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Following the announcement by the Department of Health (DH) on the H1N1 vaccination programme for front line workers that stated “those pharmacists and their clinical staff…who have regular clinical contact with patients and who are directly involved in patient care as part of their pharmacy practice will be eligible for the vaccine”.

The NPA has written to PCTs urging them to move swiftly to make arrangements for community pharmacists and pharmacy staff to be offered the vaccine.

John Turk said

“Pharmacists and their staff are in daily contact with those who are sick, elderly or are immunocompromised and their carers. They are vital to ensuring that the supply of medication to those who have long term or acute conditions continues throughout the pandemic. Pharmacies are the first port of call for many of those needing treatment for the symptoms of flu or other self limiting conditions. It is clear that PCTs should include community pharmacists and pharmacy staff in H1N1 vaccination programmes for frontline workers and we look forward to prompt implementation within all PCT areas.”

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Community pharmacies that are members of the Pharmaceutical Society of Australias Pharmacy Self Care program are this week getting behind Adult Learners Week through educational material and fact sheets available from the pharmacies.

Adult Learners Week in Australia, which runs until 8 September, is part of an international festival of adult learning designed to highlight and promote the thousands of opportunities to learn as an adult. Acting President of the PSA, Grant Kardachi, said it was never too late for consumers to learn about their health and how to use their medicines properly and one of the most accessible places to begin this journey of learning was at their local pharmacy.

“Community pharmacists are highly trained and respected members of the healthcare profession and their accessibility means that if you want to learn more about your health, you can walk in off the street for advice and literature which may help,” Mr Kardachi said.

“The PSA has in place the Pharmacy Self Care program which boasts more than 1700 pharmacies as members. The program integrates a consumer health information component with the provision of a pharmacy staff program of evidencebased, peerreviewed education. It also has a strong focus on the quality use of medicines.

“What this means is that not only are the consumer able to learn more about their health through the advice, literature and Fact Cards provided by Pharmacy Self Care pharmacies, but the staff have extra training and resources to help them.” Mr Kardachi said the pharmacists role in self care involved helping consumers to learn more about, and take more active control of, their health by offering relevant and timely information, therapeutic advice, and effective products and medicines in the area of preventive health care, wellness maintenance, minor ailments and chronic disease.

“The program was launched across Australia some 22 years ago which makes it the most successful and longestrunning professional support program in pharmacy in the country,” Mr Kardachi said. “One of the foundations of the program is a wideranging series of more than 80 Fact Cards which help you and pharmacy staff learn more about certain aspects of your health and wellbeing, and how to use medicines properly.

“Adult Learners Week is a great opportunity for consumers to come in and start learning more about their health and how they can manage it.”

The Royal Pharmaceutical Society of Great Britain is urging older people to review the medication they are taking, as new research released by the Society reveals how millions of over 65s in Britain are taking a cocktail of medicines without fully understanding what they are, or the side effects they may be suffering from.

The research shows how almost 4 out of 10 (38%) over 65s in Britain are currently taking over five medicines at any one time. However, a staggering 6 out of 10 (62%) over 65s believe they either definitely or possibly have had a side effect from a medicine yet one in four said that they did not get it checked out. Other findings of the research revealed that almost one in 10 (8%) admit to not fully understanding what their medications do or how they treat their condition, and one in seven (14%) say they sometimes forget to take a pill at the recommended time.

In response, the Royal Pharmaceutical Society are launching a campaign to encourage older people and those with long term medical conditions to visit their pharmacy to reassess their medication in a Medicines Use Review (MUR). An MUR is a service that can be provided by a community pharmacist on an annual basis to a patient on one or more medicines and/or long term conditions.

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Royal Pharmaceutical Society

A new study shows that patients who use workplace primary care and pharmacy services have higher adherence rates to medications for chronic conditions, suggesting that by investing in integrated workplace health and pharmacy programs companies can realize health care savings while also improving patient outcomes.

