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A Familiar Health Care Model

Harold E. Cohen, RPh
Editor-in-Chief

8/20/2013

US Pharm. 2013;38(8):1.

These are exciting times for the profession of pharmacy. In the last few months there has been a flood of major reports issuing from various credible sources that underscore the important role pharmacists could play in curbing needless health care spending while improving health care outcomes. Not since 1996—when the city of Asheville, North Carolina, a self-insured employer, decided to tap community pharmacists for their drug expertise in overseeing employees with chronic health problems—has such a voluminous amount of positive health data been published. While each report approaches the subject of medication compliance and adherence from a different perspective, the messages from all the data come across crystal clear: the U.S. health care system is broken, patients are suffering because of it, and pharmacists can help fix it. Over the past 17 years, the Ashville Project, which started as an experiment in health care, has been pouring out positive outcomes data while continuing to keep the city’s health care costs in check.

In one study, titled Medication Adherence in America: A National Report Card, Langer Research Associates in concert with the National Community Pharmacists Association gave Americans aged 40 years and older with chronic medical conditions an average grade of C+ on their medication usage. But even more disturbing, the report gave 1 in 7 adults with chronic conditions, or the equivalent of more than 10 million people, a failing grade of F.

Another study approached the health care debacle from a financial perspective. According to data compiled by the IMS Institute for Healthcare Informatics, titled Avoidable Costs in U.S. Healthcare, “healthcare costs caused by improper and unnecessary use of medicines exceeded $200 billion in 2012.” This is equal to 8% of the nation’s health care spending that year and “would be sufficient to pay for the health care of more than 24 million currently uninsured citizens.” The report identified six key areas of opportunity to reign in the excessive costs. These include medication nonadherence, delayed evidenced-based treatment practice, misuse of antibiotics, medication errors, suboptimal use of generics, and mismanaged polypharmacy in older adults. Pharmacists practicing medication therapy management on an ongoing basis could easily control each of these areas.

Medication adherence was also the key topic in a research study conducted by Avalere Health and funded by the National Association of Chain Drug Stores. The authors of this study concluded that “prescription drugs, when used appropriately, are often the most cost-effective component of the healthcare delivery system.” They continued to say that incentivizing patients with lower copayments, reducing dosing frequency, and using pharmacist-directed medication therapy management are “innovative strategies” that could be used to increase adherence and improve outcomes.

As Yogi Berra was fond of saying, “It’s déjà vu all over again.” Nearly 2 decades after the launch of the Ashville Project, a familiar health care model is emerging once again and is one that pharmacists should embrace without hesitation. For years, insurance providers and payers have ignored the value pharmacists bring to our health care system. There is too much irrefutable evidence and data to ignore their importance in improving health care outcomes and lowering health care costs in the U.S. as patients live longer and, hopefully, healthier lives. Pharmacists need to be fully integrated into our health care system and recognized and paid appropriately as the medication specialists they are.

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