Summer Intern Perspectives: Samirul Islam, AMCP Foundation/Pfizer Managed Care Intern
Published October 2021
During my first year of pharmacy school, my curiosity about the individualized medicine concept and its future raised my interest in exploring insights into the managed care pharmacy. Pharmacy school provided me with a deep understanding of medicines; however, I lacked the knowledge about the drug distribution chain that begins from the manufacturer through the health insurance to the consumer. I am a foreign pharmacist grown up in the melting pot of New York. My personal life experience helped me realize the drug distribution chain is a complex process where pharmacy professionals can go out of the box to help their patients.
I couldn’t fill a prescription in a retail pharmacy because there was prior authorization in place, higher copays that are even harder for non-insured patients. Is it ethical for a pharmacist to say insulin is not covered? How could a pharmacist send a patient home without filling their prescription for asthma, COPD, diabetes, HIV? Can I dispense naloxone for free with an opioid more than 50 MME or opioids with benzodiazepines? Pharmacy school never answered my questions, so I have had my eyes on this internship from the first day of my pharmacy school.
During the summer of 2021, AMCP Foundation/Pfizer Managed Care internship opened the door to put my foot into managed care. From the first, the Horizon Blue Cross Blue Shield of New Jersey pharmacy team was welcoming and willing to do anything to help me become successful. I developed multitasking, adapting to change, and taking the initiative skills crucial to succeed in managed care. Soon I have realized that managed care pharmacist doesn’t have a minute to waste, so I advanced my time management to adapt to the profession. The panels I have attended are concise, usually last less than 30 minutes, where significant interactions occur between the payers and pharma companies. Becoming a managed care pharmacist is like being a spy; they are up to date with clinical trials, pipelines, market share projections, and drugs that are expanding indications, making it harder for pharma to impress their friend. Horizon BCBSNJ opened the floor to me for networking with medical science liaisons and account executives from different companies who educated me on rare disease states. Pfizer helped me understand the impact of the pharmaceutical industry through weekly panels where I have learned about HEOR, oncology drug development process, COVID-19 vaccine development, and the impact of pharma companies improving public health. I evaluated clinical trials, identified their strengths vs. weaknesses, made comparison charts between drugs, and volunteered to present them to the clinical team. Even as an intern, I have provided significant inputs to assist the team in making their decisions. The team always provided me with constructive feedback and appreciated me for taking the initiative and staying at the top of my work.
I have worked with my preceptor, Dr. Christopher J. Bigness, in approving prior authorization, drug utilization reviews, developing drug monographs, formulary, and PBM management. I have completed therapeutic chapter reviews, medication reconciliations, adherence, opioid management, CMR, drug pipelines design, health insurance comparisons with my mentor Dr. Hannah Jang. I was lucky enough to have Dr. Dean Gianarkis as my Pfizer mentor, who taught me a lot about atopic dermatitis, SLE, health benefits from using biologics, the management of OA, RA, and other rare genetic conditions. His mentorship educated me and raised my awareness of contemporary issues that I would not even imagine before. He shared resources where he is actively involved that significantly impact direct patient care.
A delightful aspect of the internship was the opportunity to work on a research project using the Horizon BCBS of NJ pharmacy claim data. New Jersey had taken two significant opioid initiatives in 2017 and 2020 to minimize the adverse events associated with opioids. In May 2021, Horizon BCBSNJ received a large number of ≥50 MME opioid prescription claims. We were certain to understand the trend for writing a high number of opioid scripts. We took the first initiative by sending a fax letter to the prescribing physicians requesting more information. We have analyzed the members’ and prescribers’ demographics, prescription characteristics, and supplement naloxone prescription claims. We compared the New Jersey department of health data before and after the COVID-19 pandemic and the number of scripts per zip code to identify the matching information. The CDC and respective guidelines recommendations were taken under consideration and critically evaluated to finalize the analysis. I was interested in working on opioids, and my preceptor was willing to work with me. Focusing on something I cared about led to a better final product than working on something that is not passionate to me.
I am looking forward to presenting my capstone project during AMCP Nexus 2021 in Denver, CO. Please visit me during the Nexus to hear about my project and my experiences from this summer.
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