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Last week, the Centers for Medicare and Medicaid Services released its final Notice of Benefit and Payment Parameters for the 2021 benefit year...This final rule permits insurers to exclude the value of a pharmaceutical manufacturer’s copay support program from a patient’s annual deductible and out-of-pocket maximum obligations...Translation: CMS has confirmed that insurers have the option to use copay accumulator adjustment for their pharmacy benefit programs...Patients on specialty drugs lose big from accumulators, while plans profit from the lower spending that results. Consequently, copay maximizers have emerged as a more patient-friendly alternative to accumulators...Plan sponsors are publicly denouncing copay support programs—while they’re privately embracing them. CMS’s final rule ignores the troubling reality behind maximizers and accumulators: They encourage plans to use pharmacy benefit deductibles as a scheme that allows payers—not patients—to reap the greatest benefits from a manufacturer’s patient support program...READ MORE

The Texas State Board of Pharmacy issued a new rule that no prescriptions for hydroxychloroquine could be dispensed without a diagnosis, then changed their tune...On March 20...issued a new rule that no prescriptions for hydroxychloroquine or azithromycin could be dispensed without a diagnosis “consistent with evidence for its use.”...Over six weeks after the original rule was published, the Texas State Board of Pharmacy has recently changed its guidance to pharmacists...The website now says, “The rule does not prevent a physician from prescribing one of these drugs for an off-label use. Please note, the intended use for the drug is not required if the practitioner determines the furnishing of this information is not in the best interest of the patient…”READ MORE

A recent study identified pharmacy-level barriers to treatment for opioid use disorder in rural areas, indicating a need for policy changes regarding buprenorphine access and monitoring...The case study, published in the International Journal of Drug Policy, looked at buprenorphine dispensing practices in 12 rural Kentucky counties across 15 community pharmacies. The investigators aimed to determine whether dispensing patterns were influenced by features of the rural risk environment...“Concerns about exceeding a ‘Drug Enforcement Administration cap’ on opioid dispensing stifled dispensing,” the investigators wrote. The other factors that influenced dispensing were distrust of pharmaceutical companies and prescribers of opioid analgesics and a general stigma against individual who use drugs and/or against the medications to treat substance use disorder...READ MORE

All pharmacy staff—along with everyone entering the pharmacy—should wear face masks, according to new guidance from the CDC...The CDC’s “Guidance for Pharmacists” also says that pharmacies should postpone and reschedule some routine preventive services, such as adult immunizations, since they require face-to-face interaction...This guidance applies to all pharmacy staff to minimize their risk of exposure to the virus and reduce the risk for customers during the COVID-19 pandemic...According to the guidance, pharmacies should:

Implement universal use of face coverings.
Advise staff who are sick to stay home.
Encourage all prescribers to submit prescription orders via telephone or electronically.
Limit direct contact with customers.
Reduce risk during COVID-19 testing.
Maintain social distancing
Ensure that the waiting area is cleaned regularly.
Close self-serve blood pressure units.

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When retired Navy Chief Petty Officer Richard Gray and his wife, Sheila, were able to go to the Nellis Air Force Base pharmacy, they picked up their prescriptions with full coverage and no copayment...But now their only option is off base, and the 16 medications they take between them cost upward of $2,000 a month out of pocket at Walgreens...Under the base’s public health emergency called on April 3 and renewed May 4 in response to the coronavirus outbreak, only uniformed members and their dependents and essential civilian contract employees are allowed on base, including the pharmacy...The Nellis pharmacy was placed off limits for retirees on April 10, leaving thousands of local military widows and retirees, many of them living on fixed incomes, locked out of the no-cost medication to which they are entitled. Now they are subject to copays that can quickly add up to hundreds of dollars...READ MORE

On Tuesday, May 12, Governor Gavin Newsom granted California’s 47,000 pharmacists the ability to order and administer coronavirus disease 2019 (COVID-19) tests throughout the state. His current objective is to test 60,000 California residents per day. After receiving a request for this expanded authority for pharmacists from the California Pharmacists Association, Newsom recognized that granting pharmacists the ability to test in the state would make that objective possible...READ MORE

A bipartisan letter has urged Congress to consider including provisions permanently prohibiting pharmacy direct and indirect remuneration (DIR) clawbacks by pharmacy benefits managers (PBMs) in future coronavirus relief packages...The published letter cited increased demand and existing financial strain being amplified during the current pandemic as reasons for the bipartisan push for pharmacy DIR reform...The majority of neighborhood pharmacies are already experiencing negative cash flow issues and, for their efforts to help through this pandemic, will get a big bill months from now as PBMs come calling for DIR fees. Eliminating these fees and reining in PBMs has never been more vital if pharmacies are to continue operating now and when this emergency passes...READ MORE

Rapid coronavirus disease 2 (COVID-19) testing, contract tracing, and preparing for vaccines and treatments are the 3 key priorities as the United States reopens, NACDS said in a new report...Pharmacies: A Vital Partner in Reopening America...The organization also urged that additional steps should be taken to ensure that pharmacists and pharmacies are fully utilized to support this national effort...READ MORE

Despite the unprecedented impact of coronavirus disease 2019 (COVID-19) on the economy and society, its impact on the health plan enterprise appears to be practical and functional rather than strategic and financial. This conclusion comes from a pilot study with health plan decision-makers...“business as usual."...READ MORE

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Maintain Commercial Membership
Shift to Medicaid and Affordable Care Act Markets
New Product Launches

The Alliance for Pharmacy Compounding announced the launch of its free resource, which serves as a liaison between hospitals with 503B outsourcing facilities, or 503A sterile compounding pharmacies, that can supply treatments currently in shortage due to the COVID-19 pandemic...APC’s Compounders’ Shortage Drug Source for Hospitals mimics its earlier online bulletin board...The news release provided information to hospitals interested in utilizing the resource:

• FDA-registered 503B outsourcing facilities and qualified, board of pharmacy-approved 503A sterile compounders may provide the resource with information about their available supplies. Only those shortage drugs listed by FDA in appendices to its recent temporary guidance document for 503Bs and 503As may be listed.

• Data submitted by outsourcing facilities and 503A pharmacies will post this information for hospitals to access.

• If hospitals are unable to source the needed drug(s) from a 503B, they may access a secondary page listing information submitted by 503A pharmacies about shortage drugs they can prepare...

• APC has asked the American Hospital Association and the American Society of Health System Pharmacists to make its hospital members aware of the resource...READ MORE