Pharmacy Update: July 23

NACDS contends that “direct and indirect remuneration” (DIR) fees must be addressed in drug-pricing legislation. NACDS says DIR fees have exploded by 45,000 percent from 2010 and 2017 and are inflating seniors’ out-of-pocket costs for prescription drugs and forcing pharmacies out of business.

DIR fees result from a Medicare regulation loophole. Often six-to-eight months or more after a pharmacy fills a Medicare prescription, payers are taking back money paid to pharmacies. Payers claim this practice relates to performance on so-called quality measures. Yet these measures can be unknown, unpredictable, inconsistent and outside of a pharmacy’s control. This practice is unworkable for pharmacies, thousands of which have closed in recent years. The practice also inflates patients’ out-of-pocket costs because of complexities of how such costs are calculated.

Parents and pharmacists are grappling with a continuing shortage of the allergy shots and hurdles that stymie alternatives. A persistent shortage of Mylan’s NV’s EpiPpen anti-allergy injectors is forcing patients and pharmacists to go to great lengths to get their hands on the lifesaving device. EpiPens have been hard to get since at least May 2018, when the FDA said the device was in short supply.

While other options are available, including an identical lower-priced version of the device from Mylan, consumers have also struggled to secure alternatives thanks to uneven distribution, the reluctance of insurers to pay for similar treatment and uneasiness with unfamiliar products.

“We’ve got to keep our local pharmacies open,” said United States Senator Shelley Moor Capito on C-Span 2 in July.

Within 12 years, global insulin use will increase by 20%, according to news published in The Lancet Diabetes & Endocrinology. Prices for this life-saving medication are projected to climb, leading to adherence problems and uncontrolled diabetes in huge numbers of Americans.

According to UpWell Health, 45% of people with diabetes avoid taking their medication because its is to expensive. In the U.S. 30.3 million Americans — or 9.4% of the population — suffer from the disease, according to the CDC. Of these, 23.1 million of them are diagnosed and 7.2 million are not. Every year 1.5 million new cases of diabetes are diagnosed in the U.S.

Last year the American Diabetes Association determined that people with diabetes spend around $9,000 a year in expenses related to their condition. The cost of insulin has tripled in the past decade.

A federal judge has blocked a Trump administration rule that would have required drug manufacturers to include the price of the drug in ads if the medicine’s list price was over $35 a month.

Even with the availability of vaccinations in the U.S., officials say there is an unfortunate rise in the number of people refusing to immunize themselves and their children due to misinformation about the safety of vaccinations. Approved vaccines undergo rigorous testing and are proven safe for pubic use. there is no scientific evidence supporting claims that immunization can lead to disorders, disease or life-threatening side effects.

Companies have raised medicine costs by 27% on average last month, with a subsidiary of Teva Pharmaceutical Industries Ltd hiking the price for a generic anti-diuretic by 909%. Closely held Epic Pharma LLC cam second on the list of top increases, jacking up prices on two versions of its drug by 300%.

Shoppers wait in line at Walmart after the company eliminated jobs as it seeks to reduce costs and plot a new course in an evolving health-care landscape. The number of jobs being cut was not disclosed, but one official said the cut could include as many as 40% of senior pharmacists along with cuts for some new hires and reduction in part-time staffers.