Pharmacy Update: August 5

The new Safe Importation Action Plan is the next important step in the Trump Administration’s work to end foreign freeloading and put American patients first, said HHS Secretary Alex Azar in response to the President working on efforts to allow prescription drug imports from Canada.

“President Trump has been clear: for too long American patients have been paying exorbitantly high prices for prescription drugs that are made available to other countries at lower prices,” says Azar.

“This pathway could be particularly helpful to patients with significantly high-cost prescription drugs. This would potentially include medications like insulin used to treat diabetes, as well as those used to treat rheumatoid arthritis, cardiovascular disorders and cancer,” the FDA says.

“We’ll thoughtfully evaluate the administration’s proposal and its impact on community pharmacies and the patients we service. Although we have concerns about unintended consequences that could rise form importation such as patient safety, the possibility of standards lower than those established by the Drug Supply Security Act, and disappointing costs savings that fail to deliver on the hope for better patient access,” says Douglas Yoey, RPh., CEO of the National Community Pharmacists Association.

Life-saving, overdose-reversing drug, Narcan, was approved three years ago in Virginia. Journalists in the Virginian-Pilot visited pharmacies over several months only to find about 20 percent of them refused to dispense naloxone without a doctor’s note, even after the standing order was mentioned.

Some pharmacists and pharmacy techs said they weren’t “authorized” to dispense it, while others dismissed the standing order entirely, saying they’d never heard of it or the order didn’t apply to their pharmacy. The various responses show how difficult and discouraging it can be for the average person to get naloxone despite the state’s effort to make it easier to obtain.

Virginia’s Commissioner of Health issued a standing order allowing board-certified pharmacists in Virginia to dispense naloxone one of three ways: through the Narcan nasal spray, the EVzio auto-injector, or in prefilled syringes. The Commissioner warned pharmacists that opioid overdose deaths were expected to rise by 25% and told them to prepare for patients requesting naloxone. About 45% of the pharmacies immediately knew about the standing order.

One in four patients with diabetes will ration or even stop their insulin due to skyrocketing costs…sometimes leading to death. In the U.S. only 3 companies make insulin, driving up prices.

Data released by the U. S. Centers for Disease Control and Prevention show that fatal drug overdoses fell 5.1 percent from 2017 to 2018. This represents the first significant decline in drug overdose deaths since the 1990’s. The data also reveals doctors are prescribing fewer opioid medications than they used to.

CMS issued guidance, effectively eliminating “spread pricing” in Medicaid and CHIP managed care plans. The guidance clarifies that the amount retained from a PBM under “spread pricing” must be excluded from the amount of actual claims used in calculating Medicaid and CHIP managed care plans’ medical loss ratio.

United State Congressman Alex Mooney responded to the West Virginia Pharmacists Association Executive Director Richard Stevens’s request to cosponsor The Pharmacy and Medically Underserved Area Enhancement Act, which protects rural pharmacies to ensure prescriptions covered by Medicare are available in rural West Virginia.