Latebreakers: March 20, 2006

Many enrolled in two Part D plans

Many Medicare beneficiaries have discovered they are enrolled in more than one Part D Rx plan, leaving them at risk of being charged two premiums or incorrect co-pays. In a recent memo to insurers, CMS acknowledged that "many (possibly all) of the beneficiaries who switched plans" are actively enrolled in multiple plans. The agency said it is working to resolve such enrollment discrepancies.

CMS clarifies Part D specialty pharmacies

Wal-Mart to carry Plan B

Retail giant Wal-Mart has reversed company policy and will stock the emergency contraceptive Plan B in all its pharmacies effective March 20. The announcement came after the Massachusetts pharmacy board ordered Wal-Mart to stock Plan B after three women filed suit. In addition, Connecticut's attorney general said the state's employee health insurance program should no longer use Wal-Mart pharmacies unless the chain agreed to stock EC pills. Wal-Mart will retain its conscientious objection policy, which allows pharmacists who do not want to dispense EC to refer patients to another pharmacist or pharmacy.

ACPE adopts revised Pharm.D.standards

ACPE has adopted revised standards for the Pharm.D. degree, which will become effective July 1, 2007. Pharmacy colleges and schools being evaluated by ACPE will have to meet the new standards by the 2007-08 academic year. The revised standards and guidelines are posted at http://www.acpe-accredit.org/standards/default.asp. ACPE has also created a dedicated e-mail account at standards@acpe-accredit.org
for ongoing stakeholder feedback on the standards and guidelines.

CMS wants LTC pharmacy rebatesfor Uncle Sam

Since the federal government is paying nearly 100% of the tab for Part D beneficiaries in nursing homes, any access/performance rebates drug companies pay to long-term care (LTC) pharmacies should accrue to the U.S. government, said CMS in a memo seeking comment on proposed changes to the program. By eliminating or limiting such rebates, an additional financial burden will fall on community LTC pharmacies, according to NCPA, which asked CMS to advise Part D plans to pay adequate dispensing fees to compensate for the unique services community LTC pharmacies provide.

Illinois Blues offer 90-day retail Rxs

Blue Cross & Blue Shield of Illinois has created a preferred pharmacy network of chains willing to dispense 90-day Part D scripts to beneficiaries for the price of two monthly retail co-pays. Participating chains include Albertsons, Safeway, Kroger, Target, Wal-Mart, Kmart, Schnucks, Meijer, and their affiliates.

Depression treated with new patch

A new formulation of selegiline effectively treats depression and is now available from Bristol-Myers Squibb and Somerset Pharmaceuticals. Emsam (selegiline transdermal system) has been approved by the FDA for the treatment of major depressive disorder in adults and is worn as a once-daily patch. The new monoamine oxidase inhibitor (MAOI) is unlike oral MAOI antidepressants that pass through the digestive tract and inhibit MAO-A, an enzyme needed for breakdown of tyramine. While increased levels of tyramine can potentially lead to a hypertensive crisis, the Emsam patch inhibits MAO in the brain to give the antidepressant effect, but preserves MAO-A activity in the digestive tract, allowing for tyramine breakdown. The manufacturers state that when using the patch with the lowest dosage (6 mg/24 hour), dietary modifications of tyramine are not necessary; however, they are required with the 9-mg/24-hour and 12-mg/24-hour patches in order to reduce the risk of hypertensive crisis.