Author: Peter

Laura Joszt, assistant managing editor at The American Journal of Managed Care. Welcome to This Week in Managed Care from the Managed Markets News Network

The number of small claims against the NHS (National Health Service) has risen by 26 per cent in one year...Four in five GPs say they are ordering needless tests and drugs for patients for fear of otherwise being sued...It comes amid soaring numbers of successful small claims against the NHS, which have risen by more than a quarter in one year...A survey of more than 1,300 doctors by the Medical Protection Society found 87 per cent are increasingly fearful of litigation...In total, 84 per cent said their worries about being sued had caused them to order needless tests or refer patients to consultants, while 41 per cent admitted to prescribing medication when it was not clinically required.

A Las Vegas investigator with the state Board of Medical Examiners was sexually harassed by her boss and retaliated against by co-workers after complaining to her superiors...The lawsuit...by investigator Lara Ward, alleges that the sexual harassment was part of a pattern of unprofessional conduct by officials in the state office that investigates complaints against licensed medical practitioners...While the sexual harassment claims form the core of the lawsuit, Ward also levels numerous allegations of unprofessional conduct by various members of the board. Among them, the complaint alleges that:

■ Andreas held personal vendettas against certain physicians, whom he targeted by keeping cases open after doctors were cleared of accusations.

■ Board officials closed several investigations of malpractice concerning high-profile physicians.

■ Doctors sued by a major insurance company for fraud had malpractice cases administratively closed. Those cases accused doctors of misuse of spinal cord and cervical injections and opioids.

■ Opioid overprescription investigations were delayed, including those resulting in death. The delays were part of an overall pattern of mishandling of overdose cases that included closure after lab reports were misread.

■ Female co-workers in the Las Vegas office favored by Andreas were promoted to investigative positions even though they lacked required bachelor’s degrees.

■ Ward, who has a bachelor’s in criminal justice from the University of Colorado, was denied a promotion to senior investigator and received poor marks from Chief of Investigations Pamela Castagnola on an employee review because she inquired about the position.

A California law allowing pharmacists to prescribe birth control sought to make it easier for women to obtain contraception, but few drug stores provide the service... Only 11 percent of retailers in the state offered pharmacist-prescribed contraception one year after the law went into effect, the research shows...Our findings strongly suggest that more pharmacies need to offer this service to live up to the promise of widespread, easier access to birth control...Four states - California, Oregon, Colorado and New Mexico - allow pharmacists to prescribe contraceptive pills, patches, rings and injections after training about how to assess health risks and counsel women on contraceptive choices... Most stores that offered the service charged a fee...Under the Affordable Care Act, insurance carriers must pay for family planning consultations with healthcare providers. But the law does not cover pharmacists...Oregon requires Medicaid to pay pharmacists for the service. California’s law has a similar provision, but it doesn’t take effect until 2021...

Disasters, both natural and manmade, wreaked havoc on pharma supply chains this year, exposing vulnerabilities and costing the industry hundreds of millions, if not billions, of dollars...Hurricanes took out power and plants in Puerto Rico...Less visible but much more sinister was the cyberattack that managed to penetrate systems at Merck & Co...Experts say both kind of threats are only going to get worse...Some natural disasters, like earthquakes, don’t follow seasons and can’t be tracked. They just happen...The FDA pointed out that the Federal Food, Drug, and Cosmetic Act, does not include a specific provision giving the agency the authority to require a contingency plan for preventing drug shortages if a facility goes offline, regardless of the cause...Some events have nothing to do with weather or geography. Merck was the only drugmaker to publicly acknowledge that it had not adequately protected its computer systems and was a victim of the Petya cyberattack...Expect this trend to continue in 2018...the disruption caused by ransomware to industrial organizations in 2017 didn’t directly affect the automation controllers, “we expect that a new, more damaging type of ransomware will specifically target controllers” in 2018...if those threats were not enough to keep pharma executives up at night...the chilling observation that North Korea, “has quietly developed a cyber army capable of unleashing attacks against critical infrastructures that could have global implications.”

Despite personal attempts by Netanyahu and government ministers to persuade pharmaceuticals giant's chief to reduce number of planned layoffs, Kåre Schultz doubles down, insisting any compromise will only result in 'further redundancies and the closure of more factories,' notes program represents a ‘small part’ of cost slashing spree around the world...Prime Minister Benjamin Netanyahu failed to convince...Teva CEO Kåre Schultz to reduce the number of Israeli layoffs he intends to execute in the pharmaceuticals giant in a plan that has sparked outrage and triggered multiple protests.

An Elko cardiologist has been arrested on 39 charges of unlawful distribution of prescription opioids and Medicare and Medicaid fraud...58-year-old Dr. Devendra I. Patel...is charged with...routinely prescribing fentanyl, hydrocodone, and oxycodone for his patients without a legitimate medical purpose from May 2014 to September 2017, and fraudulently billing Medicare and Medicaid for medical tests he did not perform. The indictment alleges Patel performed EKGs on his patients, so he could then order nuclear stress tests which he did not administer. He allegedly used a poorly-calibrated machine and presented his patients with fraudulent X-rays to deceive his patients into thinking they had coronary issues that needed to be treated by him...

Nicole Crisano, PTNN. This weekly video program provides our readers with an in-depth review of the latest news, product approvals, FDA rulings and more.

The twin goals of improving health outcomes and generating economic savings can be achieved by ensuring more people take prescribed medicines as intended, and pharmacy services are extended to more Australians, the Society of Hospital Pharmacists of Australia said today...SHPA’s Federal Budget 2018-19 Submission details policy measures to boost medicines compliance – particularly among people at high risk of non-adherence and hospital readmission, and patients taking high cost PBS medicines (Pharmaceutical Benefits Scheme)...SHPA recommendations for the 2018-19 Federal Budget

• Support compliance and maximise return on investment in high cost PBS medicines.
• Reduce harm caused by opioid use initiated in hospitals
• Bridge the gap for high-risk patients leaving hospital and returning to care in the community.
• Provide additional funding to support seven-day clinical pharmacy services in hospitals in the National Health Funding Reform Agreements for Public Hospitals beyond 2020.
• Address safety and quality concerns in aged care by embedding pharmacists in Commonwealth facilities and home nursing services.
• Improve antimicrobial stewardship in all Australian healthcare facilities to address the threat of antimicrobial resistance.
• Fund hospitals to provide Closing the Gap Pharmaceutical Benefits Scheme Measure subsidies to Indigenous people.
• Develop a national pharmacy workforce reform strategy.