Issue 7: The Collaborative Practice®

Celebrating AmCare clinical pharmacy innovations and pharmacists across the country

We’ve been there. Your pharmacy team is stretched for time. And even after years of transition from fee-for-service to value-based care, your network’s financials are under the microscope. 

Now your focus is split between balancing the costs of medication management for your network and your patients.

To make matters worse: the 340B Program – meant to ease the financial burden of high-cost prescriptions – continues to be a political football. 

True, it’s a CPO’s job to tackle regulations and level up the quality measures that improve patient health outcomes along with their network’s bottom line. It’s why RxLive developed solutions to make that job easier – and more impactful than ever before.

This month’s Collaborative Practice explores how pharmacists can efficiently navigate the turbulent regulatory landscape to deliver consistently excellent care for all patients – no matter the regulatory headwinds.

All the best –
The Team @ RxLive

A disciplined, data-driven approach to 340B

This month, we spoke with Pharmacy and Quality leader Heather Brooks about how organizations can take a disciplined, data-driven approach to managing 340B programs. 

Since “it’s important to remember that many healthcare sites aren’t large enough to have their own data and analytics department,” Heather says, “outsourcing that service to someone who helps to do that across multiple sites, makes a lot of sense.”

The case for pharmacist intervention

In each edition of The Collaborative Practice, we highlight one anonymized patient case from a pharmacist in our network. The goal? Illustrate the value of pharmacist intervention and its benefit to the healthcare ecosystem. Here’s our case for this month…

Patient Case: The anti-inflammatory impact of colchicine on coronary artery disease

Recently our pharmacist met with an 81-year-old patient with an extensive history of coronary artery disease as well as comorbidities including gastro esophageal reflux disease, gout, chronic pain, overactive bladder, and type 2 diabetes. The provider reached out to ask the pharmacist’s opinion on the use of colchicine in light of the positive results from trials and meta-analyses, tolerability, and cost-effectiveness.

After reviewing the patient’s medication profile, our pharmacist recommended the addition of colchicine to this patient’s regimen.

Adding colchicine 0.5 mg daily to standard care can reduce the risk of the primary endpoint — a composite of cardiovascular (CV) death, myocardial infarction (MI), ischemic stroke, or ischemia-driven coronary revascularization — by 31% compared with placebo. The benefits of low-dose colchicine (Colcrys) are consistent if started months or years after acute coronary syndrome (ACS) in patients with stable coronary artery disease.

The case for pharmacist intervention

In each edition of The Collaborative Practice, we highlight one anonymized patient case from a pharmacist in our network. The goal? Illustrate the value of pharmacist intervention and its benefit to the healthcare ecosystem. Here’s our case for this month…

Patient Case: Triaging symptoms with the right medication

Recently, one of our clinical pharmacists met with a 32-year-old patient who’d been diagnosed with irritable bowel syndrome with diarrhea (IBS-D) and prominent bloating. The patient had no significant past medical history, and their current medications included a daily multivitamin and loperamide 1mg in the morning as needed.

Because treatment for IBS is typically directed at improving individual symptoms (in IBS-D this usually involves antidiarrheal medications), our pharmacist recommended rifaximin 550 mg TID for 14 days with loperamide 2mg QAM.

In this case, rifaximin was the right choice because it stays highly concentrated within the gastrointestinal tract – a necessary characteristic for a patient with excessive gas production. Clinical trials reflect rifaximin’s success in IBS cases, as well.

Stories we’re following

From 340B eligibility to widespread drug shortages, here are five stories that have our attention:

AHA, others oppose PhRMA-led campaign to restrict 340B eligibility

The American Hospital Association and other healthcare organizations are opposing a campaign led by the Pharmaceutical Research and Manufacturers of America (PhRMA) to restrict eligibility for the 340B drug pricing program.

Drug shortages reach 10-year high

224 drug shortages were reported in 2022, up from 151 in 2021, according to the University of Utah’s Drug Information Service.

HIMSS23: Are pharmacists the solution to primary care’s problems?

Andrew Mellin, MD, VP and CIO at Surescripts, discusses data released at the HIMSS23 Conference that suggests pharmacist-led interventions give PCPs more time to see patients who need more in-depth care.

Let’s shed some light on the Pharma middlemen

A report by the Senate Finance Committee outlines how pharmacy benefit managers (PBMs) exacerbate high drug prices in the US by determining reimbursement rates for pharmacies, among other practices.

Report finds health-system workforce challenges influence work of pharmacists, technicians

A report by the Bipartisan Policy Center found that workforce challenges within health systems, including staffing shortages and burnout, are impacting the work of pharmacists and pharmacy technicians.

Surveying the Schmidt sting
pain index

From the evolution of stinging behavior to the potential uses of insect venom in medicine, the world of stinging insects is – in word – wild.

We know, we know. It’s probably best to avoid them. But we still find Justin Schmidt’s career fascinating. 

Schmidt spent years studying and ranking insect stings on his “Schmidt Pain Index.” From the mild discomfort of a honeybee sting to the agonizing pain of the bullet ant, Schmidt’s work inspired a generation of researchers.

Check out the index – along with some “spicy” descriptions 

Kristen Engelen, PharmD
Kristen Engelen, PharmD, is the chief pharmacy officer of RxLive and a certified consultant pharmacist; she has over a decade of experience in retail pharmacy settings. Kristen became an RxLive co-founder because of her passion for geriatric pharmacy, with a focus on the intersection of pharmacy and aging.