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Injectable Naltrexone Administrative Cost Estimator

Overview

Current reimbursement models in Wisconsin compensate pharmacies for the cost of the medication and the dispensing fees associated with providing a naltrexone injection. However, these models currently do not cover the time (in minutes) associated with the cost to administer a naltrexone injection in the pharmacy, which can be a significant expense to individual pharmacies and a barrier to service provision in their community.

To help pharmacies better understand their total costs and time associated with providing injectable naltrexone, we developed this Injectable Naltrexone Administrative Cost Estimator Tool. The purpose of this tool is to gather information associated with the provision of a naltrexone injection for both a New Patient and a Returning Patient in your pharmacy. The Injectable Naltrexone Administrative Cost Estimator Tool should only be completed by pharmacies currently offering an injectable naltrexone service.

Upon completion of the Injectable Naltrexone Administrative Cost Estimator Tool, you will be provided with an Injectable Naltrexone Administrative Costs and Time Report. The report represents the costs and time in your pharmacy to provide a naltrexone injection to new and returning patients. The report also provides a comparison using summary/aggregate data provided by all pharmacies that have completed this cost estimator.

Completion of this Injectable Naltrexone Administrative Cost Estimator Tool is entirely voluntary.

Let's Get Started!

Please carefully review each question. You will first answer a few General Information questions about your pharmacy so that we can personalize the report. You should then open the sections associated with providing a naltrexone injection to a New Patient and a Returning Patient and follow the instructions for answering the questions in each section.

Please answer all questions so that we can provide you with the most accurate report. When all questions have been answered click SUBMIT to generate your Injectable Naltrexone Administrative Costs and Time Report.

General Information

  1. What is the name of your pharmacy?
  2. What is the location of your pharmacy?
  3. What is the average hourly salary for a pharmacist?
  4. What is the average hourly salary for a pharmacy technician?

This next part of the Injectable Naltrexone Administrative Cost Estimator focuses on the administrative services in three categories (pre-injection, injection delivery and post injection) associated with providing a naltrexone injection to a new patient in a community pharmacy. After you answer these questions for a new patient, we will ask you to respond to the same questions for providing a naltrexone injection to a returning patient.

General New Patient Instructions:

For each category (pre-injection, injection delivery and post injection), please indicate if that service is provided to a new patient who is receiving a naltrexone injection in your pharmacy. For each service provided, please estimate the amount of time (in minutes) spent on the service by the pharmacist and the pharmacy technician separately. If neither the pharmacist nor pharmacy technician are involved in providing the activity, a 0 (zero) will be automatically entered for their time.

A. Pre-Injection Services for a New Patient

  1. Patient scheduling prior to the appointment, including scheduling the injectable naltrexone appointment or calling to remind the patient of the appointment.
    1. Is this service provided to a new patient? Yes No
    2. How much time (in minutes) is spent on patient scheduling activities?
      1. Pharmacist
      2. Pharmacy technician
  2. Benefits coordination, including determining the client’s insurance and/or co-pays, discussing costs, or helping patient obtain discount cards to cover medication costs.
    1. Is this service provided to a new patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  3. Extended patient consultation, including helping the patient understand the benefits and risks associated with a naltrexone injection, providing information about resources that are available, obtaining informed consent, or ensuring that patients receive educational resources.
    1. Is this service provided to a new patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  4. Urine drug screen cup/panel, including costs associated with providing UDT (e.g., acquisition cost for Alere® 14-panel cup and test kit or administering the UDT)
    1. Is this service provided to a new patient? Yes No
    2. If yes, what is the average cost for the Alere® 14-panel cup and test kit?
    3. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  5. Drug screen interpretation and lab monitoring/management (CMP, Pregnancy), including activities such as having the patient sign permissions for toxicology screen, providing the patient with the UDT kit and show them restroom, waiting for results, or sending the UDT to the lab.
    1. Is this service provided to a new patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  6. Behavioral health consultation, including setting up the behavioral health visit or confirming with the prescriber about medication dispensing.
    1. Is this service provided to a new patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service, excluding the time the patient is in the behavioral telehealth visit?
      1. Pharmacist
      2. Pharmacy technician

