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Pharmacists Raise Concerns for Patient Access to Generic Drugs

Posted on Mon, Apr 13, 2015
Pharmacists Raise Concerns for Patient Access to Generic Drugs

Survey shows it takes one month or longer for PBMs to fix maximum allowed costs underpayments

THURSDAY, April 9, 2015 (HealthDay News) -- Nearly all pharmacists have experienced upswings in the acquisition costs of generic drugs, with price spikes reported to be worse since 2013, according to a report published by the National Community Pharmacists Association (NCPA).

In a survey of 700 community pharmacists, almost all pharmacists reported experiencing a large upswing in the acquisition cost of a generic drug over the past six months. Most pharmacists (93.4 percent) reported that the situation had gotten worse since 2013.

Most pharmacists report that it takes third-party payers one month or more to update pharmacy reimbursement rates accordingly (one to two months, 24.7 percent; three months or more, 62.3 percent). Most (92.8 percent) pharmacists report that the situation has gotten worse with respect to absorbing financial losses on these prescriptions. The typical response on appeal to pharmacy benefit management is rejection of appeal (56.9 percent), with no response in 25.9 percent of cases.

"This survey finds that this problem has only grown more severe over the past two years and requires urgent attention from federal and state policymakers," B. Douglas Hoey, R.Ph., M.B.A., chief executive officer of the NCPA, said in a statement. "Some patients are already skipping medication due to higher prices and copays or are forced into the Medicare coverage gap or 'donut hole' sooner."

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Patients May Be Modifying Meds Due to Trouble Swallowing

Posted on Mon, Apr 06, 2015
Patients May Be Modifying Meds Due to Trouble Swallowing

Some consumers do not consult health professionals if they experience problems, before modifying meds

THURSDAY, April 2, 2015 (HealthDay News) -- Some patients experience difficulties swallowing and modify medication dosage forms, without necessarily consulting health professionals, according to research published in the March issue of the Journal of Pharmacy Practice and Research.

Esther T.L. Lau, Ph.D., from the Queensland University of Technology in Brisbane, Australia, and colleagues estimated the prevalence of swallowing difficulties and medication dosage form modification among community pharmacy consumers. Three hundred sixty-nine consumers were recruited from five community pharmacies and invited to participate in a structured interview.

The researchers found that 16.5 percent of participants reported experiencing difficulties in swallowing, and 10.6 percent reported modifying medication dosage forms. About half of those surveyed (44.2 percent) thought there would be no issues with medication dosage form modification. Regardless of their thoughts about issues associated with these practices, some consumers reported that they would not seek advice from health professionals on experiencing swallowing problems and/or before modifying their medication dosage forms.

"Some consumers appeared to be accustomed to modifying medication dosage forms, even when there was no apparent or obvious need. People were also reluctant to seek advice from health professionals regarding swallowing difficulties, or modifying medication dosage forms," the authors write. "Health professionals must be assertive in educating consumers about swallowing problems, and medication dosage form modification."

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Documentation Tip of the Week: Present on Admission (POA)

Posted on Wed, Apr 01, 2015
Documentation Tip of the Week: Present on Admission (POA)

Good documentation is important for new physicians as well as veteran caregivers. While documenting can seem like a very straightforward skill, there are often “best practices” that can be utilized. As a hospitalist for EmCare at St. Petersburg General Hospital in St. Petersburg, FL I write a “weekly documentation tip” email to help physicians improve their clinical documentation. I also share these documentation strategies with the residents I teach.

A diagnosis cannot be the main reason for admission, the Principal Diagnosis, unless it is present on admission. Please document if there is a “Possible” diagnosis (eg possible sepsis) at the time of admission.

Did You Know? Hospital Acquired Conditions (HACs) – Hospitals are not paid additional monies for certain medical conditions that occurred during the hospitalization. Please document these conditions in the H&P so there is clear documentation that the condition was PRESENT ON ADMISSION

Examples of HACs:

  • Cath associated UTI
  • Manifestation of poor glycemic control eg DKA
  • Vascular cath infection
  • Ttrauma
  • Blood Incompatibility
  • Foreign object retained after surgery
  • Stage 3/4 pressure ulcer
  • DVT & PE after ortho procedure
  • Fractures


Dr. Timothy Brundage is a hospitalist for EmCare at St. Petersburg General Hospital in St. Petersburg, FL. Dr. Brundage earned his bachelor’s degree in chemistry and molecular biology at the University of Michigan, his M.D. at the Wayne State University School of Medicine and completed his residency in internal medicine at the University of South Florida College of Medicine. Subscribe to Dr. Brundage’s weekly documentation tips, or ask him about specific documentation issues, by emailing him at


Innovative Prototype Presented for Post-ICU Patients

Posted on Mon, Mar 30, 2015
Innovative Prototype Presented for Post-ICU Patients

Collaborative care model can maximize cognitive, physical, psychological recovery of ICU survivors

FRIDAY, March 27, 2015 (HealthDay News) -- A collaborative care model, the Critical Care Recovery Center (CCRC), represents an innovative prototype aimed to improve the quality of life of intensive care unit (ICU) survivors, according to a report published in the March issue of the American Journal of Nursing.

Babar A. Khan, M.D., from the Indiana University School of Medicine in Indianapolis, and colleagues discuss the development and implementation of a collaborative care model, the CCRC, which opened in 2011 and aims to maximize the cognitive, physical, and psychological recovery of ICU survivors.

The researchers note that the CCRC was developed around the principles of implementation and complexity science, with a secondary focus on research. Care was provided through a pre-CCRC assessment of patient and caregiver needs; an initial diagnostic work-up visit; and a follow-up visit, including a family conference. During the initial assessment, the CCRC team formulates and implements an individualized care plan. During the follow-up phase, the patient's care plan is monitored and modified based on feedback relating to patient progress.

"Our preliminary data and experience with the CCRC suggest that a collaborative, interdisciplinary care model can enhance the cognitive, physical, and psychological recovery of ICU survivors," the authors write. "The CCRC represents a prototype in the United States for providing post-ICU care to patients who present with post-intensive care syndrome."

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