News & Events

Surescripts Real-Time Prescription Benefit for Pharmacy Tool: Big Advance or a Non-starter?

In early June, Surescripts announced the launch of its new Real-Time Prescription Benefit for Pharmacy Tool, which allows “pharmacists to access information on out-of-pocket prescription costs and therapeutic alternatives at the point of dispensing.”[1]   Surescripts promotes that the tool will enable pharmacists to “collaborate with patients and prescribers on choosing an alternative medication that is both clinically appropriate and affordable.”  The tool accesses the patients’ prescription benefit information to provide days’ supply constraints and potentially less expensive formulary alternatives.

The premise behind this service is the pharmacist is willing to provide therapeutic substitution recommendations to the prescriber and patient at the point of dispensing.  If this tool gains momentum, expect drugs with a prior authorization to be placed at a significant disadvantage.  In many cases, the pharmacy patient will have just come from the provider’s office with a prescription, where the expectation is the provider should have had this discussion with the patient prior to writing the prescription.  We expect pharmacists to continue to submit prescriptions to the payers for adjudication and only suggest therapeutic substitutions if a claim is rejected and/or the patient voices a concern, which is standard operating procedure today.

The new Surescripts tool provides pharmacists with the opportunity to evaluate options before contacting the prescriber.  The cost to the pharmacist is unknown at this time.  More than likely, the pharmacist will contact the prescriber and let the prescriber evaluate and prescribe a different product if warranted. With continued reductions in pharmacy reimbursement, we do not expect widespread adoption of this new tool in pharmacy practice.  This new tool repackages the Real Time Benefits Check (RTBC) available to prescribers and will likely be a non-starter in pharmacy practice.  As is currently seen in the prescriber space, the validity and usability of this tool will depend on payers’ ability to provide updated formulary and pricing information to Surescripts in a timely manner.  If prescriber uptake of these RTBCs occurs, the use in pharmacies would not be needed.

[1]!content/surescripts-empowers-pharmacies-with-benefits-based-prescription-price-transparency-tool, Accessed June 15, 2020.


Posted June 16, 2020

2020 Summer Newsletter:

New FDA Guidance Will Impact Supply Shortages

ComputerTalk for the Pharmacist May/June 2020

PHSL Co-founder Tim Kosty contributed to the May/June 2020 edition of ComputerTalk for the Pharmacist. In his Viewpoints article, Tim discusses the California Consumer Privacy Act (CCPA), including specific provisions and the potential impact on consumer privacy laws.

Click here to read Tim’s article entitled “CCPA: Requirements and Consequences”. You can read full versions of current and past ComputerTalk issues at

PHSL is Operating

As per the office of Governor Wolf of Pennsylvania to Pharmacy Healthcare Solutions, LLC (PHSL):

“Governor Wolf and Secretary Levine’s recent orders calling for the closure of non-life-sustaining businesses do not appear to require your business to close at this time. Your business appears to be within a life-sustaining business sector that contributes to the health and safety of Pennsylvania. You do not require a waiver/exemption to remain open…We appreciate your efforts to combat the spread of COVID-19.”

Our technology provides us with the tools to continue with uninterrupted service and communication to our clients and each other.  Please email or call us for custom solutions built for your business.  We are here for you and we are all in this together.

From all of us at Pharmacy Healthcare Solutions, LLC


Coronavirus Preparation Tips

The novel Coronavirus (COVID-19) pandemic is occurring during a time that overlaps with cold and flu season, as well as seasonal allergies. For mild illnesses, including those associated with Coronavirus, supportive care may be the best option. PHSL recommends keeping the following items on hand in case your household is impacted by illness. Many of these items can be purchased at your local pharmacy, grocery store, retailer, or online, which may provide an option for delivery.

Over-the-counter (OTC) medications for symptomatic treatment of respiratory illnesses include:

  • Tylenol (acetaminophen) for fever and aches
  • Mucinex (guaifenesin) to loosen chest congestion
  • Robitussin DM (dextromethorphan) or Delsym for cough
  • Sudafed (pseudoephedrine) or Sudafed PE (phenylephrine) for head congestion

Parents should ensure that they have an adequate amount of infant or children’s strength Tylenol (acetaminophen) and cough medicine. Parents or caregivers should consult a physician before using cough and cold medicine in children under 6 years of age. Also consider keeping alternative remedies, such as honey, for sore throat and saline drops for nasal congestion on hand.

