SAN DIEGO -- When the permanent Medicare prescription drug benefit becomes effective in 2006, retail pharmacies will depend on information systems that deliver real-time data to implement it, said David Fong, corporate vice president of pharmacy for Safeway, Pleasanton, Calif.
"Retail pharmacy is where the rubber meets the road on providing drug benefits," Fong stated. Fong outlined his concerns about the upcoming program during a panel at the National Association of Chain Drug Stores' Pharmacy & Technology Conference here last week. The session, "Update on Medicare Prescription Drug Benefit Programs: Part D and Medicare Advantage," focused on the impact of the impending Medicare reforms on community pharmacies. Part D goes into effect in January 2006, replacing the current discount card program.
Most prescription claims are already successfully processed in real time, Fong added, but neither the retail pharmacies nor Medicare wants to frustrate customers during the transition to the new drug plan, which has many complicated parts.
Electronic prescribing will be one important element of establishing real-time information, he pointed out, cautioning that prescription plans and providers, as well as pharmacies and physicians, need to be ready.
"The reality is we need to be positioned for e-prescribing," Fong asserted. As pharmacies look at the mostly low numbers of prescriptions currently flowing through the system, they need to consider the future potential of that connection as a two-way system that better manages customer information, he said.
There are potential downsides to e-prescribing, Fong warned. For example, there is a risk that the process may steer patients toward mail-order pharmacies while they are still in physicians' offices. Continuing to provide service to customers at the point of contact throughout the transition will help community pharmacies maintain their role by becoming an important educational source for beneficiaries.
Other areas potentially impacted by the new regulations include pharmacy participation and access standards, retail pharmacy equity with mail-order pharmacy, medication therapy management programs (MTM), coordination of benefits, and formularies, Fong said.
The Centers for Medicare and Medicaid Services, Baltimore, has requested public comments on these areas, according to Tom Hutchinson from the agency's Center for Beneficiary Choices. He also spoke on the panel, outlining the provisions of the Medicare Part D and Medicare Advantage programs. CMS has established a comment period on the proposed standards that lasts until Oct. 4. A number of key elements of the program will be decided between now and 2006, said John Coster, vice president of policy and programs for NACDS, during his introduction of the session topic.