B. Injection Delivery Services for a New Patient

  1. Providing supplies associated with the injection, including gloves, bandage, alcohol swabs, gauze, sharps disposal, etc.
    1. Is this service provided to a new patient? Yes No
    2. What are the average supply costs to the pharmacy for a naltrexone injection?
    3. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  2. Injection professional services, including mixing and drawing the injections or the actual provision of the injection.
    1. Is this service provided to a new patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  3. Patient monitoring, including observing the patient for an adverse reaction to the medication.
    1. Is this service provided to a new patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician

C. Post Injection Delivery Services for a New Patient

  1. Patient follow-up activities, including providing education or resources for the patient to address adverse events, scheduling the next follow-up appointment, or providing documentation if the patient needs proof of service (e.g., for drug court).
    1. Is this service provided to a new patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  2. Administrative documentation, including documenting the provision of the injection (e.g., when, where etc.), recording injection provision in the pharmacy system, or sending confirmation to the provider.
    1. Is this service provided to a new patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  3. Billing, including completing any billing paperwork for the UDT, injection fee, or dispensing fee.
    1. Is this service provided to a new patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician

General Returning Patient Instructions:

For each category (pre-injection, injection delivery and post injection), please indicate if that service is provided to a returning patient who is receiving a naltrexone injection in your pharmacy. For each service provided, please estimate the amount of time (in minutes) spent on the service by the pharmacist and the pharmacy technician separately. If neither the pharmacist nor pharmacy technician are involved in providing the activity, a 0 (zero) will be automatically entered for their time.

D. Pre-Injection Services for a Returning Patient

  1. Patient scheduling prior to the appointment, including scheduling the injectable naltrexone appointment or calling to remind the patient of the appointment.
    1. Is this service provided to a returning patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  2. Benefits coordination, including determining the client’s insurance and/or co-pays, discussing costs, or helping patient obtain discount cards to cover medication costs.
    1. Is this service provided to a returning patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  3. Extended patient consultation, including helping the patient understand the benefits and risks associated with a naltrexone injection, providing information about resources that are available, obtaining informed consent, or ensuring that patients receive educational resources.
    1. Is this service provided to a returning patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  4. Urine drug screen cup/panel, including costs associated with providing UDT (e.g., acquisition cost for Alere® 14-panel cup and test kit or administering the UDT)
    1. Is this service provided to a returning patient? Yes No
    2. If yes, what is the average cost for the Alere® 14-panel cup and test kit?
    3. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  5. Drug screen interpretation and lab monitoring/management (CMP, Pregnancy), including activities such as having the patient sign permissions for toxicology screen, providing the patient with the UDT kit and show them restroom, waiting for results, or sending the UDT to the lab.
    1. Is this service provided to a returning patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  6. Behavioral health consultation, including setting up the behavioral health visit or confirming with the prescriber about medication dispensing.
    1. Is this service provided to a returning patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service, excluding the time the patient is in the behavioral telehealth visit?
      1. Pharmacist
      2. Pharmacy technician

E. Injection Delivery Services for a Returning Patient

  1. Providing supplies associated with the injection, including gloves, bandage, alcohol swabs, gauze, sharps disposal, etc.
    1. Is this service provided to a returning patient? Yes No
    2. What are the average supply costs to the pharmacy for a naltrexone injection?
    3. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  2. Injection professional services, including mixing and drawing the injections or the actual provision of the injection.
    1. Is this service provided to a returning patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  3. Patient monitoring, including observing the patient for an adverse reaction to the medication.
    1. Is this service provided to a returning patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician

F. Post Injection Delivery Services for a Returning Patient

  1. Patient follow-up activities, including providing education or resources for the patient to address adverse events, scheduling the next follow-up appointment, or providing documentation if the patient needs proof of service (e.g., for drug court).
    1. Is this service provided to a returning patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  2. Administrative documentation, including documenting the provision of the injection (e.g., when, where etc.), recording injection provision in the pharmacy system, or sending confirmation to the provider.
    1. Is this service provided to a returning patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician
  3. Billing, including completing any billing paperwork for the UDT, injection fee, or dispensing fee.
    1. Is this service provided to a returning patient? Yes No
    2. How much time (in minutes) is spent on activities related to this service?
      1. Pharmacist
      2. Pharmacy technician