Archive for September, 2009

Limits on promotion of new drugs?

Wednesday, September 30th, 2009

In a policy paper, Improving FDA Regulation of Prescription Drugs, released Sept. 24, 2009, the American College of Physicians (ACP) proposed that FDA “be given the authority to require new drugs be labeled with a symbol that indicates it is a new drug and that direct-to-consumer advertising be limited for the first two years after a drug’s approval.”

The paper makes five other important recommendations. The one I’ve singled out above has broad implications and is worthy of some debate within pharmacy.

Promotion advocates would suggest that such a proposal would limit access to important advances in medicine, while opponents might argue that a 2-year “soft launch” would protect consumers by allowing greater experience with products before significant promotion occurs. APhA has numerous policies regarding direct-to-consumer advertising, but nothing that would guide us regarding whether pharmacy would support or oppose the ACP proposal.

What do you think?

MTM in Baucus/HCR proposal: Your voice is being heard!

Friday, September 18th, 2009

This week’s release of the long-awaited Senate Finance Committee health care reform (HCR) proposal sets the stage for an interesting study in lawmaking on Capitol Hill. As the process moves forward, pharmacy and medication therapy management (MTM) are exactly where we hoped at this point: MTM is in both Senate bills and the key House HCR proposal, and the profession is engaged and being heard by legislators.

I do believe that APhA’s focus, focus, focus on MTM, as well as advocacy from others, will pay off. This is truly a generational opportunity for pharmacists. The fact that these sound MTM provisions, although not precisely identical, are in the proposals on both sides of the Capitol makes our chances of final passage much more likely.

Our hat is off to many other national and state pharmacy associations that have worked diligently to help secure these provisions. Many pharmacy organizations have promoted MTM along with other concerns, but APhA has been focused on MTM. As members of a stakeholders’ coalition, we have supported in letters and deeds an AMP fix and DMEPOS surety bond relief, and I give our partners credit for their successes.

Please stay tuned and informed. If debate takes a negative turn for pharmacists, we will need your aggressive and immediate calls of support. Meanwhile, we can smile, knowing that the Hill is listening to pharmacy.

Survey says… We have some work to do.

Thursday, September 17th, 2009

In October (American Pharmacists Month, or “APhM”), we will release the results of a survey APhA commissioned to gain insight into consumers’ medication habits and the relationship they have with their pharmacist. Results suggest we have some work to do as a profession to ensure that our patients see us as a partner in their health care. APhM is a perfect vehicle to get out that message. We’ll do our part with the media. I hope you will help us by letting your patients know that you are eager to become more involved in their health and to help them use their medications correctly.

“Know Your Medicine, Know Your Pharmacist” will again be the theme and call to action for this year’s campaign. Our consumer outreach efforts will place a special emphasis on using a personal medication record (PMR) to help patients get to know their pharmacist. Survey results revealed that only 28% of consumers carry an up-to-date list of their medications. The most common reason, the survey showed, that patients did not use medication lists was, “I never thought about it (49%).” Encourage your patients to keep a list and share it with all of their health care providers to minimize the risk of improper dosing, duplicating medications, and harmful drug interactions and side effects. I challenge all APhA members to get involved this APhM to help carry out APhA’s mission of improving medication use and advancing patient care. I’d also like to give a special thanks to McNeil Consumer Healthcare for their continued support of American Pharmacists Month.

Yesterday’s surgical strike

Wednesday, September 16th, 2009
APhA Takes to the Hill for Health Care Reform
Nancy Alvarez (APhA Board of Trustees) and Patricia Epple (Executive Director, Pennsylvania Pharmacists Association) with Rep. Tim Holden (D-PA).
APhA Takes to the Hill for Health Care Reform
Florida Pharmacy Association Executive Director and CEO Michael Jackson and APhA President Ed Hamilton in front of the U.S. Capitol

On Tuesday, a group of 18 APhA Trustees, representatives, and state pharmacy association executives spent the day on Capitol Hill conducting what one executive director described as a “surgical strike.” The group was selected based on their Senators’ and Representatives’ membership on key committees. We spent the day working with members of the Senate and House to assure that the key MTM provisions are secure as currently present in the Senate HELP proposal and the House Energy and Commerce proposal. We also worked on an AMP fix, DMEPOS Surety Bond relief, workforce support, and other key pharmacy issues.

