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5 Reasons You May Need Compound Medication

Standard, mass-produced medications aren’t the best option for everyone. In some circumstances, a patient fares better with something custom-made for them. Thankfully, Medicap Pharmacy owns and operates our own compounding lab. We can customize your prescription to better suit your needs.

Our professional staff will discuss your needs and the available options to make your medication fit you. Find out more about what compound medication is and the top five reasons you may benefit from it.

What is compound medication?

Pharmacy compounding is the science of preparing personalized medications for patients with unique needs. The practice dates to the very beginning of the pharmacy profession and was the standard means of providing prescription medications before pharmaceutical companies started mass production.

Some commercial medications don’t meet the needs of all patients because they are limited in delivery form and dosage. This is due to conflicts in distribution, storage, stability, and profitability.

With new technology and techniques, compounding pharmacists can make customized medications to meet the specific needs of their patients. Individual ingredients are mixed together in the exact strength and dosage form required by the patient.

Our compounding specialists can prepare medications free of problem-causing excipients such as sugar, lactose, dyes, alcohol, or preservatives. Our ultimate goal is to work closely with health care practitioners to create the best medication for each patient.

Why do you need compound medication?

There are a few reasons someone may benefit from compound medications prepared by Medicap Pharmacy experts.

1. To Customize the Dosage

Many medications are mass-produced by large pharmaceutical companies. They are, therefore, available in the most commonly prescribed sizes and dosages. When your doctor prescribes a medication not available in a standard dosage, your compounding pharmacy can adjust the dosage to the appropriate amount.

For example, if you need 15 mg of a certain drug that is only available commercially at 30 mg, you might try to cut your medication in half at home. This can result in inconsistent dosing or a reduction in the medication’s effectiveness. Medicap Pharmacy can instead prepare your medication so that it comes in the desired form and dosage.

2. To Avoid a Nonessential Ingredient to Which You Are Allergic

Some medications contain nonessential ingredients that many people are allergic to, such as dyes, lactose, or gluten. If you have known allergies, make sure your pharmacist knows so they can evaluate your medication and recommend a change if necessary. Our pharmacists can reformulate your medication without your particular allergen so you can still reap the benefits without unwanted allergic reactions.

3. To Alter the Form of Delivery

The given form of a commercially produced medication may not be convenient for you. Do you have trouble taking pills, or do certain coatings make your medication difficult to swallow? Whatever the reason for needing an alternative, our compounding pharmacy can change the form of your medicine entirely. Depending on the drug, there are a wide variety of forms your medicine can take including pills, drops, powders, and ointments.

4. To Create Better-Tasting Medicine

Some people, especially children, struggle to take their medicine if it tastes awful. When you are already feeling sick, you may find that the taste of certain medications makes you feel worse. Our pharmacists can formulate your prescription medication so that it tastes better, improving compliance with your doctor’s recommendations. In fact, we’ll even do the same thing for pet medications.

5. To Combine Medications

Doctors may prescribe combined medications which need to be filled at a compounding pharmacy like Medicap. You may also have multiple medications that you regularly take together. Depending on what they are, we may be able to make your life simpler by combining them. Some common examples are topical medications and prescription mouthwash.

For more information

Medicap’s compounding pharmacy can make your life and access to certain medications much easier. If you are unsure whether you need a compound medication, simply ask your pharmacist about your options. Our professional staff can answer all of your questions and are bound by confidentiality.

Medicap Pharmacy’s compounding lab is licensed and regulated by the Idaho State Board of Pharmacy and is overseen by the FDA. Our pharmacists have extensive training and education to compound medications safely and efficiently.

10 Ways to Give Back This Holiday Season

Supporting our local community, even in the smallest way, can make a big difference. Investing in our community doesn’t have to cost a lot or take up significant amounts of time. New to getting involved? It can be easy, and it is never too late to start! Here are 10 way to give back:

1. Find a Cause to Support

There are many different causes and charities you can choose from to support. Whether you want to volunteer your time to a local food bank or make a monetary donation, either way makes a difference. To find local opportunities in your area, visit www.volunteermatch.org and get matched with a cause that inspires you! This website allows you to choose from over 100,000 participating charities, including organizations that support local arts or work with children or elderly individuals.

2. Donate to a Holiday Food Drive

The holiday season is quickly approaching, which also means many local businesses, grocery stores, schools, or community centers organize food drives. These typically ask for donations of unopened, non-perishable canned or boxed food items to donate to local food banks. Either look through your pantry and find items that you could donate or simply purchase a few extra items the next time you are out and about grocery shopping. It may not seem like a lot to you, but these food drive donations can make a difference in someone else’s life. If a local business doesn’t have a food drive, you can always search for your local food bank by visiting a site like www.feedingamerica.org/find-your-local-foodbank and making a personal donation directly.