Having a humidifier to run in the room while asleep will increase moisture in the air and may help with cold and respiratory symptoms.  Vick’s VapoRub or equivalent vaporizing rub ointments that contain camphor, eucalyptus oil and menthol can also be beneficial. Additional supplies to keep on hand include a thermometer, tissues, and drinks containing electrolytes, such as Gatorade or Pedialyte, to prevent dehydration. If your local retailer does not have electrolyte solutions available, the World Health Organization (WHO) recommends the following combination to create your own: one level teaspoon of salt, eight level teaspoons of sugar, one liter of clean drinking or boiled water and then cooled.

In addition to OTC medications and supplies for supportive care, you may want to consider purchasing the following items so you do not run out in a time of isolation:

Being prepared during this time is the best way to care for yourself and those around you. If you are uncertain if your illness requires additional treatment, always contact your healthcare provider or utilize telehealth services for assistance.


Posted March 20, 2020

2020 Spring Newsletter:

Key Questions and Answers about Ibuprofen Use for COVID-19

COVID-19 have you Quarantined? – Weekend Activities for your To-Do List

Market Effects from COVID-19

Market Effects from COVID-19

Prescription volume dispensed by retail and mail service pharmacies has increased dramatically in March as a result of COVID-19 concerns.  It is common knowledge that the first week of the month is the busiest in retail pharmacy departments.  Medicare checks are received by seniors and updates are made to the Medicaid eligibility files, leading more patients to obtain their needed prescription medications.  This is what pharmacies experienced the week of March 1 to 7.  However, instead of the normal drop-off the week of March 8 to 14, we are aware of pharmacy dispensing volume being 5 to 10% greater than the first week in March.

In a Reuters report published in U.S. News & World Report on March 13th, it was noted that doctors, insurers, and the CDC were urging patients, especially those with chronic conditions, to get enough medicine to last a long period.  Insurers were recommending patients that typically receive only a 30-day supply of their medications talk to their pharmacist, and if needed, their doctor, about getting a 90-day supply. Some insurers were allowing early refills of prescriptions to accommodate their patients’ needs.  All of this created the spike in prescription volume seen in the second week of March.

The increase in prescription volume will lead to an increased demand for prescription drugs and PBM services.  The increased demand will likely create strains on resources, both product materials for manufacturers and services via PBMs.  We believe that this will also lead to an increase in adherence measures, as calculations may be artificially inflated due to early refills and 90 days supply prescriptions.

Will there be a drop in prescription demand when this pandemic is over?   We suspect that patients will increase the days’ supply that they keep on hand, leading to a “new normal” for consumers.

All of this has put more pressure on suppliers to keep more product on hand, for manufacturers to ramp up production, and for raw material suppliers to keep up with demand.  This will require close monitoring in upcoming weeks and months.  The most important thing our industry can do right now is to try to keep up with patient needs and ensure that those in greatest need have access to the supplies they require and medications they take.

In the end, there will be much to learn from this crisis.  Governments, manufacturers, health-care systems, and retailers (not just pharmacies), will all need to look back on the lessons learned to devise and implement processes and procedures to put in place, should we ever encounter something like COVID-19 again.  Furthermore, entities in each of these sectors should work together to develop best practices that are in harmony and will ultimately promote and provide the best patient care and outcomes possible.

Finally, best wishes to all of those on the frontline in healthcare– they are our heroes in this fight against this virus.  It is for their sake that steps are taken to ensure that the supplies and medications needed are always available.


Posted March 20, 2020

2020 Spring Newsletter:

Coronavirus Preparation Tips

Key Questions and Answers about Ibuprofen Use for COVID-19

COVID-19 have you Quarantined? – Weekend Activities for your To-Do List

COVID-19 have you Quarantined? – Weekend Activities for your To-Do List

As millions of Americans quarantine themselves in their homes, numerous sources have touted “fun activities you can do at home” and “10 ways to spend the weekend indoors”.  Instead, what about crossing a few forgotten items off your to-do list?  PHSL has five ideas for you to improve your health and increase your sense of accomplishment by checking another item off your list.

