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Proposal would increase efficiency in refilling prescription drug orders

Special to the Legal News

Published: November 6, 2015

State Reps. Tim Brown and Tim Ginter have presented a bill that would allow patients to permissively participate in a process with their physician and pharmacist to align their medications to be refilled on the same day.

The process is known as medication synchronization or med sync.

House Bill 116, which unanimously cleared the House in June, has been sent to the Senate Medicaid Committee.

In sponsor testimony last week, Ginter, R-Salem, said it is estimated that 21 percent of Americans are prescribed three or more medications and 10 percent take at least five.

“Patient and caregiver lives are simplified by eliminating multiple trips to the pharmacy each month. It also minimizes confusion over when a prescription is due to be refilled and minimizes disrupting treatment through delayed or missed refills,” he said.

Ginter went on to say Medicare Part D has allowed med sync since January 2014. The process was projected to save millions of dollars in health care costs.

“We would like to point out that if you are a customer of Rite Aid or Ohio-based Discount Drug Mart you already have the opportunity to utilize a med sync program,” he said.

“So why do we need a bill? The rationale addresses patient copays and pharmacist dispensing fees.”

Ginter said HB 116 would require commercial plans and Medicaid to offer opportunities similar to Medicare Part D, while also providing for coverage of partial drug refills with pro-rated copays plus dispensing fees in order to achieve synchronization and allowing pharmacists to receive their full dispensing fee for filling a partial script.

“Allowing patients or their family members to make a single trip to the pharmacy to pick up prescriptions each month, makes it more convenient for them to stay on track with their long-term medications, boost their ‘adherence’ to the medication and improve their medical outcomes related to their conditions,” he said.

The National Community Pharmacists Association has suggested that the annual national costs of non-adherence to medications could be as high as $290 billion.

Similar bills have been enacted in 10 states over the last two years.

HB 116 is backed by several organizations including the Ohio Pharmacists Association, American Pharmacists Association, Ohio State Medical Association and American Cancer Society Action Network.

Larke Recchie, CEO of the Ohio Association of Area Agencies on Aging, previously stumped for the bill saying that it offers patients more control and promotes better coordination of care.

“Medication synchronization can help put people back on track with their treatment regimen,” she said.

“HB 116 would also lessen the financial burden by allowing for pro-rated copays when a pharmacy provides a partial fill to promote synchronization. Medicare Part D already requires daily cost-sharing rates for certain prescriptions and HB 116 would extend this to other insurers.”

Brown, R-Bowling Green, said medication synchronization programs do not change existing federal or state prescribing laws.

“For example, federal law prohibits the issuance of refills of Schedule II drugs; thus, synchronization programs cannot authorize refills of Schedule II drugs without a legitimate prescription,” he said.

“However, in an effort to not undo the work on shutting down pill mills or possibly limiting excess pills from being available, we have prohibited all Schedule II, substances with opiates and benzodiazepines from being synced.”

Additionally, Brown said that patients participating in such programs typically receive monthly calls and check-ins from their pharmacist to ensure that the patient is taking their medications.

“This provides the pharmacist another opportunity to advise patients on the appropriate use of medications and potentially address misuse of such medicines,” he said.

Brown said signing the bill into law would have no impact on patients who use multiple pharmacies.

“However, having an appointment-based model in place should encourage patients to use a single pharmacy, thus improving patient outcomes by removing the burden on patients to manage complex medication regimens and by eliminating unnecessary trips to the pharmacy,” he said.

If enacted, HB 116 would apply to the following types of health insurers: health insuring corporations, sickness and accident insurers, multiple employer welfare arrangements and public employee benefit plans.

The bill’s provisions would not apply to health insurance that is part of employee benefits offered by private employers that self-insure their benefit programs.

HB 116 is scheduled for a second hearing Wednesday.

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