new york state laws and regulations - erie county (new ... · web viewclobetasol 0.05%...

P a g e | 1

ERIE COUNTY

REQUEST FOR PROPOSAL (RFP)TO PROVIDE COMPREHENSIVE PHARMACY

MANAGEMENT SERVICES

RFP #1637VF

Release Date: 12/13/2016Response to Questions: 01/06/2017

Sheriff Timothy HowardErie County Sheriff’s Office

10 Delaware AvenueBUFFALO, NEW YORK 14202

RFP 1637VF Response to Questions

P a g e | 2

SCHEDULE OF EVENTS

RFP Release date: December 16, 2016

Deadline for receipt of questions via e-mail: December 28, 2016

Due date for RFP Responses: January 13, 2017

Intended date for Contract Award: January 27, 2017

Intended Contract Implementation date: March 1, 2017

The following questions were submitted by several vendors. The question will not include the vendor identification or be sequenced in any particular order. All questions that have been submitted have been answered to the best of the Counties ability. The Counties response is colored in red, so there is no confusion. There will not be a second round of questions due to the time constraint of the County. All final RFP submittals will be due no later than 01/13/2017.

Questions:

1. Who is the current pharmacy provider? Kinney Drugs- Health Direct Pharmacy Services

2. What is the current contract reimbursement rate?In compliance with all applicable laws, unused packaged products may be returned to the Contractor for credit and/or destruction in accordance with all Federal and State Laws and regulations. Upon receipt, the Contractor shall issue a full credit equal to the cost of sale of all usable or unused products returned.

3. How much has Erie County spent for pharmacy services in the previous 12 months for the facilities included in this RFP?The Average spent at the Holdig nCenter is $55,018.62 monthly ($660,223.44 annually) and at the Correctional Facility is $ 42,951.22 ($515,414.64 annually). Branded Drugs and single generic- AWP minus 26%Generic Drugs AWP minus 72%Dispensing Fee $2.49Facility Stock Medication AAC 7%OTC Supplies AWP -10%

4. Please provide utilization data for each month over the past six months for the Holding Center?Brand Name Medication: 14.97%, Generic 85.03%


P a g e | 3

5. Please provide utilization data for each month over the past six months for the Correctional Facility?Brand Name 15.36% and Generic Name 84.64%

6. How many fills were dispensed each month over the past six months for the Holding Center?Over the last 6 months the Erie County Holding Center filled 10,043 scripts.

7. How many fills were dispensed each month over the past six months for the Correctional Facility?Over the last 6 months the Erie County Correctional Facility filled 2,586 scripts.

8. How many patients received a medication fill each month over the past six months for the Holding Center?Over the past 6 months the Erie County Holding Center refilled 4,685 of inmate medication

9. How many patients received a medication fill each month over the past six months for the Correctional Facility?Over the last 6 months the Erie County Correctional Facility refilled 2,153 inmate medications.

10. What was the pharmacy expenditure for medications each month over the past six months at the Holding Center?The Average spent at the Holding Center is $55,018.62 this amount includes Mental Health medication as well as HIV medication.

11. What was the pharmacy expenditure for medications each month over the past six months at the Correctional Facility? The average expenditure for the Erie County Correctional Facility is $ 42,951.22.

12. What was the pharmacy expenditure each month for Mental Health medications, HIV Medications, and Hep C Medications, each month over the past six months? The expenditures for both locations are including all medications utilized. The current vendor does not separate Hepatitis medication.

13. Please provide the top 50 prescribed medications from December of 2016 with quantity for the month.

Holding Center:

PRILOSEC OTC 20 MG TABLET 69VENTOLIN HFA 90 MCG INHALER 63FOLIC ACID 1 MG TABLET 58HYDROCHLOROTHIAZIDE 25 MG TABS 43SULFAMETH/TRIMETH 800/160 TAB 43AMOX TR-K CLV 875-125 MG TAB 39METFORMIN 500 MG TABLET 37SERTRALINE 50MG TABLET 36LISINOPRIL 10MG TABLET 34LORATADINE 10MG TABLET 31FLUOXETINE 20 MG CAPSULE 30AMOXICILLIN 500MG CAPSULES 29


P a g e | 4

SERTRALINE 100MG TAB 29RISPERIDONE 1 MG TABLET 26LISINOPRIL 20 MG TABLET 26AMLODIPINE 5 MG TABS 26ATORVASTATIN 20 MG TABLET 25LOPERAMIDE 2MG TABLETS 24MIRTAZAPINE 15 MG TABLET 23CLONAZEPAM 0.5 MG TABLET 22BUSPIRONE 15MG TABLET 22AMLODIPINE 10 MG TABS 22METFORMIN 1000 MG TABLET 21VITAMIN B-1 100 MG TABLET 21BUSPIRONE 10MG TABLET 21CEPHALEXIN 500 MG CAPS 19CLINDAMYCIN 150MG CAPSULE 18TRUVADA TABLET 18RISPERIDONE 0.5 MG TABS 17VIT B-1 100MG THIAMINE 17GABAPENTIN 100MG CAPSULE 17ATORVASTATIN 40 MG TABLET 16GABAPENTIN 600 MG TABLET 16OXCARBAZEPINE 300 MG TABLET 16RISPERIDONE 2 MG TABS 15TAMSULOSIN 0.4 MG CAPS 15CLONIDINE 0.1MG TABLET 15PRAZOSIN 1MG CAPSULE 15HYDROXYZINE PAM 25MG CAPSULE 15CITALOPRAM 20MG TABLET 15NAPROXEN 250 MG TABS 14MELOXICAM 7.5 MG TABLET 14PANTOPRAZOLE 40MG TABLET 14FLUOXETINE 10 MG CAPSULE 13CITALOPRAM 40MG TABLET 13DIVALPROEX EC 250 MG TABS 12HYDROCHLOROTHIAZIDE 12.5 MG TB 12FLUPHENAZINE DEC 25MG/ML 5ML 12ESCITALOPRAM 20 MG TABLET 11HYDROCHLOROTHIAZIDE 12.5MG CAP 10

Correctional Facility:

