(BUSINESS WIRE)--Community pharmacists have stepped up to meet the shortage of Tamiflu by compounding doses for children suffering from the H1N1 flu virus, but they are struggling with supply problems and insurance plans, according to the National Community Pharmacists Association.
Tamiflu’s manufacturer, Roche, asked pharmacists to compound the medicine until supplies improve. The time-intensive process involves extracting powder from capsules, calculating the quantity of medicine, and mixing the right amount with liquid, such as cherry syrup, to produce a suspension with the appropriate prescribed strength for young children.
Over a recent 48-hour period, 80 community pharmacists from around the country told NCPA about their experiences compounding Tamiflu. Nearly half (48%) reported preparing 25 or more suspension compounds since Sept. 1. Virtually all (97%) experienced difficulty in obtaining commercial Tamiflu suspension and many (48%) said the same about Tamiflu capsules, consistent with a front-page story in The Washington Post.
Most prescription coverage is administered by pharmacy benefit managers (PBMs) and 61% of pharmacists surveyed had difficulty adjudicating claims with them for compounded Tamiflu. Most commonly mentioned were the big three – CVS Caremark, Express Scripts, Inc. and Medco Health Solutions, Inc. – but nearly every PBM was identified as a source of difficulty.
Experts advise starting antiviral treatment as quickly as possible. But one pharmacist said, “We had several children that are ‘covered’ by the federal employee [health benefits] program [administered by CVS Caremark] and were told that this compound requires prior authorization which can take from 24 to 72 hours to obtain.”
“Compounding has long been a specialty of independent community pharmacists, and they’re working overtime against H1N1,” said NCPA Executive Vice President and CEO Bruce T. Roberts, RPh. “They’ve helped countless children and won the gratitude of just as many parents.”
“Unfortunately, this is harder than it should be,” Roberts added. “We hope insurance plans and PBMs will reexamine their claims processes to ensure kids get relief as quickly as possible.”
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Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts
Tuesday, November 03, 2009
Tuesday, September 22, 2009
Cap and Trade Legislation Would Increase Uninsured by Millions
/PRNewswire/ -- The U.S. Senate can increase the number of Americans with health insurance by tens of millions -- at zero cost to taxpayers -- by rejecting cap-and-trade legislation passed by the U.S. House, according to an analysis just released by The National Center for Public Policy Research.
In June, the House of Representatives approved the American Clean Energy and Security Act, commonly referred to as the Waxman-Markey bill, which seeks to reduce U.S. greenhouse gas emissions by more than 80 percent by 2050.
The National Center for Public Policy Research contends Waxman-Markey would increase energy prices, slow the economy and result in higher unemployment. This, in turn, the group says, would increase the number of uninsured.
"For every one percentage point increase in unemployment, 1.1 million Americans lose their health insurance coverage," said David A. Ridenour, Vice President of The National Center for Public Policy Research. "With the Waxman-Markey legislation projected to cost an average of 1.15 million jobs annually between 2012 and 2030, this could translate into tens of millions of Americans losing their health insurance coverage. The best health care reform is doing nothing at all - at least on cap-and-trade."
Loss of health insurance coverage is only one of the negative health consequences that would result from a Waxman-Markey-style bill, according to Ridenour.
"The stress and loss of self-esteem that accompanies job loss can lead to unhealthy lifestyles, including substance abuse and poor eating habits," said Ridenour. "The unemployed are more likely to be diagnosed for hypertension, heart disease, diabetes and stroke, and because discretionary income drops with the loss of a job, so too do routine screenings that might prevent late-stage diseases."
Ridenour cites a study by Kate Strully of the State University of New York at Albany showing that involuntarily unemployed factory workers are 83 percent more likely to develop a new health problem than those who keep their job.
Ridenour's analysis is available at http://www.nationalcenter.org/NPA577.html.
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In June, the House of Representatives approved the American Clean Energy and Security Act, commonly referred to as the Waxman-Markey bill, which seeks to reduce U.S. greenhouse gas emissions by more than 80 percent by 2050.
The National Center for Public Policy Research contends Waxman-Markey would increase energy prices, slow the economy and result in higher unemployment. This, in turn, the group says, would increase the number of uninsured.
"For every one percentage point increase in unemployment, 1.1 million Americans lose their health insurance coverage," said David A. Ridenour, Vice President of The National Center for Public Policy Research. "With the Waxman-Markey legislation projected to cost an average of 1.15 million jobs annually between 2012 and 2030, this could translate into tens of millions of Americans losing their health insurance coverage. The best health care reform is doing nothing at all - at least on cap-and-trade."
Loss of health insurance coverage is only one of the negative health consequences that would result from a Waxman-Markey-style bill, according to Ridenour.
"The stress and loss of self-esteem that accompanies job loss can lead to unhealthy lifestyles, including substance abuse and poor eating habits," said Ridenour. "The unemployed are more likely to be diagnosed for hypertension, heart disease, diabetes and stroke, and because discretionary income drops with the loss of a job, so too do routine screenings that might prevent late-stage diseases."
