MPhA News

Small Doses

May 18, 2018
News from MPhA
Minnesota News
National News

MPhA Events

News from MPhA

Mission Moments:

GRAPh/MPhA Town Hall

Thanks to all who participated in the Town Hall event last week in Grand Rapids, Minn. More than a dozen people attended; they heard from Dr. Eric Johnson, Associate Professor in the Department of Family and Community Medicine at the University of North Dakota School of Medicine and Health Services on how to reduce cardiovascular events in patients with Type 2 diabetes. Then MPhA President-Elect Jason Varin and Interim Executive Director Marsha Millonig provided an update on Minnesota Pharmacy’s advocacy efforts in 2018 and led a Town Hall. Thanks also to GRAPh President and MPhA Director-elect Heather Bibeau of Bigfork Valley Hospital & Clinics for her work in planning the event!

COP Student Presents Post at AMCP Conference

Xin Xu presented a poster at the AMCP annual conf in Boston. She was happy to have the support of her mentors Drs. Stephen Schondelmeyer, Bithia Anderson and Mahsa Salsabili in perfecting this scholarly work. Support from the Century Mortar Club helped to make this trip possible.

Editor’s Note: During our Annual Learning Networking Event in September, MPhA made note of Mission Moments — those times when a member clearly exemplified our mission to advance patient care. As we move through the year, we will continue to showcase these Mission Moments as part of Small Doses. If you have an example to share, please send it to Laurie Pumper.

Legislative Update:

CMS Says Minnesota Is out of Compliance

As this update was written, both the House and Senate have yet to pass their massive Omnibus Finance spending bill that includes both policy for many stakeholders and supplemental funding adopted for all departments of the Minnesota state government. The Conference Committee met on Thursday night to hopefully pass the spending bill. However, there have been many indications that the governor will veto the bill — and then another round of negotiations will begin to come up with a spending bill he can support. This is all happening with four days left in the legislative session. The governor, in both his letters to the legislature, has stated that he does not need to sign a supplemental funding bill to make sure the government is functioning.

On May 16, the Minnesota Department of Human Services (MDHS) convened a conference call with stakeholders, including several representatives of Minnesota pharmacy, to let them know that the Centers for Medicare & Medicaid Services (CMS) has officially determined that Minnesota is out of compliance with the HHS-CMS Covered Outpatient Drugs Final Rule or the pharmacy outpatient reimbursement ruleand that in order to have Minnesota in compliance, action is needed now. Being out of compliance could potentially jeopardize millions of dollars in Medicaid drug spend funding for Minnesota.

Readers will recall that stakeholders, including Minnesota pharmacy, worked with the MDHS to come up with a consensus legislative pharmacy reimbursement proposal that would put the state in compliance with the rule; in the process, pharmacy reimbursement in Minnesota would move to a NADAC + $11.35 reimbursement rate. It also covered the 2% wholesale/provider tax donut hole on all fee-for-service MA prescriptions; without that, Minnesota pharmacists would dispense these fills at a substantial loss. The fiscal note associated with the implementation of the rule was estimated to cost approximately $3.8 million to the state annually. However, the MDHS is proposing a “revenue neutral” interim fix that would be adopted this week. It would have a NADAC +$10.48 reimbursement rate and would not include the 2% reimbursement language among other considerations to get to a “no-cost” solution.

This is unacceptable. We are working with the Minnesota Retail and Merchant Association as well as other stakeholders to address our concerns. Minnesota pharmacy is opposed to the current proposal, but is working to find a solution much closer to the 2017 consensus reimbursement rate and language. A letter has been sent this morning to Senator Rosen and Representative Knoblach outlining our concerns and encouraging them to include the 2% tax reimbursement.

Other provisions that are currently included in the Supplemental Finance Omnibus important to Minnesota pharmacy include:

  • Fair Practices/PBM contracting reform in the form of:
    • A gag-order prohibition,
    • lowest cost of medication to the patient provided,
    • and medication synchronization on refills allowed.
  • Pharmacist medication administration (IM/SubQ shots) for alcohol and opioid addiction treatment medications.
  • Emergency pharmacy fulfillment and remote data/systems access.
  • Statewide prescription drug repository established.
  • 30-day opioid prescription limit and 45 days on refills of opioids (schedule 2-4).
  • Opioid stewardship grant, pilot project, education and other various provisions (it is not known at the time of this writing if a manufacturer and wholesaler of opioids will see a fee as proposed in several bills including Senate Finance Chair Julie Rosen’s bill).
  • The bill does not include the language that would have authorized pharmacists in Minnesota to prescribe Naloxone, tobacco and smoking cessation medications as well as travel medications.