  1. Clean out your Medicine Cabinet – When is the last time you’ve cleaned out your medicine cabinet and removed expired OTC medications and unused prescriptions? As you’re thinking about purchasing supplies for a prolonged quarantine, it is important to first inventory the products you have on hand to determine what you actually need.  In order to ensure everyone gets the medications they need, it’s important to not stockpile excessive amounts of OTCs.  Instead, review your current supply to determine where gaps exist in your personal inventory.  Although the DEA’s Prescription Drug Take Back Day scheduled for April 25th has been canceled, many retail pharmacy locations have drop boxes where expired medications can be deposited.
  1. Establish your Healthcare Power of Attorney (HCPA) – A HCPA, sometimes referred to as an Advance Directive, is a legal document that allows another individual to make medical decisions on your behalf when you are incapacitated. The named healthcare power of attorney acts as a healthcare proxy and is called upon to communicate with a patient’s doctor to inform them of the patient’s wishes.  A HCPA can be a family member, friend, or even an attorney.  A lawyer can help you establish an HCPA, or there are many online providers that can execute the required documentation.
  1. Setup your Online Health Record – Many insurance providers and doctor’s offices have online portals available where you can access information on your office visits, medications, vaccine history, diagnoses, lab results, and more. In order to have quick access to this information and avoid needing to call your physician’s office, it is recommended that you set up a username/password and familiarize yourself with the system.  Being able to provide your own information in the event of an illness, can save valuable time for you and your healthcare team.
  1. Review Child Safety Procedures – For those with kids who may now be home from school, the weekend is an excellent time to review safety procedures with your child. Do your kids know what to do in case of an emergency?  Can they provide your address or phone number to a trusted adult?  The weekend also provides ample time to do a walk-around of your home and identify any potential hazards such as missing electrical outlet covers, lack of cabinet locks, lose stair gates, or exposed cords or wires.
  1. Be Active – Go for a walk outside, start seedlings for your spring garden, or stream an online exercise class. Being stuck at home doesn’t mean there aren’t ways to stay fit and be active.  With the current pandemic, a number of companies are offering free subscriptions, so do a little online research, and find something that interests you!


Posted March 20, 2020

2020 Spring Newsletter:

Coronavirus Preparation Tips

Key Questions and Answers about Ibuprofen Use for COVID-19

Market Effects from COVID-19

Key Questions and Answers about Ibuprofen Use for COVID-19

If I am experiencing symptoms consistent with coronavirus, should I take ibuprofen?

With the most current information available, the World Health Organization (WHO) has stated they are not recommending against taking Ibuprofen. This means that you can still take ibuprofen to manage symptoms. Please refer to the diagram below for the WHO statement.


If I am experiencing symptoms consistent with coronavirus, should I take naproxen or other NSAIDs?

Yes, as long as you follow normal guidelines for daily intake of these medications. There has been no information that naproxen or other NSAIDs have an adverse impact with respect to COVID-19.


WHO Ibuprofen Announcement

These questions arose after a March 17th WHO announcement where they recommended against the use of ibuprofen (Motrin, Advil, among other brands) for patients with COVID-19 symptoms, due to a concern that anti-inflammatory drugs could worsen the COVID-19 infection. Likewise, acetaminophen (Tylenol, among other brands) is still safe to use as directed.  The theory hypothesized that ibuprofen could increase an enzyme, ACE2, that is used by the virus to infect the host. There is no evidence that other medications impacting that pathway, such as ACE inhibitors and ARBs, play any role in COVID-19 either.  Patients should continue to use prescribed medications as directed by their physicians.


For more information from WHO about COVID-19, visit


Posted March 20, 2020

2020 Spring Newsletter:

Coronavirus Preparation Tips

Market Effects from COVID-19

COVID-19 have you Quarantined? – Weekend Activities for your To-Do List


ComputerTalk for the Pharmacist January/February 2020

PHSI President Ann Johnson and Co-founder Don Dietz contributed to the January/February 2020 edition of ComputerTalk for the Pharmacist. In their Viewpoints article, Ann and Don review new formulary exclusion lists from Express Scripts, CVS Caremark, and OptumRx, and discuss their impact on pharmacies and patients.

Click here to read Ann and Don’s article entitled “2020 Formulary Exclusion Lists — Why All the Changes?” You can read full versions of current and past ComputerTalk issues at

Priority Review and Rare Diseases Reign Supreme for 2019

Based on the FDA’s count, there were 48 novel drug approvals in 2019 with 60% receiving FDA fast track status, priority review, or accelerated approval.  This count does not include vaccines, plasma products, or gene therapy products.  When the majority of drugs are being reviewed in an expedited time frame, it is a strong indicator that the market is shifting towards the specialty drug space.  The high number of expedited approvals begs the question, “how much of an advantage is an expedited approved when everyone else is getting the same treatment?”

