Ron Harrison

With looming Medicare drug cost changes, LTC pharmacies are facing a potential crisis. Eight of the ten drugs currently under negotiation are heavily prescribed to LTC patients. This could potentially lower the cost for the consumer but also be costly for LTC pharmacies. LTC pharmacies already rely on thin margins, and with these potential changes, many are bracing for the impact. To help navigate these challenges, consider the numerous benefits of automating processes within your pharmacy. This can save time and money, lower operational costs, and offset the impact of drug price changes on your margins. Contact us today to streamline and automate your pharmacy before the drug prices take effect. #LTCPharmacy #Automation #CustomSoftware #Pharmacy

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Many innovative ideas can become obscured when communicated, which was a significant challenge for Patient Blood Management #PBM as it was introduced to benefit those suffering from #anemia, in hopes of enabling surgery without the use of donated blood upon leaving the ER (Emergency Room). The PBM educational approach supports bloodless surgical procedures. To reduce this obscurity, we are simplifying the message and increasing awareness, benefiting #researchers, manufacturers, and healthcare practitioners. Most importantly, we are enhancing the patient experience and raising public awareness. We are confident that many global organizations, healthcare providers, and blood management surgical equipment manufacturers will support our efforts as we continue to be pioneers in building a bridge of engagement for public access, which will benefit this field of medicine. Remember our medical icons, just in case one day you need direction to the OR. #Bloodlines #BBTS #Blood #SABM

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Biosimilars promise savings, but often fail to deliver. Plan sponsors (and members) face pain and complexity on the path to realizing those savings within their PBM contracts. How can plan sponsors navigate the promises of biosimilars? On Wednesday, July 10 at 12 p.m., our team will equip you with the information you need to assess today’s biosimilar market and its impact on your pharmacy benefits plan as our team breaks down: • What plan sponsors need to know about the current biosimilar pipeline • The challenges that can impact realized savings • Our recommendations and insights for optimizing your approach to biosimilars Register at: https://lnkd.in/dGz9qbRT

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As the specialty medication landscape becomes increasingly intricate, Field Reimbursement Managers (FRMs) serve as vital liaisons between stakeholders, making connections and expediting processes. Whether hired in-house or outsourced, FRMs help bridge the gaps between pharmaceutical companies, insurers and providers. Want to learn more about the power of FRMs? Read our blog: https://lnkd.in/dMEG249m

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APHA: PBM networks have ignored our members’ requests to negotiate more reasonable rates, which will be at a minimum 3% below cost on dispensing brand meds. This is unsustainable. Read our recommendations for CMS to improve Part D contracts & pharmacy access #PBM #PBMReform #pharmacychoice #pharmacy #independentpharmacy Read more https://lnkd.in/eMYYCQbt

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Pharmacists are essential in providing diabetes care, buprenorphine, and hepatitis C treatments to unhoused patients. Discover how clinical pharmacists are making a difference in the Winter issue of California Pharmacist with the feature article 'Prescription for Hope: How Clinical Pharmacists Are Transforming Healthcare Among People Experiencing Homelessness.' Read it here: https://lnkd.in/gBssVcxw

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PBMs play a pivotal role in the healthcare landscape, especially when it comes to formulary management—the process of determining which medications are covered by a prescription benefit plan. This control has a significant impact on both drug pricing and member access. Unfortunately, the industry standard among many PBMs, particularly the largest players, often leads to higher prices and limited access. At TrueScripts, we’re setting a new standard by prioritizing transparency and alignment with the best interests of our members and clients. Our formulary management approach emphasizes providing the lowest net cost while maintaining a clinical focus. This means actively managing formularies to ensure members have access to effective, affordable medications without the preferential treatment of certain drugs that can drive up costs unnecessarily. We will never “stack” our formularies to promote the use of higher-cost drugs that drive PBM rebate revenue. Our prescription drug lists (formularies) have undergone careful review by a committee of prescribers and pharmacists and are actively managed by a P&T Committee to consistently deliver clinically optimal drugs at the lowest net cost. Before signing into a new PBM agreement for the year(s) ahead, request full transparency of your PBM’s formulary development process, revenue model, and audit rights to ensure that responsibilities -such as formulary management- are being fulfilled to align with the goals of the health plan.