3. Support Local Farmers

Have you ever been to your local farmer’s market or farm stands? Attending and making a purchase is a great way to give back to the hard-working farmers in your local community. Items sold could include fresh produce, meat, jams, salsa, and much more. You may not be able to get everything you need for your grocery hall, but even buying one thing helps support their farming business directly. If you aren’t sure where to find your local farmer’s market, you can visit hwww.ams.usda.gov/local-food-directories/farmersmarkets.

4. Donate Blood

Right now, especially with the COVID-19 pandemic, giving the gift of life through a blood donation is as important than ever. You may have local blood drives hosted by your employer, community center, school, etc. However, if you are not able to find a local blood drive, you could always visit www.redcrossblood.org and register for a donation. Normally, it takes around an hour to give blood. If you choose to give platelets, the process is about 2 hours. Plus, after you give blood you can enjoy refreshments and snacks!

5. Set Up a Collection Jar

Every penny counts! If you are looking for something smaller to do, think about setting up a collection jar at a local business where people can give their extra change to give back to a cause of your choice or someone in need. There are organizations who have already created collection boxes that you can pick up and display on a countertop or create your own.

6. Volunteer at Your Local Senior Center

Volunteering at your local senior center is a great way to become involved in your community! Often times, these places need volunteers to help with different programs or activities. Even just stopping by to say hello, read books, or play games means the world to these residents. You can also sign up to become a volunteer by visiting www.elderhelpers.org/ for the seniors in your community who aren’t in an assisted living facility, but need help with daily activities.

7. Become a Big Brother or Big Sister

Do you think you would be a great mentor for a child in your community? If so, consider joining a community-based mentorship program like Big Brothers Big Sisters of America. These programs are designed to be an important part of changing the lives of our youths who are in search of role models to help them feel more connected to the community. Your local area may also have a similar program, so check with your community page on social media or the city hall for more information about how to join.

8. Donate to a Charity

Donating to a charity of your choice is a great way to give back! Before you make a donation of money or goods, make sure to research the charity. Be certain that the charity is real. There are different types of donations you can provide that include financial donations, goods or personal property, vehicles, or other property like art, jewelry, or real estate. Whatever the donation may be – big or small – makes a difference. To learn more about donating to a charity, visit www.usa.gov/donate-to-charity.

9. Organize a Community Clean-Up Day

A great way to give back to the community is by cleaning up your community. A lot of times, community clean up days are at local parks, but they can also be cleaning rivers, in the ditches alongside the roads, etc. This makes for a more welcoming environment and allows you to connect with those around you. Not only will your neighbors thank you, but the environment will too! #Didyouknow many businesses allow their employees to take a personal day to volunteer in the community? Check with your employer to see if this is option.

10. Write a Letter to Our Troops

There are so many men and women who have dedicated their lives to be a soldier in the US Army. They are often recognized for their service, but what if you could make a difference by writing a few kind words to life their spirits through a letter? Through a nonprofit called Operation Gratitude, you can write personal letters of appreciation to deployed troops, veterans, recruit graduates, first responders, frontline responders, or wounded heroes and their caregivers.

There are countless ways that you can become involved in our community and give back, beyond the 10 ideas listed above. To get started, find something you are passionate about, research how you can become involved, and make it happen. Giving back is often highlighted during the holiday months but make it a goal to become involved year-round.

Does CPAP Therapy Work for Sleep Apnea?

Do loved ones constantly give you grief about your snoring? Do they complain about the nonstop sound, or the many interrupted nights of sleep your snoring has caused them?

Well, it’s time to take action.

What Really Causes Snoring?

The direct cause of snoring is vibration of the soft tissues of your mouth and throat. During sleep, the muscles around these structures may relax to the point that your lower jaw and tongue fall back, blocking your airway. A reduced airway causes the soft tissues to vibrate, i.e. snoring.

The possible underlying causes of snoring are many:

Excess body weight
Congestion
Sleep apnea
Use of drugs or alcohol

Any of these issues can lead to the relaxation of tissues in the mouth and throat, collapsing the airway to various degrees, thus resulting in snoring.

Very heavy snoring and delayed breathing (of up to 10 seconds or more) or choking may indicate a severe condition known as obstructive sleep apnea (OSA).

Obstructive sleep apnea occurs when the throat muscles and tongue collapse into the airways during sleep, blocking airflow. Once that airway becomes blocked, the person simply stops breathing until the brain senses mortal danger and finally signals a gasp for breath.

Individuals with mild obstructive sleep apnea experience 5–15 of these episodes per hour of sleep, while individuals with severe obstructive sleep apnea experience more than 30. All too often, the individual who gasps isn’t fully awakened and is completely unaware of what’s going on. Often their partner will give them the first indication that there’s a problem — by sleeping on the couch. With their sleep constantly being interrupted, individuals who suffer from OSA can go weeks, months, or even years without a truly deep, restful sleep.

