HC Spectrum - Walgreens · Specialty Pharmacy was created in 1999 and today is a leading national...

Home Care HappeningsInfusion Services Now Provided in Cincinnati, DenverWalgreens Home Care is pleased to announce that we now offer infusion services for theCincinnati and Denver areas. Patients in these metropolitan regions can now rely on Walgreens Home Care to coordinate specialized nursing services for a full range of infusion therapies.

Additionally, our Cincinnati infusion center is housed in a new, state-of-the-art Walgreens Specialty Pharmacy facility. This helps integrate Walgreens Home Care and Specialty Pharmacy operations, enhancing our ability to provide comprehensive healthcare management for patients who suffer from chronic conditions such as cancer, immune defi ciency, multiple sclerosis, and rheumatoid arthritis.

“We view this integration with specialty pharmacy as a natural extension of our home infusion capabilities as we provide the clinical expertise for these infused specialty therapies,” said Ron Allen, vice president of home care services.

City Turns to Walgreens Home Care for Patient in NeedWhether it’s volunteering goods and services for fl ood victims or donating healthcare equipment, we try to help those in need whenever possible. This summer Walgreens Home Care did just that for one Jacksonville, Fla., patient.

Laverne Sterns of the City Contract (a Jacksonville-funded program for low income patients) contacted Account Executive Frank Lorr concerning a patient who required oxygen therapy for a health condition. Unfortunately, the patient’s insurance plan did not cover this service, nor was the patient fi nancially able to pay for it on her own. Concerned for the patient’s health, Walgreens Home Care made arrangements to provide oxygen service at no charge to the patient.

In This Issue:

Letter from Our Vice President ...... 3

Focus on COPD ...... 3

Hot Topic – Specialty Infusion .. 4

HC Spectrum Q&A ................... 5

Our Latest News ...... 5

Mark Your Calendar ............. 6

We’re Listening ........ 7

Legislative Corner .... 8

Volume 3 Number 3

Accredited by theJoint Commission

continued on p. 2

HC Spectrum®

©2006 Walgreen Co. All rights reserved.

A newsletter created especially for healthcare professionals using

home care services, delivering a mix of news and trends in healthcare

and up-to-date information about our clinical programs and services

“At Walgreens Home Care, our priority is serving the patient and the community,” said Tammy Junior, facility manager for the Jacksonville Walgreens Home Care. “Sometimes that means providing a helping hand to our neighbors.” The patient received the appropriate equipment and is doing well on therapy.

New, Easy-Access Patient Education Material Now AvailablePatient education along with self-management are key to helping our patients gain confi dence in their therapy. To that end, we have updated much of our patient education material to help ensure patient compliance. Every patient receives a Walgreens Home Care folder that includes a welcome handbook with general home care information. The folder provides designated space for important phone numbers and personal health information. In addition, we now have the following new education booklets: “Home Oxygen Therapy,” “Traveling with Oxygen,” and “Home Infusion Therapy.” We are working on Spanish versions of these booklets and expect them to be available sometime next year. Booklets for CPAP and nebulizer therapies are also in development.

Patients can expect thorough information about their therapy plus information regarding safety precautions, checklists, and instructional diagrams. Our educational material is a supplement for patients. As always, a Walgreens Home Care staff member will be the primary contact for the patient. Our pharmacists, therapists, and staff are available 24 hours a day.

Walgreens Home Care Provides Health Testing at Wisconsin FairWalgreens Home Care, with the help of pharmacy students from the University of Wisconsin-Madison, provided blood pressure, glucose, and cholesterol screenings at the WPS Health Fair in Madison, Wis., June 8 and 9. The event attracted about 3,500 people and was sponsored by WPS Health Insurance, one of the largest health benefi ts providers in Wisconsin. Greg Dockter,

pharmacy manager of the Washington Ave. Walgreens store in Madison, helped Walgreens Home Care coordi-nate health screenings for the event, where approximately 1,300 fair-goers received testing.

