International Association for Hospice and Palliative Care Reaches 2000 Signatures on Declaration of Venice; Accepting Nominations for International Awards

The International Association for Hospice and Palliative Care (IAHPC) joined forces with the European Association for Palliative Care (EAPC) to promote a global research agenda in palliative care. Both organizations collaborated to draft a document calling on governments, health authorities, policy makers, institutions, and care providers to support and fund palliative care research, especially in developing countries. During the Fourth Research Forum of the EAPC, several organizations were invited to review the draft, called the "Declaration of Venice," and help finalize the declaration.

The organizations represented in this meeting and collaborated in this process were

African Palliative Care Association (APCA)

Asia Pacific Hospice and Palliative Care Network (APHN)

Eastern and Central Europe Palliative Task Force (ECEPT)

European Association for Palliative Care (EAPC)

International Association for Hospice and Palliative Care (IAHPC)

International Observatory in End of Life Care (IOELC)

American Academy of Hospice and Palliative Medicine (AAHPM)

National Hospice and Palliative Care Association (NHPCO) - USA

Palliative Care Australia (PCA)

Latin American Association for Palliative Care (ALCP)

Kings College - London, UK

Neighborhood Network in Palliative Care (NNPC) - India

Sociedad Espanola de Cuidados Paliativos (SECPAL) - Spain

Help the Hospices (HtH) - UK

Thanks to the work of Dr. Carlos Fernandez from Galicia, Spain and Lea Monsarrat and Marilene Filbert from Lyon, France, the Declaration is now available in Spanish and French. Almost 2000 individuals from 104 different countries have signed the Declaration, showing their support for this cause. The countries that have the greatest number of signatures are the US, Argentina, the UK, Spain, Colombia, and Canada. To see the Declaration in its different versions and the list of individuals who have signed it, click on http://www.hospicecare.com/dv/.

The IAHPC needs your help in endorsing the Declaration by signing it and calling on governments, policy makers, administrators, and care providers to support palliative care research, especially in developing countries. To read the Declaration and sign it, visit the Web site https://www.hospicecare.com/dv/.

The IAHPC also has announced that it is accepting nominations for the IAHPC awards in three categories:

1. Individual - Vittorio Ventafridda Award: For individuals who have demonstrated leadership in palliative care and have had a significant impact in the provision of palliative care in their communities and regions.

2. Institutional Award: For institutions (hospitals, clinics, hospices) that have implemented a successful and comprehensive palliative care program to meet the needs of the patients in the relevant community.

3. University Award: For academic hospitals, teaching institutions, and universities that have implemented formal palliative care programs as part of the undergraduate or graduate levels in either nursing or medicine.

To apply, please go to http://www.hospicecare.com and click on IAHPC Programs, then select Recognition Awards Program. You will see the guidelines for application.

Each category has a prize of US $2000. Deadline for applications is December 31, 2006. Winners will be announced in early February 2007.

Kaiser Family Foundation Survey Finds Pharmacists and Physicians See Real Benefits from Medicare Drug Law, but Most Think It Is Too Complicated and Report Customers and Patients Experiencing Problems

Substantial majorities of pharmacists (86%) and physicians (71%) believe that the prescription drug law is helping people on Medicare save money on their medications, according to two new national surveys conducted by the Kaiser Family Foundation. At the same time, pharmacists (91%) and doctors (92%) believe that the law is too complicated. A majority in both professions report that Medicare beneficiaries who they see are encountering problems in getting their medications, sometimes with serious consequences.

The two surveys were conducted between April and July during the first year of Medicare's new drug benefit. Nationally representative samples of 802 pharmacists and 834 doctors were surveyed. Each survey has a margin of sampling error of plus or minus 3 percentage points. Majorities of pharmacists and doctors say that at least some customers and patients have encountered problems getting needed medications through their Medicare drug plans, with smaller shares reporting seeing more frequent and serious problems. Eight in 10 pharmacists (81%) say that they have had customers who had problems getting their prescriptions. One in five (19%) say such problems affected "most" of their customers in Medicare drug plans. Two in three pharmacists (67%) say they had customers leave the pharmacy without a medication because the prescribed drug was not on their Medicare drug plan's formulary.

