Notes / Thoughts From The NCPDP Meeting

Here are my notes from the discussions and presentations at the NCPDP meeting in Portland.

  • The recession is a matter of perspective. Those with jobs think it’s over. Those without jobs or with family members without jobs don’t.
    • A good point to be made here is that much in life (and health) is seen thru our own lenses.
  • One of the issues with mortgages was the “liar’s loans” where people could get a bigger house by lying about their income. Things weren’t validated.
    • A good point here is the parallel with patient self-reported data and the lack of “tough love” in telling patients what they need to do to manage their weight (for example).
  • There is a new type of drug dealer – the elderly that are selling their drugs to pay for food.
  • Where is the tradeoff between competition and sharing data in the best interest of public health.
  • Kaiser pharmacies will help patients that can’t afford their medications on the spot.
  • Kaiser developed a system for converging multiple terms to ICD codes and then donated it for public use.
  • Every 7.5 seconds someone turns 50.
  • 80% of consumers see the value of a PHR but only 3% have them.
  • Only 44% of MDs are willing to use PHRs.
  • Tylenol PM is not good for people over 65.
    • The panel had a good dialogue about whose job it is to push this to consumers – AARP, Tylenol competitors, pharmacist, MD, consumer.
  • Long-term care is not just nursing homes – it is a continuum.
  • There is a whole effort focused on short-fills (daily, weekly) at long-term care.
  • Will reform kill the 340b pharmacy?
  • Are pharmacists doing what they should be doing?
  • The pharmacy metrics of # of Rxs per hour safely dispensed don’t have anything to do with outcomes.
  • More Rxs aren’t being picked up.
    • I personally wonder if this isn’t a red herring associated with more Rxs being written with electronic prescribing.
  • In one state, less than 3% of Medicaid costs are for primary care preventative services.
  • Would bankrupting the entire healthcare system be a bad thing or would it force us to collaborate?
  • Vaccines in the pharmacy is the beginning of pharmacists taking on more PCP type activities.
  • Is the CE model outdated? Did it ever work anyways?
  • Should a pharmacist take a patient’s blood pressure before refilling a hypertension drug?
  • 55% of claims filled are refills. Shouldn’t techs be able to do more of this function?
  • Ampyra is an MS drug that costs $15K per year. Its basic value is that it helps MS patients walk faster. What’s that worth?
  • If the plan design for medical and Rx aren’t coordinated, you could find patients trying to find the least costly option for products that could fall on either. Is this what was intended?
    • But who’s responsible for coordinating – payor, employer, PBM, consultant, HR?
  • RegenceRx is using a claim for an insomnia medication as a trigger to have a patient talk with a health coach. There often are other issues.
  • There are 1+ new genetic tests being launched each day.
  • 50% of mammograms offer a false positive over a 10 year period and 20% of women are harmed by these false positives.

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