Fourth-year pharmacy students from the University of Wisconsin-

Madison take time out from diagnostic testing at the WPS Health Fair in Madison, Wis.

Photo provided by Craig Sherman.

Patient folder Therapy-specifi c booklet


HC SpectrumHome Care Happenings (continued from p. 1)

Letter from Our Vice PresidentA Spectrum ChangeYou might notice a few changes with this edition of HC Spectrum. In response to feedback we have received from readers and from our account executives in the fi eld, we have added some features that we hope will keep you better informed not only about Walgreens Home Care but about the home care industry in general.

One of those features is our new back page “Legislative Corner.” Medicare continues to be a hot-button issue for our industry. It is also a confusing one. Our readers have expressed the need for more coverage of Medicare as well as other legislative issues affecting home care. We hope that you fi nd these news briefs informative. We’ll include Internet links whenever possible for access to more information.

“Caring Counts – A Case Study” has typically been devoted to patient case studies. We feel that occasionally using this forum to highlight disease states and conditions will be benefi cial to readers. See “Focus on COPD” below for a look at chronic obstructive pulmonary disease, some recent research on the condition, and how Walgreens Home Care provides therapy for these patients.

Finally, we will occasionally replace our “Leading with Research” feature with articles about an emerging issue or hot topic in the industry. This issue, for example, we take a look at the increasing integration of home care and specialty pharmacy (see “Hot Topic – Specialty Infusion” on p. 4).

We hope you like these new features. As always, we invite your thoughts and suggestions.

Tom Schencker Vice President, Home Care Sales

Focus on COPDHealthcare professionals and caregivers who deal with chronic obstructive pulmonary disease (COPD) are well aware of the tremendous toll this condition takes on its sufferers. In addition to the primary symptoms of chronic cough and diffi culty breathing, COPD can also adversely affect a patient’s mental health and quality of life.

It is estimated that approximately 16.4 million people suffer from COPD. According to the Centers for Disease Control and Prevention (CDC), COPD is the fourth leading cause of death worldwide, as well as a leading cause of disability. There is no cure for COPD. While oxygen therapy is the primary treatment, patients often benefi t from additional therapeutic options such as pulmonary rehabilitation.

According to a study published in the April 2006 issue of Chest, pulmonary rehabilitation can help Chest, pulmonary rehabilitation can help Chestreduce both direct and indirect effects of COPD. Dr. Rosa Güell and colleagues at the Hospital de la Santa Creu i de Sant Pau in Barcelona, Spain, monitored the health effects of pulmonary rehab, which includes breathing retraining and exercise, on a group of 40 COPD patients.

After four months, Güell et al. compared the physical and behavioral health of this group with that et al. compared the physical and behavioral health of this group with that et alof a control group of patients who received no rehabilitation and found that the group that received rehabilitation showed better health outcomes. Pulmonary rehabilitation not only reduced the

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HC Spectrum

severity of COPD symptoms but also reduced the risk for depression. The study concluded that pulmonary rehabilitation has a positive impact on patients’ exercise capacity and quality of life, and it may reduce adverse psychosocial effects among COPD patients.

This study emphasizes the amount of control that COPD patients have on the severity of their health condition. At Walgreens Home Care, COPD patients represent approximately 35 percent of our respiratory care. Our respiratory therapists play an important role in educating COPD patients about their condition, teaching proper inhalation techniques, and encouraging compliance with prescribed therapy. We also encourage patients to actively participate in their own care, and we help them seek additional health options to make living with COPD more comfortable. For example, Walgreens Home Care respiratory therapists can connect patients and family members with local pulmonary rehabilitation programs for additional support.

