This report is a practical document designed to highlight key problem areas, identify the root causes and effects, evaluate risks with current trends, find specific innovative solutions already implemented in pockets around the country and list actionable recommendations for implementation.
There is a public health need in the US for increased access to mental health services—including LAIs. Due to their accessibility, education and training, pharmacists have the potential to help provide an additional and needed access point. However, there are few decision-making resources currently available regarding pharmacist administration of medications beyond vaccines for health care plans and other payers and policy makers. Recognizing these needs, the National Alliance of State Pharmacy Associations (NASPA) partnered with the College of Psychiatric and Neurologic Pharmacists (CPNP) to convene a group of stakeholders to examine the available information and develop recommendations for state policy. Although the recommendations are intended to be encompassing of all non-vaccine medications, the issue was examined through the lens of LAIs. It was identified that this medication class may have the most urgent public health need for increased access.
Recognizing the investment that the health insurance industry will continue to place in these programs, a multi-stakeholder group representing patients, physicians, hospitals and pharmacists (see organizations listed in left column) developed principles on utilization management programs to reduce the negative impact they have on patients, providers and the health care system. The group strongly urges health plans, benefit managers and any other party conducting utilization management (“utilization review entities”), as well as accreditation organizations, to apply the principles to utilization management programs for both medical and pharmacy benefits. We believe adherence to the principles will ensure that patients have timely access to treatment and reduce administrative costs to the health care system.
CPNP has developed an official position paper to help increase patient access to comprehensive medication management and to support efforts to obtain payment for the service. The paper reviews the need for psychiatric pharmacists, the unique training and experience of the psychiatric pharmacist, outcomes from studies specifically examining interventions for patients with psychiatric and neurological disorders, and comprehensive medication management.
For nearly 50 years, there have been pharmacists who have specialized in providing pharmaceutical care to individuals receiving psychotherapeutic medication. As a member of an interprofessional treatment team, the psychiatric pharmacist focuses on optimizing drug treatment by monitoring clinical response, recognizing and managing drug-induced problems, recommending appropriate treatment plans, ensuring that baseline and follow-up laboratory tests and physical assessments pertinent to drug therapy are ordered and utilized, and counseling the patient and family members about their medication.