How to be an advocate for current pharmacy issues

E. Michael Murphy, PharmD

Pharmacy Advancement Fellow

The Ohio State University College of Pharmacy

No relevant financial disclosures for this speaker

Disclosures

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▪ Explain the importance of advocacy within the profession of pharmacy

▪ Discuss the process by which public policy can be changed and the role of members of the profession in this process

▪ Compare current state and national pharmacy issues and describe their relevance/importance

Objectives

Where should advocates for the profession of pharmacy prioritize their efforts?

a) Scientific knowledgeb) Social strategyc) Scientific knowledge & social strategyd) Social strategy & political will

Self assessment questions

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Whose responsibility is it to advocate for the profession of pharmacy and on behalf of patients?

a) Pharmacy organizationsb) Pharmacists/studentsc) Colleges/schools of pharmacyd) All of the above

Self assessment questions

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Advocacy Activity

Name Your Legislators: Senators

Tim KaineMark Warner

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Name Your Legislators: Congresswoman/man

Name Your Legislators

State SenatorState

Representative

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Set the stage (Why is advocacy important?)

How to change public policy

Overview of current pharmacy issues

How to incorporate advocacy into your professional role

Agenda

Set the stage

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Healthcare costs

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Why is advocacy so important?

What does a pharmacist do?

Why is advocacy so important?

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Advocacy - a tool (or

lever) to create change

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Advocacy - a tool (or

lever) to create change

How to change public policy

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Julius B. Richmond Model for Changing Public Policy

Julius B. Richmond, MD

12th Surgeon General of the United StatesAdapted from a slide by the American Academy of Pediatrics

Scientific

KnowledgePolitical

Will

Social

Strategy

Tobacco Oversight – Scientific Knowledge

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Tobacco Oversight – Social Strategy

Tobacco Oversight – Political Will

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Overview of current pharmacy issues

Overview of Current Pharmacy Issues

Professional

▪ Scope of practice▪ Prescriptive authority

▪ Prescription adaption

▪ Medication administration

▪ Pharmacy technicians

▪ Telepharmacy

▪ Drug prices

Business

▪ Provider status▪ Payment for cognitive services

▪ Pharmacy benefit managers

▪ Direct and Indirect Renumeration (DIR) fees

▪ Regulatory compliance

▪ Workplace issues

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Overview of Current Pharmacy Issues

Professional

▪ Scope of practice▪ Prescriptive authority

▪ Prescription adaption

▪ Medication administration

▪ Pharmacy technicians

▪ Telepharmacy

▪ Drug prices

Business

▪ Provider status▪ Payment for cognitive services

▪ Pharmacy benefit managers

▪ Direct and Indirect Renumeration (DIR) fees

▪ Regulatory compliance

▪ Workplace issues

Federal Provider Status

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▪ Many services pharmacists offer, but in many instances, they cannot directly bill payors for those services

▪ Comprehensive medication management ▪ Chronic disease education and monitoring▪ Long-acting injectables▪ Medication therapy management▪ Medication reconciliation▪ Ordering and evaluating lab tests▪ Prescribing

Why Provider Status?

Adapted from a slide by Stuart Beatty

▪ Reintroduced in the 115th Congress▪ HR 592 – 296 of 435 cosponsors▪ S 109 – 55 of 100 cosponsors

Pharmacy and Medically Underserved Areas Enhancement Act

The Congressional Budget Office…

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Compensating Pharmacists for their Cognitive Services – A Case Study

Compensating Pharmacists for their Cognitive Services – A Case Study

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Compensating Pharmacists for their Cognitive Services – A Case Study

Ohio Provider Status

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▪ Senator Matt Dolan’s SB 265 was signed into law in January 2019

▪ Pharmacists lacked many of the provider recognitions and protections afforded to other health care professionals.

▪ Certain parts of Ohio law recognized pharmacists as providers, pharmacies as providers, and then other parts that explicitly state pharmacists are not providers.

▪ SB 265 ironed out the creases in Ohio law.

Adapted from a slide by Stuart Beatty

Ohio Provider Status

▪ The Ohio Pharmacists Association and Ohio pharmacies began investigating CMS data

▪ Columbus Dispatch began highlighting the controversy

▪ State lawmakers began questioning Medicaid on discrepancies

▪ Summer 2018, a state audit revealed $244 million excess by Medicaid managed care PBMs

Ohio Pharmacy Benefit Manager Story

Adapted from a slide by Stuart Beatty

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▪ Governor Mike DeWine announces reprocurement for all Medicaid managed care plans

▪ Weeks after the Ohio provider status law took effect, Medicaid managed care executives were called out by state lawmakers for their perceived mismanagement of pharmacy benefits

Ohio PBM Story

Adapted from a slide by Stuart Beatty

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Recent Updates

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How to incorporate advocacy into your professional role

▪ Capitol Hill/Statehouse Legislator Meetings

▪ Inviting legislator to school/college of pharmacy and/or pharmacy/practice site

▪ Legislative Days

▪ Letter Writing Campaigns

▪ Social Media Campaigns

▪ Community Outreach Presentations/Education Campaigns

Big “A” Advocacy

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▪ Thoughtful focus of daily responsibilities to promote awareness of a cause through natural social interactions

▪ Introducing yourself as the pharmacist/student pharmacist▪ Educating patients about the clinical services you’ve

provided▪ Interprofessional education on the clinical services the

pharmacist/student pharmacist provides▪ Educating other healthcare professionals and/or

patients/the public on advocacy initiatives could increase access to pharmacist/student pharmacist provided care services

Little “a” advocacy

How will you incorporate Big “A” and little “a” advocacy into your responsibilities as a member of the profession of pharmacy?

Where should we be focusing our efforts to advocate for increased patient access to pharmacist provided care services?

Think / Pair / Share

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“As stewards of this esteemed occupation, all pharmacists do in

fact have a moral and ethical obligation to advocate on behalf

of patients and are obliged to leave it in a better place than that

in which we found it.”

▪ The profession of pharmacy and our healthcare system have many opportunities for improvement

▪ Use the tool of advocacy to leverage your expertise in the profession to create positive change

▪ Focus your advocacy on the social strategy in addition to changing political will

Summary

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Where should advocates for the profession of pharmacy prioritize their efforts?

a) Scientific knowledgeb) Social strategyc) Scientific knowledge & social strategyd) Social strategy & political will

Self assessment questions

Whose responsibility is it to advocate for the profession of pharmacy and on behalf of patients?

a) Pharmacy organizationsb) Pharmacists/studentsc) Colleges/schools of pharmacyd) All of the above

Self assessment questions

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Questions?murphy.981@osu.edu

@Advocate_Rx

https://www.linkedin.com/in/emichaelmurphy/

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