Many of the newly approved agents are first-in-class and indicated for rare disease states.  Oncology approvals continue to outpace approvals for other disease states, with approximately 20% of drugs approved for the oncology space, whether for diagnosis or treatment.

Three new infectious disease agents were approved in 2019, which is a positive step in developing new therapies to combat antibiotic resistance.  Because of the Generating Antibiotics Incentives Now Act (GAIN Act), three agents (Fetroja, Recarbrio, and Xenleta) received priority review as Qualified Infectious Disease Products (QIDPs).  With the rise of antibiotic resistance, the need for new antibiotic innovation is increasingly important, and the FDA’s Safety and Innovation Act (FDASIA) seeks to promote their development.

What does 2020 hold?  PHSL highlights five top trends to watch out for in this year’s drug approval space:

  1. Digital Drugs – expect to see an increase in the approval of digital therapeutics and digitally enabled drugs, as technology moves into the mainstream pharmacy space.
  2. NASH Drugs – Drugs indicated to treat nonalcoholic steatohepatitis (NASH), or a fatty liver, are expected to be approved in 2020. With a high price tag and potentially huge patient market, payers should monitor these approvals closely.
  3. Gene Therapy – targeted therapies based on patients’ genetic factors promises to be a key area. This high-dollar space may be a cash cow for those targeting disease states with a sizeable patient population.
  4. Biosimilars – Will 2020 be the first year that an “interchangeable” biosimilar is approved? If not, we expect the number of biosimilar approvals to steadily increase, creating a more commodity-like atmosphere in the biologic space in products with multiple biosimilar competitors.
  5. Expedited Reviews and Approvals – As seen in 2019, expect the FDA to continue approving many products via the fast track, breakthrough, priority review, or accelerated approval processes. With the high number of specialty drugs being approved, this may become the new norm of drug approval.

A full listing of 2019 approvals, by approval type, is shown in the chart below.

2019 FDA New Drugs


Posted February 2020

Pharmacy Healthcare Solutions, LLC of Pittsburgh Adds Experienced Industry Thought Leader to Staff

PHSL logo

Media Contact:
Terry Johnston


For Immediate Release
Pharmacy Healthcare Solutions, LLC of Pittsburgh
Adds Experienced Industry Thought Leader to Staff

Patricia Milazzo, RPh joins PHSL as a Senior Consultant   

PITTSBURGH (January 17, 2020) – Pharmacy Healthcare Solutions, LLC (PHSL) is pleased to announce the hiring of Patricia Milazzo, RPh as a Senior Consultant.

Patty has over 30 years of experience in the U.S. and global healthcare industries. Her industry background includes clinical drug information creation and technology use, PBM (Prescription Benefit Management) design, and oversight of major drug data systems. She has extensive experience with government agencies, including FDA (Food and Drug Administration) and Medicare/Medicaid programs. Patty has held leadership positions in National Council for Prescription Drug Programs (NCPDP) and Pharmacy Quality Alliance (PQA) and has served as an author of various white papers and industry blogs.  Patty holds a B.S. in Pharmacy from Purdue University and is a licensed pharmacist.

Prior to joining PHSL, Patty was Senior Director at Wolters Kluwer Clinical Effective, overseeing global teams responsible for drugs’ clinical and pricing information.  Patty previously worked at CVS Health (CVS Caremark) in roles related to formulary and client benefits development and management, mail order dispensing oversight, and drug file and data management.

“Patty brings a new depth of drug compendia knowledge to our consulting team.  As a leading drug compendia authority in the industry, Patty’s contributions will provide innumerable benefits to our clients,” noted PHSL President, Ann Johnson.

PHSL Vice President, Melissa Krause, said “We are pleased to welcome Patty to our team of consultants.  We have enjoyed getting to know Patty at industry events over the years and value her expertise in the areas of compendia, health informatics, pharmacies, and payers.”


Founded in 1996, Pharmacy Healthcare Solutions provides pharmacy consulting solutions in a variety of areas including, but not limited to, product and program development, market research, operational efficiency, claims-data analysis, and training program construction.