Side Effects of Obstructive Sleep Apnea

Due to the serious cardiovascular threat it poses, sleep apnea should not be ignored. With so little oxygen in the blood, blood pressure quickly creeps upward because the heart has to work harder. Such nocturnal increases in blood pressure can lead to hypertension (chronic high blood pressure). The risk of having a stroke or sudden cardiac arrest soars: people with OSA are three times more likely to have a stroke than those without. In severe cases, OSA can trigger a heart attack in the middle of the night.

Fragmented sleep leads to sleepiness and chronic fatigue during the day — additional signals that OSA has been hard at work while its victim tried to rest. No wonder individuals with OSA are four to six times more likely to be involved in a car accident and are more likely to be injured at work. The stealth factor is high with OSA: symptoms may continue for years unnoticed as the person simply becomes conditioned to feeling tired all the time.

How to Stop Snoring and Treat Sleep Apnea

As many as 50 percent of people snore to some degree. Thankfully, most cases aren’t too serious and can be corrected with simple steps:

Losing weight
Avoiding drugs and alcohol
Using nasal strips or a humidifier while sleeping

And thankfully there is a very effective remedy for sleep apnea sufferers. Continuous positive airway pressure (CPAP) machines are a lifesaver to those struggling with obstructive sleep apnea. A CPAP machine works by gently but continuously blowing pressurized air through the airway. The increased air pressure prevents the airway from collapsing when you breathe. When used as directed, it can immediately improve the quality of life for individuals with sleep apnea.

The CPAP machine will have one of the following attached to it:

A mask that covers your nose and mouth, known as a full-face CPAP mask
A mask that covers your nose only, called a nasal CPAP mask
A mask that fits directly into the base of your nose, with e cushions that seal around your nostrils, known as a nasal pillows CPAP mask

You’ll likely notice less snoring, fewer breathing obstructions, and a decrease in daytime sleepiness — among other health benefits. Research has shown that CPAP therapy can reduce the risk of health problems linked with obstructive sleep apnea, such as high blood pressure, depression, and cardiovascular issues.

Do you think you have obstructive sleep apnea? Here’s how to get started with CPAP therapy.

Take Our Sleep Apnea Quiz

If you suspect you have sleep apnea or another form of disordered breathing, make an appointment to see your primary physician. He or she will evaluate your signs and symptoms and, if necessary, refer you to a specialist or for a sleep study. Depending on your symptoms and insurance guidelines, you may have an in-home sleep test or an in-lab test. Your physician will use the results of the study to determine whether or not to prescribe a CPAP machine. Yes, as a medical device, a CPAP machine requires a prescription.

Once you have had a study and your physician has written a prescription for a machine, you want to verify that your referral paperwork has been sent to our office. Once we receive your records we will verify that we have everything required to research your eligibility and coverage and bill your insurance policy. If prior authorization is required, we will take care of getting your insurance company everything needed for them to approve your equipment.

Once we have authorization, our very knowledgeable respiratory therapists will meet with you to discuss your sleep study, instruct you on CPAP machine usage, and fit you for a mask. They will follow up with you to fine-tune your settings and CPAP equipment so that you sleep comfortably.

Have questions? Talk to one of our specialists who can guide you through the process.

Are Artificial Sweeteners Safe for Kids?

You’re a health-conscious shopper. When choosing healthy snacks for the kids, you’ll pick up that yogurt container and take a look at the nutrition label. Low in calories and added sugar? Check. And so that yogurt finds a home in your shopping cart.

But you may have overlooked something.

We all understand that most “diet” foods and drinks that have no calories are artificially sweetened, as are many junk foods. But artificial sweeteners are often present in regular foods, like bread, canned foods, jam, and yogurt. In an effort to provide the products that consumers want — foods low in added sugar but still as sweet as ever — manufacturers leave out added sugar and sweeten their products artificially.

How does a savvy shopper make a decision?

On the one hand, overconsumption of sugar is an epidemic in this country. The average child consumes more than three times the recommended amount of added sugar every day. Both adults and children consume more than 50 pounds of pure sugar annually. We crave sweetness, and sugar is prolific in our highly-processed foods, making it easy to consume far too much of it. After all, a single 12 oz can of soda contains nearly double the daily recommended levels of sugar. Sugar substitutes offer value because they are many times sweeter than sugar and have low or no calories. If artificial sweeteners help to cut back on sugar, aren’t they worth it?

On the other hand, artificial sweeteners bring with them a host of questions about their safety. Suspicions that they may be responsible for cancer, multiple sclerosis, and many other health problems have been abundant for decades. The plot thickens with accusations of conflicts of interest and government cover-ups by regulators that are supposed to protect the public. To pile on, artificial sweeteners might even be addictive!

