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Plan would streamline prescription refills

TIFFANY L. PARKS
Special to the Legal News

Published: May 13, 2015

State Reps. Tim Brown and Tim Ginter have asked lawmakers to support a bill that would provide for partial drug prescription refills in order to synchronize multiple prescriptions for one patient.

House Bill 116 would allow patients with diseases requiring chronic prescriptions to permissively participate in a process with their physician and pharmacist to align their medications to be refilled on the same day or days.

The process is known as medication synchronization or med sync.

“It is estimated that 21 percent of Americans use three or more medicines and 10 percent take five or more medicines. Using multiple medications increases with age, with almost 40 percent of U.S. adults aged 65 using five or more medicines,” said Ginter, R-Salem.

“Patient and caregiver lives are simplified by eliminating multiple trips to the pharmacy each month. It also minimizes confusion over when a prescription is due to be refilled and minimizes disrupting treatment through delayed or missed refills.”

In campaigning for the bill before the House Health and Aging Committee, Ginter said Medicare Part D has allowed medication synchronization since January 2014.

The system is projected to save millions in health care costs.

Ginter also noted that Rite Aid and Discount Drug Mart customers already have the opportunity to utilize a med sync program.

“So why do we need a bill? The rationale addresses patient co-pays and pharmacist dispensing fees,” he said.

“Our bill seeks to require commercial plans and Medicaid to offer opportunities similar to Medicare Part D, while also providing for coverage of partial drug refills with pro-rated co-pays plus dispensing fees in order to achieve synchronization and allowing a pharmacist to receive their full dispensing fee for filling a partial script.”

Ginter said allowing patients or their family members to make a single trip to the pharmacy to pick up prescriptions each month, makes it more convenient for them to stay on track with their long-term medications and boost their “adherence” to the medication and improve their medical outcomes.

The National Community Pharmacists Association has estimated that the annual national costs of non-adherence to medications could be as high as $290 billion.

“Ohio would not be unique in adopting this plan,” Ginter said.

“In 2014, Oregon, Vermont, Colorado, Utah, Connecticut all passed similar bills. California passed it, but the governor vetoed it because it did not explicitly state it was initiated by the patient, a lesson we learned for our introduced version.”

The proposal has been endorsed by the Ohio Pharmacists Association and its concept has been supported in other states by the National Community Pharmacists Association and the National Association of Chain Drug Stores.

In anticipation of concerns from legislators, Brown, R-Bowling Green, addressed a few aspects of how the program would work.

With regard to varying due dates of refills, he said pharmacists would work with prescribing physicians to ensure all of the refills are authorized and amounts are adjusted to accommodate synchronization.

“This could include partial prescription medicine refills to coordinate prescription refills across multiple medications. This process supports productive pharmacist and physician dialogue,” he said.

In the event of a dosage adjustment, Brown said pharmacists would work with prescribing physicians prior to a patient’s pharmacy appointment to adjust the dose.

“This is no different than the currently established standard of practice,” he said, adding that a medication synchronization program would not change existing federal or state prescribing laws.

“For example, federal law prohibits the issuance of refills of Schedule II drugs; thus, synchronization programs cannot authorize refills of Schedule II drugs without a legitimate prescription. However, in an effort to not undue the work on shutting down pill mills or possibly limiting excess pills from being available, we have prohibited all Schedule II, substances with opiates, and benzodiazepines from being synched.”

Additionally, Brown said patients participating in these programs typically receive monthly calls and check-ins from their pharmacist to ensure patients are appropriately taking their medications.

“This provides the pharmacist another opportunity to advise patients on the appropriate use of medications and potentially address misuse of such medicines,” he said.

If enacted, HB 116 would have no impact on patients who use multiple pharmacies.

“Med sync programs are a win-win-win situation for patients, payers and pharmacists alike,” Ginter said. “We have a bright future to both improve health outcomes and reduce costs. Working together we can ensure that potential is realized.”

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