The findings, published in the current issue of the American Journal of Managed Care, show that overall adherence to medication was nearly 10 percent (9.72 percent) higher among patients treated in the workplace than those treated in the community. The authors of the study concluded that due to the negative impact on patients health and significant costs associated with nonadherence, these results support the concept of workplace health as a means to save “not only health care dollars, but lives as well.”

“This study truly demonstrates the value of the workplace health care model in addressing medication adherence one of the most challenging and costly obstacles faced by providers and payers of health care,” said Dr. Sharon Frazee, an author of the study and vice president of health research for Take Care Health Systems. “Having care accessibly located at the worksite allows employees to build a trusted, facetoface relationship with both their clinicians and pharmacists, providing an opportunity to engage in a dialogue about their condition and treatment plan, and ultimately, promote patient adherence through education and communication.”

Low rates of medication adherence are a growing issue for the countrys health, recently referred to as “Americas other drug problem” by The National Council on Patient Information and Education, and can potentially result in serious negative health outcomes for patients. In fact, a report by the World Health Organization stated that the magnitude of nonadherence and the scope of the pathology related to nonadherence are so alarming, that greater health benefits would result from improving adherence to existing treatments than by developing new medical therapies. Additionally, nonadherence takes an economic toll on national health care spending, currently costing an estimated $100 billion a year.

Despite the existence of employersponsored workplace health programs for some time, this was the first study of its kind to examine the relationship between the use of employer health offerings at the worksite and adherence to medications.

“The increased use of generic medications, along with increased adherence, decreases overall medication expense,” said Allan Khoury, MD, Chief Medical Officer for Take Care Health Systems. “This leads to better health at a lower cost. This approach is an important lesson for all of American health care.”

The retrospective study looked at data from the health benefitcovered population from eight different locations of a large employer and included current employees, retirees and dependents. The findings for increased adherence were consistent regardless of medication type, number of days supplied or the location of the worksite. Medications used to treat diabetes, heart arrhythmia, hypertension, heart disease and thyroid disorders were included in the study.

This study was the second study in a twopart series on the value of integrated workplace primary care and pharmacy services. Take Care Health Systems previously authored a study published in the April 2007 Journal for Health and Productivity illustrating that when doctors and pharmacists work closely together in a workplace primary care health center, prescribing practices favor older, firstline antibiotics that produce significant savings and provide important therapeutic benefits. The approach, studied at four onsite facilities of an existing Take Care Health Systems client, translated into an estimated potential $1.5 million in savings on antibiotic prescriptions for the host company over three years.

Authors of the study published in the American Journal of Managed Care include Bruce Sherman, MD, FCCP, FACOEM, director, health and productivity management, Employers Health Coalition of Ohio; and Take Care Health Systems colleagues Sharon Glave Frazee, PhD, vice president of health research; Raymond Fabius, MD, CPE, FACPE, strategic advisor to the president; Rochelle Broome, MD FAAFP, regional medical director; James Manfred, RPh, vice president, pharmacy services; and Jeffery Davis, MBA, health informatics analyst.

About Take Care Health Systems

Take Care Health Systems, a wholly owned subsidiary of Walgreens (NYSE, NASDAQ WAG) and part of Walgreens Health and Wellness division, is the largest and most comprehensive manager of worksite health and wellness centers and convenient care clinics in the country. TCHS is comprised of Take Care Consumer Solutions and Take Care Health Employer Solutions . Take Care Consumer Solutions manages Take Care Clinics at select Walgreens drugstores throughout the country. Patient care at each of the Take Care Clinics is provided by Take Care Health Services, an independently owned state professional corporation established in each market. Take Care Health Employer Solutions manages primary care, health and wellness, occupational health, pharmacy and fitness centers at large employer campuses. Combined, Take Care Health Systems manages more than 700 worksite and retail health care centers.

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The Pharmacists Support Service (PSS) has been boosted with the announcement that the Australian Friendly Societies Pharmacy Association has committed to provide financial support to the service for the next three years.

