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Kevin James, RPh, MBA, vice president of payer strategy at US Bioservices, discusses the impact of Accountable Care Organizations on specialty pharmacy.

Erin Hohman, PharmD, BCPS, director of Clinical Pharmacy Services at Amber Pharmacy, discusses trends in the specialty pipeline pharmacists should keep an eye on.

Humans, and the microbes that live inside us, could be the source of the next generation of antibiotics...German researchers just discovered an antibiotic (lugdunin) produced by bacteria (S. lugdunensis) that inhabit our noses. This new antibiotic can kill MRSA (methicillin resistant S. aureus), the poster child for drug resistance and the culprit behind the most pernicious hospital-acquired staph infections..."Our study can help to understand what we can do to eradicate these pathogens from the microbiota of healthy people," said Andreas Peschel, lead author of the study, published...in Nature...

Faced with budgetary constraints, England’s National Health Service took several controversial steps to delay coverage of Gilead Sciences’s pricey hepatitis C treatments, but did so at the expense of patients, according to an investigation by the BMJ (British Medical Journal)...Specifically, the agency’s moves caused delays in providing treatment to many of the estimated 160,000 hepatitis C patients, while others were unable to obtain the medications due to rationing. As a result, some people are now traveling out of the country to receive treatment. Meanwhile, Gilead has been blamed for igniting the problem due to its pricing practices...Gilead has regularly maintained that the high cure rates will eventually lead to lower health care costs by reducing the need for hospitalizations and other treatments for liver cancer and liver transplants. The NICE recommendations acknowledged such calculations. But such savings are only recognized later and, meanwhile, a growing number of payers in various countries complained the drugs were budget busters..."It is truly ironic that NHS England should choose to start rationing drugs that are so effective they cure almost everyone who is treated," The Hepatitis C Trust, a patient group in the UK, told the BMJ. The group is seeking a judicial review of the decision to ration the drugs, which...could have "repercussions for other patients as more new drugs increasingly become available at higher prices."

Medicare Advantage and other supplemental Part D plans encourage medication adherence to achieve higher star ratings... This rating system measures insurance plan quality, as higher quality plans improve patient outcomes and minimize costs. Adherence represents 10.9% and 29.5% of Medicare Advantage and supplementary plans’ star ratings, respectively...Community pharmacies...have initiated automatic refill programs to improve adherence. These programs have the added benefit of boosting insurance plans’ star ratings...(CMS) confidently assumes that patients of brick-and-mortar pharmacies use their refills if they pick up the prescriptions...researchers reported that an automated prescription refill program improved medication adherence of Medicare Part D patients...Easing barriers to refilling prescriptions enhances adherence, and reinforced adherence enhances pharmacy sales directly and indirectly. Insurance companies prefer pharmacies that strengthen their star ratings; they’re less likely to engage with pharmacies with mediocre adherent patient populations from coverage, and they provide bonuses to pharmacies for high adherence...Future studies assessing the impact of automatic refill programs should develop a superior method of measuring actual medication intake.

Justin Gallagher, associate publisher of The American Journal of Managed Care. Welcome to This Week in Managed Care...

U.S. and British officials announced an ambitious collaboration...designed to accelerate the discovery and development of new antibiotics in the fight against one of the modern era’s greatest health threats: antibiotic resistance...CARB-X, for Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator, will create one of the world’s largest public-private partnerships focused on preclinical discovery and development of new antimicrobial products...The undertaking includes two agencies within the U.S. Health and Human Services Department that focus on biomedical research and Britain’s Wellcome Trust, a London-based global biomedical research charity. It also includes academic, industry and other nongovernmental organizations...The partnership is committed to providing $44 million in funding in the first year and up to $350 million in new funds over five years to increase the number of antibiotics in the drug-development pipeline. The ultimate goal...is to move promising antibiotic candidates through the critical early stages so they can attract enough private or public investment for advanced development and win approval by U.S. and British regulatory agencies...

Cancer treatments, drug discovery, genome sequencing...are all driving big spending for personalized and precision medicine...Driven by demand for personalized medicine in cancer treatments and advancements in new healthcare technologies, the precision medicine market is expected to reach $87.79 billion by 2023, according to a report by Global Market Insights...Revenue growth will be sustained by favorable government regulations and standards...The trend toward an individualized diagnosis approach is growing thanks to large-scale biologic database development, efficient methods for patient characterization, and computational tools to analyze large data sets...Recent research advances have helped expand benefits to various aspects of healthcare by enabling better understanding of disease mechanisms, assessment of disease risks and prediction of optimal therapy...A large number of investments in diagnostic research will further accelerate the shift from treatment to preventive medicine in healthcare...

Hospital clinics and outpatient departments that bill Medicare for unused portions of certain medications recently gained six additional months to meet newly mandated documentation and billing requirements...the Centers for Medicare and Medicaid Services announced that Medicare administrative carriers must delay until January 1, 2017, implementation of a policy requiring the use of the "JW" modifier on Part B claims for appropriately discarded leftovers from single-use vials or packages...CMS introduced the JW modifier—a code that essentially enables itemized billing for the unused portion of certain medication vials—in 2007. But the agency allowed each MAC to decide whether to require the use of this billing mechanism or, instead, reimburse for wasted medication without separately itemizing it...Hospitals aren't required to bill for wasted medications, but those that don't are missing out on full reimbursement for eligible products...The...communication from CMS did not specify the reason for the implementation delay.

GlaxoSmithKline is not planning to exit the U.K. just because the U.K. is exiting the European Union. As if to emphasize its commitment, the drugmaker today said it intends to put a big chunk of money into expanding its manufacturing there...GSK will invest £275 million ($360.3 million)...(Specifically...£92 million at Barnard Castle to build an aseptic sterile manufacturing plant for biologics, £110 million to expand API production for HIV drugs and vaccines at the Scotland plant and £74 million at the Ware site for expansion of production of inhalers for its Ellipta respiratory drug)...The company said it expected the expansion to lead to some unknown number of new jobs and provide further work for the 2,750 people already working at the three sites...The company said there were plenty of reasons to feel good about new U.K. investments. It lauded the...benefits of the so-called patent box tax legislation from several years ago which taxes at a lower rate profits on new intellectual property created in the U.K.