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Rising prices for prescription medicines have become an increasingly contentious issue and cast a harsh spotlight on the pharmaceutical industry. As a result, a growing number of state and federal lawmakers are proposing legislation to somehow halt the trend. Drug makers maintain their prices fuel needed innovation and blame insurers for forcing consumers to pay higher costs. But Troy Brennan, the chief medical officer and executive vice president at CVS Health, argues differently. CVS runs the nation’s second-largest pharmacy benefits manager, which negotiates drug prices for companies and government agencies, among others. He maintains CVS is cutting costs to clients. Here is an excerpt of our conversation...

...outcry over drug pricing has forced healthinsurers and pharmaceutical companies to devise ways of expanding access to potentially life-saving drugs without breaking the bank...Value-basedcontracts, in which insurers pay for drugs based on their effectiveness, have begun to sprout, and more are expected to follow. But experts believe these types of deals, although potentially beneficial, are not a panacea for managing drug costs. Value-based contracts may also be hard to orchestrate since they require doctors, insurers, pharmacy benefit managers and drug companies, often rivals, to cooperate and share data...What you still don't know at the end of the day with these outcomes agreements is whether they save money…Paying for the efficacy of drugs is a logical extension of how the U.S. wants to finance healthcare. Medicare rewards hospitals that deliver good care and penalizes those with high levels of costly readmissions. Private insurers have created narrow networks with selected health systems and doctors presumably based on their low costs and superior quality...most difficult hurdle may come once insurers, PBMs and drug companies have agreed on measurable, clinically relevant metrics. Those groups then have to share their medical and pharmacy data to track outcomes, which requires a high level of cooperation from fierce, often unfriendly negotiators...

Pharmacy students at the University of South Florida Health College of Pharmacy will see a great emphasis placed on 4 main pillars: 1. Geriatric pharmacotherapy 2. Translational pharmacogenomics 3. Health informatics 4. Leadership/management...Dean and professor Kevin Sneed, PharmD, spoke with Pharmacy Times about the importance of these pillars—namely that no matter how the health care arena transforms in the future, these pillars will continue to evolve and remain relevant….Dr. Sneed provided more insight into what a student can expect to experience at USF College of Pharmacy.

• Q: What is unique about your school/program?
• Q: What is the teaching style or philosophy at your college?
• Q: What are some community outreach activities or programs that your college participates in? What volunteer opportunities are available to students?
• Q: What opportunities do students have for internships or co-ops?
• Q: What advice do you have for students who will graduate this year?

McKesson AccessHealth...expanded its suite of reimbursement and performance enhancement tools and relationships...While the shift to preferred networks and new reimbursement models is challenging for many independents, there are also opportunities for incentives...There is a tremendous chance for innovative pharmacies to leverage their strengths, improve their overall pharmacy performance and maximize their reimbursement by interacting with their patients and providing care...more than one-third of Medicare D claims through AccessHealth contracts will include performance-based reimbursement incentives...those pharmacies or pharmacy networks who display top performance will be charged a smaller...Direct and Indirect Remuneration, amount than those who underperform. This...presents independent pharmacies with an...opportunity to reduce their DIR charges, thereby maximizing their potential reimbursement. The new suite of tools include:

• AccessHealth Pharmacy Performance Guidebook...offers detailed instructions on how to develop action plans to improve patient behavior and boost outcomes using such tools as medication therapy management case completion, refill reminder programs, medication synchronization and behavioral coaching;
• AccessHealth DIR Estimator Tool...allows a pharmacy to enter information specific to them and estimate accrual and incentive amounts that may impact DIR payments in order to plan accordingly;
• AccessHealth Webinar Series...designed to help independent pharmacies prepare for new reimbursement rates as well as identify opportunities to leverage the movement toward pay-for-performance incentives.

Children in China's eastern Jiangsu province are being widely exposed to antibiotics from tainted food and drinking water, potentially harming long-term health, local media reported...citing research from Shanghai's Fudan University...which tested for 21 common antibiotics, including those used for animals, found traces of at least one type in 80 percent of a pool of 505 schoolchildren in Shanghai, China's modern business hub with a population over 20 million...China suffers from serious overuse of antibiotics, with doctors prescribing them to half of all outpatients, far above recommended levels...nearly two-thirds of Chinese believed antibiotics should be used to treat colds and flu, while one-third thought antibiotics were effective against headaches...Misuse of antibiotics is becoming a global risk, making the drugs much less effective at treating common infections...

