Transcript 2010-11 APhA Policy & Policy Review Committees Assignments

Moderator:
Bradley P. Tice, PharmD, MBA, FAPhA
Speaker, APhA House of Delegates
Please submit your thoughts on the policy topics throughout the
webinar or send them to [email protected]
 If you are using a phone line to listen, please dial
415-655-0062; Access Code: 856-377-400. Be sure to include
your Audio PIN
 To request to speak, click on the raise hand tab and you will be
placed in the queue. The comments we take or mention on the
webinar may be limited due to time. However, all comments will
be provided to the Policy Committee for use in their
deliberations.
 The moderator will clarify issues but will not engage in debate.
 Remember, be courteous to your colleagues in your
communications.

1.
To provide an opportunity for member input on policy
topics prior to the proposed statement development
by the Policy Committee
2.
To promote the early engagement of Delegates on the
development and submission of quality new business
items on topics not assigned to the Policy Committee
3.
To generate Delegate interest in Policy and Houserelated committees as part of the policy development
process
1.
Review the purpose of the House of Delegates
2.
Review the policy development process
3.
Review 2013 proposed policy topics and gain perspectives
on the issues
4.
Generate interest and solicit names for House Committees
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Webinar scheduled for 90 minutes.
 10 minutes for intro, 20 minutes per topic, 20 minutes for final
comments
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House of Delegates
• “serves as a legislative body in the development of
ASSOCIATION policy. It shall act on such policy
recommendations as shall come before it and shall adopt rules
or procedures for the conduct of its business.” (from APhA
Bylaws)
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Association Policy
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Advocacy Activities
External Communications
Advisory Committees
Association Activities
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House of Delegates Policy Committees
 Policy Committee
 Policy Review Committee
 Policy Reference Committee
 New Business Review Committee
 House Rules Review Committee
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House of Delegates Election Committees (every other year)
 Committee on Nominations
 Committee of Canvassers
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50 states plus DC, Guam, and Puerto Rico
12 National Pharmacy Organizations
 AAPS, AACP, ACA, ACCP, AIHP, AMCP, ASHP, ASCP, ASPL,
NCPA, National Pharmaceutical Association, National
Pharmacists Association
5 Federal Pharmacy Groups
 Air Force, Army, Navy, PHS, VA
APhA
 Academies: APPM, APRS, ASP
 Board of Trustees
 Former Presidents
 Former Speakers
Bradley P. Tice, PharmD, MBA, FAPhA
Speaker, APhA House of Delegates
APhA Board of Trustees
William H. Riffee, PhD
Speaker - Elect,
APhA House of Delegates
Thomas E. Menighan, BS Pharm, MBA,
ScD (Hon), FAPhA
Secretary, APhA House of Delegates
APhA Executive Vice President & CEO
APhA Board of Trustees
 Topic Generation
 Ideas obtained from Delegates, Members, State
Pharmacy Associations, Committees, Trustees, Staff,
and Surveys
43 topic submissions received
 Recommendations by APhA-APPM/APRS/ASP Joint
Policy Standing Committee
Background on issues and potential direction assembled
Topic Prioritization
Committee discussed the top 15 topics
Further discussed top 15, topics combined, and then ranked top 3
Refined direction of top 3 by answering key questions
 What is the problem?
 Why is it a problem?
 What are the issues that need to be
addressed?
1. Expanding Access to Pharmaceuticals
2. Ensuring Access to Pharmacists’ Services
(Role of payers and providers in Patient
Care)
3. Medication Take Back/Disposal Programs
APhA
House of
Delegates
APhA
Members
State
Associations
GAC
APhA
Staff
Surveys
, Other
APhAAPPM/APRS/ASP
Joint Policy
Standing
Committee
APhA
Board of
Trustees
IDEA
APhA
House of
Delegates
Policy Committee
IDEA
IDEA
APhA
Board of
Trustees
APhAAPPM/APRS/ASP
Joint Policy
Standing
Committee
ACTION
Implementation IDEAS
For Policy Statements
Webinar
YOU!
