US Pharm. 2006;5:3.      

The latest reports from financial analysts who closely watch the health care sector are telling us what we all already know in our gut to be true: Health care costs are out of control. In fact, depending on what report you read, by the end of the decade, health care spending will represent anywhere from 16% to 20% of the U.S. economy. To put it into perspective, USA Today recently reported the federal government is admitting that within a decade, $1 out of every $5 spent in the U.S. economy will go for health care, with annual spending consistently growing faster than the overall economy. WNBC.com ran a recent story with the headline "Nation's Health Care Bill to Hit $4 Trillion by 2015."

A great many factors cause this dramatic rise in health care costs, not the least of which is that Americans are living longer and need more treatment and medication. Natural disasters also contribute to the rise, as does the recently enacted Medicare Part D legislation, which will specifically increase government spending on prescription medication from about 2% to 27% this year alone. While medications are only a fraction of the overall cost of the health care bill (approximately 10%), they are a major factor in controlling those costs. However, I firmly believe that the medications themselves are not the answer; it is how prescriptions are used.

The solution to solving the nation's staggering health care bill is relatively simple, and yet, top economists in both the government and private sectors have barely broached the topic. The solution in a single word is compliance.

The truth of the matter is that sickness and devastating illnesses will always be with us. But you would think that since the success rate for treating devastating diseases has been steadily increasing over the years, people would be healthier, thus reducing the nation's health care expenditures. That is almost true. So why are costs skyrocketing? The answer is simple. As a nation, we have to make sure that patients are compliant to their treatment, including their medication therapy.

Study after study has demonstrated that patients with acute or critical illnesses who adhere to therapy get better quicker and suffer fewer side effects. But from an economic perspective, compliance works best on expensive chronic disorders like diabetes, asthma, hyperlipidemia, and hypertension. Compliance to therapy helps keeps these patients' conditions in check, keeps patients out of the doctors' offices and emergency rooms, and reduces costly hospital stays. The end result of increasing compliance to treatment is faster recovery and fewer complications, thus lowering the overall health care bill.

Pharmacists are in the best position to foster compliance. In general, they see the patient more frequently and are more accessible than any other health care professional. Doesn't it make more sense to pay the pharmacist a professional fee to perform medication therapy management upfront, than to pay trillions in what could be unnecessary health care costs? It is time for the government and private sector health insurers to get serious about compliance. It is time for them to approach the pharmacist community to see how they can work together to make this nation more compliant to therapy. Pumping more money into an already-broke health care system certainly isn't the answer.

Harold E. Cohen, R. Ph.
Editor-in-Chief

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