Hot Topic – Specialty InfusionIs It Home Care or Specialty Pharmacy?The growth of biotech drugs, in both use and development, is staggering. Spending on specialty drugs rose 17.5 percent last year (compared with 10 percent for traditional drugs).1 Given the

increased use of specialty medication and the fact that hundreds of specialty drugs are in the pipeline, it’s no wonder that spending for this class of medication is expected to more than double by 2009, potentially becoming a $90 billion industry responsible for 28 percent of all pharmacy expenditures.1

But the impact of specialty medication goes far beyond the fi nancial. The market is literally creating a new healthcare service that blends the roles of home infusion and specialty

pharmacy. This new service, commonly referred to as “specialty infusion,” is requiring home care and specialty pharmacy providers to re-evaluate their operational and clinical service models and consider acquisition or consolidation as a means to more effectively serve this emerging market.

Overlap of Home Infusion and Specialty Pharmacy Therapies

Flolan®

IVIG and other blood factorsNovantrone® Oncology drugs Pipeline drugsRemicade®

Remodulin®

AntibioticsCardiac infusionsEnteral nutritionHydration Oncology support Pain control Parenteral nutrition

Growth disordersHemophiliaHepatitisInfertilityIVIGMultiple sclerosisRheumatoid arthritisSynagis®

Home Infusion Specialty Pharmacy

Adapted from design by Richard Bulich of Pharmaceutical Buyers, Inc.


HC SpectrumFocus on COPD (continued from p. 3)

The impetus for this change stems from the nature of the specialty medication itself. Specialty drugs require complex administration and monitoring. They are also extremely expensive. For example, four specialty drugs are available to treat infl ammatory disease. Each drug costs an average of $1,417 for a month’s prescription.

As a result of these factors, traditional home care companies are looking to add specialty pharmacy capabilities and specialty pharmacy providers are partnering with home infusion companies. These partnerships are also entering into contracting relationships with payors, network managers, and drug manufacturers.

Here is where Walgreens Home Care has a distinct advantage. As a subsidiary of one of the largest U.S. retail pharmacy chains, we have access to an established medication delivery model that serves more than 5,000 stores in 47 states and Puerto Rico. In addition, Walgreen Co., through its health services division, can provide integrated specialty pharmacy and home infusion services. Walgreens Specialty Pharmacy was created in 1999 and today is a leading national provider of injectable medications and specialty therapies.

HC Spectrum Q&AThank you for your questions.

Q. If a patient requires home infusion of a specialty drug, is the service covered under a medical benefit or a pharmacy benefit?A. It’s a good question and one that even the government has trouble clearly delineating. The short answer is that it depends on the type of insurance the patient has. For a patient on Medicare, coverage will most likely fall under Medicare Part D, the government’s pharmacy benefit— however, there are 13 categories of drugs covered under Medicare Part B. The Centers for Medicare & Medicaid Services (CMS) is requiring Medicare Part D plans to add several acute care home infusion drugs to their formularies by next year. For a quick guide on Part B and Part D coverage, refer to our 2005 fall issue of HC Spectrum at www.walgreenshealth.com/ common/pdf/HCSpectrumFall2005.pdf. For patients not on Medicare, home infusion of specialty drugs can be covered as a medical benefit or a pharmacy benefit. It all depends on how the insurance carrier chooses to classify the medication therapy. The good news is that Walgreens Home Care can provide service whether a patient’s coverage falls under a medical benefit or a pharmacy benefit.

Our Latest NewsMerger Expands Walgreens’ Northeast PresenceOur retail growth continued its brisk pace this summer. In June, Happy Harry’s, a Delaware-based pharmacy chain, merged with Walgreen Co. The merger includes all 76 Happy Harry’s stores in Delaware, Pennsylvania, Maryland, and New Jersey, as well as the corporate offi ce and distribution center in Newark, Del. “Happy Harry’s is one of the strongest regional chains in the drugstore industry with a great following in a market where we have little presence,” said Walgreens Chairman Dave Bernauer. “Its brand reputation and market share are a great base from which to build our presence

continued on p. 6


HC SpectrumSpecialty Infusion (continued from p. 4)

there. These stores are performing well and will benefi t us right from the start.” This is Walgreens’ largest retail acquisition since 1986 when it purchased the 66-store Medi Mart chain in the Northeast.

