ABSTRACT
OBJECTIVE: To discuss changes in the law that allow community pharmacy loyalty programs to include and offer incentives to Medicare and Medicaid beneficiaries. SUMMARY: The retailer rewards exception of the Patient Protection and Affordable Care Act of 2010 and its change to the definition of remuneration in the civil monetary penalties of the Anti-Kickback Statute now allow incentives to be earned on federal benefit tied prescription out-of-pocket costs. The criteria required to design a compliant loyalty program are discussed. CONCLUSION: Community pharmacies can now include Medicare and Medicaid beneficiaries in compliant customer loyalty programs, where allowed by state law. There is a need for research directly on the influence of loyalty programs and nominal incentives on adherence.
Subject(s)
Community Pharmacy Services/economics , Medicaid/legislation & jurisprudence , Medicare/legislation & jurisprudence , Patient Protection and Affordable Care Act , Community Pharmacy Services/legislation & jurisprudence , Cost Sharing , Fees and Charges , Fraud/legislation & jurisprudence , Humans , Medicaid/economics , Medicare/economics , State Government , United StatesABSTRACT
OBJECTIVE: To evaluate the stability of U-500 regular insulin in prefilled syringes stored under refrigeration for up to 28 days. METHODS: U-500 regular insulin was drawn up in 1 mL insulin syringes in a clean, nonsterile environment to emulate conditions of a patient's home. Samples were assayed using a stability-indicating reverse-phase high-performance liquid chromatography method immediately after preparation (day 0) and after 7, 14, 21, and 28 days under refrigeration. Before evaluation, all samples were diluted to a concentration of 40 units/mL in the starting mobile phase. Stability was determined by evaluating the percentage of the initial concentration remaining at each time point. RESULTS: At least 93.3% of the initial U-500 insulin concentration remained throughout the 28-day study period, with no statistically significant changes in the amount remaining. The percent of initial concentration remained above 97% for the first 21 days of the study. CONCLUSION: A prefilled syringe with U-500 regular insulin is stable for at least 28 days when stored under refrigeration. These data are similar to those reported for U-100 regular insulin, indicating that prefilling syringes with U-500 insulin is a safe and effective practice for patients who are unable to accurately draw up their own point-of-care doses.