What Does the Evidence Say?

We can only make decisions with the knowledge that we possess. While science is sometimes an imperfect process, it is the best method of discovery that we have. The debate on artificial sweeteners exceeds 50 years, and due to public interest has become one of the most researched areas in health. We don’t have the space to cover everything here, but we can simplify what thousands of studies and hundreds of institutional and regulatory bodies all say:

There’s no smoking gun to condemn artificial sweeteners, but they aren’t the magic bullet that people were hoping for.

Most of the big issues that have scared people away from artificial sweeteners don’t hold up to scrutiny. In fact, most of those rumors about horrid side-effects can attribute their origin to a very popular hoax.

Worries about cancer go back to studies in the 1970s when rats megadosed with saccharin developed bladder cancer. Many followup studies showed that it was a side effect unique to rat biology and is not applicable to humans. Similarly, health issues that early on were thought to be attributed to sugar substitutes were actually due to problems in the studied populations.

For example, a person at high risk for diabetes, obesity, and heart disease might be prone to using a sugar substitute as damage mitigation. If they aren’t successful, it’s due to genetics and lifestyle, not their Diet Coke.

After rigorous study, the American Heart Association (AHA) and the American Diabetes Association (ADA) have given a nod to the use of artificial sweeteners in place of sugar to combat obesity, diabetes, and heart disease.

The FDA has approved five artificial sweeteners: saccharin, acesulfame, aspartame, neotame, and sucralose. It has also approved one natural low-calorie sweetener, stevia. They’ve also provided conservative recommendations for an Acceptable Daily Intake (ADI), an amount deemed safe for daily consumption. Each of these sugar substitutes acts differently in the human body, so what is true with one isn’t necessarily true of another.

Why We Should Still Be Cautious With Artificial Sweeteners

There might not be evidence that these approved sugar substitutes have dire health consequences, but they still may not be as beneficial as one might hope.

Animal studies suggest that artificial sweeteners may be addictive. In studies of rats who were exposed to cocaine, then given a choice between intravenous cocaine or oral saccharine, most chose saccharin.

It’s also possible that artificial sweeteners change the way we taste food. They are all far more potent than natural sugars or table sugar. This may prevent us from associating sweetness with caloric intake, especially in children.

Overstimulation of receptors from hyper-intense sweeteners could mean that naturally sweet foods, such as fruit, are less appealing and unsweet foods, such as vegetables, are downright unpalatable. As a result, we may crave more sweets, tend to choose sweet food over nutritious food, and gain weight.

Sugar Substitutes — How Much is TOO Much?

Saccharin

Sold under the brand names Sweet’N Low, Sweet Twin, NectaSweet, and others, saccharin has been around the block. This is the same substance responsible for the bladder cancer issue in rats mentioned above, which resulted in warning labels and temporary removal from markets. It has subsequently been labeled as safe.

ADI is 15 mg/kg, a range of 300-1,200 mg per day. One packet of Sweet‘n Low contains 36 milligrams of saccharin.

Acesulfame Potassium

Acesulfame Potassium is very popular in beverages. Due to a slightly bitter aftertaste, it’s often combined with other sweeteners. It has a long shelf-life and is stable under heat, and so is used in baked goods, medications, and protein shakes.

ADI is 15 mg/kg, a range of 300-1,200 mg per day. One 12 oz. Coke Zero contains 46 milligrams of acesulfame potassium.

Aspartame

Aspartame is one of the most-studied food ingredients of all time. Despite approval from regulatory agencies around the world, many are still skeptical of this sugar substitute. Aspartame contains the essential amino acid phenylalanine, so those with the rare disease phenylketonuria must avoid this additive (warning labels will be present on products containing aspartame, much like you’d see warnings for peanut allergies).

ADI 50 mg/kg, a range of 1,000-4,000 mg per day. One can of Diet Coke contains 188 milligrams of aspartame.

Neotame

Neotame is the successor to aspartame, and is in fact a derivative of it. It is free of phenylalanine, so it is safe for those with phenylketonuria. It’s also the most potent sweetener known, being thousands of times sweeter than sucrose and 30-50 times sweeter than aspartame.

ADI .3 mg/kg, or 6-24 mg per day. One soda sweetened with neotame contains about .006 milligrams of this sugar substitute.

Sucralose

Popularly known under the brand “Splenda”, sucralose has had a lot of commercial success due to favorable comparisons against its peers in taste, stability, and safety. It’s unique in that it’s available in a granulated form that allows a volume-for-volume substitution for sugar (although it doesn’t taste exactly the same as sugar).

ADI 5 mg/kg, or 100-400 mg per day. One Diet Mountain Dew contains 27 milligrams of sucralose.

