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Small Doses

July 21, 2017
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Breaking News

HHS OIG Report Identifies Extreme Use of Opioids in Medicare Part D

From NCPA Advocacy Center Update, July 17: The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) recently released a report, Opioids in Medicare Part D: Concerns about Extreme Use and Questionable Prescribing. The report provides baseline data on the extent to which Part D beneficiaries receive extreme amounts of opioids and appear to be “doctor shopping.”

The report also identifies prescribers who have questionable opioid prescribing patterns, based on 2016 data. Highlights include:

  • One-third of Medicare Part D beneficiaries received a prescription opioid;
  • Approximately 500,000 beneficiaries received high amounts of opioids and almost 90,000 beneficiaries are “at serious risk”; and
  • Approximately 400 prescribers had questionable opioid prescribing patterns for beneficiaries at serious risk.

The OIG notes that one-third of prescribers with questionable prescribing for beneficiaries at serious risk were nurse practitioners or physician assistants. The report was released in conjunction with the OIG and Department of Justice announcement regarding a July 2017 nationwide “health care fraud takedown.”

National Health Care Fraud Takedown Results in Charges Against More than 400 Individuals

From APhA’s Pharmacy Today, July 14: More than 400 people have been charged in the largest-ever health care fraud enforcement action by the Medicare Fraud Strike Force, Attorney General Jeff Sessions and Health and Human Services (HHS) Secretary Tom Price, MD, announced on July 13. The individuals — including doctors, nurses, pharmacists, and other licensed medical professionals — are suspected of participating in health care fraud schemes involving about $1.3 billion in false billings.

The charges aggressively target schemes billing Medicare, Medicaid, and TRICARE for medically unnecessary prescription drugs and compounded medications that frequently were never even purchased and/or distributed to beneficiaries. Additionally, the charges involve individuals contributing to the opioid epidemic, especially medical professionals involved in the unlawful distribution of opioids and other prescription narcotics. HHS Secretary Price said, "Health care fraud is not only a criminal act that costs billions of taxpayer dollars — it is an affront to all Americans who rely on our national health care programs for access to critical health care services and a violation of trust. ... The historic results of this year's national takedown represent significant progress toward protecting the integrity and sustainability of Medicare and Medicaid, which we will continue to build upon in the years to come."

Minnesota News

MDH Receives Funding for Improved Opioid Tracking and Prevention

The Centers for Disease Control and Prevention (CDC) has announced that the Minnesota Department of Health (MDH) received a $345,000 grant to better track and prevent opioid-involved overdoses. The funds will support MDH’s ongoing Data-Drive Prevention Initiative (DDPI) work, which includes improving the department’s ability to do field work to monitor the opioid crisis and to set up an opioid data dashboard. Read the full press release.

UMN College of Pharmacy Wins Awards at AACP

Graduate student Bob Bechtol is a co-author on the poster that received the SAS Best Poster Award at AACP’s Annual Meeting.

The University of Minnesota College of Pharmacy had a significant presence at the American Association of Colleges of Pharmacy (AACP) Annual Meeting in Nashville this week. The College won the 2017 Award of Excellence in Experiential Education and a poster sponsored by the College and Regis University was named best SAS Poster. MPhA Member Kerry Fierke was named chair-elect of the Leadership Development SIG. Several faculty members — including MPhA members Lara Kerwin, Kristin Janke, Jean Moon and Ann Philbrick — made presentations and/or had posters at the event.

Use Your Member Benefits

Get Smart about Your Student Loan Repayment Options: MPhA Membership Benefit

Many pharmacists have incurred steep education debt by the time they begin practicing. Loan relief programs can reduce a major source of stress and save thousands of dollars for pharmacists on their student loans. MPhA is partnering with Navigate, LLC for student loan expert advice.

Schedule your student loan consultation today. MPhA members receive over 50% off regular rates. A regular public service loan consult would be $1,000 — but MPhA members are able to receive this consult for $395. A regular loan refinance consult would be $500 but MPhA members are able to receive this service for $195. That’s a savings of $305-$605 and provides an incredible return on your MPhA membership investment. Satisfaction is guaranteed!

Navigate’s principal, Joy Sorenson Navarre, is a national expert on student loan management who consults individually with physicians and pharmacists. She is a popular speaker at residency programs, medical schools and hospitals. Her articles appear in journals and websites throughout the medical community.

Schedule your phone appointment today. Get smart about your student loan repayment options and take advantage of this important MPhA member benefit!

National News

U.S. House Ag Appropriations Bill Directs FDA to Preserve Access to Compounds

From NCPA Advocacy Center Update, July 17: The U.S. House of Representatives Committee on Appropriations released its Full Committee Report on the FY 2018 Agriculture Appropriations Bill. In this report, Congress has clearly stated that the FDA is misinterpreting the DQSA in regards to compounding policies and overstepping their regulatory authority.

