WVPA Update: December 21

The spreading legalization of marijuana bodes ill for the sleep industry. Many folks in states where pot is legal are turning to it not to get high, but to combat insomnia. Colorado offers a revealing test case. Sales of insomnia drugs, which had been growing, plummeted in 2014, when the state legalized marijuana. Some research suggests that pot can be an alternative to over-the-counter sleep meds.

Sleeping pills are big business. About half of the population has sleep issues. Americans spend tens of billions of dollars per year on sleep drugs. As recreational pot gets OK’d in more states, growers and vendors will grab a bigger share of the market.

Congressional leaders are near a deal on two health care issues. First, reining in surprise medical billing, in which patients who have an urgent need for expensive care from an out-of-network provider get hefty invoices for the amount that isn’t covered by their insurance. Second, details are foggy, but a bill with bipartisan support looks likely to pass. The legislation would create an arbitration system for patients to dispute medical charges.

According to The Associated Press, the Trump administration, eager to show progress on prescription drug costs, is moving forward with its plan to allow Americans to safely and legally get access to lower-priced medicines from abroad.

Walgreens continues to broaden its health care offerings opening physician-staffed clinics and announcing the debut of in-store Medicare services centers. The 2,500-square-foot clinics will offer comprehensive primary care services with their own entrances and waiting rooms.

The West Virginia Pharmacists Association requests pharmacists to attend “Pharmacy Day at the Legislature” on Monday, February 24, at the Capitol in Charleston. “The event will include meeting with legislators and discussing legislation of interest to pharmacy,” said Executive Director Richard Stevens.

Senator Dave Sypolt (R) of Kingwod along with Delegate Barbara Fleischauer (D) of Morgantown and Delegate Larry Rowe (D) of Kanawha spoke favorably toward passage of Rule 114 SCR 99 during a hearing before Senators and Delegates at the Capitol, December 18. “The rule will improve reporting requirements of pharmacy benefit managers, and prohibit them from providing a network comprised only of mail-order,” said Richard Stevens, WVPA Executive Director, who attended the hearing. Delegate Brandon Steele (R) of Raleigh County spoke against the bill. However, it passed by a voice vote.

Pharmacists are alerted some PBM manuals contain sections detailing the obligation to report disciplinary actions, investigations and/or proceedings against the pharmacy, often requiring written notification for actions. One area that can be problematic for pharmacies is the timing of when disclosure is required to be made. PBM manuals typically require disclosure of any reportable action within 5-10 business days or sooner, depending on the seriousness of the circumstances.

The Center for Medicare and Medicaid Services (CMS) has issued a notice that some Medicare drug plans (Part D) will have a Drug Management Program to help patients who are at risk for prescription drug abuse. CMS alerts patients who get opioids from multiple doctors or pharmacies that they may be required to get their medications only from certain doctors or pharmacies to better coordinate their health care.

CMS is to send a letter to these patients advising them that they may tell the plan which doctors or pharmacies they prefer to use. The Drug Management Program generally won’t apply if the patient has cancer, in hospice, palliative or end-of-life care, or if they live in a long-term care facility.

The employment of pharmacists is projected to show little or no change from 2018 to 2028, according to the Occupational Outlook Handbook. Specifically, in retail pharmacy, sales will be affected by the increase in the use of mail order and online pharmacies. In nonretail settings, the outlook for pharmacist employment is projected to increase by 6.9% by 2028, with the biggest growth in hospitals and outpatient care centers.