Communication is the KeyPharmacy Purchasing Pearls

Marvin Finnefrock, PharmD

Steven L. Gratch, Pharm. B.Sc., R.Ph.

Diane Daskey

Joanie MacIntosh, CPhT

Learning Objectives (for Technicians & Pharmacists)

At the end of this activity, the participant will be able to: Describe the role of the pharmacy buyer in preparing for P&T meetings. Outline the communication relationships between manufacturer,

wholesaler, GPO, pharmacy buyer, pharmacy staff, clinical pharmacists, and pharmacy director.

Differentiate circumstances and situations that may be managed by the pharmacy buyer versus clinical pharmacists versus pharmacy management.

Describe the “glue” required for effective communication within and outside of the pharmacy department.

Presentation Overview

Patient

Buyer and pharmacy team

Medical and Nursing Staff

Administration

Vendors and GPO

Buyer Support for the Clinical Pharmacist

The clinical specialist should work very closely with the Pharmacy buyer/purchasing agent

Tell them what they do not know

Think outside the package

Know the formulary and empower yourself

The Connection Between Pharma, Wholesaler, GPO & Pharmacy Buyer

Pharmacy Buyer

GPO

Wholesaler

Pharmacy Operations

Manufacturer

Group Purchasing Organization

Contract Compliance Business Class

DEA Status “Not for” or “For” profit status

Group Purchasing Organization

Robinson Patman Act Sets rules for discount pricings

Business Class (DEA license status) Volume Discounts Formulary restrictions

Litmus test = “Own Use” Patients register to the facility Employees

Profit Status – exemptions for “Not for Profit” Limited dispensing – inpatient ED and hospital outpatients

Wholesale Distributors

Prescription Drug Marketing Act of 1987 Amended in 1992 and 2006 Regulates resale of drugs by hospitals States must license Wholesalers FDA 5% rules annual sales to other pharmacies

without Wholesale License States may have a more stringent regulations

Drug Pedigree Resale to hospital own outpatient pharmacy Resale to clinics and physician offices

Pharmaceutical Sales Representatives

An important role in providing medication information they are guest of the hospital and expected to follow hospital policies

HIPPA, PHRMA Accepted Rules of Conduct and Security

Verify contact information including representative’s district/regional manager

Sign Acknowledgement of understanding hospital rules

Pharmaceutical Sales Representatives

Set the expectations for service: Educational programs Information displays

Contact with Physician and Staff Location restrictions Discussion of P&T activities

Penalties for inappropriate activities

Pathway to P&T

Pharmacy Buyer

Preparation

Analysis

Drug Shortages

Tools

Preparation to bring a new drug onto formulary

Manufacturer Contracts/LOP’s/LOC’s Reimbursement/HCPCS

codes Storage and Handling Shelf life Patient Assistant Programs Educational plan for

Medical and Pharmacy staff

DOP or Clinical RPH Therapeutic Indication Where will item be stocked Suspected Usage Start up Min/Max levels

Cost Analysis

Cost Comparison to similar medications currently on formulary

Correct Contract tiers based on market share. 340 pricing if eligible.

Shortage Report

New Shortages Ongoing Shortages Permanent Outages Resolved Shortages

Reason for Shortage Expected Release Date Product Management Supply information

Shortage Report - Sample

Pharmacy Bulletin June 2011 National Backorders - Drug Shortages

Medication Reason for Shortage Expected Release Date Product Management Supply Information

New Shortages

Bisacodyl Enema 10mg/30ml

none given TBD bisacodyl suppositories #6 in the pharmacy and #4 in pyxis

Ongoing ShortagesAcetylcysteine 10% and 20% vials

American Regent supply issues

Late May for 10ml and larger sizes; 4ml TBD

ordered in 10ml and 30ml vials to compound 4ml inhalation as needed

10% - #30 4ml vials; 9 10ml vials; 20 30ml vials; 20% - #12 4ml vials; #0 30ml vials

Permanent OutagesBaygam Discontinued   Gamastan 0

Resolved ShortagesAcyclovir Sodium Injection Intermittent shortages due to

increased demand and mfr delays

  APP has product available for direct ship

10ml -30 vials on hand ;20ml - 30 vials on hand

The Buyer is the “Glue”

Pharmacy Staff

Medical Staff

Pharmacy Management

Team

Patient

Pharmacy Staff

Ordering Two way Communication Shortages and Recalls

Shortages Anticipated length Allocation Alternative item

Recalls Anticipated length

Pharmacy Staff

Formulary Management Additions/Deletions New CDM’s

Location of Product Location, Location, Location!

Medical Staff

Drug Shortages Anticipated Length Alternative Item

Recalls Ancillary Departments Clinics Physician Offices

Newsletters ISMP Pharmacy Newsletter

Formulary Updates

Pharmacy Management Team

Pharmacy Buyer Drug Shortages Recalls Contract Updates Vendor Representative

Update New products

Pricing Availability

Reports Budget

Pharmacy Management Team DOP

Budget New Services

Clinical New Initiatives

Technician Supervisor Automation Scheduling

Patient

Drug Shortages Recalls Non-Formulary Items

Communication is the KeyPharmacy Purchasing Pearls