5 Pharmacy Terms You Need to Know
By Shari Steinbach, MS RDN, RDBA Contributing Editor
According to the Deloitte 2015 Retail Health & Wellness report there are approximately 40,000 pharmacies within the top 10 retail chains. Pharmacies allow for personal interactions with patients and they are well positioned to help shape the consumer-focused health care system of the future. As more supermarket dietitians engage with their pharmacies to provide nutrition expertise for patient care, it is important to understand some key terms used in the pharmacy industry.
Medication Therapy Management (MTM) - A service rendered by a pharmacist that provides a comprehensive and in-depth examination of a patient’s medication regimen that helps to ensure proper medication utilization.
Specialty Pharmacy - Focuses on providing services to patients with often rare conditions, who require high-cost, complex medications, frequently only available from a limited panel of specialty pharmacies. Data from the Accreditation Commission for Health Care (ACHC), one of the organizations that provides accreditation for specialty pharmacies, states that there are more than 2,000 newly accredited locations from retail pharmacies within the supermarket chains Albertsons, Meijer, and Price Chopper.
Central Fill Pharmacy - One large pharmacy or facility that packages many routine medications and delivers them to smaller pharmacies for distribution to patients. This allows the pharmacist more time to focus on customers.
Formulary - A drug formulary, or preferred drug list, is a continually updated list of medications and related products supported by current evidence-based medicine, judgment of physicians, pharmacists and other experts in the diagnosis and treatment of disease and preservation of health. The primary purpose of the formulary is to encourage the use of safe, effective and most affordable medications.
Pharmacy Benefit Managers (PBMs) - A pharmacy benefit manager (PBM) is a third-party administrator of prescription-drug programs for end payers, such as private insurers, and Medicare Part D plans. With preferred formularies and exclusion lists, PBMs dictate which drugs consumers can receive from their plan without incurring additional out-of-pocket costs. They also leverage access to their formularies, and threats of exclusion, to negotiate rebates and discounts from the world's drug makers.
Point-of-care (POC) testing - Involves performing a diagnostic test outside of a laboratory that produces a reliable result rapidly to aid in disease screening, diagnosis, and/or patient monitoring. These tests are waived under the Clinical Laboratory Improvement Amendments (CLIA) of 1988 and pharmacists can charge patients directly or bill third party payers. Point-of-care testing for infectious diseases provides an excellent opportunity for community pharmacies to enhance revenue by expanding patient care services while improving health at the patient and population level. The screening and diagnostic process can be completed during a single encounter, thereby improving access to care, counseling, and patient outcomes.