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DATE 2017-07-01

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MESSAGE
DATE 2017-07-24
FROM Pharmacist e-Link
SUBJECT Subject: [Hangout - NYLXS] CBO Says ACA Repeal Would Add 32 Million
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Subject: [Hangout - NYLXS] CBO Says ACA Repeal Would Add 32 Million
Uninsured by 2026,
Lower Deficit by $473 Billion | Pharmacist eView | July 24, 2017
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Click here to view an online version of this email ( http://sable.madmimi=
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( http://sable.madmimi.com/c/29106?id=3D7531687.55814.1.b24a0ba660fea6d9=
303b14f7df2e356b )

\*\*Pharmacist eView\*\* is the twice-weekly email newsletter written spe=
cifically for pharmacists. Get fresh, relevant pharmacy news delivered ri=
ght to your inbox twice each week when you subscribe to Pharmacist eView.=
=

Follow -at-pharmacistelink ( http://sable.madmimi.com/c/29106?id=3D7531687.5=
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\*\*COMING AUG. 1: _qAM_, a New Daily Newsletter\*\*

NCPA has a new prescription to help you keep up with the latest in pharma=
cy.

( http://sable.madmimi.com/c/29106?id=3D7531687.55816.1.7be13912da94c317d=
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t in your email box starting next Tuesday morning, Aug. 1.

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A, and a cup of coffee.

\*\*=C2=BB\*\* \*\*Industry News\*\*

- =


CMS Should Evaluate Providing Coverage for Disposable Medical Devices Tha=
t Could Substitute for Durable Medical Equipment
( #941398 )

- =


Lawsuit: New TennCare Rates Endanger Hemophilia Patients
( #941423 )

- =


Safeway to Pay $3 Million to Resolve U.S. Drug Probe
( #941131 )

- =


WHO Estimates Cost of Reaching Global Health Targets by 2030
( #941130 )

\*\*=C2=BB\*\* \*\*CE Spotlight\*\*

- =


Addressing Substance Abuse: A Pharmacist's Role in Harm Reduction From Op=
ioids
( #111111 )

- =


Pharmacists' Impact on Quality Measures and Opportunities for Pharmacy En=
hanced Services
( #111112 )

- =


Women's Weight Loss Wellness: Effective and Safe Diet Techniques
( #111113 )

- =


High Risk Medications: What Can Community Pharmacists Do to Make Patients=
Safer?
( #111114 )

- =


Compounding for Otolaryngology
( #111115 )

\*\*=C2=BB\*\* \*\*Drugs and Treatment\*\*

- =


'It's Raining Needles': National Drug Crisis Creates Pollution Threat
( #941128 )

- =


Importing Drugs May Endanger Patients
( #941422 )

- =


That Drug Expiration Date May Be More Myth Than Fact
( #941395 )

- =


What's Behind the Low Vaccine Rate Among Teens?
( #941424 )

\*\*=C2=BB\*\* \*\*Health Care Legislation & Regulation and Medicaid/Medi=
care\*\*

- =


Advocates Urge Veto of Rhode Island Bill to Open Prescription Drug Databa=
se to Law Enforcement
( #941421 )

- =


CBO Says ACA Repeal Would Add 32 Million Uninsured by 2026, Lower Deficit=
by $473 Billion
( #941419 )

- =


FDA Approves Drug for Hepatitis C
( #941132 )

- =


Gov. Walker Signs 11 Special Session Bills to Curb Opioid Epidemic in Wis=
consin
( #941659 )

\*\*Industry News\*\*

\*\*
CMS Should Evaluate Providing Coverage for Disposable Medical Devices Tha=
t Could Substitute for Durable Medical Equipment
\*\*
_
Government Accountability Office (07/17/17)
_

According to the U.S. Government Accountability Office (GAO), Medicare sp=
ent $6.7 billion on durable medical equipment in 2015. Companies have dev=
eloped disposable versions of some of these medical devices, such as insu=
lin pumps, that could act as potential substitutes. GAO found that some o=
f these disposable devices could potentially save money or result in bett=
er health outcomes compared to the durable versions in some cases, but th=
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\*\*
Lawsuit: New TennCare Rates Endanger Hemophilia Patients
\*\*
_
Associated Press (07/18/17)
_

A lawsuit filed recently by Tennessee specialty pharmacies and their whol=
esaler accuses the state's Medicaid program, TennCare, of targeting clott=
ing-factor pharmacies to save up to $15 million annually. The pharmacies =
are accusing the state of breaking federal law and endangering people wit=
h bleeding disorders such as hemophilia by reducing reimbursements for pr=
escription blood-clotting drugs. "TennCare's voluntary decision to save m=
oney by singling out clotting factor has placed the bleeding disorder com=
munity in great danger," the lawsuit asserts. The lawsuit states that if =
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Care's bleeding disorder patients will have to withdraw from serving them=
and close their operations in the state.

