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Valeant Pharmaceuticals' much-ballyhooed agreement with Walgreens includes an unusual inventory provision that helps explain why the pharmacy chain might have been eager to strike a deal...Valeant is buying back its drugs from Walgreens and selling them on consignment to the pharmacy, a provision that triggers an upfront financial hit. Walgreens won't physically return the drugs, just the title to them...It's just one out-of-the-ordinary feature of an out-of-the-ordinary pharmacy deal. Valeant announced last week that it had teamed up with Walgreens to distribute its drugs, discounting key skin and eye brands by 10% and another slate of meds by an average of 50%. Walgreens is taking the Valeant drugs on consignment and collects fees for filling prescriptions…The Walgreens partnership replaces Valeant's relationship with Philidor, a specialty pharmacy that was closely tied to the drugmaker until questions arose about its operations...The drugmaker is expecting a sales hit from the pharmacy shift, partly because of the mechanics of the Walgreens deal and partly because of lower demand for its drugs in the wake of the Philidor allegations.

California and Oregon…will soon make access to birth control easier for millions of women by allowing them to obtain contraceptives from pharmacists without a doctor’s prescription…Most Western countries require a doctor’s prescription for hormonal contraceptives…but starting sometime in the next few months, women in California and Oregon will be able to obtain these types of birth control by getting a prescription directly from the pharmacist who dispenses them, a more convenient and potentially less expensive option than going to the doctor…Pharmacists will be authorized to prescribe contraceptives after a quick screening process in which women fill out a questionnaire about their health and medical histories…pharmacists’ organizations, plan to lobby for it across the country…One unanswered question, however, is whether insurers will pay for the time pharmacists spend reviewing women’s questionnaires or helping evaluate options. To cover that cost, some pharmacists may charge fees...The laws in Oregon and California differ in some ways. California’s has no age restriction; the Oregon law requires that teenagers under 18 obtain their first contraceptive prescription from a doctor. In California, pharmacists will also most likely have to take women’s blood pressure for contraceptives containing estrogen.

Eric A Wright, PharmD, MPH, investigator I for Geisinger Health Research and associate professor at Wilkes University, discusses communication obstacles that hinder community pharmacists from playing a more active role in transitions of care.

Jean Coutu Group is prepping …pharmacists for expanded health care services now available through pharmacies…Quebec implemented Bill 41, which amended the province’s Pharmacy Act to enable pharmacists to provide certain health care services previously performed only by doctors...

• Extend a doctor’s prescription.
• Prescribe medication when a diagnosis is not required to prevent certain health problems, including such areas as travel health, pregnancy, women’s health, smoking cessation and public health.
• Prescribe medication for certain conditions in which a patient has already received a prescription from a doctor.
• Substitute a medication in case of a supplier inventory shortage.
• Administer medication to a patient to demonstrate the drug’s administration method.
• Adjust the form, dosage, quantity or dose of a prescription according to a patient’s condition.
• Prescribe certain laboratory tests related to a patient’s medication.

All MTM (medication therapy management) services may be billed for, but the question remains: which insurance companies will reimburse them? Many studies have validated the value of the pharmacist in providing MTM services solely as a cost-avoidance model for any specific medical group. Ideally, MTM services would be billed and reimbursed while cost-avoidance would be documented through an increasingly positive outcome of care for these specific patients...MTM services may be focused on specific situations such as a targeted medication review or discharge education, or they may be provided as complete comprehensive medication reviews...The following are general descriptions of the different forms of MTM services:

• Comprehensive Medication Review
• Target Medication Review
• Bedside MTM
• As Time Permits
• Inpatient MTM Program
• Outpatient MTM Program
• Complete MTM Program
• Billing for MTM Services
• MTM Implementation
• Conclusion

Bryan Ziegler, PharmD, executive director of Kennedy Pharmacy Innovation Center, gives some examples of sustainable business models that can expand the role of the pharmacist.

Royal Pharmaceutical Society and National Association of Primary Care have launched a consultation on radical proposals to integrate general practice and community pharmacy… The new proposals are designed to create an environment in which community pharmacists and GPs work much closer together, re-purposing resources to alleviate pressure points in general practice and improve patient care.

The American College of Cardiology has recognized pharmacists as advanced practice providers, valuable to car­diovascular team-based care…sees this as an inspiring time, encour­aging other historically physician-driven, non-pharmacist organizations to support pharmacists, as they push for healthcare provider status…“ACC recognizes that there’s a shortage of cardiologists,”…The ACC recognizes that there’s a lot of work to go around but not enough cardiologists to do it. They see the benefit of advanced practice providers, which includes pharma­cists, nurse practitioners and physician assistants, and they believe that’s the way to make it happen…to offer care where care isn’t being given.”… With the ACC’s backing, there’s hope that other non-phar­macist organizations will support pharmacists...

Yet another sign of trouble for Valeant Pharmaceuticals has emerged. The beleaguered drug maker already faces congressional hearings into its pricing practices. Now, one of its bread-and-butter product lines may not ring the register as often as before…Fewer dermatologists are prescribing Valeant medicines…The change constitutes more fallout from a scandal involving the drug maker’s relationship with a mail-order pharmacy known as Philidor Rx Services. Valeant reportedly hid its ties to the pharmacy in order to inappropriately boost prescriptions and insurance reimbursements...68 percent are writing fewer prescriptions for Valeant’s dermatology products and a similar percentage expect they will not prescribe Valeant drugs in coming months.

California women who have long had to schedule a doctor’s appointment for a birth control prescription will be able to go straight to the pharmacy for the contraception… state law, passed in 2013 with plans to be implemented in October, gives licensed pharmacists authorization to prescribe self-administered hormonal contraceptives,...SB 493, also allows pharmacists to prescribe nicotine replacement products,…travel medication, and gives pharmacists status as health care providers.