Pharmacy

Maryland Pharmacists Can Now Dispense Naloxone under Statewide Standing Order

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Yesterday, Dr. Howard Haft of the Maryland Department of Health and Mental Hygiene (DHMH) issued a statewide standing order that allows pharmacists to dispense naloxone to individuals holding a training certificate under Maryland’s Overdose Response Program (ORP). See the press release here.

naloxone

Naloxone (trade names Narcan® and Evzio®) is a prescription medication that is used to reverse the effects of opioids – a class of drugs that includes prescription medications like oxycodone, codeine, and morphine, as well as illicit drugs like heroin. It is a life-saving medication that can restore breathing in an individual that has stopped breathing due to an opioid overdose. Naloxone can be adminstered intranasally, intramuscularly, or subcutaneously. It is not a controlled substance, which means it does not carry any risk of dependency. Side effects are minimial, if any, and are usually self-limiting.

Prior to this standing order, patients had to obtain a prescription from their doctor, which may have required them to schedule an appointment, explain to the doctor why they wished to carry a naloxone kit, and perhaps experience some pushback from the prescriber (due to lack of education about naloxone, level of comfortability prescribing naloxone, or other reasons). The time spent trying to obtain a prescription is valuable time lost, during which an overdose could occur.

Now, patients who have completed training through the Maryland ORP (and present a valid training certificate) may obtain a prescription from any pharmacy in Maryland under the new standing order. This is a huge win for pharmacists! DHMH is recognizing both our role in overdose prevention, as well as the trust our patients place in us as an integral part of their healthcare team. It has been said that pharmacists are the most accessible healthcare provider, with over 90% of Americans living within five minutes of a community pharmacy.

Under the standing order, patients will still be responsible for paying for the medication and/or kit, whether through prescription insurance or other means. Maryland Medical Assistance (Medicaid) covers the medication at a $1.00 copay. The nasal atomizer used to administer the naloxone intranasally is covered by Medicaid as a Durable Medical Equipment (DME) benefit.

If you or a loved one are interested in more information about naloxone, how to obtain it, consult one of these resources:

  • GetNaloxoneNow.org – great resource for patients and healthcare professionals alike
  • PrescribeToPrevent.org – dedicated to healthcare professionals, and includes information for prescribers and pharmacists, including patient education resources.

 

Photo credit: dispatch.org

Special Phi Delta Chi Announcement!

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Brothers,

Thank you for taking the time to read this. I think we can all agree that our Fraternity has provided each of us numerous opportunities that have helped shape us in to the pharmacists and student pharmacists we are today. Whether Phi Delta Chi helped you find a friend, a colleague, a preceptor, a boss, or even a spouse, I’m sure it’s unanimous that our lives have been enriched in a positive way because of our Fraternity. I often reflect on how I can give back to Phi Delta Chi, despite the fact that I may never fully repay the debts it has provided me.

After much thought and prayer, I have decided to run for Grand Vice President for Communications. The primary responsibility of this office, as I’m sure you are aware, is to edit and oversee the publication of The Communicator and e-Communicator. It would be an honor to help keep our Brothers across the country connected through these two publications.

I ask you to review my experience, qualifications, and candidate statement when it becomes available, and contact me directly with any questions you may have. I appreciate your support, and look forward to seeing you all at the 70th Grand Council in Albuquerque, New Mexico.

Thanks for reading this post!

Alterum Alterius Auxilio Eget,

Eric

Crest-Color-Shaded

New FDA Drug Shortages mobile app

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Attention pharmacy friends (especially those frustrated with current drug shortages) — earlier this month, Food and Drug Administration (FDA) released a mobile app that helps you track drug shortages, check on resolved drug shortages, and even report actual or potential drug shortages. I’ve tried the app out, and the functionality is great. The app is very easy to navigate, and doesn’t have a lot of unnecessary bells and whistles.

When you first download the app, which is available as a free download for iOS and Android, you’ll arrive at the simple Home screen:

Home Screen

Photo Courtesy: iTunes Store

From here, you can access the different menus, which allow you to browse by drug name, browse by therapeutic category, search by drug name, or report a shortage.

Browse by Drug Name

From this menu, you can easily view drug shortages listed by drug name. You can also look at resolved drug shortages and drugs that have been discontinued. One thing I noticed when browsing the drugs is that most of the drugs listed are hospital (inpatient) drugs. Hopefully the FDA will expand the functionality of this app to include more retail (outpatient) drugs.