VENTOLIN HFA 90 MCG INHALER 52LORATADINE 10MG TABLET 52AMOX TR-K CLV 875-125 MG TAB 47PRILOSEC OTC 20 MG TABLET 41AMOXICILLIN 500MG CAPSULES 31HYDROCHLOROTHIAZIDE 25 MG TABS 27AMLODIPINE 10 MG TABS 25LISINOPRIL 20 MG TABLET 24CLINDAMYCIN 150MG CAPSULE 22SERTRALINE 50MG TABLET 22SERTRALINE 100MG TAB 21ATORVASTATIN 20 MG TABLET 20MELOXICAM 7.5 MG TABLET 20CITALOPRAM 20MG TABLET 17MIRTAZAPINE 30 MG TABLET 16LAMOTRIGINE 25 MG TABLET 15FLUOXETINE 20 MG CAPSULE 15LISINOPRIL 10MG TABLET 15MIRTAZAPINE 15 MG TABLET 14DULOXETINE 60MG CAPSULES 14RISPERIDONE 1 MG TABLET 12SULFAMETH/TRIMETH 800/160 TAB 12FIBER LAX 625MG CAPLET 12GABAPENTIN 100MG CAPSULE 12DULOXETINE 30MG CAPSULES 12PRAZOSIN 1MG CAPSULE 11GABAPENTIN 600 MG TABLET 11XARELTO 20 MG TABLET 11LAMOTRIGINE 100 MG TABLET 10NAPROXEN 250 MG TABS 10NAPROXEN 500 MG TABS 10HYDROCHLOROTHIAZIDE 12.5 MG TB 10HYDROCHLOROTHIAZIDE 12.5MG CAP 9DIVALPROEX EC 250 MG TABS 9METFORMIN 500 MG TABLET 9FIBER-LAX TABLET 9VENLAFAXINE HCL ER 75 MG CAP 8


P a g e | 5

VENLAFAXINE HCL ER 150 MG CAP 8FLUOXETINE 10 MG CAPSULE 8CITALOPRAM 10MG TABLET 8DIVALPROEX EC 500 MG TABS 7CEPHALEXIN 500 MG CAPS 7METFORMIN 1000 MG TABLET 7AZITHROMYCIN 1 GM PWD PACKET 7MONTELUKAST 10MG TABLET 7OXCARBAZEPINE 600 MG TABLET 7RISPERIDONE 2 MG TABS 6LEVETIRACETAM 750 MG TABLET 6METRONIDAZOLE 500 MG TABS 6DOXYCYCLINE 100MG CAPSULE 6

14. Please provide the top 50 medications by cost.Holding Center:

TRUVADA TABLET $8,450.78STRIBILD TABLET $5,138.58LANTUS 100 UNIT/ML VIAL $3,987.11INVEGA SUSTENNA 234 MG PREF SY $3,894.78REYATAZ 300 MG CAPSULE $3,650.19SPIRIVA 18MCG 30 CAPSULES $2,136.68ATRIPLA TABLET** $2,126.19HUMALOG 100 UNIT/ML VIAL $2,043.83JANUVIA 50MG TABLET $1,951.14ARIPIPRAZOLE 5MG TAB $1,610.93ABILIFY MAINTENA ER 400 MG VL $1,597.31OLANZAPINE 20 MG TABLET $1,391.49OLANZAPINE 15 MG TABS $1,369.97VENTOLIN HFA 90 MCG INHALER $1,332.78SENSIPAR 30MG TABLET $1,329.16INVEGA SUSTENNA 156 MG PREF SY $1,299.12CHLORPROMAZINE 100MG TABLET $1,218.29PREZISTA 800 MG TABLET $1,210.48NORVIR 100 MG TABLET $1,156.74SYMBICORT 160/4.5 MCG INHALER $1,049.30ARIPIPRAZOLE 10MG $947.59ADVAIR 250/50 DISKUS 30 DAY $898.92STRATTERA 80 MG CAPSULE $828.16ISENTRESS 400 MG TABLET $802.84ARIPIPRAZOLE 15MG $786.90XARELTO 20 MG TABLET $659.26CHLORPROMAZINE 200MG TABLET $658.71LYRICA 200 MG CAPSULE $617.74OXCARBAZEPINE 300 MG TABLET $611.05RISPERIDONE 0.5 MG TABS $576.31FLUPHENAZINE DEC 25MG/ML 5ML $498.60IBUPROFEN 200MG 500CT $473.76ARIPIPRAZOLE 2MG $466.47HALOPERIDOL DEC 100 MG/ML VIAL $462.12NOVOLOG 100 UNIT/ML $456.08LYRICA 150MG CAPSULE $454.34PRILOSEC OTC 20 MG TABLET $418.72STRATTERA 100 MG CAPSULE $414.08OLANZAPINE 7.5 MG TABS $408.83ELIQUIS 5 MG TABLET $399.16OLANZAPINE 5 MG TABS $396.75ADVAIR HFA 230/21 MCG INHALER $393.31DIVALPROEX EC 500 MG TABS $382.82FLOVENT HFA 110 MCG INHALER $382.40PREZCOBIX 800 MG-150 MG TABLET $372.44OXCARBAZEPINE 600 MG TABLET $364.81AMOX TR-K CLV 875-125 MG TAB $362.54PULMICORT 180 MCG FLEXHALER $361.00GABAPENTIN 600 MG TABLET $357.83RISPERDAL CONSTA 25 MG SYR $355.03

Correctional Facility:

TRUVADA TABLET $6,176.20COMPLERA TABLET $4,458.72PREZCOBIX 800 MG-150 MG TABLET $2,760.92TRIUMEQ TABLET $2,140.51ATRIPLA TABLET** $2,126.19ADVAIR 250/50 DISKUS 30 DAY $1,498.20TIVICAY 50 MG TABLET $1,265.86


