A Pharmacist’s Plan

A pharmacist jumps into the health care debate with a series of ideas and proposals to both improve health care and lower costs.

In the current economic environment, healthcare reform is front and center; especially among the uninsured, and those who have to pay for insurance or care (high costs and accelerating costs). While other healthcare stakeholders have presented their programs to improve care and control cost, pharmacy has been strangely silent. Yet, pharmacists are drug experts and have at least three times more face time with patients than any other healthcare specialist. As a pharmacist and a healthcare professional, I would like to offer a program where pharmacists offer their expertise to improve care and lower costs.

The elements of this plan are:

1. Initiatives to improve care and provide optimal outcomes:

a. Identify issues of coordination of care due to multiple treating practitioners and notify the practitioners involved with a simplification plan

b. Identify and decrease the use of redundant and multiple drugs, that lead to adverse effects and unnecessary drug interactions

c. Identify issues with compliance in therapy and implement training programs for patients to improve their overall compliance with their therapeutic regimen.

d. Establish systems to identify and correct medication errors.

e. Establish systems to identify and correct problems with dosing, and how drugs are taken. Pharmacists have a multitude of anecdotes of direct patient improvements in these areas and these examples can, and should, be teaching moments for patients and practitioners.

f. All of the above are elements of clinical pharmacy practice and within the expertise and skill level of every Doctor of Pharmacy.

2. Initiatives to provide cost savings on every prescription by educating the patient and the practitioner on:

a. Switches to generics of the prescribed drug if possible, or to a generic in the same therapeutic category so that the patient avoids brand copay and the health plan/employer purchaser pays a lower fee.

b. Switches to a lower cost brand in the same category if a generic is not available.

3. Let patients know about lower cost options.

a. Establish a usual retail price for cash paying patients that is based on cost as an understandable and reasonable measure for the health plan/employer purchasers and patient. Publicize the “transparent” benefits to purchasers, patients and practitioners.

b. Provide the discounted generic retail price and publicize the avings to health plan/employer purchasers, patients and practitioners.

c. Publicize examples of improved outcomes and risk avoidance to demonstrate that lower cost initiatives result in better quality care.

All of the above actions are available today and can be implemented with minimal effort. The onus is on the pharmacist to declare to patients, purchasers/employers that the pharmacist who was sensitive to your costs is the same person who can solve your therapeutic problems. When patients and purchasers demand these initiatives, the solutions will follow.