Proposed rules on consultant pharmacists in SNFs draw Omnicare to comment

Omnicare, Inc., released a statement Thursday regarding its ongoing review of new Centers for Medicare & Medicaid Services proposed rules on consultant pharmacist services in nursing homes, saying it believes at this time that the “potential change would not have any material adverse effects on Omnicare’s business.”

The proposed rules would change the Conditions of Participation for Long Term Care Facilities by requiring nursing homes to hire independent pharmacists to review resident drug regimens instead of the services offered by companies such as Omnicare.

“We have been concerned with the potential effect on patient safety and quality of care of various contractual arrangements involving LTC facilities, LTC pharmacies, the LTC consultant pharmacists these pharmacies provide to LTC facilities, and pharmaceutical manufacturers and/or distributors,” CMS wrote in the proposed rules.

“We are greatly concerned with financial arrangements that involve payments from pharmaceutical manufacturers directly or indirectly to LTC pharmacies and LTC consultant pharmacists for encouraging physicians to prescribe the manufacturer’s drug(s) for residents […] These types of arrangements may result in incentives for the LTC consultant pharmacist to make recommendations that conflict with the best interests of nursing home residents, as well as with Part D sponsors’ formularies and/or drug utilization management (DUM) programs.”

CMS estimates that three LTC pharmacy organizations have 90 percent of the market, therefore making it more likely that “these arrangements are widespread,” according to the proposed rules.

Omnicare said in the statement that the company plans on providing CMS with “accurate information” concerning the role of its consultant pharmacists and the “beneficial effects” of those individuals in lowering costs and ensuring patient safety.

“Omnicare believes that regulators need to pursue a thoughtful and evidence-based evaluation of the role of consultant pharmacists,” the statement read. “Omnicare’s payors and customers and their residents currently benefit from the consultant pharmacists’ expertise in the areas of geriatric drug therapy and long-term care pharmacy regulations.

“Omnicare’s concern remains that payors and customers and their residents may be denied these benefits or forced to pay more for them if CMS were to mandate the change it is considering. Omnicare believes that rather than reducing costs, the CMS proposal is likely to add costs.”

Omnicare said it charges market rates for its consultant pharmacist services and that its consultant pharmacists do not prescribe pharmaceuticals “but may recommend a drug if it is clinically equivalent and at a lower cost to the payor, or recommend another therapy option in accordance with published CMS guidance.”

“For example, Omnicare’s consultant pharmacists over the past five years have made more than 700,000 recommendations to prescribers regarding antipsychotic use, 99.7 percent of which were to reduce a dose; discontinue the drug; question the reason the drugs are used; or monitor for potential, known side effects,” the statement read.

Bloomberg reported that the CMS proposed rules “would appear to suggest that CMS is likely to take a dim view” of a potential combination of Omnicare and PharMerica Corp., which Omnicare has made a hostile bid for in recent months.

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