The Final Word

When choosing sugar substitutes, it pays to be a savvy consumer. Artificial sweeteners and sugar substitutes may help with weight management and diabetes (ask your doctor) — and they won’t cause cavities. But they aren’t a magic bullet and should be used only in moderation by adults. The occasional or incidental consumption of sugar substitutes in a low sugar dessert isn’t something that should worry you, just don’t develop a habit of drinking Diet Coke all day.

In children, we recommend avoiding artificial sweeteners as much as is practical. While they are regarded as safe, there is still a fair amount of gray area and no benefit for children.
Hooking developing children on extreme sweetness is a disservice that could impede them for life. An occasional naturally-sweetened soda isn’t the end of the world, and preferable to drinking artificially sweetened drinks every day. Better yet, drink water!

Is Snoring a Sign of Sleep Apnea?

Sometimes you can do everything right and things still don’t go your way. Just ask Sergeant Hayden.

Sergeant Jeffrey Hayden was a cavalry scout in the US Army. He was fit, ate as well as a soldier could, and took good care of himself. After 10 years of hard training, he was strong and had quite a bit of muscle. But despite all his efforts, his health was on a rapid decline, and he was inexplicably gaining weight.

He had uncontrollable high blood pressure and treatment wasn’t working; his doctor was at a loss. His constant heartburn became so frequent that it often caused vomiting. Jeffrey also had immense difficulty sleeping, even when using a prescribed sleeping aid. And when he did sleep, his snoring could be measured on the Richter Scale.

When on duty, his platoon dreaded sleeping anywhere near him. No one was sleeping if Hayden was nearby. At home, he slept on the couch so as not to disturb his wife and their newborn child.

He’d spent his entire adult life dedicated to perfect health, but his life was still being ruined by seemingly untreatable health problems.

The Silent Killer

Service men and women are required to have regular checkups. When given the choice, Hayden opted to see his own provider. His doctor noticed something others had missed: he had a small airway and a large neck.

When the doctor asked him if he snored, Hayden brought up the sleep issues he was having. This information, combined with data from his chart, put up giant red flags. Jeffrey needed a sleep study ASAP.

Hayden checked into a lab that specializes in sleep studies. After they set up the monitoring equipment, he went to sleep. While the study was supposed to consist of a two-night stay in the lab, they had all the data they needed after 88 minutes and stopped the study. It was clear: Hayden had obstructive sleep apnea (OSA), and it could have killed him.

In those 88 minutes, he stopped breathing 44 times. His oxygen levels dropped to dangerously low levels, and while he appeared to be happily snoring (which could be heard down the hall), he never actually got past stage one of REM sleep.

Jeffrey had a naturally smaller-than-average airway and a wrestler’s neck that had been enlarged from years of strength training. As he slept, his airway collapsed, which caused the snoring, and his breathing completely stopped every couple of minutes. His attempts at sleep became a recurring nightmare in which he never reached deep enough sleep to have an actual dream.

The techs briefly woke Hayden up to outfit him with a CPAP appliance designed to keep his airway open. After that, Hayden immediately went into normal phases of sleep, with optimal oxygen levels (and no snoring). He finished the night with the best sleep he’d had in a long time.

Do You Have Sleep Apnea?

Take Our Sleep Apnea Quiz

Sleep apnea is a tricky beast. It’s called the “silent killer” because it can cause dangerous complications (such as hypertension) that may be treated while the underlying cause remains undetected. In fact, 80–90 percent of those with sleep apnea aren’t even aware they have it, and most people don’t know much about it.

Your case may not be as dangerous as Hayden’s was, but that is no reason to shave years off your life by leaving it untreated. We see this often; you can’t really gauge yourself when sleeping, so the best tip you may get is when those around you complain about your snoring.

If you answered yes to more than a couple of the questions on the above quiz and you snore, you are at high risk for OSA. Contact your doctor for an appointment. He or she will evaluate your signs and symptoms and, if necessary, refer you to a specialist or for a sleep study.

If you’re prescribed CPAP therapy, Medicap is here to help you get started smoothly. Our very knowledgeable respiratory therapists will meet with you to discuss your sleep study, instruct you on CPAP machine usage, and fit you for a mask. They will follow up with you to fine-tune your settings and equipment so that you sleep comfortably.

Have questions? Talk to one of our specialists who can guide you through the process.

Loved Ones & Diabetes: How Can YOU Help?

Diabetes affects millions of people in the US and sometimes those affected are family or loved ones. When someone you love is diagnosed with diabetes, it can be emotional and can cause a million questions to run through your mind, such as; what the medical costs are going to be or how you can help them manage their diabetes. You feel the need to support them, and you can.