Walgreens Acquires Two Specialty Pharmacy CompaniesWalgreens made two acquisitions last month that substantially bolstered our commitment to providing comprehensive specialty pharmacy services—Chicago-based C&M Pharmacy, LLC, and Pittsburgh-based Medmark Specialty Pharmacy Solutions.

C&M Pharmacy is a 10-year-old specialty pharmacy that serves Chicago-area patients living with HIV/AIDS, hepatitis C, and behavioral health conditions. C&M also provides nutritional therapies, wound care, and IV infusion therapies. Medmark is a full-service, national specialty pharmacy company that provides pharmacy care to patients with unique or chronic conditions such as multiple sclerosis, infertility, hemophilia, organ transplants, and cancer.

Mark Your CalendarWith fall just around the corner, don’t miss opportunities to get outside and enjoy the weather. Some of the organizations listed below host walks, runs, or other community events. Take this as a personal invitation to donate time or needed supplies or to join a walk or marathon. Visit the sponsoring organization’s web site for more information about these events.

Take note, the month of October gives special recognition to physical and respiratory therapists and case managers.

Observance Date Sponsor/Web Site

Healthy Aging Month September Educational Television Network, Inc. www.healthyaging.net

National Pain Awareness Month September National Pain Foundation www.understandingpain.org

Prostate Cancer Awareness Month September National Prostate Cancer Coalition www.pcacoalition.org

Talk About Prescriptions Month October National Council on Patient Information and Education www.talkaboutrx.org

Children’s Health Month October U.S. Environmental Protection Agency www.childrenshealth.gov

National Physical Therapy Month October American Physical Therapy Association www.apta.org

National Depression Screening Day October 5 Screening for Mental Health, Inc. www.mentalhealthscreening.org

National Case Management Week October 8 to 14 Case Management Society of America www.cmsa.org

Respiratory Care Week October 22 to 28 American Association for Respiratory Care www.aarc.org

For a complete list of this year’s national observances, visit the National Health Information Center’s web site at www.healthfi nder.gov/library/nho.


HC SpectrumOur Latest News (continued from p. 5)

We’re ListeningProviding Care with CompassionThe Walgreens Home Care offi ce at the Los Alamos Medical Center in New Mexico received a letter from a patient who wanted to express her appreciation for Esther Monnet, a Walgreens documentation specialist. “Recently I was diagnosed with diabetes. I was not expecting to hear this information and I was quite upset about the news…Ms. Monnet saw I was quite upset and crying because of my diagnosis and she was kind to me during my emotional circumstance…Although I asked her a lot of questions, Ms. Monnet did not take offense. She was professional and responsive to

all my questions. She is very knowledgeable about the Walgreens Home Care and prescription processes. I was quite impressed with the way Ms. Monnet treated me in my time of need. She calmed me down and I was grateful for her assistance.” Our many thanks to Esther for representing what Walgreens Home Care is all about—patient care and understanding.

Delivering Quality Service, Personal CareShelli Berry, patient service representative for our Wauwatosa, Wis., location, related a phone call she received from a patient’s daughter praising the personal touch of Blair Bancroft, one of our delivery technicians. “A huge compliment for Blair came in today. The daughter of [a Walgreens Home Care patient] called today with the unfortunate news that her mother had passed away. She and her family could not compliment Blair enough for all his hard work and enormous amount of kindness and caring nature he provided for their mother. In fact, the mother would not let Blair leave after each visit without a hug!”

Professionalism RecognizedA nurse manager from a senior care facility in West Allis, Wis., sent us a fax complimenting the Wauwatosa, Wis., staff for their service and noting the exceptional professionalism and assistance of Sandy DeKarsky, patient service representative. “I have had the pleasure of working with your team by phone and must report the excellent service I have encountered. I especially would like to draw attention to Sandy. I have designated her as my ‘go-to’ person. Sandy is always friendly and pleasant on the phone along with being professional…Thanks for the great service!”

