Literature Review

Palliative care pharmacist discusses how building relationships with patients leads to rewarding career Drug Topics - Voice of the Pharmacist; by Killian Meara; 10/22/24 A discussion with Madison Irwin, PharmD, BCPS, clinical pharmacist specialist in palliative care at University of Michigan Health and clinical assistant professor at the University of Michigan College of Pharmacy. ... Irwin currently works as a clinical pharmacist specialist in palliative care in both inpatient and outpatient settings. She supports a palliative care consult team and outpatient palliative care clinics by seeing patients who are transitioning out of the hospital or patients who have more complex medication management needs. Although there are plenty of challenges that she faces in her practice, Irwin said that really getting to know patients through her work is extremely rewarding. ... In a conversation with Drug Topics, Irwin discussed how her career has unfolded, a program that she worked on that exemplifies the value of pharmacists in patient care, opportunities out there for pharmacists to expand their role, and how high rates of chronic pain will impact the pharmacy profession in the coming years.

Why your drug store is closing CNN Business, New York, NY; by Nathaniel Meyerson; 10/16/24 CVS is closing 900 stores. Rite-Aid is closing 500. Walgreens announced Tuesday it plans to close 1,200 stores, meaning 1 in 7 will disappear. What is going on with America’s drug stores? Walgreens and other chains overexpanded during the 1990s and 2000s to drive out competitors and draw more customers. They are now shutting down because of shifting consumer habits, competition and changes in the pharmacy industry. Around 25% of Walgreens’ stores aren’t profitable, CEO Tim Wentworth said in an interview with the Wall Street Journal in June, and the chain will look to close stores that are right by one another or struggling to hold down theft. ... CVS, the largest US chain, closed 244 stores between 2018 and 2020. In 2021, it announced plans to close an additional 900 stores. Earlier this month, CVS said it planned to cut about 2,900 jobs corporate jobs. And Rite Aid filed for bankruptcy last year, closing up to 500 stores.

Palliative medications: what works in practice for symptom control?Nursing Times; by Sally-Anne Francis, Eunice Sirkett, Emily Anderson and Sarah Yardley; 10/14/24 This article explores the real-life challenges of managing symptoms with medication at the end of life. ... Key points:

HopeHealth CMO: Hospice rules for ‘unrelated care’ getting stricter Hospice News; by Jim Parker; 9/25/24 Dr. Ed Martin began working in hospice in 1987 after hearing families talk about their experiences with those services. Today, he is chief medical officer of Rhode Island-based HopeHealth. The more than 50-year-old nonprofit organization also serves parts of Massachusetts. Martin recently spoke about the complicated issue of care that is deemed “unrelated” to a patient’s terminal diagnosis at the National Hospice and Palliative Care Organization’s Annual Leadership Conference in Denver. Hospice News sat down with Martin at the conference to discuss how he and his organization are addressing the matter of unrelated care, as well as the efficacy of requirements for an addendum to the election statement. [Click on the title's link to continue reading this interview.]

FTC sues big 3 Pharmacy Benefit Managers PlanSponsor; by Remy Samuels; 9/20/24 The Federal Trade Commission filed a lawsuit against the largest PBMs, following its July report exposing the ‘opaque’ business practices of the ‘powerful middlemen.’ ... The Federal Trade Commission filed an administrative lawsuit Friday against the three largest pharmacy benefit managers—Caremark Rx, Express Scripts and Optum Rx—and their affiliated group purchasing organizations. The regulator argued the firms are responsible for inflating the cost of prescription drugs, such as insulin, and preventing patients’ access to lower-cost products. The FTC’s complaint, filed under its administrative process, not a federal court, alleges that the big three PBMs, which the FTC stated administer about 80% of all prescriptions in the U.S., have “abused their economic power by rigging pharmaceutical supply chain competition in their favor, forcing patients to pay more for life-saving medication.” 

American Heart Association affirms importance of palliative care in treating cardiac conditions Hospice News; by Jim Parker; 9/4/24 Multidisciplinary palliative care offers clear benefits to patients with cardiovascular disease, particularly when it comes to medication management and goals-of-care conversations. Palliative care with effective medication management, shared decision making and symptom management can help improve quality of life for heart disease patients, according to a scientific statement from the American Heart Association (AHA) — “Palliative Pharmacotherapy for Cardiovascular Disease.” The statement offers guidance for health care providers to integrate palliative methods as part of holistic medication management at all stages of a patient’s illness, the AHA indicated. This underscores the importance of collaboration between palliative care professionals and other clinical specialties, according to Dr. Andrew Esch, director of palliative care program development at the Center to Advance Palliative Care (CAPC). 