Ask for Help

So, where do you start? This can be hard to figure out, especially when you find out someone you love has been diagnosed with diabetes. First, ask your healthcare provider what you can do to keep your loved one safe and healthy. If you have other family members who have this disease, you can also reach out to them to get advice or ask questions. Asking for help is the first step in supporting this new journey for your loved ones.

Prepare & Plan

Getting the news of your loved one being diagnosed with this disease can be a shock at first, but when that wears off, find comfort in knowing there are many ways to help them along the way. Living with diabetes can be a challenge, but it is something you can meet head on through planning and preparation. Get back to daily life and regular routine activities through:

Regular physical activity
Balanced diet – one that everyone can enjoy

Just because your loved one has diabetes, does not mean they can’t achieve their goals or dreams.

Talk About IT

A key part of managing diabetes is making sure everyone is open and able to talk about their fears, frustrations, and hopes for the future. This disease can create different emotions. Making sure your loved one has someone to talk to is important. If they do not feel comfortable talking with you, reach out to a professional or the community.

Keep On Keeping On

Just because your loved one has been diagnosed with diabetes, doesn’t mean life stops. Life goes on. Follow these planning tips to keep life moving in the right direction:

Before traveling, schedule an appointment with a healthcare provider to make sure all medications are current. Get written prescriptions for insulin and other medications in case they are lost, along with a doctor’s letter and treatment instructions
If you have a child with diabetes and need a babysitter, consider hiring a teenager who is familiar with this disease.
Plan ahead for birthday parties, holidays or going out to eat. Communicating with the host about special nutrition requirements or check out the restaurant menu before deciding on a place to eat.

Information provided by diabetes.org.

PBMs: Bad for Your Health, Your Wallet, and Your Tax Bill

Pharmacy benefit managers, commonly known as PBMs, are third-party administrators contracted by health plans, large employers, unions and government entities to manage prescription drug benefits programs.

PBMs are the single biggest influence on the soaring price of prescriptions. Originally intended to process claims on behalf of clients, PBMs profit at every stage of the supply chain from drug maker to patient. They are often called the “invisible middleman” because they are hidden between the patient’s insurance company, who the PBM works for, and the pharmacy, who the PBM reimburses for dispensing the prescription. Currently the three largest PBMs are Fortune 500 companies and control nearly 80% of the prescription benefits market in the United States. While the prescription benefits plans have different names, most can be tied back to one of the “Big Three” PBMs.

How Are Patients Affected by PBMs?

PBMs make rebate deals with drug manufacturers to have the product included on the insurance formulary (drugs that are covered by your plan). These rebates collected by the PBM are not passed on to the plan or to you the patient, and they raise drug costs.

The rebates sound like a way to lower costs and save money, but the reality is that these rebates go in the pockets and bank accounts of PBMs, padding their own bottom lines instead of passing along savings to plans and patients.

PBMs also influence which drug a patient receives, taking away choice from the prescribing doctor, pharmacist, and the patient; the decision about which drug is ultimately filled is usually decided by which drug the PBMs chose to cover – and that decision is often based off which drug has the highest rebate, not necessarily which drug will provide the patient with the best outcomes.

Not only do PBMs work as middlemen, some also own (or are owned by) the pharmacies they mandate a patient uses. They also own retail, mail order, and specialty pharmacy facilities. That means that PBMs are setting reimbursements for local independent pharmacies – their competition. At the same time, they are steering patients toward their own brick-and-mortar or mail-order pharmacies, conveniently in-network, and can set a different reimbursement for those stores.

How Are Taxpayers Affected by PBMs?

Recent investigations in states like Ohio, Kentucky and Arkansas have uncovered serious questions about the level of profiteering PBMs that manage Medicaid may be engaged in. As with private health plans, PBMs provide a third-party prescription drug benefit plan to Medicaid and Medicare enrollees, and bill the government for their services. State government pays for services with money raised by local taxes and receives matching federal funding (also taxes) to cover costs.

The amount they bill the government is a very different – and much higher – amount than what they are paying the pharmacies that are filling the prescriptions. An independent investigation in Ohio found that a PBM had been charging the state as much as 9 times the cost of a prescription drug while reimbursing local pharmacies below cost.1 The PBMs pocket that difference, and it is all taxpayer-funded profit.

How Do They Get Away with It?

The lack of regulatory oversight and demand for transparency in the PBM industry has allowed PBMs to overcharge for prescription drugs for decades. PBMs typically don’t provide clients with complete, itemized billing statements so it’s only when informed patients and health plan sponsors “put 2 and 2 together” that they begin to understand how they’re probably greatly overpaying for their prescription medications while the “savings” they thought they would see go directly into the pockets of the PBMs — and their shareholders.