The legislature is constitutionally mandated to adjourn by Monday, May 21. Any legislation to be acted upon by the governor must be sent to him by midnight on Sunday, May 20. The governor already vetoed the House and Senate tax bill, calling for $180 million in “emergency school funding” before entering into any negotiations or signing a revised tax bill. On Wednesday, the Senate voted down the proposed bonding bill (a two-thirds vote is needed). There is much uncertainty around how the 2018 legislative session will come to a close.

LicenseTrak

Minnesota News

COP Promotes Two Faculty Members

The University of Minnesota College of Pharmacy has announced the promotion of Courtney Aldrich, PhD, to a full professor of Medicinal Chemistry, and of David Stenehjem, PharmD, to associate professor with tenure in Pharmacy Practice and Pharmaceutical Sciences. Both were honored at a ceremony at the College on May 17. Congratulations to both MPhA members!

MPhA Events

Need CE Hours? Less than Five Months to Reporting Deadline:

Minnesota Board of Pharmacy requires the completion of 30 hours of continuing education by September 30.

MPhA’s continuing education program provides more than a licensing requirement — you’ll also get the opportunity to network with your colleagues, stay on top of your professional game and practice to the top of your license. Don’t miss our Leadership Summit/House of Delegates Meeting, our Virtual Coffee Break Webinars, or Town Halls!

You can check the CE credits earned through MPhA programs by going to www.mpha.org. Log in; then scroll under Membership>Member Central>Manage Profile, and click. When you are on the Manage Profile page, look under “Content and Features” and select Professional Development. You will see all the MPhA activities you have attended. You can specify a date range, then print or email your transcript. If you need any assistance, please contact Bryan Mowry at bryanm@mpha.org.


MPhA Leadership Summit and House of Delegates Meeting: Traveling the Road Forward

Thursday, May 31, 2018 • 8 a.m.-6:30 p.m.

Register by May 21 for the Earlybird Discount!

Save $15 by registering before midnight on Monday, May 21! The 2018 Leadership Summit and House of Delegates Meeting will be inspirational and motivational and provide you with the opportunity to network, learn and share with your peers throughout the day. The morning program will feature invigorating messages of creating change and professional advancement, tips for working across generational differences, and insights into succession and transition planning to achieve your professional advancement goals.

We will share MPhA and pharmacy’s advocacy successes in the afternoon and be challenged to lay the groundwork for future advocacy initiatives to enable pharmacists to meet the health needs of Minnesota communities. During the House of Delegates, you will hear about the State of MPhA from leadership, discuss policy proposals and new business and install MPhA’s new leadership for the year. We’ll close our day with a networking reception honoring our Past Presidents and MPhA volunteers. The day is designed to provide us with a glimpse of how far we have come to advance patient care and practice and where we need to go next.

Register Now


Save the Date: MPhA Town Hall

Sunday, June 10, 2018 • 5:30-8 p.m.

Braham Community Center, Braham, Minn.

JJoin your colleagues in the Braham/Mora area for a chance to network, learn and share with one another while having your voices heard! MPhA Past President Brent Thompson will host the event. You’ll have the opportunity to mix, mingle and visit with exhibitors while sharing fellowship before the dinner program.

Christine “Tina” Larsen, PharmD, is an MTM pharmacist at Allina Health System. She received her Doctor of Pharmacy Practice from the University of Minnesota and also hold a bachelor’s degree is Genetics, Cell Biology and Development. Her PGY1 residency was completed at FirstLight Health System in collaboration with the University of Minnesota. Tina will present an update on genetics. Then MPhA Interim Executive Director Marsha Millonig will provide an update on Minnesota Pharmacy’s advocacy efforts in 2018 and lead a Town Hall.

Watch for more details and registration soon!


Register Now: June 20 MPhA Virtual Coffee Break

Updates to Diabetes Guidelines: A Focus on Evidence and Clinical Application of Newer Agents

Wednesday, June 20, 2018 • 11:30 a.m. • Online Webinar

Updates will be provided on the American Diabetes Association guidelines as well as the American Association of Clinical Endocrinologists guidelines, with a focus on newer agents and evidence supporting use of these medications.

Learning Objectives:

  • Summarize and apply the 2018 clinical guidelines for the treatment of hyperglycemia;
  • Recommend appropriate anti-diabetic agents according to patient characteristics and comorbidities;
  • Apply evidence-based medicine beyond the guidelines to clinical decision making in patients with diabetes;
  • Summarize several cardiovascular outcome trials related to antidiabetic agents and apply trial data to clinical decision making.

