In brief: PAP therapy helps to improve outcomes, indie pharmacies worry about ‘DIR hangover’

INDIANAPOLIS – People with heart failure and obstructive sleep apnea can significantly reduce hospitalizations and ER visits, as well as related costs, by being adherent with PAP therapy, according to two recent studies. 

The studies were supported by ResMed and presented at SLEEP 2023. 

One study analyzed 1,472 people with OSA and systolic heart failure, with exactly half adherent on PAP therapy and half non-adherent. The adherent patients had 24% fewer ER visits and incurred 40% lower costs related to hospitalizations and ER visits over one year ($3,500 vs. $5,879) compared to non-adherent patients. 

The second study analyzed 1,926 people with OSA and diastolic heart failure – again, half adherent, half non-adherent. The adherent patients had 36% fewer ER visits, 57% fewer hospitalizations and incurred 18% lower related costs (an average $12,732 vs. $15,610) over one year.  

The studies hold significant implications for managing heart failure patients, since 76% of them also have sleep apnea. 

“Since three out of four people with heart failure also have sleep apnea, these findings underscore the significant role PAP treatment plays in keeping people healthy and out of the hospital,” said Fatima Sert Kuniyoshi, MSc, PhD, lead author and ResMed clinical research director. “I hope this leads to a greater emphasis on PAP prescription and monitoring for the sake of patients, as well as the hospitals and ERs, that would otherwise require added beds and resources to care for them.” 

Survey: Independent pharmacies worried about ‘DIR hangover’ 

ALEXANDRIA, Va. – Seventy percent of independent community pharmacy owners/managers are concerned about upcoming cash flow challenges resulting from changes to federal policy effective Jan. 1, 2024, according to a new survey released by the National Community Pharmacists Association. 

The NCPA asked independent pharmacy owners/managers for insight relating to the “DIR hangover” – what it calls the period starting Jan. 1, 2024, when bills for pharmacy direct and indirect remuneration for the end of 2023 will come due to pharmacy benefit managers, just as those DIR fees for the beginning of 2024 will be moved to the point of sale. The “DIR hangover” is a result of provisions from CMS’s Medicare Part D final rule for contract year 2023 going into effect. 

“With pharmacy benefit manager pressures and other economic issues at play, it continues to be a challenging environment in which to operate an independent pharmacy,” said Anne Cassity, senior vice president of government affairs at NCPA. “Under pressure from regulators and policymakers to straighten up, PBM insurers are in overdrive trying to make people believe they don’t need oversight or reforms, while seemingly carrying on with tactics that make it difficult for patients to access care and independent pharmacies to remain healthy. Without hard results, their promises are empty. Work must continue to advance changes that demonstrably support pharmacy teams, the patients they serve, and the supply chain we all rely on.”  

Ninety-eight percent of survey respondents say they are concerned about the upcoming “DIR hangover” and how it will affect their pharmacy; a majority (70%) say they’re very concerned. 

Eighty-five percent of respondents say they are taking steps now to prepare. When asked to select ways they are preparing, respondents most commonly reported putting aside cash for estimated DIR (64%), exploring loan opportunities to get through the “hangover” period (42%), updating technology and leveraging pharmacy software systems to help predict reimbursements (28%), and working with consultants (23%).  

Northshore Care Supply partners with Cubs Radio 

GREEN OAKS, Ill. – NorthShore Care Supply and its NorthShore brand of adult diapers are now the official sponsors of "Walks by Opposing Pitchers" on Audacy's Cubs Radio AM670 The Score. NorthShore uses sports analogies to highlight the prevalence of bladder and bowel control problems that affect one in three adults in the United States. "Incontinence is very common, often treatable and, regardless, very manageable," said Adam Greenberg, founder of NorthShore. "Yet people are embarrassed to ask for help, so many stay close to home and avoid fun outings such as attending baseball games. NorthShore adult diapers' will be mentioned by the Cubs' broadcast team of Hall of Famers Pat Hughes and Ron Coomer when the Cubs earn a ‘walk’ due to their opponents' pitching ‘control problems.’” The campaign is an extension of NorthShore's successful campaign with Bulls Radio. 

WHO publishes wheelchair guidelines 

GENEVA, Switzerland – The World Health Organization has published guidelines to support improved access to wheelchairs. The guidelines are relevant for all countries and apply to all wheelchair users and types of wheelchairs. They emphasize that the best outcomes in wheelchair access occur when wheelchair users have the benefit of wheelchair selection following an individual process of assessment, fitting, training and follow up, provided by appropriately trained personnel. Ultimately, the purpose of the guidelines is to ensure that wheelchair users have timely access through wheelchair services that are people centered and responsive to their needs, the WHO says. Achieving equitable access to appropriate wheelchairs requires an overall strategy that places people at the center, and focuses equal attention on policy, products, provision and personnel as interconnected elements that must come together for a holistic result, it says. The guidelines offer service and system level recommendations and implementation guidance toward optimizing wheelchair service models, delivering wheelchair service activities, ensuring training for all personnel that play a role in wheelchair provision, strengthening systems to monitor and evaluate wheelchair provision, and encouraging a supportive policy environment. 

Viemed completes HMP acquisition 

LAFAYETTE, La. - Viemed Healthcare has successfully completed its previously announced acquisition of Tennessee based Home Medical Products, a large regional provider of respiratory focused home medical solutions. “I’m incredibly proud to welcome the HMP team to the Viemed family,” said Casey Hoyt, CEO of Viemed. “Both organizations share a culture that focuses on high quality patient interaction in the home driven by clinical excellence and supported by technology. Today, we immediately expand our existing reach through product, payor, and geographic diversity. We will continue our on-going efforts to ensure a seamless integration of the two organizations and to leverage our shared experience to deliver synergized growth while driving positive clinical outcomes and improving the quality of life for our patients.” HMP, which was founded in September 2004, currently serves approximately 45,000 active patients and employs approximately 180 individuals throughout Tennessee, Alabama and Mississippi.