After tapping on a drug, you’ll be taken to a screen that contains the drug name, current status, the date the shortage was first reported, and the therapeutic category. Information for each manufacturer involved in the shortage (likely more than one if the problem is a nationwide or raw material shortage) and their phone number. Following that, there’s a plethora of information about the drug in shortage, including everything from the NDC to the shortage reason and other notes about the shortage. Some drugs even list an expected release date when the product will return to market.

Browse by Therapeutic Category

In this menu, you can access a list of the drugs sorted by therapeutic class. Once you tap on a drug, you’ll be taken to the same screen with the same information I discussed previously.

Search By Drug Name

This section is as simple as it sounds. If you enter a drug name that is not currently in shortage, you’ll receive an error message of “There were no results returned.”

Report a Shortage

Surprisingly, FDA does not allow you to report a shortage directly from within the app. You’ll need to e-mail or call FDA directly with the contact information listed in this section. I guess this prevents pesky kids from downloading the app and inundating FDA with false reports.

Help & Support Links

This section obviously contains various links for help within the app, but it also provides links to an RSS Feed and to sign up for e-mail alerts of drug shortages, which is pretty nifty.

Overall Review

Pros: This app is a handy reference to have in your pocket that outlines the current drug shortages without having to search the Internet or rely on your wholesaler to let you know which drugs are in shortage. The app is very easy to navigate and has a good deal of information about each drug currently in shortage. The functionality to browse by drug name, therapeutic class, or search is also helpful. It’s also great to see FDA taking a proactive step towards monitoring drug shortages and making that information readily available to healthcare professionals.

Cons: The app menu is in the upper right corner of the app, and is the only way to navigate. It seems unnatural for me to keep tapping in that corner to work my way around the app. The addition of a “Back” button in the upper left corner would be an improvement. Also, like I mentioned earlier, most of the drugs in the app are hospital drugs, so a better representation of retail prescriptions in shortage would be helpful to a wider audience. Of the drugs I looked at, not many had a direct reason for shortage (most listed as “Other”), and did not have a release date (or listed as “TBD”). This data would be incredibly helpful for practitioners and inventory specialists alike.

Questions: How often are the shortages listed in the app updated? Is the app real time, or does it update as needed?

Suggestions: Push notifications for new drug shortages.

Bottom Line

If you’re a practicing healthcare professional and can spare some space on your mobile device, I would download this app. If you work in a setting where drug shortages are of little concern, or if you have a wholesaler who notifies you of shortages on their website, you can probably survive without it.

Thanks for reading! I would love to hear your comments on this app once you’ve downloaded and used it.

Provider Status: 2015 Edition

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All of my pharmacy friends should be familiar with the term “provider status.” It’s a phrase that gets tossed around in all areas of pharmacy practice – but what does it really mean?

If you’re not a pharmacist or student pharmacist, I have a question for you. Would you consider your pharmacist a healthcare provider?

Believe it or not, according to the Social Security Act, pharmacists are not considered healthcare providers under Medicare. What does that mean? That means that pharmacists who provide the same services as other healthcare providers are ineligible for payment for these services. This also means Medicare doesn’t cover certain services when they’re provided by a pharmacist. This could mean that beneficiaries may have to travel hours or perhaps even across state lines to see a practitioner that can provide the services they need.

What provider status is:

  • Provider status has been introduced in both the House of Representatives (H.R. 592) and the Senate (S. 314) as the Pharmacy and Medically Underserved Areas Enhancement Act.
  • It is a bipartisan bill to increase patient access to pharmacists’ care, especially in medically underserved communities (Do you live or work in a medically underserved community or healthcare provider shortage area? Click here to find out.)
  • The fact that both of these bills have been introduced in both chambers of Congress is a great testament to the growing momentum behind the provider status movement. Last year, a bill was introduced in only the House of Representatives (H.R. 4190). After much work by pharmacists and student pharmacists across the country, there were 123 bipartisan cosponsors of the bill as of the end of 2014.
  • Provider status will help fix the problem of medication non-adherence — in total healthcare costs, that’s a $290 billion (with a B) problem — by increasing access to pharmacists, who are the medication experts.
  • With more and more Americans gaining healthcare coverage under the Patient Protection and Affordable Care Act (“Obamacare”), there is an increased need for accessibility to care. The Association of American Medical Colleges projects that, by 2020, there will be more than 91,000 fewer doctors than needed to meet demand, and the impact will be most severe on underserved populations. Nearly 90% of Americans live within five miles of a community retail pharmacy, making pharmacists one of the most accessible healthcare team members.
  • The goal of provider status is to increase access to care by utilizing pharmacists as an integral part of the healthcare team to optimize medication regimens and improve patient health outcomes.

