What color bag? Three emerging practices pharmacists should know

Over recent years, more and health systems have been affected by payer care coverage policies referred to as “bagging.” These practices come about payers vertically integrated with PBMs specialty pharmacies owned those PBMs. With “bagging,” medications are filled then shipped either the patient or directly patient’s system. Medications used in bagging often intravenous drugs—such infusions for oncology rheumatoid arthritis—requiring support provider administration, although is left only professional component of reimbursement. “This something that going end up affecting a lot people inadvertently,” said Wendy Mobley-Bukstein, PharmD, BCACP, an ambulatory pharmacist associate professor pharmacy practice at Drake University Des Moines, IA. She pharmacists all settings should be familiar these terms recognize might change over time. The chain custody how filled, transported, administered differentiate various terms: ▪Brown bagging: picks prescription takes it provider’s office administration.▪White A pharmacy, predominantly discretion payer, ships provider, who holds product until arrives treatment.▪Clear internal (e.g., system–owned pharmacy) dispenses transports location drug administration. “Brown frowned upon almost exclusively,” Mobley-Bukstein. brown bagging, patients must educated on storage medication, they transport medication appointment preparation There clear safety issues while white brings its own issues. main concern continuity care. Oftentimes, steered facility other than system which currently being seen. This can due contractual agreement set forth third-party outside accept white-bagged provide administration under contracted price. “White could cause delay treatment locating will work setting appointment, awaiting delivery drug,” Brown baggingPatient acquires pharmaceuticals from their physician’s hospital administration.2. Patient obtains medicationView Large Image Figure ViewerDownload Hi-res image Download (PPT)3. Hospital/clinicView (PPT)White baggingA (hospital clinic).1. Specialty pharmacyView (PPT)2. (PPT)Clear system’s fulfills prescription, administration.1. Internal (PPT) clinic). Issues caused baggingBagging ultimately impact treated. Some common include▪Negatively quality because procurement strategies do not meet standards pharmaceutical products moving one entity another. Normally, procuring help ensure exchanges accurate, timely, follow best prior administering patient.▪Restricting providers’ ability choose options, may lead fragmented between patient, pharmacist, providers▪Limiting operational efficiencies allow choice site care, through collaborative efforts providers▪Creating additional workload providers when treatments delayed restricted Bagging include ▪Negatively