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With specialty drug spending soaring 60% in the past five years, large health systems have jumped into the specialty pharmacy business to assert some control over those costs by dispensing the drugs to their patients and covered employees...Health systems say those pharmacies help them better manage outpatient drug costs. A growing number of insurance contracts and Medicare initiatives tie payments to quality metrics that reach beyond hospital stays to hold providers accountable for patients' total medical costs, including drugs...Phoenix-based Banner Health started its own specialty pharmacy last year...hired three clinical pharmacists, three patient advocates and three staff members to support operations. The system also spent $1 million on a drug-dispensing robot for the specialty pharmacy's new home-delivery service...In the first year, Banner shaved about 1% off its specialty drug spending for about 1,200 workers and their families covered by the system's employee health plan...Health systems that own specialty pharmacies argue they can do a better job overseeing the use of the drugs they dispense. That's because their pharmacies can easily access medical records, laboratory results and physician notes, allowing pharmacists to closely monitor the effectiveness of the drugs prescribed and react quickly when something goes wrong or patients need help...They know if the patient is getting the value for the high-cost drug...Launching a specialty pharmacy does not require significant capital investment, and the high prices of the drugs—even sold at slim margins—make it possible to quickly see a return on that investment.

ASHP today announced that it will release a comprehensive suite of its…drug information databases, including AHFS Drug Information®, in early 2016. Recruitment for beta testers will begin during ASHP’s 50th Midyear Clinical Meeting this week in New Orleans…The new product, AHFS® Clinical Drug Information, will provide clinicians with easy access to detailed drug information, including real-time drug and safety updates, direct links to more than 60,000 supporting evidence sources, and in-depth coverage of off-label uses… AHFS Clinical Drug Information will be available via Web browser as well as iOS and Android apps. Individual pricing will begin at $10 per month. The user interface will also integrate into clinical workflow solutions in hospitals and ambulatory care settings.

In New Jersey, a bill (A2477) authorizing pharmacists filling a prescription for a biological medication to select an interchangeable biological product, was signed into law…A substitution cannot be made if the prescriber indicates that there shall be no substitution. The law requires the New Jersey State Board of Pharmacy to maintain a link on its website to FDA’s current list of interchangeable biological products. Further, the law requires a pharmacist or designee to notify the prescriber of the biological product dispensed, including the name of the product and the manufacturer, within five days…The pharmacist is also required to record on the prescription label, and record of dispensing, the product name of the interchangeable biological product, followed by the words “Substituted for” and the name of the biological medication for which the prescription was written, and the manufacturer of the interchangeable biological product.

Ken Whittemore Jr, Surescript's senior vice president of professional and regulatory affairs, talks about some ways independent pharmacists could encourage local prescribers to adopt e-prescribing of controlled substances.

Liz Tiefenthaler, president of Pharm Fresh Media, talks about some ways a pharmacy can differentiate itself from its competition.

David Lassen, chief clinical officer at Prime Therapeutics, discusses implications for specialty pharmacy from health care reform.

..FBI…announced a $390 million settlement against NOVARTIS...in a civil fraud lawsuit based on claims that NOVARTIS gave kickbacks to specialty pharmacies in return for recommending two of its drugs, Exjade (deferasirox) and Myfortic (mycophenolic acid)…two specialty pharmacies, Bioscrip, Inc. and Accredo Health Group, agreed to pay a total of $75 million to resolve federal and state claims against them based on the same allegations...today’s settlement, the federal and state governments will recover $465 million in total based on the kickback allegations in this lawsuit…a whistleblower, and asserted that NOVARTIS violated the False Claims Act and the Anti-Kickback Statute…by giving kickbacks to specialty pharmacies in return for recommending Exjade…and Myfortic…With respect to Exjade, the Government alleged that NOVARTIS gave kickbacks in the form of patient referrals and rebates to Bioscrip and Accredo to induce those pharmacies to recommend Exjade refills…the Government alleged that, to increase Exjade sales, Novartis incentivized and pressured the pharmacies to emphasize Exjade’s benefits to patients while understating the drug’s serious, potentially life-threatening, side effects. With respect to Myfortic, the Government alleged that NOVARTIS gave rebate contracts to specialty pharmacies to induce the pharmacies to recommend to doctors that they switch patients to Myfortic from competitor drugs.

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...

CBI’s Specialty Therapies Forum, the conference that brings together healthcare and pharmaceutical thought leaders to share best practices for managing specialty therapies…an opportunity to discuss not only strategies for managing the cost of specialty therapies, but also to provide the latest information and case studies dedicated to ensuring access and quality care in specialty benefit management. New to the agenda this year is a workshop dedicated to Specialty Pipeline Management.

Dialogue led by key thought leaders:

Avella Specialty Pharmacy | Blue Cross Blue Shield of Massachusetts | Blue Cross and Blue Shield of Minnesota | Blue Cross and Blue Shield of North Carolina | Denver Health Medical Plan | Fairview Specialty Pharmacy | Florida Blue | Gorman Health Group | Horizon Blue Cross Blue Shield New Jersey | Independent Health | NSHOA Cancer Centers in NY | Rutgers RWJ Medical School | Walgreens | Walmart | Widener University

The Compounding Expert Committee approved a new General Chapter, <800> Hazardous Drugs—Handling in Healthcare Settings. The purpose of this General Chapter is to provide standards to protect personnel, patients and the environment when handling hazardous drugs (HDs). The chapter applies to all healthcare personnel and all entities which handle HDs. Building on existing standards and guidelines, General Chapter <800> provides a comprehensive approach for handling HDs in healthcare settings with the ultimate goal of preventing and/or limiting potential exposures to HDs...The revised General Chapter <800> will be published on February 1, 2016 in the First Supplement to USP 39–NF 34. Additionally, the Expert Committee approved a delayed official implementation date of July 1, 2018 to allow entities more than two years to implement the chapter.