Why one health system thinks its new PBM can disrupt the marketModern Healthcare; by Lauren Berryman; 8/23/24The University of North Carolina-affiliated health system announced a plan this month to launch UNC Health Pharmacy Solutions, a "transparent" PBM for employers seeking an alternative to CVS Health subsidiary CVS Caremark, Cigna division Express Scripts and UnitedHealth Group unit OptumRx, which dominate the market... “Our costs were skyrocketing,” DeFalco said. UNC Health has since in-sourced key PBM functions and customized its formulary to focus on lower net cost drugs. UNC Health Pharmacy Solutions is similar to others that market themselves as transparent. UNC Health will charge clients administrative fees and pass through all rebates to plan sponsors. The health system has saved 32% on employee pharmacy costs and expects to deliver similar results to employers in North Carolina and South Carolina, DeFalco said. The health system may consider partnering with businesses in bordering states down the line, she said... The landscape comprises around 70 players, but CVS Caremark, Express Scripts and OptumRx have a combined market share of about 80%, and the top six PBMs control 90%. Larger PBMs generally can use scale to extract better rebates from drugmakers, which at face value could look attractive to benefits brokers even though it may not mean lower overall savings.

Integration of palliative pharmacists to elevate oncologic care Pharmacy Times; by Alexis Beachy, PharmD and Jessica Geiger, PharmD, MS, BCPS; 8/20/24... Conclusion: This case demonstrates several aspects of care palliative pharmacists can assist with, though it is certainly not all-encompassing. All things considered, pharmacists are an essential asset of the palliative team. Their experience further enriches the interdisciplinary team and grants all patients and families many benefits. Specifically, patients receiving oncologic care benefit from collaboration with a palliative care pharmacist. In addition to offering a more individualized and holistic approach to care, palliative pharmacists can also provide patients with quicker and improved symptom management, which often improves quality of life and may also increase survival rates.Editor's Note: This article provides excellent history, definitions, and descriptions of the pharmacist's significant role in providing expert palliative and hospice care.

Humana will pay $90 million in Medicare drug fraud settlement Bloomberg Law; by Daniel Seiden; 8/16/24 Humana Inc. agreed to pay $90 million to the federal government to settle a whistleblower’s False Claims Act suit alleging that the company submitted fraudulent bids for Medicare Part D prescription drug contracts. Whistleblower Steven Scott alleged that, since 2011, Humana began offering its Medicare Part D prescription drug plan, known as the basic Walmart Plan, and “knowingly provided benefits under that plan that have been significantly less valuable than Humana promised in its bids,” according to Scott’s suit filed in 2016 in the US District Court for the Central District of California. ... This suit was among several in 2016, including suits against Humana, United Health, Cigna Corp., and Optum RX Inc., accusing health insurers of secretly overcharging for prescription drugs.

Optimi Health and Psyence Biomedical sign non-binding letter of intent to advance global psilocybin drug development Psyence Biomedical Ltd; by Andrea Mestrovic; 8/13/24 Optimi Health Corp. ..., a GMP-approved, Health Canada licensed psychedelics pharmaceutical manufacturer specializing in botanical psilocybin and MDMA, and Psyence Biomedical Ltd., ... a developer of nature-derived psilocybin-based therapeutics, are pleased to announce that the companies have entered into a non-binding Letter of Intent (“LOI”). This arrangement would position Optimi as the exclusive supplier of GMP nature-derived (non-synthetic) psilocybin extract for Psyence’s global drug development and commercialization initiatives for FDA-approved use in the Palliative Care context.

Top PBM executives grilled in contentious congressional hearingModern Healthcare; by Michael McAuliff; 7/23/24Lawmakers and executives from three major pharmacy benefit managers presented diametrically opposing views at a heated Capitol Hill hearing Tuesday, as major bills aimed at reining in the organizations remain stalled in Congress. Members of the House Committee on Oversight and Accountability blamed the highly concentrated PBM industry for raising drug prices and running independent pharmacies out of business, while leaders from CVS Caremark, Express Scripts and Optum Rx all countered that the sector in fact lowers prices and supports local pharmacies.

PharMerica reaches $100 million settlement over alleged SNF pharmacy kickbacksMcKnight's Long-Term Care News; by Josh Henreckson; 7/18/24One of the nation’s leading pharmacy companies has agreed to pay $100 million to resolve allegations of false claims and kickbacks in its dealings with long-term care providers. The legal claims against PharMerica have been ongoing in the District Court of New Jersey since 2011, when whistleblower Marc Silver accused the company of undercharging skilled nursing facilities for their Medicare Part A patients in order to secure more lucrative Medicare Part D and Medicaid contracts.

Another healthcare, pharmacy chain files Chapter 11 bankruptcy Idaho Statesman; by Daniel Kline; updated 7/30/24 ... Rite Aid has been in Chapter 11 bankruptcy since October and has closed nearly 700 locations. CVS (CVS) and Walgreens (WBA) have managed to stay solvent, but both companies have been closing stores as well. That's partially something that can be blamed on Covid. The pandemic caused a population shift and that left thousands of pharmacies in locations that lack audience. If you used to pick up your prescription, and maybe a snack, at a pharmacy during your lunch break and you now no longer go into the office most days, that makes it hard for those locations to thrive. Now, another pharmacy chain that also operates an array of services for older Americans is facing financial distress.