PSS has been assisting Victorian pharmacists since 1995 by providing telephone counselling and support to distressed pharmacists. The President of the Victorian Branch of the Pharmaceutical Society of Australia, Mark Feldschuh, said the commitment was significant and sees the Friendly Societies join PDL as major backers of the PSS. “The support of PDL and AFSPA acknowledges that the PSS is for the benefit of all pharmacists whatever their area of practice or their particular organizational membership,” Mr Feldschuh said. “The service is there for pharmacists during times of trauma, distress or need and offers counselling to these pharmacists. PSS operates on the Lifeline model of telephone counselling and can be contacted on a toll free number 1300 244 910.”

Mr Feldschuh said the PSS telephone line is answered by volunteer pharmacists who have undertaken extensive training and are able to relate with the problems faced by pharmacists. “But to expand the service and effectively assist pharmacists outside Victoria, PSSneeds financial support to build resources and to develop a network of contacts in each state of Australia,” Mr Feldschuh said.

“At the moment PSS is able to operate on a tight budget because of the generosity of its volunteers. However funding is required for training and administration to ensure that the service is effective and of a high quality. The commitment of the Friendlies and the ongoing backing of PDL are pivotal to the ongoing success of the service.”

Both AFSPA and PDL will now be represented on the committee of management of PSS.”Donations and sponsorship from pharmacists and pharmacy organisations are being sought so that PSS can expand throughout Australia,” Mr Feldschuh said.

The Royal Pharmaceutical Society of Great Britain (RPSGB) is demanding the closure of a legal loophole which allows nonpharmacy retailers to sell dangerously large amounts of paracetamol.

The RPSGB became concerned last week when it was informed a Poundland store in Kent was selling 48 tablets of the painkiller for just £1.00.

The RPSGBs Director of Policy, David Pruce said “It is extremely worrying to know peoplemay purchase this medicine without any consultation or guidance and inadvertently use itincorrectly. We know that limiting the amount of paracetamol sold at one time has reduced thenumber of deaths from paracetamol poisoning”

Over a decade ago, the Medicines and Healthcare products Regulatory Agency (MHRA)limited the paracetamol pack size in nonpharmacy retailers to 16 tablets but allowed up tosix packs to be sold at a time.

Most stores, including pharmacies, will only sell a maximum of two packs at a time.

David Pruce said “I urge members of the public to see their local community pharmacist if theyare in need of medicines. Pharmacists are wellplaced to give people expert advice and care,and are conveniently located on the high streets of most towns. In addition, the public can besure medicines bought from a registered pharmacy would have met strict quality controlstandards, and would have been manufactured to UK requirements.”

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An unidentified trade group representing independent pharmacies on Wednesday plans to send to Federal Trade Commission Chair Jon Leibowitz a series of letters from pharmacy benefits manager CVS Caremark that indicate the PBM charges higher copayment rates for some of its members who opt to fill their prescriptions at pharmacies other than CVS, the Wall Street Journal reports. The letters, which were obtained and reviewed by the Journal, were sent by CVS Caremark to its members as recently as February.

According to the Journal, the patients were enrolled in CVS “Maintenance Choice” program, which allows them to fill 90day prescriptions through the companys mailorder pharmacy or pick them up directly from a drugstore at no additional cost. The Journal reports that some of the letters indicated that copays for patients who filled prescriptions at nonCVS pharmacies would increase to 50% of the price on their prescriptions, instead of the 25% of the cost of the drugs they would be charged at a CVS pharmacy.

Another letter sent to a beneficiary stated that “no additional fills of your prescriptions will be covered” at a nonCVS pharmacy, despite the treatment being covered under the patients plan. A third letter obtained by the Journal explained that when the Medicare patient in January filled a prescription for a 30day supply of a generic cholesterol drug at a nonCVS pharmacy, Medicare did not pay anything while the beneficiary paid $4.70. However, when the patient filled a 90day supply of the same drug at a CVS pharmacy in March, Medicare had to pay $165.99 while the patient made a $15 copay.

According to the Journal, some independent pharmacies raised concerns in 2007 when FTC approved the merger between CVS and Caremark that the $27 billion deal would have a negative impact on their business. The Journal reports that independent pharmacists say that prior to the merger, CVS vowed not to discriminate against them.