This group of motivated folks volunteered their time to be here on behalf of all American pharmacists. For that I am grateful, as all readers of this blog should be. Also, I would like for you to commit to making contact with your own representatives STAT should we get word that any of our provisions are in trouble in the coming debate. We’ve made this plea in the past, and we may make it again in the future. Nothing is assured until legislation is passed. Of course, we will then gear up our work with CMS to assure that regulation is workable and in the best interests of our patients as the statute is operationalized through regulations.

Sept. 11, 2001, at 9:37 a.m.

Friday, September 11th, 2009

September 11, 2001, at 9:37 a.m. That was the exact moment of the 9/11 attack on the Pentagon. Today marks eight years since that day. Thanks to our country’s response to those attacks, I can safely look out my office window and see the site where American Airlines Flight 77 hit the Pentagon. I am grateful to the troops who voluntarily put themselves in harm’s way every day in Iraq, Afganistan, and around the world to ensure we can live freely and safely. 

A good historical account of the 9/11 attack on the Pentagon can be found on CNN . What I remember from that day is watching the events on my computer screen from my office in Rockville, MD, just a few miles from APhA. I was the APhA President at the time. Last night, I called John Gans, and we recalled together the events of that day here at APhA. I have always been proud of John for his focus, and the focus of the senior staff on the safety of our staff here at the building. That day, they had no doubt that the staff had to be evacuated quickly and safely. I’m sure many of our staff have memories. I hope those who were here will share them. Let’s never forget.

International Pharmacy Federation: The world stage

Thursday, September 10th, 2009

Yesterday, I returned from the International Pharmacy Federation meeting in Istanbul, Turkey. The FIP meeting was attended by nearly 2,000 pharmacists and scientists from literally all around the world. As I spoke with pharmacists from Turkey, Australia, Japan, the Netherlands, Portugal, China, Canada, the UK, Sweden, India, and many other countries, I noted the influence American pharmacy has had on the world stage. In many countries, pharmacists are far more politically effective than we are, and there are certainly innovative practice leaders who shine and lead their country’s practitioners to higher ground. American pharmacy too can be proud of our innovations and the interest others have in what we’re going to do next. 

Despite our current apoplexia over health care reform, or health insurance reform as it is now being called by the White House, we are blessed in the US with resources well beyond those enjoyed in most countries. Together with other developed countries, we need to continue to lead and listen, as others show us new and better ways to help our patients get the most from their pharmacist experience.

Obama speech heads up

Wednesday, September 9th, 2009

Check your local listings. According to Politico, President Obama is “set to strongly endorse a public insurance option before Congress tonight but stop short of an ultimatum, leaving room for negotiation. Reaching out to the GOP, he plans to acknowledge a problem with malpractice litigation.” For APhA’s coverage of the speech, watch your Twitter feed and Facebook page, or check pharmacist.com about an hour after the President completes his address from the chamber of the House of Representatives.

Next Monday and Tuesday (September 14 and 15), APhA will host a Hill “fly in” with a group of nine state pharmacy association executives and a number of our elected leaders. We will carry the message again to our own Congressmen and Senators that pharmacists’ services must be a part of any health reform package.

Town hall meeting in Ohio – Guest blogger Ernie Boyd

Wednesday, September 9th, 2009

On Tuesday, August 25, Ernie Boyd was one of four panelists at a local health care reform town hall meeting sponsored by AARP in Wintersville, OH. Below is an excerpt of the report from Ernie, who is executive director of the Ohio Pharmacists Association. I thought it captured the spirit of the debate that this past month has witnessed.