PROPOSED
Policy Statement
APhA
House of
Delegates
Webinar
ADOPTED
Policy Statements
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Setting the stage
 Current drug classification system
▪ Rx and OTC (some state variances)
▪ Role / Involvement of pharmacists is variable
▪ Access by patients to some pharmaceuticals restricted
▪ Practice acts
▪ Insurance
▪ Access to care provider
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Summary of Key Concepts
 Financial constraints / shortage of primary care physicians
 Growing interest in increasing access
 Pharmacists have knowledge / skills
 When pharmacists are more involved in patient care, health outcomes
improve and costs go down.
 FDA is considering a new paradigm of medication use
▪ Reluctance among the physician community and some consumer groups that the
new paradigm will sever the patient-physician relationship.
 Concern with use of vending machines, that are resulting in patients
purchasing prescription and behind-the-counter medications without
access to a pharmacist.
Potential Scope
 Supporting the creation of an “OTC+” or
“Conditions of Safe Use” category of drugs
which require pharmacist intervention
 Behind the counter and vending machine
distribution of medications (EC)
 Stress importance of patients having access
to beneficial medications and access to
pharmacists’ services
What are the issues that a proposed policy statement should address and what are your suggested directions that
the Policy Committee should consider in crafting proposed policy language?
 Overall importance of patient access to pharmacists
 OTC+
▪ Support opportunities for pharmacists to assume patient care roles, including
OTC+
▪ Support updating state and federal laws/regulations to require access to
pharmacists
▪ Need some pilots
▪ Which prescription medications (or categories), if any, are appropriate for the
OTC+ concept?
▪ What drug categories should be included; that we support the process, include
monitoring and follow-up; could incorporate adherence for chronic disease
medications.
▪ Opportunity to increase access and decrease cost
▪ Way to loop people back into the healthcare system (coordination and
collaboration)
▪ Coordination with payers for payment and quality measures
▪ Way to improve quality ratings
▪ Address concerns raised by other health professions
What are the issues that a proposed policy statement should address and what are
your suggested directions that the Policy Committee should consider in crafting
proposed policy language?
 How should vending machine distribution be
controlled to ensure patient safety?
▪ Are there features that should be included
(access to pharmacist?)
▪ Are there medications that should not be
distributed via this mechanism?
What are your
thoughts?
Potential Scope of Proposed Policy
 What is preventing pharmacists from
performing medication therapy
management (MTM) or other patient
care services?
 Are there system issues impacting this?
▪ What is preventing payers from incentivizing or
encouraging pharmacists to perform MTM or other
patient care services?
▪ Are there practice issues creating barriers?
What Is The Problem? What are the issues that a proposed policy statement should address
and what are your suggested directions that the Policy Committee should consider in
crafting proposed policy language?
 Health benefit data (medical and pharmacy) should be
connected
▪ look at pharmacoeconomic and overall healthcare costs.
 Decisions need to be pursuant to evidence-based data
 CMS standards for MTM programs and contracting
directly with providers
What Is The Problem? What are the issues that a proposed policy statement should address
and what are your suggested directions that the Policy Committee should consider in
crafting proposed policy language?
 Others
▪ Prior authorization programs and formulary management
policies can create barriers to patient care
▪ Payment to pharmacists by insurance and PBMs for
medication management/patient care services
▪ PBM transparency
▪ Pharmacy overregulation
▪ Accountability of PBMs regarding the MTM benefit
administration and the scope of benefits
▪ Provider status recognition and network inclusion
What are your
thoughts?