Ridenour cites a study by Kate Strully of the State University of New York at Albany showing that involuntarily unemployed factory workers are 83 percent more likely to develop a new health problem than those who keep their job.
Ridenour's analysis is available at http://www.nationalcenter.org/NPA577.html.
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Monday, August 10, 2009
Rep. Tsongas Has Her Choice of Health Care, but What about the Little People?
TT Note: Members of Congress have their choice of health care. Does Rep. Tsongas really think the current health care reform bill will increase the choices for Americans? Does she really think the current health care reform bill will strengthen private health care?
Hmmm. Government exchange provision will provide any private insurance company? Gee, that's not what the White House said.
Yes. The system needs reworking-- but not by government mandates of an one payer system.
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Hmmm. Government exchange provision will provide any private insurance company? Gee, that's not what the White House said.
Yes. The system needs reworking-- but not by government mandates of an one payer system.
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Thursday, July 16, 2009
Long-Term Care: The Next Big Women's Issue?
/PRNewswire/ -- Long-term care is getting a lot of exposure in the current health-reform discussions, but we ain't seen nothin' yet, according to Denise Gott, Chairman of the Board of LTC Financial Partners LLC (LTCFP) -- http://www.ltcfp.com/ -- one of the nation's largest and most experienced long-term care insurance agencies. "Wait until the most-affected individuals get wind of what's in store for them; all hell could break loose," she says.
And who are those individuals? The millions who succumb to longer-lasting illnesses and injuries, requiring help with eating, toileting, dressing or moving around?
"No," says Gott. "It's the women who end up caring for them. They're the ones suddenly forced to provide 24/7 assistance to their husband, parent or other loved one who can't function on their own anymore." A majority of women will eventually need long-term care themselves, "but they tend to live longer than men, and social norms still consign females to the care giving role. So they're the ones who have to sacrifice their futures when they're still relatively young and fit, with years of productive, enjoyable life still to live."
Long-term care insurance would free women from this forced care giving, since it provides funds for professional nursing home or in-home care, "but the vast majority of women have no long-term care buffer. No policy for their husband or mother or father, let alone for themselves." Ordinary health insurance doesn't cover long-term care, nor does Medicare. Medicaid does, but only for the less affluent who lack assets.
The media's recent attention to long-term care centers around the Community Living Assistance Services and Supports (CLASS) Act of 2009, which would create a public insurance program for adults who become functionally disabled. "But the benefits would be less than half of those provided by a typical private policy, and they wouldn't kick in for five years," Gott says. "This could be better than nothing for lower-income people, but inadequate, in my opinion, for the middle class. Women would still be saddled with significant care giving chores."
A better solution would be "significant new tax incentives to help people buy private LTC insurance on their own, tailored to their needs," Gott attests. "Women should be screaming about this to their representatives in Congress. Their futures depend on it."
Also, the talk shows should be talking it up, Gott says. "I'm surprised Oprah, The View, and 60 Minutes aren't all over this."
Forced care giving has an economic as well as lifestyle downside. "Household income dwindles whenever a woman has to give up her job for unpaid care duties," says Gott. "Multiply that by the millions of women affected, and think of the drain on the economy. It extends into the billions." Tax breaks for long-term care insurance, "would be a great federal investment, helping us pay for other aspects of health reform."
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And who are those individuals? The millions who succumb to longer-lasting illnesses and injuries, requiring help with eating, toileting, dressing or moving around?
"No," says Gott. "It's the women who end up caring for them. They're the ones suddenly forced to provide 24/7 assistance to their husband, parent or other loved one who can't function on their own anymore." A majority of women will eventually need long-term care themselves, "but they tend to live longer than men, and social norms still consign females to the care giving role. So they're the ones who have to sacrifice their futures when they're still relatively young and fit, with years of productive, enjoyable life still to live."
Long-term care insurance would free women from this forced care giving, since it provides funds for professional nursing home or in-home care, "but the vast majority of women have no long-term care buffer. No policy for their husband or mother or father, let alone for themselves." Ordinary health insurance doesn't cover long-term care, nor does Medicare. Medicaid does, but only for the less affluent who lack assets.
The media's recent attention to long-term care centers around the Community Living Assistance Services and Supports (CLASS) Act of 2009, which would create a public insurance program for adults who become functionally disabled. "But the benefits would be less than half of those provided by a typical private policy, and they wouldn't kick in for five years," Gott says. "This could be better than nothing for lower-income people, but inadequate, in my opinion, for the middle class. Women would still be saddled with significant care giving chores."
A better solution would be "significant new tax incentives to help people buy private LTC insurance on their own, tailored to their needs," Gott attests. "Women should be screaming about this to their representatives in Congress. Their futures depend on it."
Also, the talk shows should be talking it up, Gott says. "I'm surprised Oprah, The View, and 60 Minutes aren't all over this."
Forced care giving has an economic as well as lifestyle downside. "Household income dwindles whenever a woman has to give up her job for unpaid care duties," says Gott. "Multiply that by the millions of women affected, and think of the drain on the economy. It extends into the billions." Tax breaks for long-term care insurance, "would be a great federal investment, helping us pay for other aspects of health reform."
-----
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