P a g e | 6

VENTOLIN HFA 90 MCG INHALER $1,259.07PREZISTA 800 MG TABLET $1,207.99AMOX TR-K CLV 875-125 MG TAB $986.27STRATTERA 25 MG CAPSULE $838.45ARIPIPRAZOLE 5MG TAB $786.90SYMBICORT 160/4.5 MCG INHALER $783.24FLUOCINONIDE 0.1% CREAM $751.66DULOXETINE 60MG CAPSULES $747.83PRILOSEC OTC 20 MG TABLET $712.78AMLODIPINE 10 MG TABS $665.81LYRICA 100 MG CAPSULE $617.74SPIRIVA 18MCG 30 CAPSULES $610.48BUDESONIDE EC 3 MG CAPSULE $554.30BREO ELLIPTA 200-25 MCG INH $534.06PRISTIQ 100 MG TABLET $522.16CLOBETASOL 0.05% OINTMENT 60GM $428.28QVAR 40 MCG INHALER $401.40LAMOTRIGINE 25 MG TABLET $396.75DULOXETINE 30MG CAPSULES $392.51IBUPROFEN 200MG 500CT $384.93STRATTERA 40MG CAPSULE $383.97STRATTERA 60MG CAPSULE $383.97BETAMETH DIP AUGM 0.05% OINT $383.42TUBERSOL 5TU/0.1ML 1ML $363.28SERTRALINE 100MG TAB $361.48LEVETIRACETAM 750 MG TABLET $351.02ARIPIPRAZOLE 2MG $342.73OLANZAPINE ODT 10 MG TABS $339.78JANUMET 50-1,000 MG TABLET $325.19JANUVIA 50MG TABLET $325.19JANUVIA 100MG TABLET $325.15OLANZAPINE 20 MG TABLET $325.12CITALOPRAM 20MG TABLET $325.04ELIQUIS 5 MG TABLET $322.10ATORVASTATIN 20 MG TABLET $319.85LYRICA 200 MG CAPSULE $308.87SERTRALINE 50MG TABLET $305.94OLANZAPINE 5 MG TABS $301.06AZASITE 1% EYE DROPS $292.38GABAPENTIN 600 MG TABLET $281.62LORATADINE 10MG TABLET $277.70MIRTAZAPINE 30 MG TABLET $271.81LUMIGAN 0.01% EYE DROPS $271.40

15. Please identify the current local pharmacy or pharmacies who are serving as the back-up pharmacy provider? The Erie County Holding Center and Correctional Facility utilize the following pharmacies: The Erie County Holding Center and the Erie County Correctional Facility does not get billed directly, all billing goes through Health Direct.

Walgreens650 Delaware Ave, Buffalo NY 14202

Rite aid13090 Broadway St, Alden NY 14004

16. How many times the back-up pharmacy was utilized each month over the past six months? Unknown, we are currently not invoiced for back- up pharmacy services.

17. How many orders were dispensed by the back-up pharmacy each month over the past six months? Unknown, we are currently not invoiced for back- up pharmacy services.

18. What was the total back-up pharmacy cost for the each month over the past six months?Unknown, we are currently not invoiced for back- up pharmacy services.


P a g e | 7

19. The items listed below are available in multiple sizes. Which size should respondents price?The pharmaceutical respondent should provide the pricing for all available sizes.

AMMON LACTATE 12% LOT 2,275.00

AMMONIUM LACTATE 12% CREAM 1,155.00

AMMONIUM LACTATE 12% CREAM 840.00

AMMONIUM LACTATE 12% CREAM RX 280.00

CLOBETASOL 0.05% OINTMENT 300.00

CLOTRIMAZOLE 1% CREAM 225.00

DORZOLAMIDE/TIMOLOL EYE DROPS 80.00

DOUBLE ANTIBIOTIC BACI/POLY B 85.20

DOUBLE ANTIBIOTIC OINT 28.40

HEAD & SHOULDERS 2N1 DRY SCALP 1,260.00

HEMORRHOIDAL CREAM 51.00

HYDROCERIN CREAM 17,700.00

HYDROCERIN LOTION 16,082.00

HYDROCORTISONE 0.5% CREAM-FOUG 28.35

HYDROCORTISONE 1% LOT-FOUGERA 118.00

HYDROCORTISONE 1% OINT (PV) 112.00

HYDROCORTISONE 2.5% CREAM 600.00

HYDROCORTISONE 2.5% LOTION 354.00

HYDROCORTISONE 2.5% OINT 240.00

HYDROCORTISONE POWDER 2.00

HYPERCARE SOLUTION 75.00

IBUPROFEN 100MG/5ML ORAL SUSP 6,149.00

ICY-HOT CREAM 90.00

INSTA-GLUCOSE 40% GEL 744.00

KETOCONAZOLE 2% CREAM 90.00

KETOCONAZOLE 2% SHAMPOO 2,520.00

KETOROLAC 0.4% OPHTH SOLUTION 5.00

KETOROLAC 0.5% OPHTH SOLUTION 25.00

LICE KILLING SHAMPOO 3,776.00

MILK OF MAGNESIA SUSP (IRA) 8,875.00

MILK OF MAGNESIA SUSPENSION UD 3,000.00

MOMETASONE FUROATE 0.1% CREAM 90.00

MOMETASONE FUROATE 0.1% SOLN 60.00

MULTIPURPOSE CONTACT SOLN 360.00

MUPIROCIN 2% OINTMENT 330.00

NYSTATIN 100,000 UNIT/GM CREAM 60.00

PERMETHRIN 1% LOTION 59.00


P a g e | 8

PERMETHRIN 5% CREAM 4,860.00

RISPERDAL CONSTA 25 MG SYR 8.00

RISPERDAL CONSTA 50 MG SYR 5.00

20. The items listed below are discontinued. Should "N/A" be placed in the pricing?

ASACOL 400MG TABLET 2,576.00ASACOL EC 400 MG TABLET 28.00

Yes

21. There are various drugs that are now available in a generic form. Should respondents price the less expensive generic product or the brand name drug?Yes, the pharmaceutical respondent should respond with the most competitive pricing.

22. Please provide a copy of the current contract for these services, including the current pricing schedule.The Erie County Holding Center and the Erie County Correctional Facility are under the New York State Agreement for Pharmaceuticals OGS, contact number PC67017.

Branded Drugs and single generic- AWP minus 26%Generic Drugs AWP minus 72%Dispensing Fee $2.49Facility Stock Medication AAC 7%OTC Supplies AWP -10%

23. Section 1.11 states that the vendor’s barcode label must be compatible with the EMAR/EMR vendor and Jail Management System. What EMAR/EMR vendor and Jail Management System are currently used by the facilities?The Erie County Holding Center and Correctional Facility currently utilize Centricity Fusion- a GE product for the EMAR/EMR and Blackcreek as the JMD security system.