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\*\*
Safeway to Pay $3 Million to Resolve U.S. Drug Probe
\*\*
_
Reuters (07/18/17) Raymond, Nate
_

The U.S. Justice Department reports that Safeway Inc. has agreed to pay $=
3 million to settle claims that it failed to report in a timely manner mi=
ssing or stolen drugs, including opioid medications, at its pharmacies. A=
ccording to the office of U.S. Attorney Annette Hayes in Seattle, which h=
andled the case, the U.S. supermarket chain accepted responsibility for f=
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\*\*
WHO Estimates Cost of Reaching Global Health Targets by 2030
\*\*
_
WHO News Release (07/17/17)
_

A new analysis suggests that investments to expand services towards unive=
rsal health coverage and other Sustainable Development Goal (SDG) health =
targets could prevent 97 million premature deaths worldwide between now a=
nd 2030. In addition, they could add up to 8.4 years of life expectancy i=
n some nations. The SDGs were adopted by the United Nations in 2015 as th=
e world's to-do list for the next 15 years. The list includes 17 goals an=
d 169 targets aimed at creating a "healthier, safer and fairer world by 2=
030." The "SDG Health Price Tag," published by the World Health Organizat=
ion (WHO) in The Lancet Global Health, found that under an "ambitious" sc=
enario, achieving the targets would require new investments increasing fr=
om $134 billion annually to $371 billion by 2030. The "progress" scenario=
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\*\*CE Spotlight\*\*

\*\*
Addressing Substance Abuse: A Pharmacist's Role in Harm Reduction From Op=
ioids
\*\*

Abuse of opioids such as heroin, morphine, and prescription pain reliever=
s is a serious global issue that affects the health, social, and economic=
welfare of our society. It is estimated that between 26.4 million and 36=
million people abuse opioids worldwide, with an estimated 2.1 million pe=
ople in the United States suffering from substance use disorders related =
to prescription opioid pain relievers and an estimated 467,000 addicted t=
o heroin. The consequences of this abuse have been devastating, and only =
continue to rise. For example, the number of unintentional overdose death=
s from prescription pain relievers has sky rocketed in the United States,=
more than quadrupling since 1999.

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\*\*
Pharmacists' Impact on Quality Measures and Opportunities for Pharmacy En=
hanced Services
\*\*

The rapidly evolving health care landscape is currently experiencing a ma=
jor shift from a volume-based, fee-for-service system to a value-based pa=
yment system. As such, today's health care system is challenged to improv=
e quality by creating new models of care that decrease both payer and pat=
ient costs and improve patient outcomes. The Centers for Medicare & Medic=
aid Services (CMS) is committed to rewarding quality. On Oct. 14, 2016, t=
he CMS released the Final Rule of the Medicare Access and Children's Heal=
th Insurance Program (CHIP) Reauthorization Act (MACRA) of 2015. This rul=
e dramatically changes how physicians are compensated for their services =
under Medicare and will likely pave the way for private payers to follow =
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\*\*
Women's Weight Loss Wellness: Effective and Safe Diet Techniques
\*\*

The U.S. obesity epidemic has hit women hard, and the most efficacious we=
ight control options are still unclear. Diet and weight loss industries h=
ave boomed as a result, but health safety remains a concern associated wi=
th many diet options. Pharmacists are poised to contribute to women's wei=
ght loss efforts by providing positive reinforcement and safe, effective =
approaches to diet and nutrition. Pharmacists must be able to counsel pat=
ients, when approached, about diet and weight loss products. More than th=
at, though, pharmacists should increase their own knowledge of nutritiona=
lly sound alternatives so as to proactively engage consumers about the be=
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\*\*
High Risk Medications: What Can Community Pharmacists Do to Make Patients=
Safer?
\*\*

Clinical pharmacy has historically been believed to be with pharmacists c=
onducting services within the confines of a hospital or nursing facility.=
However, patient care extends beyond the confines of the hospital, to wh=
ich the goal ultimately remains to keep the patient safe, healthy, and ou=
t of the hospital. This provides community pharmacists a unique opportuni=
ty to be the point of care as all prescriptions are funneled through the =
pharmacy. The pharmacist is then able to determine if the patient is rece=
iving the most safe and efficacious therapy. The pharmacist can then form=
a relationship with the patient, so when they are appropriately prescrib=
ed a high-risk medication, the pharmacist can counsel on monitoring point=
s for the prescribed medication. This in turn leads to patient trust in t=
he pharmacist, so that when the patient experiences an adverse event, it =
is reported immediately, ultimately potentially preventing a hospitalizat=
ion.

