Editorial: Planning

"Plan" is defined as a detailed scheme, program, or method worked out beforehand for the accomplishment of an objective. Every individual, organization, and business is involved in some type of planning; where will we have dinner tonight, how are we going to increase membership, how are we going to increase our bottom line�just to name a few.

In order to make plans, it is beneficial to have some "facts" to guide in the decision-making process. When it comes to planning for pharmacy compounding, we abruptly come to a brick wall because there is no single entity that has assumed the responsibility of collecting "facts and figures" for this area of pharmacy practice. It encompasses virtually all practice sites, and many pharmacists who compound may not even be aware of their involvement. However, any preparation of or manipulation of a dosage form involves compounding.

Since compounding is so diverse and includes independent pharmacies, chain pharmacies, hospitals, infusion centers, specialty pharmacies, etc., it becomes difficult to obtain data for planning for the future; especially since the future is somewhat dependent upon changes in the healthcare system and others.

As a journal, where do we obtain facts and figures to make our plans? As a compounding provider of equipment, supplies, and information, from where does the information come? As a compounding-related organization, where is the data necessary for planning?

Much of it is obtained from attending meetings, talking with compounders, etc. and doing surveys. Two surveys of interest are now listed:

IJPC
Now's your chance to tell IJPC exactly what you think! Take our customer survey today and help us improve the Journal, CompoundingToday.com, and the Compounders' Network List by letting us know what works, what doesn't, and what you think we should add! Tell us a little about yourself and your practice so we can continue to provide the information and tools needed help you make the best compounding decisions possible. The survey is hosted remotely at https://www.surveymonkey.com/s/YQ6JLVQ and all individual information will be kept confidential to IJPC. You will be eligible for a drawing for a unique mortar and pestle.

USP
The USP is doing a survey to obtain information on what resources to develop for compounding pharmacists for the future. (See below for information from Chamberlain Research Consultants and how you can receive compensation for your opinion.)


Loyd V. Allen, Jr., PhD, RPh
Editor-in-Chief

40 Million Out-of-Date Swine Flu Vaccine Doses Destroyed
About a quarter of the swine flu vaccine produced for the U.S. public, valued at about $260 million, has expired and is being written off as trash. The outdated vaccine, as much as four times the usual leftover seasonal flu vaccine, likely sets a record and will be incinerated. And, that's not even all of it as about 30 million more doses will expire later and may go unused, according to one government estimate. If all that vaccine expires, more than 43 percent of the supply for the U.S. public will have gone to waste.

Millions of doses of flu vaccine typically go unused every year and are marked for burning; generally, the leftovers amount to about 10 percent of the supply, rather than the 25 percent expiring now.
http://www.washingtonpost.com/wp-dyn/content/article/2010/07/01/AR2010070101006.html

Georgia Creates Waiting List for HIV/AIDS Drugs
The state of Georgia has closed enrollment in their program that provides medication for low-income Georgians with AIDS and HIV, thereby creating a waiting list that could grow to 1,300 people in a year. The program's enrollment has jumped 17 percent in the past year, to 5,700 people. Supporters of the program say they are worried that the delay in access to the federal AIDS Drug Assistance Program could lead people to become sicker, with some developing full-blown AIDS and perhaps even dying.

The program provides prescription medication for people who are poor, uninsured or under-insured and would require an infusion of $11 million to eliminate the wait list. It receives $33.7 million in federal funding and $12.4 million in state money. The program has not suffered budget cuts, officials said, but it cannot keep up with the increasing demand.
http://www.ajc.com/health/state-creates-waiting-list-562281.html

Surprise, Surprise, Surprise!!!!
The healthcare reform law contains a little-known provision that could significantly increase tax recordkeeping requirements and costs for nearly 40 million self-employed workers, small businesses and charities. Starting in 2012, self-employed workers, small businesses, charities, and government agencies will be required to issue Form 1099s to every vendor from which they purchase more than $600 in goods during the year. As an example, if a self-employed consultant buys a $700 computer from an office supply store, they would be required to send a Form 1099 to the store and to the IRS. Currently, businesses are required to provide Form 1099s for services, such as payments to independent contractors, but not for goods.

The Congressional Budget Office estimates that the new reporting requirement will raise $17 billion in tax revenue over 10 years, which would be used to offset some of the costs of healthcare reform. This requirement could force small-business owners and charities to purchase new software and hire additional accounting services. Businesses that make qualified purchases from at least 250 vendors during a year will be required to file their 1099s electronically, generating an additional expense for software, personnel, etc.
http://www.usatoday.com/money/smallbusiness/2010-07-08-taxreporting08_ST_N.htm

Some States Say They're Not Receiving the Medicaid Services They're Paying For
The day after passage of the health-care bill in March, St. Louis-based insurer Centene saw its stock jump 11 percent. That may be the first signal that the major changes ahead would be a boon to one subset of the healthcare industry: companies that manage Medicaid for the states.

These insurers are now working to get a foothold in states that outsource Medicaid, knowing the law could add 16 million people to the federal-state program for the poor and the disabled. In Texas, where Medicaid rolls are expected to grow by 1.8 million people, Centene is scrambling to win additional contracts, having laid the groundwork by contributing $250,000 to state legislators' campaigns since 2008.

However, all is not rosy for the states. A recent report found that 2.7 million children on Medicaid in nine states, where most of them outsource Medicaid, are not receiving required screenings and immunizations. In Milwaukee, the two biggest provider networks in the city broke ties with Centene, and the state is overhauling its Medicaid contracts for southeast Wisconsin, dropping Centene from the mix. The complaint was that the insurer was creating profits at the expense of patient care.

Managed Medicaid has produced a steady stream of controversies. Last year, insurer WellCare agreed to pay Florida $40 million in restitution after it admitted shortchanging children on Medicaid by setting up a subsidiary to make it look like WellCare was spending more on medical care than it was.

Today, 70 percent of the 48 million Medicaid enrollees are in a managed plan. States typically pay insurers a per-person rate, and the insurers, or HMOs, negotiate rates with doctors and hospitals. Although some states manage the program on their own, the majority contract out most of their Medicaid. Insurers are now vigorously lobbying state legislators for more outsourcing, using states' budget woes as a reason for doing so.
http://www.washingtonpost.com/wp-dyn/content/article/2010/07/07/
AR2010070703560.html?sid%3DST2010070705230&sub=AR

Chamberlain Research Consultants, an international market research firm, is conducting two market research studies on behalf of the United States Pharmacopeia (USP) with Compounding Practitioners regarding resources you may use in your practice.

The time commitment and compensation for the two studies is as follows:

• Online Bulletin Board: From July 21 to July 25 - 15 to 20 minutes per day via the Internet (5 days total). For your time you will be compensated $125.
• In-depth Interviews: August 8 to August 25, one 45 minute to one-hour long interview via telephone. For your time you will be compensated $150.

All information discussed is confidential and there will be no sales or solicitations involved - we are simply looking for your opinions and expert advice to share with USP. Please respond at your earliest convenience as our timeline is very sensitive on this project. Your insight and opinions are very valuable to this research.

To see if you qualify, please reach us by phone at our office: 1.877.968.9272 x 4294 Monday through Friday: 9:00 AM to 7:00 PM Central Time

Thank you very much for your time and consideration!

Chamberlain Research Consultants