24. Under “Scope of Work” at the top of page 6, the RFP states “Erie County is seeking a contractor to provide off-site comprehensive pharmacy management services as well as an electronic medication record and computerization system at the facilities listed herein.” Is Erie County expecting the vendor to just be compatible with the facilities’ current EMAR/EMR vendor as stated in Section 1.11 OR is Erie County expecting the vendor to actually provide the EMAR/EMR system as stated at the top of page 6? If Erie County is expecting the vendor to actually provide the EMAR/EMR system, can the vendor charge for providing the system?The Erie County Holding Center and the Erie County Correctional facility currently utilize an EMR/EMAR system; the pharmaceutical vendor would be responsible for the interface costs and fees.

25. Section 1.11 states that the vendor’s barcode label must be compatible with the EMAR/EMR vendor and Jail Management System. What EMAR/EMR vendor and Jail Management System are currently used by the facilities?The Erie County Holding Center and the Erie County Correctional facility currently utilize Black Creek Sallyport for the JMS. The Barcode system utilized is Data Matrix 2D Barcode.


P a g e | 9

26. Will there be an opportunity for a second round of questions if any answers in the first round of questions needs clarification?Due to the time frame of this project a second round of questions will not be permitted.

27. Will Erie County consider extending the due date for Submission of Response to accommodate thoughtful consideration of answers to all questions submitted and a potential second round of questions in order to provide the most cost effective proposal possible? Due to the time frame of this project a second round of questions will not be permitted. Erie County will not be extending the RFP due date.

28. Considering final answers to all questions submitted by 12-28-16 will be released on 1-6-17 and the requirement to mail/deliver a physical copy with offeror’s response by 1-13-17, most respondents will need to send/ship their physical copies by 1-10-17 to account for possible shipping delays for inclement winter weather. This allows for only two (2) days at most, depending on the time of day the answers are released, to consider all answers provided revise offeror’s proposal based upon those answers provided. Will Erie County consider extending the due date ten (10) business days from the original due date (January 27, 2017) for Submission of Response to accommodate thoughtful consideration of answers to all questions submitted and answered by 1-6-17 in order to provide the most cost effective proposal possible and ensure a fair and equitable procurement process. Most of the answers to questions asked would already be known to the current vendor, thus giving them an advantage in pre-formulating responses to the RFP requirements already known to them, but other offerors need ample time to formulate proposal responses based upon information released on 1-6-17.Due to the time frame of this project a second round of questions will not be permitted. Erie County will not be extending the RFP due date.

29. Please confirm the physical address where RFP submittals should be mailed to. Is it the Erie County Sheriff’s Office address listed on the cover page of the RFP?The address to mail hard copy of RFP is:Attention: Christa Cutrona and Michael Reardon134 West Eagle Floor 5, room 515Buffalo, NY 14202

30. Please describe in detail how the Evaluation of Proposals will be scored and weighted.This is described under RFP standard information: evaluation of proposal on page 4 and 5.

31. Is Erie County considering final BAFO presentations for finalists to be a part of this RFP process? If so, what would be the selection process for those participating in an in-person BAFO presentation? In our experience, it is often helpful for all parties involved to participate in an in-person BAFO presentation meeting with the most qualified and highest scoring vendor(s) prior to the intent to award announcement to provide an opportunity to meet the vendor that you are contracting with, receive a personalized presentation on their services offered, and an


P a g e | 10

opportunity for all parties to ask qualifying questions regarding the specifics of the RFP and RFP response. This is described under RFP standard information: evaluation of proposal on page 4 and 5.

32. What is your current cutoff time for next-day delivery orders to be submitted to the pharmacy? Do you intend to keep this the same?Erie County currently has two drop off times from pharmacy. The last cut off for the afternoon order is 1700. For emergency medications we utilize a local pharmacy.

33. Actual utilization data would be helpful for potential bidders to study medication mix and prescriber ordering trends in order to prepare a responsible and competitive bid rate. Can you please provide the past 3 months pharmacy invoices for review? What is the average pharmacy dollar amount spent monthly over the past 12 months?The Average spent at the Holding Center is $55,018.62 this amount includes Mental Health medication as well as HIV medication.

The average expenditure for the Erie County Correctional Facility is $ 42,951.22.

34. What is the percentage of stock medications vs. patient specific medications? Please provide utilization for all stock medications for the past three (3) months.The Erie County Holding Center and the Erie County Correctional Facility does not have a percentage of stock verse patient specific medications. On average the Erie County Holding Center spends $1,415.18 on stock medication. The Erie County Correctional Facility on average spends $979.85 on stock medication.

35. Do you receive stock medications in 30 count blister cards or is all stock in manufacturer’s bulk bottles?The Erie County Holding Center and the Erie County Correctional Facility receive all stock medication in manufacturer bulk bottles.

36. What type of medication packaging do you currently use in your facility? (Ex: Blister Cards, Vials, strips, etc.) Do you intend to keep the same packaging type?Both the Erie County Holding Center and the Correctional Facility utilize blister packs. As per the specification section number 1.10 Erie County requests blister packs for dispensing medication.

37. How many days’ worth of medication is typically dispensed for routine medication orders? (Ex: 7, 14, 30 days.)Erie County requests that all acute medication is dispensed in 14 day quantities, chronic care medication will be dispensed in 30 day quantities.

38. May we have a copy of your current formulary?Erie County is in the process of creating a formulary. Below is the classification of medications the facilities are requiring for medication administration. The CMO for some classes has not selected a medication.