Almost six in 10 pharmacists (58%) say they had customers pay out-of-pocket for their drugs because they could not verify their enrollment in a Medicare drug plan. Nearly one-half of pharmacists (49%) say they had customers leave without a prescription because they could not afford the co-pay charged under the Medicare drug plan. Nearly one half of pharmacists (45%) who serve "dually eligible" beneficiaries, who were previously getting coverage through state Medicaid programs, say that these customers experienced more problems filling their prescriptions than other Medicare customers.

Among doctors with patients in Medicare drug plans, 59% say that they have had patients who experienced problems getting their prescriptions, with 15% saying "most" of their patients in Medicare drug plans had such problems. One in 10 (10%) say that they had a patient who suffered a "serious medical consequence" as a result of such problems.

Assistance for Patients

Pharmacists and, to a lesser degree, physicians report a willingness to help their customers and patients resolve issues related to their drug benefit, with 85% of pharmacists and 57% of physicians saying that they have "a lot of" or "some" responsibility to advise people about their Medicare drug plans. A large majority of pharmacists say that they have helped customers navigate the system. Most pharmacists say they have talked to Medicare customers regarding concerns about the out-of-pocket costs of their drugs (84%), helped a customer to decide whether to enroll in a Medicare drug plan (77%), and helped to figure out whether a specific drug was covered by their plan's formulary (75%).

Pharmacists report experiencing a number of administrative challenges under the Medicare drug benefit, which is provided by dozens of different private drug plans in each state, each with its own formulary, cost-sharing requirements, and other restrictions. At least one half of pharmacists say dealing with utilization management controls (57%) or getting through to hotlines run by drug plans (50%) are major problems. Perhaps significantly because they are expected to help patients manage their medications, doctors report having little knowledge about the plans' formularies, with 69% saying that they are not too familiar or not at all familiar with them and 59% reporting that they rarely or never check a formulary before prescribing a specific drug to a Medicare patient.

Administrative and Financial Burdens for Providers

The survey also examined the administrative and financial burden of the new drug benefit on pharmacists and doctors. Most pharmacists (53%)say the new Medicare benefit resulted in "a lot" of administrative burdens for them. The same share (53%) say that the administrative burdens associated with the Medicare benefit are worse than those associated with commercial insurance.

Independent pharmacists, who often are business owners rather than employees, are more likely to report "a lot" of burden (65%) than their counterparts who work at chain drug stores (48%). Many independent pharmacists also say that the new drug benefit caused financial challenges for their pharmacies. More than one in four (27%) say that they had to take out a loan or a line of credit because of cash-flow problems related to the Medicare drug benefit. Approximately three in four independent pharmacists say that they have dispensed prescriptions to their customers without knowing whether they would be paid and that the reimbursements they receive from Medicare drug plans are less than what they get from commercial payers.

One positive element cited by pharmacists is the electronic system used to verify key information when filling customers' prescriptions. More than eight in 10 (82%) of pharmacists whose computer systems are set up to verify enrollment information electronically say that the system works very well or somewhat well. A similar share of pharmacists (86%) whose systems allow them to verify formulary information electronically say that the system works well; however, little more than one-third (38%) have systems that are able to perform such electronic verification.

Among doctors, approximately one in four (27%) say helping patients make decisions and get their drugs under the Medicare drug benefit resulted in "a lot: of administrative burdens for them and their staff. Among doctors with patients enrolled in Medicare drug plans, 46% say that the burdens of dealing with prescriptions under Medicare drug plans are worse than those associated with commercial insurance.

Findings from the surveys are available at http://www.kff.org/kaiserpolls/pomr090706pkg.cfm.

The Kaiser Family Foundation is a nonprofit, private operating foundation dedicated to providing information and analysis on healthcare issues to policymakers, the media, the healthcare community, and the general public. The Foundation is not associated with Kaiser Permanente or Kaiser Industries. Visit http://www.kff.org/ for more information.