Moderator:Bradley P. Tice, PharmD, MBA,
FAPhASpeaker, 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 House-related 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
Webinar scheduled for 90 minutes. 10 minutes for intro, 20 minutes per topic, 20 minutes
for final comments
• 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)
• Association Policy• Advocacy Activities• External Communications• Advisory Committees• Association Activities
House of Delegates Policy CommitteesPolicy CommitteePolicy Review Committee Policy Reference CommitteeNew Business Review CommitteeHouse Rules Review Committee
House of Delegates Election Committees (every other year)
Committee on Nominations Committee of Canvassers
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 GroupsAir Force, Army, Navy, PHS, VA
APhAAcademies: APPM, APRS, ASPBoard of TrusteesFormer PresidentsFormer Speakers
Thomas E. Menighan, BS Pharm, MBA, Thomas E. Menighan, BS Pharm, MBA, ScD (Hon), FAPhAScD (Hon), FAPhA
Secretary, APhA House of Delegates APhA Executive Vice President & CEO
APhA Board of Trustees
Bradley P. Tice, PharmD, MBA, FAPhABradley P. Tice, PharmD, MBA, FAPhASpeaker, APhA House of Delegates
APhA Board of Trustees
William H. Riffee, PhDWilliam H. Riffee, PhDSpeaker - Elect,
APhA House of Delegates
Topic GenerationIdeas obtained from Delegates, Members, State
Pharmacy Associations, Committees, Trustees, Staff,
and Surveys43 topic submissions received
Recommendations by APhA-APPM/APRS/ASP Joint Policy Standing CommitteeBackground on issues and potential direction assembledTopic Prioritization Committee discussed the top 15 topicsFurther discussed top 15, topics combined, and then
ranked top 3Refined 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
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ADOPTEDPolicy
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ADOPTEDPolicy
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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
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 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)
2009 Medication Disposal1. 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
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.
2006/2003 Unit-of-Use Packaging
APhA encourages the continued development, distribution and use of unit-of-use packaging as the industry standard to enhance patient safety, patient compliance, and efficiencies in drug distribution.
What are your
thoughts?
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
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]
Policy Committee MeetingSept 7-9, 2012
Webinar on proposed policy statementsJanuary 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 / CommentsBradley P. Tice, PharmD, MBA, FAPhASpeaker, APhA House of Delegates
Email: [email protected]