...48 states and the District of Columbia, pharmacists’ scope of practice allows for collaborative practice agreements with prescribers—although each state has its own rules and nuances about what, where, and with whom pharmacists can collaborate... Antonio Ciaccia...Ohio Pharmacists Association... the state’s new collaborative practice agreement laws will have a major impact on all pharmacy practice settings, including compounding, long-term care, hospital, ambulatory, community, and consulting. While he believes that pharmacists have "more than adequate training" to perform the services permitted under the new law... Because of the variations in state pharmacy practice acts, pharmacists can best defend themselves against such liability claims by taking the time to familiarize themselves with the authority granted to them under their collaborative practice agreement to ensure that they do not exceed that authority. Pharmacists may also check with their malpractice insurance carrier...Despite the increased potential for malpractice and liability issues...expanded collaborative practice agreement law as a victory for prescribers, pharmacists, and patients...engagement of the pharmacist on the health care team is a great driver for improving outcomes...

...online market giant Alibaba Group launched a pilot medical service last month in China that promises a patient can visit a doctor online and get his prescription filled the same way with home delivery and payment to boot...part of Alibaba's health business, aims to tap into a market that iResearch said had an estimated revenue stream of 16 billion yuan ($2.4 billion) last year…We want to build a health care product sales platform that links manufacturers, wholesalers and retailers to offer various medical products and services to customers…The pilot saw patient Hu Tianshun enter medical data via an online form and then a video chat with a doctor in another city was held…adding the doctor made a diagnosis and places a online prescription order with an Alibaba's online shops...Hu got his drugs the next day, and completed the transaction by paying the deliveryman…

The National Pharmacy Association will be launching a petition for pharmacy contractors in an attempt to combat the government’s proposed 6% cuts to the community pharmacy contractual framework...This is going to be a petition aimed at the prime minister and this is going to be a petition where we mobilise contractors… and patients...The NPA wanted a paper petition so customers at pharmacies could sign it...It is to complement the parliamentary e-petition which has already gathered 42,000 signatures...Mike Smith...at Walgreen Boots Alliance, said he believed the cuts will go ahead regardless of efforts to counter them. "I personally think the £170m is gone, despite the consultation process, but we have to change and work with the Department of Health,"...It almost makes the Pharmaceutical Services Negotiating Committee’s job role defunct… because if [the Department of Health] is going to bulldoze what it wants onto us, there is no negotiating going on...Sharpe (chief executive of the PSNC) said: "Would I say to people at this stage to start investing to deliver more services from their pharmacies? No, I think that would be premature. We need to understand exactly what they want from us before we would responsibly tell people to start investing more."...She added that pharmacists should not stop delivering existing services until they "really have to", warning that if pharmacists withdraw services or go on strike, they may lose the support of their patients.

Your patients may not realize that the effectiveness of their medications is largely within their control...According to the Institute of Medicine, nearly 50% of US adults have trouble understanding their medications’ instructions, so pharmacists should engage patients in interactive conversations in order to ensure that they do not stop taking them...Here are some common reasons why a patient’s medications may not be working properly:

1.  Patients are not taking medications exactly as directed.
2. A patient’s diet may be interfering with medications.
3. A patient’s lifestyle habits may be interfering with medications.
4. A patient may have comorbid conditions.

A big hospital chain’s surprise decision to write off a slug of bad debt may be a signal of much deeper consumer healthcare strains being caused by ObamaCare...Community Health Systems surprised analysts this week...the company would take a $169 million provision for bad debt. The write off was a big part of Community’s dismal fourth quarter earnings report...The rising amount of uncollected co-pays and deductibles may be an early sign of consumer stress as the economy weakens. But more likely, it also reflects changes in the healthcare market that are saddling consumers with a much bigger share of their medical costs...ObamaCare is playing a big role...The structure of the insurance products offered under ObamaCare was deliberately skewed toward hollowed-out health plans. These plans sport large out-of-pocket limits and often skimpy or no co-insurance on drugs and doctors purchased outside a health plan’s increasingly narrow drug formularies and provider networks...Americans are now less insured for medical costs…The earnings report from Community Health was an early financial harbinger of this trend. Collecting on these rising out of pocket costs will get more difficult for healthcare providers as the ObamaCare insurance designs become the new market standard. This will be ObamaCare’s legacy – a new standard for hollow health coverage.