Why Your Pharmacy Vendor Should be Hiring Independent Consultants to Audit Work

There is a potential conflict of interest that the Centers for Medicare and Medicaid Services (CMS) have wanted to squash for some time. Many consultant pharmacists at long term care facilities are supplied by the pharmacy vendor. These consultant pharmacists are responsible for many things:

  • Reviewing and managing medication regimens
  • Ensuring regimens are as safe and effective as possible
  • Educating patients and doctors about medications
  • Preventing medication-related complications

However, CMS has observed some behaviors that have made them want to require consulting pharmacists to be independent from pharmacy vendors. The major behavior is changing drug regimens to take advantage of discounts that the pharmacy gets from drug manufacturers. This practice can compromise the health of patients, and also increase Medicare costs.

In particular, they are worried about increases in the amount of antipsychotic medication being prescribed to patients in nursing homes. A testimony presented by former Inspector General Daniel Levinson said that 14% of nursing-home residents had prescriptions for these drugs, and that half of the prescriptions should not have been paid for. This is a very scary statistic! It may seem unbelievable that some vendors push their consultant pharmacists to find cost savings, but if the CMS is investigating then there is definitely a problem.

Some pharmacies think that it would be too much of a hassle to implement independent consultants. There are a lot of legal hurdles. A separate company has to be set up to hire the consultants, and great care must be taken to ensure that they stay independent. It’s a big headache for the pharmacy, but it delivers peace of mind to facilities. No facility wants to think that the consulting pharmacist has an agenda beyond doing their job.

Vendors should take the step to hire independent pharmacy consultants. By having independent consultants, this conflict of interest can be easily removed. The results would help drive down Medicare costs and provide an improved quality of life for patients in long term care facilities. In turn, this would give the facilities we serve peace of mind about their pharmacy, and lead to improved customer service.

Supporting material: //www.ncbi.nlm.nih.gov/pmc/articles/PMC3278190/