Erie County Correctional Health Diabetes:Lantus/ LevemirHumalog or other rapid- acting insulinGlipizide vs glimepirideJanuviaMetformin


P a g e | 11

Dextrose/ Oral GlucoseHypertension:ACE inhibitorARBHCTZ/chlorthalidoneIsosorbide mononitrateAmlodipineAtenolol/ Coreg/ metoprololHydralazineMethyldopaClonidineSpironolactoneCOPD/Asthma:AlbuterolAdvair vs Symbicort ICSLABASpiriva SingulairBenzonatate/ GuaifenesinIpratropriumGout:ColchicineAllopurinolIndomethacinNON HAART antivirals:Valcyclovir/ AcyclovirGI medications:PPI: Generic omeprazole OTCGeneric lansoprazole OTC

Generic Name Brand Namecimetidine Tagametfamotidine Pepcidnizatidine Axidranitidine ZantacPancreatic enzymesLoperamideLaxatives: Erie will have 2 laxativesDicyclomine: XifaxanLactuloseHemorrhoid medicationAntiemeticSucralfateSulfasalazineCardiovascular:AspirinPlavixDigoxinDiltiazemStatinWarfarinVitamin KLasixPotassium chlorideTopical nitroglycerinPropranololQuestranLabetalolAmiodarone


P a g e | 12

Gemfibrozil for TG>500Endocrine:SynthroidPTU/ TapazoleAnalgesics:TylenolIbuprofen/ naproxenAmitryptilineNeurologic:CarbamazepinePhenytoinKeppraGabapentinDepakoteLamictalVimpat/ lacosamideAtivanValium PropranololMeclizineSinemetLyrica/ Gabapentin (for neuropathy)Imitrex (9 tabs per month)Robaxin (14 days per 3 months)Remeron Allergies /Antihistamine:Nonsedating antihistamineNasal steroidsTopical low potency steroid Hydrocortisone and triamcinolonePrednisoneBenadrylAntibiotics:FluoroquinoloneBactrimAmoxicillin/ AugmentinFlagylRocephin/ VantinKeflexAzithromycinDoxycylineTopical ketoconazoleNystatinPermethrinClindamycinGenitourinary:Tamsulosin OxybutyninProscarVitamins/ Supplements:Folic acidThiamineFerrous sulfateCyanocobalaminPrenatal vitaminsVitamin b6Magnesium oxide

Ophthalmic Meds:


P a g e | 13

Ocular antibioticGlaucoma medications

39. Please provide a sample of currently/commonly prescribed NDCs and the frequency in which medications are dispensed.Erie County does not have a sample that can be provided.

40. In order to ensure a fair and equitable evaluation of pricing where the County can ensure they are comparing prices from all bidders on the exact same date, would the County consider updating the Pharmaceutical Pricing Appendix to include a recent date from which pricing should be provided for evaluation?Please respond to the RFP within the provided dates.

41. How does the County send prescription new orders and refills to the pharmacy vendor? Email, Fax, Remote Provider Order entry? If multiple methods are used, approx. what percentage of each type of transmittal apply?Currently the County uses EMAR for scripts to be filled.

42. Please identify the number of facilities to ship to from the Pharmacy and the specific ship-to addresses. There are two facilities that are required to be shipped to:

Erie County Holding Center 40 Delaware AveBuffalo, NY 14202

Erie County Correctional Facility11581 Walden AveAlden, NY 14004

43. What is the current preferred method for delivery? Erie County currently has two daily drop offs at both locations by the current pharmaceutical vendor’s currier.

44. Please describe the frequency for medication deliveries to your facility by current vendor.Erie County currently has two daily drop offs at both locations.

45. Are medical supplies (needles, syringes, diabetic test strips, etc.) for your location ordered from the current contracted pharmacy?Currently Erie County does not order needles, syringes and diabetic test strips from the pharmacy vendor.

46. Does the County currently have an eMAR or EHR in place? If so, what is the name of the program currently in place? If so, is an interface required to connect with the system?Erie County is currently utilizing Centricity Fusion- GE for the EMR and EMAR. Any interfaces for the pharmacy will be the responsibility of the pharmacy vendor.

47. Please define “computerization system” as listed in RFP P. 6 under Scope of Work. Does this refer to actual computer hardware or CPOE system for ordering and delivery reconciliation?


P a g e | 14

This refers to the CPOE system for ordering and delivery of prescribed medications.

48. Please clarify under what section of the RFP response should offerors describe their proposed electronic medication record or does Erie County consider the computerization system to be the electronic medication record as outlined in Specifications and requirements 1.7 and 2.4?This refers to the vendor’s computerization system.

49. Please confirm that the county is requiring offeror’s to interface with local community pharmacies for after-hours back-up pharmacy electronic ordering? (RFP Specifications and Requirements Section 2.8) It is very uncommon for a private Correctional Pharmacy to provide an electronic interface with a public, community pharmacy for the small amount of after-hours orders that would be required by Erie County. Traditionally, after-hours emergent orders from local back-up pharmacies are ordered by telephone and not sent electronically. Yes, the County is requesting a tracking mechanism. Within NYS all medical practices as well as providers are required to use an electronic system for ordering medications.

50. Please confirm whether all cost information should be included in the Cost Proposal Section or whether costs for the provision of back-up pharmacy emergency prescriptions should be included as requested in Section 2.8 (page 7 of RFP).Yes all pricing should be included.

51. Can you please provide the name of the correctional facility inmate management software or jail management system? Blackcreek- Sallyport

52. Is an interface required to connect with the inmate management software system? Does the inmate management software currently in use support an HL7 interface?The JMD software is currently HL7- however it is not required for an interface to occur with this software.

53. Does the County use an on-site automated medication supply unit (Talyst or other)? Due to strict NYS laws Erie County currently does not have an automatic delivery system.

54. If so, in what capacity are these automated medication supply units being utilized?N/A

55. What is/are the current daily census system(s) used to interface with the Pharmacy Information System? Blackcreek- Sallyport

56. Does the daily census management system have HL7 interface capability?Blackcreek- Sallyport- it has the capability to interface with HL7.

57. How often are updates transferred from the daily census management system to the pharmacy information system? (Hourly, daily, etc.?)This update occurs every 15 minutes.


P a g e | 15

58. How are the prescription returns from your facility currently handled? Do you currently receive credit for returned medications? Are there any restocking fees or minimum costs to qualify as a return?Erie County currently receives a credit for all medication that is returned. In compliance with all applicable laws, unused packaged products may be returned to the Contractor for credit and/or destruction in accordance with all Federal and State Laws and regulations. Upon receipt, the Contractor shall issue a full credit equal to the cost of sale of all usable or unused products returned.

Erie County does not pay a restocking fee for medications, and there is no minimal cost per NYS law.

Section 11. a-f RETURNS AND CREDITS

Pharmacy Vendor will provide credit to the DOCS in accordance with the guidelines as outlined in sections (a-f) for medications delivered by Pharmacy Vendor to the designated facilities. For facilities that are approved Pharmacy Vendor are required, to receive medications in blister packs, credit will issued in guidance NYCRR Title 10 §425.18 (see below). Credit will only be given on blister packs that are returned with 45 days of the original dispensing.

