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It’s Not Only About the Money

Harold E. Cohen, RPh
Editor-in-Chief



1/20/2012

US Pharm. 2012;37(1):1. 

For the many years that I practiced retail pharmacy, the two questions I fielded repeatedly from patients about their prescriptions were, “How long will it take to fill?” and “How much is it going to cost?” The “how long and how much” questions were asked so many times that I would automatically take the prescription(s) and offer the answers before the questions were posed. And truthfully, from the patients’ point of view, even today these are two very important questions that need to be answered. Let’s face it, patients hardly ever come to the prescription department in a good mood; all they want is to get their prescription filled in a timely manner, pay for it, take their medication, and hopefully get well quickly. Even with insurance, prescription costs are always a factor. Some copays are impossibly high, and most people don’t get sick on a schedule that coincides with their paycheck. It is widely believed that in many instances medication costs are responsible for patients not filling or refilling potentially lifesaving prescriptions. 

I suppose that’s why I was speechless when I came across an article that reviewed a study conducted by researchers at Boston’s Brigham and Women’s Hospital involving heart attack survivors who were offered free prescription heart medications. Imagine my surprise upon learning that only half the patients who were offered the free medications actually accepted them. 

While one can draw many conclusions from the data, the takeaway for me is that while medication costs are certainly a contributing factor to poor compliance and adherence to medication therapies, it’s not only about the money. It is also about pharmacists who do not perform consistent medication therapy management and in-depth patient counseling. 

As much as I was disappointed to read that patients won’t even accept free medication, I was excited to read that Walgreens has taken patient counseling to a new level. The chain has been renovating some of its stores to provide private counseling areas for pharmacists to discuss medication therapies with their patients away from the hectic activity behind the prescription counter. Even though some other chains may advertise the availability of their pharmacists for patient counseling, I’ve yet to see a coordinated and committed program like the one Walgreens recently launched. And while the Walgreens program is commendable, it actually doesn’t go far enough. Pharmacists should get paid extra for their counseling services; after all, there are a number of statistically valid studies confirming that pharmacists’ counseling efforts can save lives and reduce national health care costs. 

The issue of health care is sure to take a commanding role in the upcoming 2012 presidential election. Regardless of the Supreme Court’s decision on the constitutionality of mandatory health insurance, I am fairly certain that our health care system will be considerably different in the future. Now is the time for pharmacists to seize the opportunity to be part of that change in a positive way. Pharmacists save lives, reduce health care costs, and constitute a vital component of the health care delivery system. It would be a shame to let this extraordinary opportunity slip through our hands. 

To comment on this article, contact editor@uspharmacist.com.

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