Wintersville is a small town on the eastern border of Ohio, a beautiful area of hills and lakes. A herd of deer crossed the road at 5 am as I made my way to the meeting. I had spoken previously at a town hall meeting in the Congressman Charlie Wilson’s (D-OH) 6th District after he introduced legislation to correct the tamper-resistant prescription problem. That meeting was attended about 60 people, and there were some questions, with the Congressman handling a wide range of issues. He has recently moved to Congress from the state legislature, where we interacted rather often. 

I assumed that the meeting in Wintersville would be about the same size, although the topic was health care reform. I was wrong. AARP had arranged a luncheon, and they sold out the more than 360 seats. I arrived early, but people with signs on both sides of reform debate were already gathered in the parking lot. During the luncheon, cards were distributed for the people to submit questions. The moderator introduced us, and the fun began. The format consisted of an opening 15-minute presentation by Congressman Wilson, followed by 5-minute presentations by each panelist. Congressman Wilson, very well-liked by his constituents, is a conservative “Blue Dog” Democrat. His remarks covered the state of health care reform and the impact he felt change would have on the district. A national board member of AARP spoke, followed by the exec of the state medical association. Then the representative from the Service Employees International Union spoke, followed by me. I was given excellent background on pharmacy’s national position by APhA’s Kristina Lunner, and I covered MTM and our general views on reform. I also expressed Ohio’s concern with reimbursement issues, since the Governor just cut our reimbursement far below cost.  

The crowd politely listened to our presentations, but it was obvious that they were chomping at the bit to get to questions. The moderator began by posing one of the written questions, and the Congressman answered. However, an audience member stood up and emphatically asked his question. That was followed by a number of others. The questions ranged from the cost of the program —especially given all the other money Congress has spent this year. How will the funds be found? Some answers were followed by relatively loud sounds of disbelief. One person quizzed the Congressman on the concept of abortion being paid under the bill. Another brought up veteran benefits. It was a bit unnerving to be the focal point of 700 eyeballs, with the crowd pretty activated. It was extremely interesting to watch this microcosm of grassroots involvement. The crowd was polite, never interrupted, listened, but was very dedicated to getting answers.

I gained a lot of respect for Congressman Wilson for meeting with some relatively upset constituents face-to-face, and having strong answers for their questions. I’ve lobbied for a lot of years but had never seen a time when constituents were as informed, aware, and involved as they are in the health care reform debate. The information is shaky, but that’s understandable with the speed that Congress is trying to get this done. It was good to have a chance to provide pharmacy’s position, and I did have a few comments following the meeting. This meeting, however, was about what the participants wanted the Congressman to hear, rather than the other way around. Interesting politics.

After thinking more about this meeting, I also realized that our Ohio pharmacist membership is more activated than I’ve seen in my 21 years here. During August, we had at least six interactions of our members in small groups or in pharmacies with members of Congress. Over the past 6 months, I can think of dozens more, including a meeting of Congressman Zack Space with pharmacist John Coler and me in Zanesville, OH. John was incensed with the DMEPOS accreditation, and brought out the book of material needed, and discussed the hours of work his staff had to do. Being in the pharmacy, seeing what we are up against, and being face-to-face convinced the Congressman to introduce legislation on DME. It is gratifying to see our members understanding the issues, and conveying our messages effectively. That’s the value of APhA and OPA: bringing the facts to the pharmacist, and hopefully, shaping the debate on health care so we are not only included, but are a key player.

American leadership at FIP

Tuesday, September 8th, 2009
69th International Congress of the International Pharmacy Federation (FIP)

About 100 Americans attended the 69th International Congress of the International Pharmacy Federation (FIP) in Istanbul, Turkey, over this past weekend. At a dinner hosted by Procter & Gamble, several current and former leaders of ASHP, APhA, AAPS, and ACCP, as well as others who continue to play important roles on the international front, posed for this photograph. 

Have you ever attended an FIP meeting? What was your experience?