Turning Lemons into LemonadeWith the thousands of orders and deliveries Walgreens Home Care handles each day, a shipment mishap occasionally occurs. We believe our skilled and understanding staff—along with prompt attention and correction of the mistake—can make all the difference to our patients when these errors arise. Kathleen Keating, our Midwest respiratory supervisor, passed along a perfect example of this. She had received a call from a patient who was upset about an incorrect shipment of supplies. While Kathleen was gathering the correct shipment information, the patient inquired about two of our patient service representatives, Kim and Bernadette Geraci. According to Kathleen, “The patient went on to compli-ment the care received by these two women, how amazing that Walgreens would take the time to actually call the patient to see how they were doing. This patient is a nurse and knows all about patient care. My highest compliments to the Geraci women, thanks for doing what you do for us.” And our thanks to Kathleen who deftly corrected the order and had it reshipped—all while still on the phone with the patient.

Although I asked her a lot of questions, Ms. Monnet did not take offense. She was

professional and responsive to all my questions.

HC Spectrum


Legislative CornerThe Latest Medicare News Plus Legislative Information Affecting the Home Care Industry

Medicare Eases Prescribing Requirements for Power Mobility DevicesThanks to a new rule issued by the government this summer, seniors and the disabled can expect easier access to power mobility devices. Effective June 5, the Centers for Medicare & Medicaid Services (CMS) ended the requirement that power mobility devices be prescribed only by specialists in physical medicine, orthopedic surgery, neurology, and rheumatology. A prescription for these devices may now be written by a physician or other treating practitioner such as a physician’s assistant or nurse. For more information, go to www.pressofatlanticcity.com/business/story/6444643p-6300203c.html.

Search Continues for Sponsor of Senate NCB BillThe DME industry continues seeking out senators willing to sponsor a bill that it hopes will offset the effects of national competitive bidding (NCB). The industry already has an NCB bill in the House of Representatives known as the Hobson-Tanner bill (HR 3559). According to its supporters, the Hobson-Tanner bill would remedy many of the competitive acquisition provisions of the Medicare Modernization Act of 2003, which some DME providers say will restrict competition, hurt small home care providers, and reduce access to home care.

Senator Questions Respiratory SubstitutionsSenator Charles Grassley (R-Iowa) expressed concern over an investigation that found some home care companies and pharmacies substituting prescribed medications with drugs they’ve compounded themselves, without the patient’s or the physician’s knowledge. In a letter to the CMS and the Food and Drug Administration (FDA), Grassley said elderly patients are often targeted because suppliers can make money by billing Medicare for brand-name drugs while providing less expensive compoundeddrugs. Grassley, a member of the Senate Finance Committee, suggested more oversight of compounded drugs. “Walgreens Home Care does not in any way participate in this kind of unethical practice,” said Steve Kennedy, manager of infusion services. “If a commercially available product is ordered by the physician, that is the product we will dispense. We would not jeopardize the health and safety of our patients or our reputation for ethical pharmaceutical care which Walgreens has worked so hard to establish.”

Reference1. Agovino T. Spending on specialty drugs soar. CBS News.com. www.cbsnews.com/stories/2006/06/07/ap/health/

mainD8I35LO80.shtml. Accessed July 12, 2006.

©2006 Walgreen Co. All rights reserved. HC4429-0806

For general information about Walgreens Home Care programs and services, call 888-492-5442,

e-mail [email protected], or visit www.walgreenshomecare.com.

Editorial Board

Editors Gail Murphy, Tiffany Shepard Consultants Tim Buckley, R.R.T.; Donna Ford, R.N., B.S.N.;

Mir Miller Hays, R.N., M.S., M.B.A.; Susan Singer Designer Maria T. Perez

Brand names are the property of their respective owners.

Articles in Walgreens Home Care HC Spectrum may be reprinted only by clients, or respective agent(s) of clients, of Walgreens Home Care. Please attach the following statement: Reprinted with permission. ©2006 Walgreen Co. All rights reserved.

HC Spectrum

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