Potential Scope
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Pharmaceuticals and Personal Care Products in the
Environments
Look at 2012 APhA-ASP policy
 Develop and implement standardized guidelines for the proper
disposal of unused or expired medications that help prevent
drug abuse and reduce harm to the environment. (Source: APhA-ASP
2012.3 – Proper Medication Disposal and Drug Take-Back Programs)
 Allow pharmacies to take back unused or expired medications,
including controlled substances, through a process that
minimizes diversion, liability, and financial burden to all
stakeholders. (Source: APhA-ASP 2012.3 – Proper Medication Disposal and Drug Take-Back Programs)
 Encourage pharmacists and student pharmacists to serve as a
source of information for the public on the proper disposal of
unused or expired medications. (Source: APhA-ASP 2012.3 – Proper Medication Disposal
and Drug Take-Back Programs)
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2009 Medication Disposal
1. APhA encourages appropriate public and private
partnerships to accept responsibility for the costs of
implementing safe medication disposal programs for
consumers. Further, APhA urges DEA to permit the safe
disposal of controlled substances by consumers.
2. APhA encourages provision of patient appropriate
quantities of medication supplies to minimize unused
medications and unnecessary medication disposal.
(JAPhA NS49(4):493 July/August 2009)
What are the issues that a proposed policy statement should address and what
are your suggested directions that the Policy Committee should consider in
crafting proposed policy language?
 Uniform disposal guidelines that align requirements for state and federal laws
and regulations for pharmacists and patients
 Disposal of medications and hazardous pharmaceuticals and materials
 Safety in the household; lack of effective and available medication take back
systems and programs in the community and through local pharmacies.
 Disposal guidelines and support for it. Should include public awareness of the
issue. Take back guidelines (unit of use vs non-unit of use), liability issues, who
should pay for the programs
 Address liability in relation to diversion by having policies and procedures,
protection of public and the patient aspect of this
 Address pharmacist education on take back programs and environment
 Policies that are driving excess meds in environment (like 90 days supply, auto
refills, etc)
 Re-use of meds returned
 Cost issues
 Ease take back program requirements through unit of use packaging
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2012 Controlled Substances Regulation and
Patient Care
APhA encourages the U.S. Department of
Justice to collaborate with professional
organizations to identify and reduce (a) the
burdens on health care providers, (b) the cost
of health care delivery, and (c) the barriers to
patient care in the establishment and
enforcement of controlled substance laws.
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2006/2003 Unit-of-Use Packaging
APhA encourages the continued
development, distribution and use of unit-ofuse packaging as the industry standard to
enhance patient safety, patient compliance,
and efficiencies in drug distribution.
What are your
thoughts?
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Continue its review of the
current APhA Policy Manual
by reviewing those
statements last reviewed in
2008 (17 statements) .
The 2012-13 APhA Policy
Review committee will
review any current APhA
policy that may be affected
by statements/topics
proposed by the 2012-13
APhA Policy Committee
Topics Include:

Automation and Technology in Pharmacy Practice
 Automation and Technical Assistance
 Experiential Education
 Residency Programs
 Expansion and Recognition of Internship, Externship,
and Clerkships
 Residencies in Community Pharmacy
 Pharmacy Schools' Curriculum and Contemporary
Pharmacy Needs
 State Boards of Pharmacy/Inspections
 National Framework for Practice Regulation
 Sale of Home-use Diagnostic and Monitoring Products
 Prior Authorization
 Regulatory Compliance/Regulatory Burden
 Pharmacists' Role in the Development and
Implementation of Disease-Based Clinical Guidelines
 Pharmacists and Ambulatory Patients
 Promotion of Pharmaceutical Care
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Opportunity to share additional thoughts or
questions
Remember, all comments will be provided to
the Policy Committee for use in their
deliberations.
You may also send your comments to
[email protected]
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Policy Committee Meeting
 Sept 7-9, 2012
Webinar on proposed policy statements
 January 2013 / February 2013
2013 APhA House of Delegates
 Policy Reference Committee Open Hearing
 New Business opportunity
Forms available on website:
www.pharmacist.com/hod
For more information,
Email: [email protected]
 Questions
 This concludes our webinar.
 Thank you for your participation and
comments.
 Questions / Comments
Bradley P. Tice, PharmD, MBA, FAPhA
Speaker, APhA House of Delegates
Email: [email protected]