CVS in a statement said, “In general it is not uncommon to have some variation in pharmacyreimbursement rates and prescription prices within retail pharmacy networks administered by PBMs.” The company added that its Maintenance Choice program is “consumer friendly,” but did not explicitly address the letters or the claims made by the independent pharmacists, the Journal reports (Martinez/Armstrong, Wall Street Journal, 5/13).

Reprinted with kind permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

TCGRx (TCG), one of North Americas leading suppliers of pharmacy equipment, announced the commercial availability of the BullsEye Tablet Splitter, an innovative device that quickly and accurately splits medication with an industryleading two percent variability between the split halves. Other products on the market frequently crush or split tablets unequally, which may put patient safety at risk. Additionally, existing products are difficult to clean, which can lead to potential contamination of medications. The BullsEye Tablet Splitter can automatically split up to 16 pills per minute and contains a replaceable blade and HEPA filter to decrease potential contamination.

Prescription medication costs comprise approximately 10 percent of national healthcare spending, and are one of the fastest growing elements within the sector. In response, healthcare providers and facilities are developing strategies to keep drug costs under control while providing patients with the best possible care. Because different strengths of medication are often priced similarly, a higher dose is purchased and split in half. Many health insurers, including UnitedHealthcare, Aetna, Medical Mutual, Dean Healthcare and others, offer tabletsplitting programs that allow their participants to significantly cut their copay costs on their medication. Conversely, some healthcare payers delay or even deny payment for lower strengths of certain medications; this often requires that pharmacies and other healthcare facilities split tablets in order to fulfill prescriptions.

“Many healthcare facilities are stocking only higher strength medications so they can save costs on formulary inventory and conserve space, resulting in significant cost savings,” said TCG CEO Duane Chudy. “Splitting pills can potentially save healthcare plans, longterm care facilities and hospitals hundreds of thousands of dollars annually. But cost savings must not come at the sacrifice of patient safety, which means ensuring that each patient is receiving the accurate and appropriate dosage of a medication. We identified an urgent need for an accurate tabletsplitter to ensure patient safety.”

Studies of costsavings associated with tablet splitting date back to 2002 when Stanford University researchers found that splitting pills from 11 medications commonly used in its health plan provided savings ranging from 23 percent to 50 percent. Researchers projected an annual savings of $295,500 to the healthcare plan if fully implemented.

A 2007 study from the University of Michigan (UM) looked at the impact of splitting cholesterollowering drugs in the UM Health system. In its first full year, the program saved UM $195,000 and saved more than 500 plan participants more than $25,000 in copayments.

“People ask us to split pills for them and we do our best, but the oldfashioned pill splitters can cause crumbling,” said Darden Heritage, president of Star Discount Pharmacy in Huntsville, Ala., and a 20year pharmacy veteran. “They split pills, but not accurately, so youre actually wasting time and money.”

A recent study at the Veterans Administration Center in Asheville, N.C., found that when patients split their own medication the variability ranged between nine and 37 percent. TCG found similar results when an independent trained pharmacy technician split 250 metroprolol tablets using the BullsEye Tablet Splitter and 250 metroprolol tablets using the Apex Pill Splitter, a standard handoperated product. Each half was measured with a caliper (0.01mm accuracy) and the 1000 data points were analyzed for variability. The variability of the BullsEye Tablet Splitter was two percent compared to 11 percent variability with the manual splitter.

“BullsEye splits pills five times more accurately than manual splitters,” Matt Noffsinger, VP of Business Development, stated. “Although we have split and tested other medications, our latest test was performed on metroprolol because it is one of the most commonly split medications. The device is designed to handle a wide range of pill sizes and types, making it suitable for all pharmacy markets.”

About TCGRx

TCGRx (TCG) is an industry leader in automation and design services for hospital, longterm care, retail, and specialty pharmacy markets. Its offering of products is designed to allow for customized solutions depending on the individual pharmacys need. TCGs solutions are modular, expandable and flexible, which allows a pharmacy to invest in technology in line with its rate of growth. TCG has made efficiency and patient safety the hallmarks of their development strategy.