New York State Laws and RegulationsNYCRR Title 10

Title: Section 415.18 - Pharmacy services

(f) Return of unused medications. (1) When services are provided by a cooperating vendor pharmacy, the facility shall establish policies and procedures which permit either the staff registered pharmacist or consultant registered pharmacist to return to the vendor pharmacy from which it was purchased any unused medications or drug products, provided such medication is sealed in unopened, individually packaged, units and within the recommended period of shelf life for the purpose of redispensing and which are in accord with the following provisions:

(i) Drug products which may be returned are limited to:

(a) oral and parenteral medication in single-dose hermetically sealed containers; and

(b) parenteral medication in multiple-dose hermetically sealed containers from which no doses have been withdrawn.

(ii) The drug products returned show no obvious sign of deterioration.

(iii) Drug products packaged in manufacturer's unit-dose packages may be returned for redispensing


P a g e | 16

provided that they are redispensed in time for use before the expiration date, if any, indicated on the package.

(iv) Drug products repackaged by the pharmacy into unit-dose or multiple-dose "blister packs" may be returned for redispensing provided that:

(a) the date on which the drug product was repackaged, its lot number and expiration date are indicated clearly on the package;

(b) not more than 90 days have elapsed from the date of the repackaging;

(c) a repackaging log is maintained by the pharmacy in the case of drug products repackaged in advance of immediate needs. (v) "Blister packs". (a) Partially used "blister packs" may be redispensed only as returned.

(b) Partially used "blister packs" may not be emptied and repackaged.

(c) Additional units of medication may not be added to partially used "blister packs".

(vi) No drug product dispensed in bulk in a dispensing container may be returned.

(vii) No medication or drug product defined as a controlled substance in section 3306 of the Public Health Law may be returned.

59. Are release medications supplied to inmates upon parole or discharge? If so, how many days’ supply is provided? Inmates do not receive medication on release from the jail. Within their inmate handbook they have a pharmacy number to call if they meet criteria for chronic disease medication. The inmate has to have been in custody for 30 days or longer and may request a 7 day supply of medication by calling the discharge line. The inmate will be responsible to pick up medications at the pharmacy. Erie County will be responsible for the payment of such medications.

60. What is the current process for notifying pharmacy of inmates release dates?The Pharmacy vendor receives a daily release report.

61. Will it be required to ship inmate discharge/transfer medications to private residences or are they shipped to each correctional facility only for discharge/transfer patients? The inmate upon release is responsible for picking up the medication from the pharmacy.

62. Is your correctional facility accredited by the National Commission on Correctional Health Care (NCCHC) or American Correctional Association (ACA)? If not, do you expect to seek accreditation during the term of the contract?


P a g e | 17

Erie County Holding Center and Erie County Correctional Facility are not currently accredited; however we will be seeking accreditation within the term of this contract. Erie County Holding Center and Erie County Correctional Facility are currently under a stipulated order of dismissal by the Federal Government.

63. Please provide all current Accreditation for all facilities. None

64. Do the correctional facilities currently maintain a Keep-On-Person (KOP) Program? If so, please provide a list of KOP medications approved by facility. Erie County Holding Center and Erie County Correctional Facility follow the NYS COC guidelines for KOP. Per the COC guidelines we are only permitted to allow inhalers and nitroglycerin as KOP. The Awarded Vendor is required to be versed in NYS laws and Regulations.

65. What percentage of your inmates, if any, are Federal? Specifically, what percentages are under jurisdiction of each the US Marshals Service (USMS) and US Immigrations and Customs Enforcement (ICE)? Erie County Holding Center and Erie County Correctional Facility currently does not house any ICE inmates or Marshall Inmates at this time.

66. Are OTC medications for commissary provided by the Contracted Pharmacy? If not, where do they come from?As per NYS laws we are not permitted to place any OTC medication on commissary.

67. How are non-formulary requests approved?All non-formulary requests or out of the normal requests facilitate through the CMO as well as the Medical Director for approval prior to dispensing.

68. Please describe your Non-Formulary Review process in detail.There is a non-formulary request form that is filled out by the provider and submitted for review of medical necessity.

69. Please describe the current destruction policy for all outdated/expired drugs.All medications follow the NYS laws in regards to destruction of medications. Erie County Follows NYS rules and regulations for destruction of narcotics as well as non-narcotic medications.

70. Does your facility have a DEA License? If so, whose name(s) is(are) under licensure?Yes Erie County Holding Center and Erie County Correctional Facility has a DEA license and it is listed under DBA: Erie County Holding Center and Erie County Correctional Facility as a class 3A institutional dispenser limited schedule II, III, IV, V.

71. If not, is your facility’s physical address listed as the business address on the DEA license of at least one of your facility’s providers? Yes both Erie County Holding Center and Erie County Correctional Facility are registered by the DEA.


P a g e | 18

72. Does your facility have a current state pharmacy license or any type of state board of pharmacy issued clinic license?Erie County does not have a state pharmacy license to practice as a dispenser.

73. Please provide the following pharmacy information by year for the last three years: number of patients on HIV medication, number of patients on psychotropic medications, number of patients on Hepatitis C medications, number of patients receiving medications associated with hemophilia, HIV medication dollars, psychotropic medication dollars, hepatitis C medication dollars, and hemophilia related medications dollars. Erie County Holding Center and Erie County Correctional Facility can provide you with the last 11 months of usage. The Correctional division is now being operated by the Sheriff’s department and does not have access to invoices prior to 2016. An average of patients prescribed HIV medications at the Erie County Holding Center are 26 monthly claims, at the Erie County Correctional Facility the average per billing month are 15 claims. An average of Psychotropic medications prescribed at the Holding Center are 543 claims per month and 220 claims per month. The current pharmacy does not have hepatitis C medication or hemophilia medication separated from billing.

74. Of inmates receiving Hepatitis C treatment, what is the nature of the treatment? Please list medications used to treat over the past three years.If a patient is currently on a hepatitis regime the Erie County Holding Center and Erie County Correctional Facility will maintain the treatment. The Erie County Holding Center and Erie County Correctional Facility will not initiate treatment unless they meet the required criteria.