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\*\*
Compounding for Otolaryngology
\*\*

Prescriptions for ear, nose and throat conditions are ordered from a vari=
ety of practitioners, such as otolaryngologists, family practitioners, al=
lergists, internal medicine specialists, emergency medicine physicians, a=
nd even obstetrics practitioners. Compounding treatment options are plent=
iful in this arena for many patient needs and offer unique solutions to o=
ften challenging problems. This is especially true when there are no comm=
ercially manufactured options available such as ingredient combinations, =
unique dosage forms or discontinued products. The vast variety of compoun=
ding options to help treat many otolaryngeal problems certainly offers ph=
armacist many ways solve problems for patients and practitioners.

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6061dcb13e15d5b4 )
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1.61c709a6a5f204a6ebaa0a1cbe9924be )=C2=A0 ( http://sable.madmimi.com/c/2=
9106?id=3D7531687.55879.1.b9241e1b6cfa971791b056f3474c5885 )

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\*\*Drugs and Treatment\*\*

\*\*'It's Raining Needles': National Drug Crisis Creates Pollution Threat=

\*\*
_
Associated Press (07/18/17) Casey, Michael

_

Syringes left by drug users in public places such as parks, trails, and b=
eaches are an escalating pollution threat. People, often children, risk g=
etting stuck by discarded needles, raising the possibility they could con=
tract blood-borne diseases or be exposed to heroin or other drugs. New Ha=
mpshire and Massachusetts, which have witnessed many overdose deaths in r=
ecent years, are seeing a growing number of discarded syringes. "We would=
certainly characterize this as a health hazard," said Tim Soucy, health =
director in Manchester, N.H., which has found 247 needles already this ye=
ar, compared with 570 for all of 2016. In Portland, ME, officials have co=
llected more than 700 needles so far this year, putting them on track to =
exceed the nearly 900 collected last year. Some experts say the problem w=
ill subside only when more users get treatment and more funding is direct=
ed to treatment programs. Others are relying on needle-exchange programs =
or the creation of safe spaces to inject. Studies have found that needle-=
exchange programs can reduce pollution, but some people argue poor superv=
ision could just put more syringes in the hands of people who may not dis=
pose of them properly.

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1.439e72eed59860bb1d94fa7cfee55300 )=C2=A0 ( http://sable.madmimi.com/c/2=
9106?id=3D7531687.55886.1.4227ae56136648dc5cf1900274da3676 )

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\*\*
Importing Drugs May Endanger Patients
\*\*
_
Baltimore Sun (07/19/17) Horton, Aliyah H.
_

The Maryland Pharmacists Association (MPhA) strongly opposes a new federa=
l proposal that would authorize prescriptions drugs to be imported from p=
harmacies outside of the United States. While the move is grounded in a d=
esire to provide relief from runaway medication costs, MPhA Executive Dir=
ector Aliyah H. Horton warns that foreign imports may include contaminate=
d, expired, or counterfeit ingredients. She cites FDA officials who have =
declared that "many drugs obtained from foreign sources that either purpo=
rt to be or appear to be the same as U.S.-approved prescription drugs are=
, in fact, of unknown quality. When consumers take such unsafe or inappro=
priate medications, they face risks of dangerous drug interactions and ot=
her serious health consequences." Given the vast threat to the public hea=
lth, Horton encourages legislators to abandon the importation proposal an=
d explore alternative solutions to lower drug prices.

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\*\*
That Drug Expiration Date May Be More Myth Than Fact
\*\*
_
NPR Online (07/18/17) Allen, Marshall
_

Lee Cantrell, who helps run the California Poison Control System, recentl=
y sought to discover if expired prescription medicine is still effective =
or dangerous. Cantrell and Roy Gerona, a University of California, San Fr=
ancisco researcher, tested 14 different drugs that were decades old. They=
found that 12 of the 14 drugs were still potent. Their findings could ha=
ve major impact on guidelines regarding expired drugs and reducing waste =
in the medical industry. Cantrell says, "Refining our prescription drug d=
ating process could save billions."

