2017 PBM Legislative Initiative

Pharmacy Benefit Managers (PBMs) serve as middlemen between health plans and pharmacies, administering drug coverage for nearly 95 percent of all Texans with health insurance. In the last several years, PBMs have become more active in administering prescription drug benefits, including:

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Texas State Board of Pharmacy Sunset Review

In 1977 the Texas Legislature created a legislative review of the duties and functions of state agencies in a process meant to Sunset an agency not performing its intended purpose. A panel of appointed legislators and staff were directed to question the need for agencies carrying out the responsibilities of state government. The Sunset Commission reviews agencies every 12 years to consider the management, roles, and responsibilities in overseeing and protecting the public from the people and entities under their oversight.

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Texas Attorney General Responds to Any Willing Pharmacy Opinion Request

To ensure patient access to care, many states -- including Texas, have adopted "Any Willing Provider" laws that require managed care companies to allow health care providers to become network providers based upon geography or other characteristics. Despite these laws, independent community pharmacists, considered the backbone of health care infrastructure in towns across the state, are often not offered contracts with managed care companies to serve patients in their communities, which may result in deterioration of chronic conditions, more physician visits, higher utilization of emergency rooms, and extended hospital visits.

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Pharmacy Technician Education and Training...A Texas Perspective

As pharmacists are spending more time providing drug use review and counseling patients on how to use their prescription drugs, the demand to expand pharmacy technician's responsibilities, training, and education is growing.

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Texas Medicaid Prescription Drug Benefit - A Texas Pharmacy Perspective

In state fiscal year 2013 (September 1, 2012 - August 31, 2013), an average of 3.7 million clients per month were eligible to receive medications through the Texas Medicaid Program. The program paid $2.7 billion for more than 38.8 million prescriptions that year through Fee-for-Service (FFS) and managed care, with an average cost per prescription of $69.08.

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Pharmacy Compounding A Texas Perspective

Pharmacy compounding has experienced a resurgence as modern technology, innovative techniques, and research have allowed more pharmacists to customize medications to meet specific patient needs.

With limited exceptions, all pharmacies and pharmacists are licensed and strictly regulated by state boards of pharmacy. Compounding is a core component of pharmacy and has always been subject to the oversight and monitoring of these agencies as determined by state law.

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Independent Pharmacy Business Owners Request Consumer Access to Prescription Drugs

In today's health care market, consumers generally access prescription drug coverage through their managed care plan. Recently these health plans have begun to use limited and restricted networks of providers to hold down costs. In all cases these "narrow networks" reduce consumer choice in lieu of lowest cost services by limited providers willing to take lower reimbursement in favor of increased volume. In pharmacy, this often results in limited access to prescription benefits to large box stores or mail-order facilities.

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Prescribing Opioids for Chronic Pain -- A Texas Perspective Texas Implements a Prescription Drug Monitoring Program

This month the Centers for Disease Control published a checklist for prescribing Opioids for chronic pain, stating plainly that opioids were not first-line therapies. Pharmacists are encouraged to talk with prescribing practitioners about best practices for improving treatment for chronic pain and addressing, first hand, trends in opioid addiction.

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Influential Texas Pharmacy Gets a Smile from New Social & Mobile Platform

Established 45 years ago in the town of Edinburg, Texas, Cantu’s Pharmacy, one of the nation’s first computerized pharmacies, is benefiting from the latest technology trend - mobile friendly websites, mobile apps and social media.

Owner Nario Cantu, a 3rd generation pharmacist and President-elect of the Alliance of Independent Pharmacies of Texas, explains how his family business is staying relevant, despite fierce competition from big brand drug stores like HEB and Walgreens setting up in this south texas town, “We were one of the first computerized pharmacies in the nation and have always embraced technology to stay ahead.”

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