What’s the solution? At the government level, states should fire PBMs or at the very least limit PBMs involvement to a purely administrative roll in state-funded programs like Medicaid and the state employees’ health benefit plan. West Virginia recently did just this and saved $54 million in the first year. Based on a report released by West Virginia Medicaid, the state saved a little over $6 per individual prescription.2

What Role do Independent Pharmacies Have?

PBMs often indicate that independent pharmacies have “massive bargaining power” when they band together and create pharmacy services administrative organizations (PSAOs). In reality, the contracts and reimbursements that PSAOs “negotiate” are often take it or leave it – and it’s hard for a pharmacy to walk away from a contract when a large percentage of their patients may be covered by one PBM. Even with PSAOs, there is little success in truly making any changes since many of the contracts have standard terms and conditions that are largely non-negotiable.3 If independent pharmacies joined together and all refused to take a contract – even under a PSAO – they would face antitrust risks. And because the PBMs own pharmacies themselves, they can just require patients to go to their pharmacies and put the independents out of business; more and more small pharmacies are going out of business every day for this exact reason.

Despite the hardships that independent pharmacies face in this situation, they are invaluable to our communities, especially in underserved and rural areas. By offering immunizations, home delivery, and personal service, local pharmacies provide the much-needed healthcare services that may not be readily available otherwise. The owners are part of the community and contribute financially to local organizations, too – keeping money close to home by supporting their neighbors.

What Can I Do About It?

Several things. Come into our pharmacy and talk to one of our team to understand how your drug plan influences the price you pay for medications. If you manage an employee benefit plan, ask your broker or PBM representative to provide a detailed explanation of your fee structure, or contact Pharmacists United for Truth and Transparency (PUTT) for information on switching to a transparent “pass through” PBM. Finally, encourage state legislators to get involved in local and federal bills that reform obscure fees that threaten the existence of independent pharmacy and raise out-of-pocket costs while enriching these insurance middlemen.

1 https://www.truthrx.org/pbmfaqs.html

2https://dhhr.wv.gov/bms/News/Documents/WV%20BMS%20Rx%20Savings%20Report%202019-04-02%20-%20FINAL.pdf

3 Government Accounting Office GAO-13-176.

*Other content provided by Pharmacists United for Truth and Transparency (https://www.truthrx.org/) and the National Community Pharmacists Association (https://www.ncpanet.org).

What’s True About the Flu?

Influenza (Flu) is a potentially serious disease that can lead to hospitalization and sometimes even death. Every flu season is different, and the infection can affect everyone differently. Millions of people get the flu every year, hundreds of thousands of people are hospitalized and thousands to tens of thousands of people die from flu-related causes every year. This year, more than ever, it is important for you and your family to receive your annual flu vaccine to help protect against the flu. When you get a flu vaccine you are protecting yourself, children, grandparents, the healthcare system, coworkers, the immunocompromised, your community, and the list goes on.

How Do Flu Vaccines Work?

Flu vaccines cause antibodies to develop in the body about two weeks after vaccination. These antibodies provide protection against infection with the viruses that are used to make the vaccine. The seasonal flu vaccine protects against the influenza virus that research indicates will be most common during the upcoming season. You should get a flu vaccine before flu viruses begins spreading in your community, since it takes about two weeks after vaccination for antibodies to develop in your body. The CDC recommends that people get a flu vaccine by the end of October. Getting vaccinated too early could lead to reduced protection against the flu later in the flu season.

Flu Facts vs. Flu Myths

“People who get a flu shot are more likely to develop Alzheimer’s disease”

FALSE. Recent studies have indicated that flu and pneumonia vaccines may actually protect people from Alzheimer’s, possibly contributing to the protection of memory, cognition, and overall brain health.

“I should get a flu shot later when there are cases in my area”

FALSE. As stated above, your body needs about two weeks after you receive the flu shot before the antibodies can protect you against the virus. Get your flu vaccine so you are covered before flu viruses begin to circulate, not after.

“The flu shot will give me the flu”

FALSE. The flu vaccination will not give you the flu. The vaccines are made from ‘inactivated’ (killed) flu viruses. Some people experience a fever or body aches for a few days after receiving the vaccine, but this is not the flu. These side effects are a normal reaction and a result from your body creating an immune response to the vaccine.

“I don’t need a flu shot, I got one last year”

FALSE. The vaccine is developed each year specifically for the virus strains predicted to circulate during the upcoming flu season. Also, the body’s immune response gradually decreases over time, so it is important to get a flu shot every year during the recommended time frame to ensure the best possible protection.

“I don’t need to get the flu shot because I have never had the flu before”

FALSE. The flu shot doesn’t just protect you from getting the flu but it also protects those around you. Many healthy people can be infected with the flu virus and spread it to others by coughing, sneezing, talking, or from touched surfaces even if they are not showing symptoms. There are also certain populations such as newborns, immunocompromised, cancer patients that are unable to receive vaccinations or are unable to develop an adequate response to the vaccine, so it is even more important for healthy individuals to be vaccinated to prevent spreading it to those most at risk of severe illness.