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\*\*

What's Behind the Low Vaccine Rate Among Teens?
\*\*
_
Drug Store News (07/18/17) Johnsen, Michael
_

More than a third of parents of teens are unaware of when their child's n=
ext vaccine is due and one-half of parents incorrectly assume that their =
doctor would initiate an appointment when the time came, according to a r=
eport from the C.S. Mott Children's Hospital National Poll on Children's =
Health at the University of Michigan. The findings are based on responses=
from a nationwide sample of 614 parents with at least one child aged 13=E2=
=80=9317 years. Centers for Disease Control data show that just a third o=
f teens have received the second dose of meningitis vaccine by aged 17 ye=
ars, while less than 50 percent of boys age 13=E2=80=9317 years have comp=
leted the HPV vaccine series and less than one-half of adolescents receiv=
e an annual flu vaccine. However, the report found that more than 90 perc=
ent of parents polled thought their teen had received all vaccines recomm=
ended for their age.

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\*\*Health Care Legislation & Regulation and Medicaid/Medicare\*\*

\*\*

Advocates Urge Veto of Rhode Island Bill to Open Prescription Drug Databa=
se to Law Enforcement
\*\*
_
Providence Journal (07/18/17) Gregg, Katherine
_

More than 20 groups are urging Gov. Gina Raimondo of Rhode Island to veto=
a bill that would allow warrantless searches of information on the state=
's prescription drug monitoring program (PDMP). The proposed legislation =
would enable certain state and federal investigators to request data in t=
he state's PDMP, which has information on every prescription for a contro=
lled substance dispensed by Rhode Island pharmacies. "We are concerned th=
at these bills, if signed into law, may drive patients 'underground' and =
away from the care that they need and have the unintended effect of incre=
asing the number of overdoses. ... Judicial review should remain the stan=
dard by which police gain access to such sensitive information," Rhode Is=
land Medical Society President Sarah J. Fessler wrote the governor.

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\*\*

CBO Says ACA Repeal Would Add 32 Million Uninsured by 2026, Lower Deficit=
by $473 Billion
\*\*
_
Wall Street Journal (07/19/17) Armour, Stephanie
_

A Congressional Budget Office (CBO) analysis estimates that a rollback of=
the Affordable Care Act (ACA), with no alternative measure to take its p=
lace, would leave millions more without health coverage. The population o=
f uninsured persons would swell to 32 million by 2026 from 17 million nex=
t year under ACA if key components of Barack Obama's signature law are sc=
rubbed, including Medicaid expansion and subsidies for the needy. Removal=
of a mandate that most Americans get policies or pay a tax, meanwhile, w=
ould send premiums up for Americans who do maintain coverage, CBO added. =
The rise in costs=E2=80=94a 25 percent increase in 2018 compared with the=
ACA and a 50 percent spike by 2020=E2=80=94would stem from healthier peo=
ple declining coverage, leaving older and sicker people to make up the bu=
lk of the insurance pool. CBO also noted that a successful repeal-only ef=
fort by the GOP would reduce the federal deficit by $473 billion.

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\*\*

FDA Approves Drug for Hepatitis C
\*\*
_
FDA News Release (07/18/17)
_

The Food and Drug Administration (FDA) approved on July 18 a fixed-dose c=
ombination tablet (Vosevi=E2=80=94Gilead Sciences) to treat adults with c=
hronic hepatitis C virus (HCV) genotypes 1-6 without cirrhosis or with mi=
ld cirrhosis. The treatment contains two previously approved drugs=E2=80=94=
sofosbuvir and velpatasvir=E2=80=94as well as a new drug, voxilaprevir. T=
he combination drug is the first treatment approved for patients who have=
been previously treated with sofosbuvir or other drugs for HCV that inhi=
bit the NS5A protein.

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\*\*

Gov. Walker Signs 11 Special Session Bills to Curb Opioid Epidemic in Wis=
consin
\*\*
_
Becker's Hospital Review (07/19/17) Zimmerman, Brian
_

Gov. Scott Walker of Wisconsin signed this week nearly a dozen special se=
ssion bills aimed at fighting the opioid epidemic in the state. The 11 ne=
w laws will provide more funding for drug courts and rehabilitation progr=
ams, expand access to naloxone, and extend the state's "Good Samaritan" l=
aw to drug users experiencing an overdose. "Like many states in our great=
nation, Wisconsin is experiencing a dangerous trend=E2=80=94a growing nu=
mber of cases of opioid abuse and overdose," said Walker during one of th=
ree signing ceremonies for the measures.