The report language directs FDA to issue a formal rule allowing office use compounding, issue a final MOU that clearly differentiates between dispensing and distribution, appoint voting members to the PCAC with recent, actual, and diverse experience in the preparation, prescribing, and use of compounded medications, and only reference laws relating to veterinary practice in any final animal drug compounding guidance. This report language is not as strong as legislation and does not change the current law. However, it does give NCPA and all compounding allies a strong tool as we continue to work to ensure patient access to critical compounded medications. Several champions of compounding rose during the Full Committee Markup to express support for preserving patient access for compounded medications. On another note, 18 members of the DQSA Coalition, including NCPA, recently wrote HHS Secretary Price asking for a meeting to discuss vital compounding issues.

U.S. Opioid Epidemic: Several Perspectives

From APhA’s Pharmacy Today, July 17: At the National Governors Association forum on the opioid epidemic, governors expressed frustration that efforts to combat the crisis have so far had little apparent effect.

One governor argued that the opioid epidemic requires the same federal support as a natural disaster, while several others called for law enforcement efforts to stem the supply of illegal opioids — along with expansion of treatment and prevention work.

Meanwhile, city budgets across the U.S. are buckling under the financial weight of reviving and rehabilitating opioid overdose victims — or burying them. Some mayors are questioning whether the money is well spent. Some communities are considering whether to ration naloxone or whether to limit the number of times emergency responders can save the same victim.

The number of infants born addicted to drugs has spiked since 2003, largely due to the opioid crisis. Communities are rarely equipped to provide the specialized treatment these babies need, so the babies may be transferred to urban centers miles away — meaning the often low-income mothers are not able to be with the babies during the recovery process. Researchers are starting to advocate a new approach in which the mother is the first line of treatment for the baby. “Rooming-in” puts mother and baby together in a hospital setting apart from the neonate ICU. Research has shown that the strategy can reduce the need to treat babies with morphine and also suggests that mothers may relapse less frequently. The cost savings was estimated at $11,000 per infant.

Continued Talks on Health Care Bill in Washington

From news sources: After the latest bill to repeal the Affordable Care Act (ACA) was rejected by the U.S. Senate earlier this week, President Trump demanded Wednesday that Republican senators resume their work to approve a plan to repeal and replace the ACA. It is unclear whether there are enough votes to even open debate on a bill to repeal, although Senate Majority Leader Mitch McConnell says he will schedule a vote for the week of July 24.

A growing number of organizations, including a bipartisan group of the nation’s governors, have voiced concern over attempts to repeal the ACA without a replacement plan available. While President Trump said he would now simply allow the ACA to fail, with Democrats shouldering the blame instead of Republicans, a number of lawmakers and governors pledged to work toward a bipartisan solution.

MPhA Events

Register Now for August 16 Virtual Coffee Break Webinar

Flu Vaccine Guidance for Minnesota Pharmacists

In this one-hour webinar on Wednesday, August 16, we will learn about new influenza recommendations and refresh knowledge of the basics of giving flue vaccine. Jennifer Heath, DNP, MPH, RN, from the Minnesota Department of Health will present essential information to prepare for the 2017-2018 influenza season and answer your questions related to providing flu vaccine.

Read more

August 16, 2017 • Online Webinar
FREE for all MPhA Members • Non-member cost: $25 per person

Register Online

Join Us at the 2017 MPhA Annual Learning Networking Event & MTM Symposium!

Chart Your Course for Change with MPhA, September 7-8 in St. Paul

Join your colleagues at this peer-designed event, which will allow to you create an agenda for your practice and professional development. We have an excellent line-up of speakers and topics! Here are just a few highlights from our MTM Symposium Track:

  • Natalie Roy, PharmD, and Stephanie Swanson, PharmD, University of Minnesota College of Pharmacy: New Drug Update — Place in Therapy vs Just Comparing
  • Allyson Schlichte, PharmD, MBA, BACCP, Fairview Pharmacy Services, and Keri Hager, PharmD, BCACP, University of Minnesota: JCPP Pharmacists Patient Care Process
  • Melani Bersten, PharmD, RPh, Minnesota Medical Solutions: Medical Cannabis from the Pharmacist’s Perspective
  • Sarah Groen, PharmD, BCPS, HealthPartners: Patient Access and Affordability
  • Ann Moyer, PharmD, HealthPartners Pharmacy Services: Patient Loss to Follow-Up

Register Online

Did You Know?

Grapefruit Juice and Some Drugs Don’t Mix

From U.S. Food & Drug Administration, July 18: Grapefruit juice and grapefruit can be part of a healthy diet. Grapefruit has vitamin C and potassium, among other important nutrients. But for patients who need to take certain medications, it isn’t good.

This food and drug interaction can be a concern, says Shiew Mei Huang, PhD, of the U.S. Food and Drug Administration. The FDA has required that some prescription and over-the-counter (OTC) drugs taken by mouth include warnings against drinking grapefruit juice or eating grapefruit while taking the drug, Huang says. Read the full article.