Lecture 4

Question 1

what are the 2 classes of drugs recognized by the FDA

Answer 1

legend and non legend

legend = by law, required to carry a “legend” on the product label/container (Rx)

non legend = nonprescription drugs

Question 2

as mentioned the FDA recognizes 2 classes of drugs – legend and non legend.
what is the unofficial 3rd class of drugs?

Answer 2

pharmacy only.
things at pharmacy behind the counter that you need a license to purchase. – pseudophedrine

Question 3

WHY is this unofficial 3rd class of drugs sold behind the pharmacy counter?

Answer 3

they can be used to make street drugs – monitored

Question 4

what are BTC drugs

Answer 4

those sold behind the pharmacy counter.
can be Rx (legend) or the unofficial 3rd class

Question 5

the FDA regulates the ___ and ___ of drugs

Answer 5

safety and efficacy

Question 6

once sold, a health plan (payer) uses ___ and ___ to evaluate drugs

Answer 6

economics and quality

Question 7

the _________ is beginning to create a class of drugs that pharmacists can prescribe

Answer 7

STATE BOARD OF PHARMACIES

Question 8

everything starts as a _____, then gets upgraded to become a ____ or _____. HIGHEST = _____

Answer 8

everything starts as a SERVICE then gets upgraded to become a PROTOCOL or PROGRAM. highest= PRACTICE MODEL

talking abt MTM(MTMS)/MR/CDTM/CMR

Question 9

between MTM(MTMS)/MR/CDTM/CMR

which is the highest? what is it considered?

Answer 9

CDTM — considered a practice model

Question 10

MTM(MTMS)/MR/CDTM/CMR

each is considered a ____

Answer 10

service

Question 11

service packed “tighter” become a ____

Answer 11

program

Question 12

what was the mission of pharmacy in the 80s? what about the 90s?

Answer 12

80s - pharmaceutical care

in 1990s — become MTM (medication therapy management).

Question 13

what put the pharmaceutical care idea of the 80s into practice?

Answer 13

MTM (medication therapy management)

Question 14

what was the 1st implementation of pharmaceutical care?

Answer 14

the asheville project

Question 15

pharmaceutical care became ____ which became ____ which became ____

Answer 15

pharmaceutical care became MTM which became MR which became CDTM

Question 16

MTM began as a _____ only service

Answer 16

MEDICARE

Question 17

true or false

dispensing and counseling are considered services

Answer 17

true.
they are services just not specialized services

Question 18

CDTM is considered a ….

Answer 18

PRACTICE MODEL. groundbreaking

Question 19

MTMS is a ___ model

Answer 19

retial

Question 20

CDTM is permitted in what settings?

Answer 20

only hospital

Question 21

what were the ORIGINAL parts of medicare?

Answer 21

A&B — 1965(6?)

Question 22

explain what parts A and B of medicare are

Answer 22

part A = HI (hospital insurance) INPATIENT

part B = SMI (supplemental medical insurance) OUTPATIENT (ie: primary care )

Question 23

explain what medicare part C is

Answer 23

CHOICE between traditional and new (new = managed care)

AKA medicare advantage plans. private insurance coverage (managed care orgs) in addition to the benefits of parts A and B. if you have C, dont need the rest

Question 24

why did they semi privatize medicare by adding part C?

Answer 24

gives more options for those with certain medical conditions. part C is like any private health plan. can have dental, vision, prescription, etc

Question 25

when was medicare part D added and what does it cover

Answer 25

medicare part D (prescription drug coverage) was added to medicare due to the medicare modernization act of 2003

Question 26

what is the downside of utilization management? which part of medicare does it primarily affect?

Answer 26

part C (semi privatized) UM is used to ensure quality and cost control, but some private insurances go too far with it and costs rise a lot

Question 27

as mentioned, MTM used to be medicare ONLY. is it still like this?

Answer 27

no -- now done for all patients

Question 28

explain what population health is and what programs it applies to

Answer 28

population health = health outcomes of a group ie: medicare = population health for the elderly medicaid = population health for the poor

Question 29

give the purpose of MTM

Answer 29

medication therapy management is a distinct service or a group of services that optimize therapeutic outcomes for INDIVIDUAL PATIENTS -done one patient at a time

Question 30

do medication therapy management services HAVE to occur in conjunction with the provision of a medication product?

Answer 30

does not have to, but can. INDEPENDENT of the drug product

Question 31

do you have to be physically present in the pharmacy to be an MTM pharmacist?

Answer 31

NO --- you can work from home

Question 32

MTM is primarily a ___ service

Answer 32

retail

Question 33

what is common to MTM and CDTM?

Answer 33

they are applicable only to SPECIFIC disease states ie: the 4C's -chronic -costly -coordination -compliance challenges

Question 34

true or false mental health is considered a costly disease

Answer 34

true

Question 35

do you need to be a pharmacist to perform MTM?

Answer 35

NO other HC providers can perform as well

Question 36

true or false medicare's MTM is the law everywhere, but some states have additional MTM

Answer 36

true

Question 37

can a regular retail pharmacist formulate a medication treatment plan? what do you mean by formulate a medication treatment plan?

Answer 37

NO formulate a medication treatment plan = SMOI

Question 38

____ is part of MTM

Answer 38

CMR (comprehensive medication review)

Question 39

what does CPA stand for

Answer 39

collaborative practice agreement (arrangement)

Question 40

under CPA = ____________ (a specialized service -- a practice model --- mentioned previously)

Answer 40

CDTM

Question 41

CDTM involves pharmacists practicing where?

Answer 41

in facilities (hospital, outpatient clinics, diagnostic center, treatment center etc. NOT LEGAL IN RETAIL)

Question 42

true or false CDTM is federally imposed and regulated

Answer 42

FALSE -- the states have their own protocols. NY has multiple

Question 43

true or false a patient has to consent before CDTM is performed

Answer 43

TRUE

Question 44

CDTM is a ____ based arrangement. what does this mean?

Answer 44

PROTOCOL BASED ARRANGEMENT this means that CDTM allows the pharmacist, in collaboration with the physician. to adjust or manage a drug regimen for a SPECIFIC disease or disease state

Question 45

is CDTM mandatory?

Answer 45

NO --- voluntary on patient and pharmacist side

Question 46

what does NYSCHIP stand for

Answer 46

new york state council of health systems pharmacists geared toward HOSPITAL + MORE (used to be just hospital)

Question 47

what is a sunset law? which specialized service that we talked about is a sunset law in NY?

Answer 47

a sunset law is a law that expires. CDTM is a law that expires every 2 years in NY, but has always been renewed with success the new law suggests added NPs as providers

Question 48

explain what medication reconciliation means

Answer 48

the process of creating the most accurate list of possible medications a patient is taking (including name, dosage, frequency, and route) and comparing that list against the physician's admission, transfer, and/or discharge orders with the GOAL of providing correct medications to the patient at ALL TRANSITION POINTS within the hospital

Question 49

why is a pharmacist often utilized to perform med rec?

Answer 49

pharmacist trained TOC (help with transition of care so patient's meds dont get lost track of)