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Abstract News 7=C2=A9 Copyright 2017 INFORMATION, INC. ( http://sable.mad=
mimi.com/c/29106?id=3D7531687.55936.1.efacacbc2fb1db47c7931c9e8efb58e6 )
( http://sable.madmimi.com/c/29106?id=3D7531687.55937.1.6968034916ed27da=
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\*\*July 24, 2017\*\*

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<BR>CBO Says ACA Repeal Would Add 32 Million Uninsured by 2026, Lower Deficit=<BR> by $473 Billion | Pharmacist eView | July 24, 2017
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">COMING AUG. 1: qAM, a New Daily Newsletter>

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CMS Should Evaluate Providing Coverage for Disposable Medical Devices Tha=
t Could Substitute for Durable Medical Equipment

e: 12px;">
Government Accountability Office (07/17/17)


=


According to the U.S. Government Accountability Office (GAO), Medicare sp=
ent $6.7 billion on durable medical equipment in 2015. Companies have dev=
eloped disposable versions of some of these medical devices, such as insu=
lin pumps, that could act as potential substitutes. GAO found that some o=
f these disposable devices could potentially save money or result in bett=
er health outcomes compared to the durable versions in some cases, but th=
ey are not covered by Medicare. GAO recommends that the U.S. Centers for =
Medicare and Medicaid Services evaluate the potential costs and savings o=
f using disposable devices as substitutes for durable ones.
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Lawsuit: New TennCare Rates Endanger Hemophilia Patients

e: 12px;">
Associated Press (07/18/17)


=


A lawsuit filed recently by Tennessee specialty pharmacies and their whol=
esaler accuses the state's Medicaid program, TennCare, of targeting clott=
ing-factor pharmacies to save up to $15 million annually. The pharmacies =
are accusing the state of breaking federal law and endangering people wit=
h bleeding disorders such as hemophilia by reducing reimbursements for pr=
escription blood-clotting drugs. "TennCare's voluntary decision to save m=
oney by singling out clotting factor has placed the bleeding disorder com=
munity in great danger," the lawsuit asserts. The lawsuit states that if =
the reimbursement rates that took effect April 1 are not immediately bloc=
ked, at least seven specialty pharmacies that help about one-half of Tenn=
Care's bleeding disorder patients will have to withdraw from serving them=
and close their operations in the state.


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Safeway to Pay $3 Million to Resolve U.S. Drug Probe

e: 12px;">
Reuters (07/18/17) Raymond, Nate


=


The U.S. Justice Department reports that Safeway Inc. has agreed to pay $=
3 million to settle claims that it failed to report in a timely manner mi=
ssing or stolen drugs, including opioid medications, at its pharmacies. A=
ccording to the office of U.S. Attorney Annette Hayes in Seattle, which h=
andled the case, the U.S. supermarket chain accepted responsibility for f=
ailing to promptly report the missing drugs. As part of the settlement, S=
afeway said it will close a pharmacy at a supermarket in Belmore, CA, and=
will suspend filling prescriptions for controlled substances for 4 month=
s at an in-store pharmacy in North Bend, Wash.
=



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WHO Estimates Cost of Reaching Global Health Targets by 2030

e: 12px;">
WHO News Release (07/17/17)


=


A new analysis suggests that investments to expand services towards unive=
rsal health coverage and other Sustainable Development Goal (SDG) health =
targets could prevent 97 million premature deaths worldwide between now a=
nd 2030. In addition, they could add up to 8.4 years of life expectancy i=
n some nations. The SDGs were adopted by the United Nations in 2015 as th=
e world's to-do list for the next 15 years. The list includes 17 goals an=
d 169 targets aimed at creating a "healthier, safer and fairer world by 2=
030." The "SDG Health Price Tag," published by the World Health Organizat=
ion (WHO) in The Lancet Global Health, found that under an "ambitious" sc=
enario, achieving the targets would require new investments increasing fr=
om $134 billion annually to $371 billion by 2030. The "progress" scenario=
, meanwhile, would require new investments rising from an initial $104 bi=
llion a year to $274 billion by 2030.
=



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ica, sans-serif; font-size: 12px;"> ica, sans-serif; font-size: 12px;">
s-serif; font-size: 14px; font-style: normal; font-weight: normal; color:=
#495a90; text-decoration: none;">CE Spotlight




al, Helvetica, sans-serif; text-decoration: none;">

Addressing Substance Abuse: A Pharmacist's Role in Harm Reduction From Op=
ioids



Abuse of opioids such as heroin, morphine, and prescription pain reliever=
s is a serious global issue that affects the health, social, and economic=
welfare of our society. It is estimated that between 26.4 million and 36=
million people abuse opioids worldwide, with an estimated 2.1 million pe=
ople in the United States suffering from substance use disorders related =
to prescription opioid pain relievers and an estimated 467,000 addicted t=
o heroin. The consequences of this abuse have been devastating, and only =
continue to rise. For example, the number of unintentional overdose death=
s from prescription pain relievers has sky rocketed in the United States,=
more than quadrupling since 1999.



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