75. Does your facility currently use a barcode electronic order reconciliation and medication return management system?Erie County Holding Center and Erie County Correctional Facility is in the process of changing to a barcode wrist band. The Current EMR/EMAR vendor is working with our facilities to accomplish this.

76. Please outline the medical personnel shifts that will require start up in-service training?Erie County Holding Center and Erie County Correctional Facility has 3 shifts: 7a-3p, 3p-11p and 11p-7a, all shifts will be required to complete training.

77. Does the current pharmacy vendor use a FDA-registered repackager to ensure compliance with federal regulations for Correctional Health stock medications?It is the Erie County Holding Center and Erie County Correctional Facility understanding that the current vendor follows all federal and state regulations.

78. Will you mandate that the pharmacy vendor use a FDA-registered repackager for Correctional Health stock medications to ensure compliance with Federal regulations?Yes, the Erie County Holding Center and Erie County Correctional Facility will require all vendors associated with Erie to follow the Federal and State regulations and requirements.

79. Will you require bidders to provide, as part of the proposal, evidence (the repacker’s license and labeler code) that they use a FDA-registered repackager, as this is the only means to ensure compliance?Yes


P a g e | 19

80. Will failure to provide proof of compliance with Federal regulations deem a bidder non-responsive and therefore ineligible for an award?Yes, failure to provide evidence of compliance with Federal and State regulations will make the proposed vendor ineligible.

81. Does your Detention Center maintain an Emergency Drug Box? If so, please provide a list of medications to be contained in the Emergency Drug Boxes.This proposal does not include the Erie County Department of Health Youth Detention Center.

82. Please provide a list of your current Stock Medications.OTC: Colace, B1, prenatal vitamins, Benadryl, 325 ASA enteric coated and non-coated, iron, Imodium, multivitamins, 81 ASA chewable, Allergy medication, Tylenol, Motrin, milk of magnesia, antacid liquid, tums, cough syrup, mag citrate, miralax, pepto, chlorhexadine, permethrin, hydrocortisone, calamine.

83. What reports are currently being utilized by Erie County? What additional reports will be required? Can Erie County provide examples of current monthly reports provided by current pharmaceutical services vendor?This is referred to within the RFP page 8 under reporting.

84. Will you be requiring monthly/quarterly pharmacy consultations/inspections? If so, please describe?This is referred to within the RFP page 8 under reporting, clinical requirements and additional requirements.

85. Are there any current committee meetings (other than P&T Committee Meetings) that would require a pharmacist or other vendor representative to attend? If so, what is the frequency of those meetings? Are the meetings required to be attended in person or will video/teleconferencing be permitted? This is referred to within the RFP page 8 under clinical requirements.

86. Please clarify where dispensing fee should be listed on Appendix B, Cost Proposal, if it should be listed there at all. If not, please confirm where you would like the Dispensing Fee to be listed in the RFP response Cost Proposal Section.This is referred to within the RFP page 10 under cost proposal. Do not include dispensing fees as part of the unit costs. A separate line item for dispensing fees associated with prescription and stock prices is to be submitted with the contractor’s bid sheet.

87.

Appendix B, can duplicate line items be combined into a single line item and total? Example: Lines 7 & 8:


*CLONAZEPAM 0.5 MG TABLET

176.00

*CLONAZEPAM 0.5MG TABLET

2,209.00

P a g e | 20

Yes, all duplicates can be combined.

88. Please clarify if the RFP is seeking an eMAR solution or an EMR solution?Erie County is currently utilizing Centricity Fusion- GE for the EMR and EMAR. Any interfaces for the pharmacy will be the responsibility of the pharmacy vendor. The computerization refers to the CPOE system for ordering and delivery of prescribed medications within NYS.

89. Do you have an emergency box? If so what is within it?

Medication StrengthAmlodipine 5 mg tabletsAmoxicillin 500 mg capsulesAmox-TR-K CLV 875-125 mg tabletsAzithromycin 250 mg tabletsBenztropine 250 mgCephalexin 500 mg capsulesCiprofloaxin 500 mgClindamycin 150 mg CapsulesClonidine 0.1 mgDoxycycline 100 mg capsuleFurosemide 20 mgHaloperidol 1 mgHydrochlorothiazide

25 mg

Hydroxyzine pam 25mgLevetiracetam 500 mgLisinpril 10 mgMetformin 500 mgMetronidazole 500 mgNitrostat 0.4 mgPrednisone 10 mgRisperidone 1 mgSulfameth/trimeth 800/160 tabletsTamsulosin 0.4 mg capsuleValproic Acid 250 mgWarfarin 1 mgWarfarin 5 mgNarcanGlucogon

Erie County only uses the emergency kit for STAT doses. It is not to be used for continuous dosing of a medication. The Emergency box is maintained within the charge nurses office. If there is a STAT dose ordered the nurse will sign it out and send a notification to the pharmacy.

90. Can you provide a list of all starter pack and stock medications utilized at each facility along with the typical quantity packaged for each medication? What quantity of each item is stocked?


P a g e | 21

The current Pharmacy Vendor supplies two protocol packs for the opiate detoxification protocol:Clonidine 0.1-0.2 mg PO BID x 5 daysDiphenhydramine 50mg q HS prn insomnia x 5 daysIbuprofen 800mg PO BID prn muscle or bone pain x 5 daysPromethazine 12.5mg PO BID prn GI upset x 5 days

We currently have 40 for am and 40 pm dosing.

91. What electronic system at the jail is currently being used to transmit orders to the local backup pharmacies?We currently do not have back up; this is an avenue that needs to be completed to be in compliance with NYS.

92. If there is a change in pharmacy vendors, will that system remain in place?If the question is referring to the transmittal of the backup pharmacy; the system will be solely dependent on the selected vendor.

93. As prices can change daily, what date should bidders reference when quoting their pricing so that all bidders can be compared with pricing on the same date?This should be the latest most competitive pricing.

