The United Compounding Network, which was launched last month to negotiate with payers and pharmacy benefit
managers on reimbursement for compounded drugs, named its key leaders, including a former high-level manager from
Express Scripts, a PBM which has drawn the ire of compounders for recently restricting its coverage of such products.
UCN Wednesday (Aug. 27) named David Ott as president and Diana Baumohl as vice president of business development.
Ott held executive positions with Anthem/ WellPoint Health Networks and worked most recently as founder and
principal consultant of Innova Health Solutions, UCN said. Baumohl has worked more than 20 years in the healthcare
industry, including “a variety of executive management positions at Express Scripts, Inc. (ESI),” UCN said in a press
release. “As VP of Business Development, her understanding of the market from both sides will guide UCN’s efforts in
working with compounding pharmacies and payors.”
The network will include state-regulated compounding pharmacies that, based on accreditation and quality standards,
meet a higher bar. The network plans to negotiate reimbursement levels and provide other services, such as standardized
claims billing.
In July Express Scripts started blocking compounding coverage of more than 1,000 bulk ingredients because of increased
prices. It is among other PBMs and payers making recent coverage changes for compounded drugs. The separate Patients and
Physicians for Rx Access — which includes participation from the International Academy of Compounding Pharmacists,
physicians and patients — also recently formed to fight the coverage restrictions. — Alaina Busch McBournie
quoted from here
2 comments:
The sooner payers (and pharmacists and doctors) recognize that they are the "pass throughs" in a vastly decentralized, sub-standard drug industry, the better. The "would be" NDA/ANDA holders are the entities filing patents, selling chemicals and formulas, and marketing and promotional materials, without warranty, escaping layers and layers of legal and regulatory scrutiny under the imprimatur of the practice of medicine and pharmacy. File a patent, write a recipe, source the chemicals, call in the marketers, drop it into 10,000 pharmacies or doctors' offices nationwide and "game-on."
If you look across the industry over decades, you will notice the “would-be” NDA/ANDA/BLA holders’ organized market entry campaigns that pop-up simultaneously across the nation—bioidentical hormones, chelation therapy, nicotine lollipops, topical pain creams take I (local anesthetics) and topical pain creams take II (centrally acting agents). These national “launches” have taken on new meaning after the Supreme Court decision, with pharmacies nudged by the “would-be” NDA/ANDA/BLA and patent holders to hire individual or shared sales forces to “detail” specific products to any willing doctor, or medical practice, or hospital, or alternative care setting.
It is a truly brilliant model for escaping and/or circumventing public health oversight—spread the manufacturing across 10,000 pharmacies, and, separated into so many pieces it has very little chance of raising regulatory scrutiny, by FDA, states, or other. And if people are being harmed in small numbers here and there from individual pharmacies and the drugs aren’t tested or tracked, it will not be a “noticeable” epidemic.
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