What provider status is NOT:

  • Pharmacists do not seek to expand their scope of practice. Pharmacists will not be able to prescribe, they will not be able to diagnose, and they do not wish to “intrude” on physicians’ (or other providers’) respective scopes of practice. Pharmacists’ scope of practice will still be dictated by state law, not federal law.
  • Provider status will not mean that pharmacists get paid more than other providers for providing the same services.
  • You will not have to pay your pharmacist to get the same personalized care you’ve come to expect.

If you’re a pharmacist or student pharmacist, I urge you to become involved and advocate for the future of our profession. Talk to your family, your friends, your colleagues, and your congressmen. Not sure what to say? Here are the basics:

  1. Pharmacists have more medication education and training than any other health care professional.

  2. When pharmacists are included on patients’ health care teams, the quality of care increases and outcomes improve.

  3. Physicians, nurses, dieticians, chiropractors, and midwives are all recognized as health care providers.

  4. PHARMACISTS ARE NOT CURRENTLY RECOGNIZED AS HEALTH CARE PROVIDERS! YOU can change that!

If you’re not a pharmacist or student pharmacist, and have read this far: THANK YOU! The word is getting out. If you want to help, call your representatives in Washington and urge them to support S. 314 or H.R. 592. Tell them a story of how a pharmacist helped you. Explain to them what provider status really means. I’m always available to talk if you’d like more information, or if you have any questions.

We were able to convince 123 Republicans AND Democrats in Washington last year that provider status was worth it. Let’s make this continue to grow this year! Our advocacy efforts paid off, but the job isn’t done yet. Pharmacy has come a long way thanks to the men and women who came before us. We would be doing them an enormous disservice if we didn’t continue to advance our profession.

Thank you for reading.

H/T to the American Pharmacists Association, the Patient Access to Pharmacists’ Care Coalition, and the National Association of Chain Drug Stores for some of the statistics presented in this post.

2015: A prospective look.

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Everyone makes New Year resolutions, but we all know they seldom make it past Valentine’s Day (if we’re lucky). I’ve been guilty of this for at least the past few years now. Perhaps if I document my goals for this year, I will (theoretically) be forced to hold myself accountable and make sure at least a few of them get done (and maybe you can help me reach them). In 2015, I hope to…

(In no particular order)

  1. Live healthier. This means watching my portion sizes, hitting the gym more, and making healthier choices. I’ll park further away when I go shopping, I’ll choose water over soda, and I’ll limit myself when I drink beer. I’ll choose salad over soup, and skip dessert, even if it looks amazing. This is going to be tough for me, so I will appreciate any help I can get.
  2. Advance my career. The role of the pharmacist is constantly changing, and I’m going to have to adapt to that. Some more specific goals in this category are:
    1. Become a Certified Asthma Educator (AE-C).
    2. Complete the American Pharmacists Association Pharmacy-Based Travel Health Services Advanced Competency Training Program. (I’m registered to do this at APhA2015 in San Diego in March).
    3. Give a Continuing Education (CE) program at a local, state, or national pharmacy meeting.
  3. Travel. I love traveling, and I love traveling even more with the people I love. I already have some ideas, some trips planned, and some tickets already bought. Here’s what my year may look like:
    1. Philadelphia in February.
    2. San Diego in March.
    3. Albuquerque in August?
  4. Serve my Fraternity. I’ve gotten so much from Phi Delta Chi, so it’s time I give back. (Brothers, if you’re reading this, here’s where AAAE comes in) My goals for 2015 include:
    1. Run for a National Office.
    2. Charter an Alumni Chapter.

If you haven’t had time (or haven’t made time) to think about how you’re going to make the most of 2015, I would challenge you to do so. Best of luck, and here’s to a great year!