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LTC Pharmacies are handling more claims and data than ever. With reimbursement trailing YoY costs and demand, controlling costs requires a more strategic approach. Here's how Vista helps: 1. Real-time adjudication and adherence monitoring — Make sure formulary decisions are supported among your partners. 2. Full insight into claims status and rebate revenue — Expert-designed, simple-to-use rebate and reporting solutions that enable your pharmacy to handle processes independent of third-party vendors. 3. Advocacy and expertise — We can help handle rebate negotiations and contract reviews, helping your operations run smoother and improve revenue capture. We're a breath of fresh air in long-term care, and we're here to help your pharmacy get more out of your data. #HealthTech #Pharmacy #Longtermcare

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PBMs are putting GLP-1 Drugs on their Formularies, will that translate to overall reduction of healthcare costs? #wellness #patientcare #pharmacy #health Learn more https://lnkd.in/ewVV_y5d

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A new interim report from the Federal Trade Commission was released recently highlighting the role that PBMs play in the prescription drug supply chain. What does this report entail, and what does it mean for payers? Learn more in this new blog from Krista Siano. Read here >> https://lnkd.in/g8HF_nVf

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#HRSA Punts on the “Patient Definition”—Again The Final #340b #ADR Rule punts on the patient definition, even though #drug makers pressed for clarity. Where manufacturers hoped that HRSA would leverage the Rule to fix the damage done by the Genesis case, the agency categorically refused. Having failed to appeal the Genesis case, HRSA has now missed a ready made opportunity to limit the resulting damage. #Drug Makers Press: As HRSA acknowledged in summarizing the comments, “[m]any manufacturers …objected to the lack of an explicit definition in the proposal for the terms ‘patient’ or ‘diversion’”. In offering that summary, however, OPA carefully avoided any reference to the Genesis case or the court’s decision, which held that Genesis need not have been responsible for the prescription of a drug to claim a discount on it. Without referencing the source of drug maker concerns, HRSA did state that manufacturers specifically asked the agency to “revise and clarify its current [1996 patient definition] guidance”. Drug makers tied the “patient definition” issue to the need “to strengthen administration of the 340B Program, including the 340B ADR process and the parties' ability to work together to resolve disputes in good faith”—all items clearly at the core of the proposed rule Having None of It: Despite the Genesis problem, HRSA slapped the drug maker request for clarification to the side. “Revision of the 1996 patient definition guidance,” HRSA flatly declared, “is outside the scope of this rule.” That answer is incredibly unsatisfying, reflecting an utter failure to use an available regulatory power to address a core threat to the program. What Did HRSA Say?: Not much. Instead of giving guidance on what the material connection must be between a patient, a CE, and a discounted drug, HRSA fell back on a description of its intended procedure: “When a #diversion claim is presented before a 340B ADR Panel, the Panel will follow the 340B statute and all applicable regulations, and consider 340B policies and guidance documents”. Interestingly, that statement doesn’t include any reference to case law, such as the Genesis case. Drug makers hope that omission is telling. But, putting that to the side, HRSA merely offered “[e]xamples of a diversion claim that may be submitted” to ADR. Specifically, HRSA referenced “(1) transferring of covered outpatient drugs to a patient where there was no record of the individual's health care or no provider relationship or (2) transferring covered outpatient drugs to an individual who is an inpatient”. In other words, by offering these “examples”, HRSA stuck to obvious scenarios, steering clear of any of the Genesis issues, whether a CE must be responsible for the prescription or at least for the treatment of the underlying condition. Bottom Line: The Rule could have plugged the gaping hole in the current “patient definition”, but HRSA took a pass, abdicating its regulatory responsibility.

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Obesity Management: Enduring Recording from ACP's 2024 Internal Medicine Meeting | Breaking Barriers in Obesity Management: Adopting a Holistic Approach to Optimize Health Outcomes | 1.5-hours CME/CE | #MedEd #cme #obesitymanagement #ACP | https://bit.ly/3V1OXJo

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Obesity Management: Enduring Recording from ACP's 2024 Internal Medicine Meeting | Breaking Barriers in Obesity Management: Adopting a Holistic Approach to Optimize Health Outcomes | 1.5-hours CME/CE | #MedEd #cme #obesitymanagement #ACP | https://bit.ly/3V1OXJo

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Obesity Management: Enduring Recording from ACP's 2024 Internal Medicine Meeting | Breaking Barriers in Obesity Management: Adopting a Holistic Approach to Optimize Health Outcomes | 1.5-hours CME/CE | #MedEd #cme #obesitymanagement #ACP | https://bit.ly/3V1OXJo

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