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Defined in the broadest sense, accreditation means the action of officially recognizing someone as having a particular status or being qualified to perform a particular activity. This definition points to the idea that the act of accreditation provides an individual or organization with an official qualification to perform said duty...The Alphabet Soup of Accreditation...URAC, ACHC, TJC, CPPA: Each of these combinations of letters represent a different accrediting body used by specialty pharmacies. There is not a single authoritative body requesting consistent data reports and patient outcomes that a specialty pharmacy provider (SPP) can utilize. Instead, there is a mix of multiple bodies requesting different kinds and different levels of data...Although the size of the pharmacy and the chosen accrediting body changes the cost for accreditation, it typically costs the pharmacy tens of thousands of dollars each time accreditation is given. And with the growing trend of pharmacies requiring more accreditations, that price is likely to rise...Why is it necessary to have at least 4 major accrediting bodies influencing the behavior of specialty pharmacies?

An estimated three out of every 1,000 Americans ring up a bill of more than $50,000 in annual prescription drug costs last year, according to a new analysis of health plan members published...by Express Scripts... The number of people who meet this threshold for high pharmaceutical expenditures has risen sharply, by 35%, since the PBM's last report on the trend in 2014. While numerically small, this group of patients accounted for more than 20% of total U.S. spending on prescription drugs in 2016...higher utilization of pricey specialty medicines for cancer, multiple sclerosis and rare diseases was the primary driver of spending among patients with annual pharmacy costs over $50,000. Yet that was a change from 2014, when new hepatitis C drugs and compounded medicines goosed spending...Nearly 96% of the plan members who cleared the $50,000 in annual spending threshold used specialty medicines, most notably cancer therapeutics. While the average annual cost of oncology drugs was lower than some other specialty categories, a quarter of all spending by this group was on cancer treatments...

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.

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.

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

Retroactive pharmacy payment reductions, a portion of direct and indirect remuneration fees, could cost the federal government $3.4 billion between 2018 and 2027. That’s according to a new study from Wakely Consulting...This...study is vitally important in showing that DIR legislation will actually save taxpayers $3.4 billion over 10 years without subtracting any benefits seniors currently receive...For pharmacies, banning these after-the-fact fees is the fair way to achieve predictability in the reimbursement for the medications they buy and dispense...The report evaluates the impact of the Improving Improving Transparency and Accuracy in Medicare Part D Drug Spending Act, which has been introduced in both the Senate and House of Representatives and prohibits retroactive pharmacy payment reductions as claims without any defect, impropriety or fraud in Medicare Part D...The legislation is part of NCPA’s efforts to end DIR Fees, which make up a small amount of overall DIR within Medicare Part D, the majority of which is made up of manufacturer rebates

Drug abuse in the workforce is a growing challenge for American business. While economists have paid more attention to the opioid epidemic’s role in keeping people out of work, about two-thirds of those who report misusing pain-relievers are on the payroll. In the factory or office, such employees can be a drag on productivity...In the worst case, they can endanger themselves and their colleagues...Then there are the added care costs...opioid abusers cost employers nearly twice as much in health-care expenses as their clean co-workers -- an extra $8,600 a year...57 percent of employers say they perform drug tests, according to the National Safety Council. Out of those, more than 40 percent don’t screen for synthetic opioids like oxycodone -- among the most widely abused narcotics, and one of the substances that new federal rules are targeting...There’s a growing consensus among economists that opioid abuse has contributed to the shrinking workforce...estimates that drugs may account for one-fifth of the drop among men...Productivity growth in the U.S. economy has been slowing for decades. There’s little consensus about the causes. But there are signs that the spread of drug-abuse could be contributing to the problem...

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.

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

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