Register Now

About Our Speakers:

Kylee Funk is clinical faculty at the University of Minnesota College of Pharmacy. Dr. Funk provides comprehensive medication management at the University of Minnesota Health Nurse Practitioners Clinic. Her research is around the impact of CMM, pharmacist and nurse practitioner partenerships, and innovative techniques for diabetes education. Dr. Funk and Dr. Schweiss are co-directors for the Diabetes and Metabolic Syndrome course.

Sarah Schweiss is clinical faculty at the University of Minnesota College of Pharmacy on the Duluth campus. She also serves as the Assistant Director for the University of Minnesota's PGY-1 residency program. Dr. Schweiss provides comprehensive medication management at St. Luke's Mount Royal Medical Clinic. Her scholarly expertise lies in the realm of innovative diabetes education, interprofessional diabetes care, and novel teaching methods among ambulatory care pharmacy residency programs. Dr. Schweiss co-directs the College's Diabetes and Metabolic Syndrome course with Dr. Funk, and also serves as the course director for an interprofessional diabetes experience elective.


Connecting the Dots between Payers & Providers in IBD Decision-Making

Tuesday, May 22, 2018 • 7:00 to 8:45 a.m. • Bloomington, MN

MPhA members, including those in the MPhA Managed Care Academy, are invited to attend a program featuring speaker John M. Inadomi, MD, Cyrus E. Rubin Chair and Head, Division of Gastroenterology, Department of Medicine, University of Washington School of Medicine. This is a complimentary CME/CE event provided by PRIME Inc. through an independent educational grant from Takeda Pharmaceuticals U.S.A. This session has been approved for 1.25 hours of credit for pharmacist through ACPE. Get more information and register.

National News

President Announces Blueprint to Lower Drug Prices

From U.S. Health & Human Services Department, May 11: President Trump has announced new actions designed to drive down drug prices for all Americans. The president’s blueprint “will seek to encourage innovation, while also promoting better price competition and addressing foreign freeloading.”

Among the actions expected to be taken by the U.S. Health and Human Services Department:

  • Take steps to end the gaming of regulatory and patent processes by drug makers to unfairly protect monopolies.
  • Advance biosimilars and generics to boost price competition.
  • Evaluate the inclusion of prices in drug makers’ ads to enhance price competition.
  • Streamline and accelerate the approval process for over-the-counter drugs.
  • Speed access to and lower the cost of new drugs by clarifying policies for sharing information between insurers and drug makers.
  • Avoid excessive pricing by relying more on value-based pricing by expanding outcome-based payments in Medicare and Medicaid.
  • Work to give Part D plan sponsors more negotiation power with drug makers.
  • Examine which Medicare Part B drugs could be negotiated for a lower price by Part D plans, and improving the design of the Part B Competitive Acquisition Program.
  • Update Medicare’s drug-pricing dashboard to increase transparency.
  • Prohibit Part D contracts that include “gag rules” that prevent pharmacists from informing patients when they could pay less out-of-pocket by not using insurance.

Learn More about the American Patients First Blueprint

Stephen Schondelmeyer, head of the Department of Pharmaceutical Care and Health Systems at the University of Minnesota, was interviewed on CBS News to provide analysis of the president’s proposal. "Let's assume all of the other countries in the world agreed to pay the same price we do—that doesn't guarantee or assure us that the drug company would lower the price in the U.S.," Schondelmeyer said. "There's nothing to guarantee that or require it, or an economic reason for it to happen."


Azar Shares Some Details on Trump's Drug Cost Proposals

Pharmacists Can Submit Comments through NCPA

From NCPA’s qAM, May 15: On May 14, NCPA representatives attended HHS Secretary Alex Azar's follow-up speech on President Trump's drug cost speech. To address patients paying the lowest price at the pharmacy counter, Azar said HHS will send a letter to plans to make clear that the agency finds "gag rule" practices unacceptable. Azar affirmed the agency's focus on rebates in drug pricing and again asserted the agency's authority to address and eliminate remuneration as a possible policy moving forward. Following the speech, HHS pre-published its request for information on policies recommended in the secretary's speech. The docket remains open for 60 days, and NCPA will file comments highlighting policies that are important to community pharmacists. Pre-pub docket can be found here.


FDA Kick-Starts Plans to Increase Competition in Drug Markets

From APhA’s Pharmacy Today, May 15: The U.S. Food & Drug Administration (FDA) has launched a website that provides more information on the branded drugs generic drug companies have had difficulty obtaining. FDA Commissioner Scott Gottlieb, MD, says the site retroactively includes data on about 150 inquiries made regarding 50 brand-name medications and will be updated on an ongoing basis. This is part of the Trump administration’s overall effort to reduce drug prices.

Read more