, want an entity other than PBMs to fill the intermediary role between manufacturers and pharmacies.

Currently, PBMs pay pharmacies for drugs, then they get rebates from drug makers that are passed to plans, though PBMs often keep some of the rebates. Under the new rebate proposal, drug makers would pay the rebates, directly or indirectly, straight to the pharmacies. The HHS Office of Inspector General uses the term “chargeback” to describe these new payments.