Now there is room for optimism that we can turn the tide and utilize community pharmacists to produce better health outcomes at lower cost.
In Asheville, N.C., officials tried a new approach to help city employees, dependents and retirees combat chronic problems like diabetes, asthma, hypertension and high cholesterol. After an initial education session, patients relied on community pharmacists to keep them on track and adhering to their medication therapy. After one year, the diabetes patients experienced lower costs (from $7,042 per patient to $4,000) and fewer sick days (from 12.6 a year to 6). Treatments for cardiovascular issues and asthma also proved to be less expensive. Even better, patients could spend more time living and less time in costlier doctor's offices or, worse, emergency rooms.
The experience of Smith Drug Co. in Spartanburg, S.C., tells a similar story. Struggling with soaring diabetes treatment costs, the company shifted its focus to prevention and medication adherence. Patients joining the new program were given free supplies and other incentives. In just one year, treatment costs were slashed to $5,406 from $11,637, while the costs incurred by patients enrolled in the more traditional regimen went up $1,500.
These trends mirror those in other countries. Japan, for example, spends 50% more of its healthcare dollars on pharmaceuticals than the U.S. does, yet its total healthcare spending pales in comparison (8.2% of gross domestic product vs. 15.2% in the U.S.).
Pharmacists face an array of challenges in today's healthcare system. We need a fairer reimbursement from Medicaid for generic drugs—one that doesn't pay 64 cents for one dollar's worth of drugs and expects pharmacies to stay afloat. We need relief from Medicare regulations that would deny seniors a pharmacy choice in getting diabetes testing supplies and other equipment for no good reason. We need transparency from pharmacy benefit managers (billion-dollar pharmaceutical middlemen) so patients and health plan sponsors can get a handle on rising drug costs.
But healthcare reform also offers a prime opportunity to advance the use of these and other medication therapy-management programs. Doing so would empower pharmacists to do what we do best, while reining in costs and achieving better patient outcomes.
Executive vice president and CEONational Community Pharmacists AssociationAlexandria, Va.
Founder and chairmanLouisiana Independent Pharmacies AssociationBaton Rouge
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