“A flu shot isn’t safe while pregnant”

FALSE. Getting the flu shot is safe during all trimesters of the pregnancy and can even pass antibodies along to the baby while protecting the mother. These antibodies can continue to protect the baby several months after birth.

How effective is the flu vaccine?

While vaccine effectiveness can vary, recent studies show that flu vaccination reduces the risk of flu illness by between 40% – 60% among the overall population during season when the flu virus circulating is well-matched to the flu vaccine. In general, current flu vaccines tend to work better against influenza B and influenza A (H1N1) viruses. There are multiple strains of flu viruses that circulate every year. Researchers predict and develop vaccines based on the most common circulating strains from the previous year. While the flu vaccine is not able to protect against all the strains, it will reduce the risk of getting the flu and should also lessen the severity if you do get sick.

Talk to your doctor or pharmacist about the best time to receive your flu vaccine!

*information provided by the cdc.gov

Summer Fun in the Sun

Did you know that the sun’s ultraviolet (UV) rays can damage your skin in as little as 15 minutes? And although some people are at higher risk of getting skin cancer, anyone can get it. People with greater risk include those with lighter natural skin color, skin that burns, freckles, or reddens easily, blue or green eyes, blond or red hair, certain types and large number of moles, family or personal history of skin cancer, and older age. Regardless if you are at high risk or not, reducing your exposure to UV rays and taking proper precautions can help keep your skin healthy and lower your chances of getting skin cancer.

Sunscreen – Apply sunscreen with SPF 15 or higher before you go outside, even on cloudy or cool days. Reapply every two hours if you are outdoors longer than that and make sure your sunscreen is not expired.
Shade – You can reduce risk of skin damage by seeking shade under an umbrella, tree, or other shelter. Even in the shade, make sure to wear sunscreen and protective clothing.
Clothing – When possible, wear long-sleeved shirts and long pants and skirts to protect from UV rays. Also, to protect your face, ears, and neck wear a wide brimmed hat with tightly woven fabric.
Sunglasses – Wear sunglasses to protect your eyes and reduce the risk of cataracts. Sunglasses also protect the skin surrounding your eyes.

Skin cancer is the most common form of cancer in the United States. A change in your skin is the most common sign of skin cancer. This could be a new growth, a sore that does not heal, or a change in a mole. It is important to know that not all skin cancers look the same, so it’s important to talk to your doctor if you notice any changes in your skin. Sun-safe skin is always in! Protect your skin now to help lower your risk of skin cancer in the future.

*information provided by cdc.gov

August is National Immunization Month

August is National Immunization Month, and it is a time to recognize the importance of staying safe, reducing the spread of diseases, and staying up to date on immunizations for each stage of life. Due to COVID-19, it is more important than ever to ensure everyone in your family is up to date on their immunizations this year. Routine vaccinations prevent illnesses that lead to unnecessary medical visits & hospitalizations, which increase your risk of exposure and further strain our healthcare system.

Why are vaccines important?

A vaccine (or immunization) is a way to help your body build its natural immunity to a disease before contracting the full strain of the disease and possibly getting sick from it. For most vaccines, a weakened form of the disease germ is injected into your body, usually via a shot in the leg or arm. Your body detects the invading germs (antigens) and produces antibodies to fight them. Those antibodies then stay in your body for a long time. In many cases, the antibodies are present for the rest of your life — this means that if you are ever exposed to that disease again, your better will be more equipped to fight it off.*

Vaccines not only help protect yourself but helps protect your loved ones, too. They are an essential part of preventing community spread of diseases, and they help protect those who are unable to get vaccines for one reason or another (allergies, immunocompromised, etc.)

When should I get my vaccine?

Some vaccines should be administered at regular intervals throughout our lives, such as the annual flu shot or the booster tetanus and diphtheria (Td) vaccine received every 10 years. Others, however, are encouraged for administration at particular ages.

For example:

Vaccinations given during any trimester provide both mother and baby with protection, even after birth. The first administration of the Tdap vaccine will help protect against whooping cough. It’s safe to receive vaccines during pregnancy and after giving birth, even while breastfeeding – and this includes the flu shot.
Babies receive vaccinations by the age of 2 that help protect them from 14 diseases, including measles and whooping cough.
Pre-teens and teens have a greater risk for diseases like meningitis and HPV, and those vaccines provide more protection at this age.
Vaccines are an essential preventative measure for older adults as they are at higher risk of developing complications if they contract certain illnesses, such as pneumonia or shingles.

Ask our team which vaccines are right for you!

*Information provided by familydoctor.org/the-importance-of-vaccinations/ & the cdc.gov