94. Over the past year, there unfortunately seems to be a higher incidence of questionable pricing when it comes to pharmacy procurements. In some procurement, it appears bidders have obtained medications on short-dated contracts or from websites that offer temporary short-term discounts to show lower pricing on a bid sheet. These bidders, however, cannot charge that price when the medications are actually dispensed. At the time of dispensing, they will bill you for medications that are actually available in the marketplace – which are at a higher, but more realistic, cost. Therefore, the prices represented on the price lists submitted with their proposals are not indicative of the price you will be invoiced. In other situations, bidders have interpreted metric quantities for items on pricing sheets in ways that result in significant and inaccurate representations of the true cost of the medications when your facility would ultimately be invoiced. This strategy makes the medication’s price submitted on the price list appear very low, but the actual cost to the facility at the time of dispensing would likely be much higher.

a. In those cases where the acquisition cost of a medication varies by more than 5% from other bidders, will Erie County request a wholesaler invoice as a means to verify pricing?

Yes Erie County will be requesting wholesaler invoices to assure adequate pricing.

95. Many medications in Appendix B are listed by brand name. If a generic entity is available in the marketplace, are bidders to quote a price on the generic medication as that is ultimately the medication that will be dispensed?Erie County is looking for the most competitive pricing for medications both generic as well as brand names.

96. Although it is anticipated, and should be expected, that bidders will comply with federal and state regulations, compliance cannot be fully assured unless written documentation is provided


P a g e | 22

to your office at the time of proposal submittal. If you are currently receiving stock in blister cards, which is a common practice within our industry, a pharmacy or a wholesaler cannot simply put those medications in a card and label them as stock and still be in full regulatory compliance. A company must be (or use the services of) a FDA-registered repackager to legally repackage stock medications into blister cards or any other packaging that results in a change to the original manufacturer packaging .

a. Will you mandate that bidders comply with these regulations and use a FDA-registered repackager if stock is provided in packaging other than the original manufacture packaging (such as blister cards)?

Yes all submittals should be in compliance with FDA/ NYS and Federal guidelines.

97. Will you require bidders to provide evidence (such as the repackager’s license, labeler code, or a letter from the repackager on their letterhead) at the time of proposal submittal that they are actually using a FDA-registered repackager?Yes

98. Will failure of a pharmacy bidder to provide written documentation at the time of proposal submittal that they comply with FDA repackaging regulations in regard to the provision of stock deem that bidder non-compliant and therefore ineligible to receive an award? This will not qualify any interested vendor to be eligible for award.

99. Are they also licensed as a wholesaler? If not, who is utilized as a wholesaler for stock distribution?Erie County Correctional Division does not utilize a wholesaler.

100. What is your total dollar amount spent on pharmacy for the past 12 months per facility? The Average spent at the Holding Center is $55,018.62 monthly ($660,223.44 annually) and at the Correctional Facility is $ 42,951.22 ($515,414.64 annually).

101. In accordance with the EPA Management Standards for Hazardous Waste Pharmaceuticals, the generator of any pharmaceutical waste (correctional facility) is responsible to classify the pharmaceutical waste as first hazardous or non-hazardous prior to making arrangements for the appropriate disposition of the pharmacy waste. To comply with federal requirements, it is our understanding that waste disposal is the responsibility of the facility and not that of a vendor. How is pharmaceutical waste currently disposed of? If this question is referring to controlled substances we follow NYS DEA rules and regulations. The County is responsible for pharmaceutical waste.

102. Do your facilities currently use a barcode electronic order reconciliation and medication return management system that is provided at no cost to you by your pharmacy vendor? Erie County has initiated the barcode system; it has not been implemented with pharmaceuticals to date. This will be a requirement for the selected vendor.


P a g e | 23

103.Do your facilities currently have access to a web based Online Reporting Dashboard for you to access meaningful and accurate reporting 24/7/365 that is provided at no cost by your current pharmacy provider? Erie County does not have access to such system.

104. Will you provide an email notification to all bidders that submitted a response of your intent to award, along with a scoring summary of all evaluators, before the final award is issued to allow for any possible clarifications? Yes, Erie County will notify all vendors of award as well as any clarification of submitted proposals.

105. The RFP schedule of events and deadline for response to questions only allows two (2) business days from the time of receipt until the required mail date to meet the proposal deadline. Would Erie County extend the due date by a minimum of one (1) week for the RFP response since the answers to questions will influence proposals and have a material impact on pricing (quantity/unit of use questions)?Erie County is not changing the event schedule.

106. Does it currently have the capability to read linear bar codes?Yes we currently have a linear bar reader

107. Please provide specs as the size (width X Depth X Height) and the medication card carrying capacity of the 8 carts requested in the RFP?Erie County requests 4 standard medication carts for each facility.

108. As some medications on the list may no longer be commonly used, and many new medications have been released since that time are not included, would the County consider updating the required pricing schedule to include 2015 or 2016 data?Erie County is not going to submit any further data.

109. Regarding BID price per unit, items such as tablets and capsules are easily priced. How does the county want other items such as creams, ointments, lotions, injectable, inhalers, and medical supply items to be broken down for pricing?Erie County is requesting that each vendor provide the most competitive bid pricing for all items. For lotions and creams etc., the vendor should quote all sizes that the vendor currently supplies to facilities per actual unit not grams or inhales etc.

110. Other items listed on the spread sheet such as bandages, test strips, adult incontinent products, etc. do not have any quantity, package size, or other indicators to be able to properly and competitively price those items further without a more detailed description.We do not currently use the vendor for these products.

111. Does this mean that the Unit Bid price could not be adjusted for pharmacy cost increases?The County will lock the vendor into firm pricing that can only be adjusted through a proposal.

112. Please confirm that the Extended Price should be computed as the usage times the bid price per unit.The vendor should provide comprehensive pricing for all medications.


P a g e | 24

113. Would this be for the full 2 year term of the contract?The County will be awarding this contract for a full 2 year term with a one year ability to continue if agreed upon by both parties.


P a g e | 25

PHARMACEUTICAL SERVICES

Insurance Requirements for “C” Professional Services can be obtained by opening the following link:

http://www2.erie.gov/law/sites/www2.erie.gov.law/files/uploads/pdfs/EC%20Final%20Cert_revised.pdf


http://www2.erie.gov/law/sites/www2.erie.gov.law/files/uploads/pdfs/EC%20Final%20Cert_revised.pdf

new york state laws and regulations - erie county (new ... · web viewclobetasol 0.05%...

Documents