Independent Tennessee Pharmacists Association Link www.tnpharm.org March 5, 2015 ADVOCACY ALERT Two Opportunities For You To Contact Your Senators and Representatives Regarding Advocacy Issues Affecting Pharmacy (1) Interchangeable Biological Products (House Bill 572 / Senate Bill 984) The Tennessee Pharmacists Association (TPA) continues to be extremely supportive of efforts to ensure that patients in Ten- nessee are granted access to the most cost-effective, highest quality care and medication therapies available. TPA continues to support efforts to create a mechanism through which pharmacists can work collaboratively with physicians and prescribers to increase patient access to interchangeable biological products. Pharmacists have worked with physicians and other prescribers to help increase the utilization of generic medications within the TennCare program to greater than 85%. Although TPA supports the intent of this legislation and supports notifi cation of prescribers in the event that a substitution of an interchangeable biological product occurs, TPA has signifi cant concerns about certain provisions contained within this legislation related to manda- tory notifi cations by pharmacists on all interchangeable biologicals. There are currently no FDA-approved interchangeable biological products on the market. Forty-two (42) states do not have leg- islation in place addressing interchangeable biological product substitution, and only eight states have enacted Interchangeable Biological Product laws at the current time. Until an interchangeable biological product actually comes to market and the FDA fur- ther defi nes policies on interchangeable biological products, the actual effectiveness and burden of these laws remains unclear. TPA urges pharmacists, student pharmacists, and members to contact your Representatives on the House Health Com- mittee and your Senators on the Senate Health Committee to discuss several very important provisions of this intro- duced legislation and to encourage them to consider amended language which addresses the following provisions: • This legislation, as introduced, limits the notifi cation requirements to only apply to pharmacists, rather than including all dispensers in these requirements. TPA supports amended language that will require all dispensers, including pharmacists and non-pharmacist dispensers, to notify prescribers when a substitution occurs. • This legislation, as introduced, emphasizes pharmacist notifi cation of prescribers through an entry in an interoperable electronic medical records system, or through an electronic prescribing technology, or a pharmacy record that is electronically accessible by the prescriber. TPA supports amended language that allows health care providers responsible for implementation of this legislation to make the ultimate determination regarding the optimal method of communication regarding notifi cation, including electronic, fax, written, or telephonic means. • This legislation, as introduced, requires pharmacists to notify physicians and prescribers EVEN IF the pharmacist dispenses an interchangeable biological product exactly as written (even when no substitution is made by the pharmacist). These additional notifi cation requirements are duplicative and unnecessary. These requirements add signifi cant time requirements and staff efforts which take away from pharmacist providers’ ability to deliver essential care and services to patients. These excessive notifi cation requirements also add increased burden on our overburdened health care system without any evidence or proof of benefi ts to patients. Pharmacists should reserve prescriber notifi cations for patient-centric communications which improve the quality, safety, and effectiveness of medication therapy. TPA supports amendments which require pharmacist notifi cation of the prescriber ONLY IF the pharmacist makes a substitution. • This legislation, as introduced, exempts only a limited number of institutional facilities. This legislation, as introduced, only provides exemptions for prescriptions dispensed for inpatients of a hospital, a nursing home or an assisted care living facility. This language was taken from the anti-epileptic substitution legislation passed in 2007. TPA supports amended and updated exemption language which is more consistent with current pharmacy practice. Continues on Page 2 This Independent Link is Published by the Tennessee Pharmacists Association & Sponsored by Pharmacy Plus Independent Link Page 2 March 5, 2015 TPA continues to support the intent behind this legislation but URGES you to contact your legislators and ask them to amend the proposed legislation to more accurately refl ect the current standard of pharmacy practice and to ensure that patients will maintain continued access to the care and services they need while reducing the overall burden on patients and health care providers. (2) Proposed TennCare Budget Cuts The Senate General Health and Welfare Committee has called a special session on Monday, March 9, 2015, at 1:30PM Central in Legislative Plaza Room 12, to discuss the TennCare Proposed Fiscal Year 2016 Budget, which includes over $24 million in proposed cuts to the TennCare Pharmacy Program. A detailed document outlining these proposed cuts can be found at http://www.tnpharm.org/tenncare-pdl-changes-effective-feb-1-2/. As pharmacists, student pharmacists, and TPA members, it is imperative that you contact your elected offi cials to discuss these proposed cuts and the negative impact these cuts will have on patients and your pharmacy practice if implemented. Proposed Cuts (with proposed amount of reduction): • Increased Buprenorphine Limits [$1.5 million (state) / $4.5 million (total)] • Compounding Cuts [$908,300 (state) / $2.6 million (total)] • Pharmacy AWP Direct Reimbursement Cuts [$6 million (state) / $17 million (total)] For a summary of the TennCare Proposed FY 2016 Budget Cuts, follow this link: http://www.tnpharm.org/wp-content/uploads/2.12.15ProposedBudgetTennCareCuts.pdf TPA urges you to contact your Senators and Representatives, and especially members of the Senate Health and Welfare Committee, to discuss the negative impact these cuts will have on your patients and your pharmacy practice. House Health Committee Members Offi ce Phone Email Cameron Sexton, Chair (615) 741-2343 [email protected] Barry Doss, Vice-Chair (615) 741-7476 [email protected] John Ray Clemmons (615) 741-4410 [email protected] John J. Deberry, Jr. (615) 741-2239 [email protected] Jeremy Faison (615) 741-6871 [email protected] JoAnne Favors (615) 741-2702 [email protected] Mike Harrison (615) 741-7480 [email protected] Matthew Hill (615) 741-2251 [email protected] John B. Holsclaw, Jr. (615) 741-7450 [email protected] Darren Jernigan (615)741-6959 [email protected] Sherry Jones (615) 741-2035 [email protected] Dr. Sabi Kumar (615) 741-2860 [email protected] Mary Littleton (615) 741-7477 [email protected] Judd Matheny (615) 741-7448 [email protected] Dr. Bob Ramsey (615) 741-3560 [email protected] Dr. Bryan Terry (615) 741-2180 [email protected] Leigh Wilburn (615) 741-6890 [email protected] Ryan Williams, Subcommittee Chair (615) 741-1875 [email protected] Senate Health and Welfare Committee Members Offi ce Phone Email Rusty Crowe, Chair (615) 741-2468 [email protected] Bo Watson, 1st Vice-Chair (615) 741-3227 [email protected] Dr. Joey Hensley, 2nd Vice-Chair (615) 741-3100 [email protected] Dr. Richard Briggs (615) 741-1766 [email protected] Ed Jackson (615) 741-1810 [email protected] Becky Massey (615) 741-1648 [email protected] Dr. Randy McNally (615) 741-6806 [email protected] Doug Overbey (615) 741-0981 [email protected] Jeff Yarbro (615) 741-3291 [email protected].