Stakeholders work toward bringing more voices into building new pharmacy law

Movers and shakers behind a new state law aimed at enhancing partnerships between pharmacists and medical providers and easing healthcare access for patients across Colorado are working hard, hoping their long hours will help ensure the progressive regulation’s long-term success.

Senate Bill 16-135, signed into law in June, took effect Aug. 10, but requires the drafting and widespread approval of highly specific statewide protocols to move forward. Surveys have gone out to pharmacists and medical providers across the state seeking their input with these protocols, designed to allow pharmacists to directly provide, and potentially gain reimbursement for, more patient services.

“We are looking for what diseases and health issues medical providers are seeing in patients, and which ones they would like to see perhaps managed by pharmacists on the front end,” said Gina Moore, PharmD, Assistant Dean for Clinical and Professional Affairs at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. “We know there are many patients out there with access issues to healthcare who can benefit,” said Moore, who has been a chief force in advancing the bill for the past two years with the CU pharmacy school and others.

Statewide protocols

Emphasizing that discussions are in preliminary stages, Moore said examples of what pharmacists could do with statewide protocols under the new law include:

• Testing patients for influenza and treating them accordingly. With the flu, access to antiviral medications within 48 hours of onset can reduce symptoms significantly, potentially lowering costs to the healthcare system while easing a patient’s misery.
• Supplying patients with contraceptives, possibly decreasing unwanted pregnancies.
• Providing smoking-cessation medications and support, allowing patients motivated by a sudden urge to quit quick access, professional guidance and potentially drug-cost reimbursement.

The intent of the surveys, issued collaboratively by the CU pharmacy school, the Department of Regulatory Agencies, and the Colorado Department of Public Health and Environment, is two-fold, said Tara Trujillo, MNM, CDPHE chronic disease specialist. Provider responses can steer and streamline the drafting process by helping prioritize protocols, and they can also alert board members to any obstacles they might envision, so that those can be addressed head-on.

“We really want to ensure that we are getting good stakeholder input and good information back to folks across the state,” Trujillo said. “We want to know what’s really needed out there.” The bill calls on the CDPHE, along with the boards of Pharmacy, Medicine and Nursing, to draft protocols and then form a consensus.

Pharmacist reimbursement

The bill also amends the Colorado Insurance Code, providing reimbursement opportunity for qualifying pharmacists for treatments under the new protocols. “We really hope it makes insurance companies aware of the services that pharmacists provide and allows pharmacies and pharmacists to have those conversations with health care insurers and become enrolled in their network of providers,” Moore said. “I know some conversations are underway.”

Collaborative practice

Another amendment, this one to the Pharmacy Practice Act, expanded collaborative practice opportunities, granting pharmacists authority to provide services to more than one patient with a physician’s orders. “For instance, physicians can now allow pharmacists to provide treatment under protocol for all of their diabetic patients,” Moore said. “So a pharmacist doesn’t have to go to each patient for individual orders, which should also simplify the process.”

Under the new law, pharmacists, per protocol, can also provide multiple therapies to a patient, rather than only a single drug. “What that means is that a patient with a complicated disease, such as diabetes (which often requires multiple-drug therapy), can be treated by a pharmacist, who can identify the medications that are best and bring that patient to goal hopefully more quickly,” Moore said. The ultimate goal is that by optimizing drug therapy, patients are healthier and health-care costs reduced, she said.

Moore said she does not expect formal protocol hearings before late November, but that pharmacists, students and other stakeholders should stay in tune with the process and be engaged. Pharmacy student Daniel Galipeau, who has been active in forwarding Senate Bill 16-135, calls on his fellow students to follow suit. "It ultimately impacts the health environment they are going to work in. For me, it's very important, because it provides greater access to patients and allows the pharmacists to provide the health services that we are trained to provide." In addition to the CU pharmacy school, up-to-date information can be found through the Colorado Pharmacists Society and the Colorado State Pharmacy Board.

“We want to make sure folks have access to the services they need,” Trujillo said. “And partnering with pharmacy is opening up a new avenue to access to see that that happens. I think that this is the beginning of seeing pharmacy really become a more integrative part of the healthcare team and ensuring that we look at pharmacy in a new way.”