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| Ohio Pharmacy Pilot Program Saves Money: Rants and Musings of a Retail Pharmacist |
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by The Redheaded Pharmacist - August 30, 2011
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Provided by The Redheaded Pharmacist
Pharmacists in the retail or community setting could be better utilized and contribute more to our healthcare system. We have the drug expertise that would allow us to favorably change outcomes for patients while saving money at the same time. Need proof you might say. Well, look to Ohio for some answers to the question of what could be in the world of pharmacy.
I’ve always thought that pharmacists could be doing more. We have the ability to evaluate a patient’s medication and medical history and make informed decisions that can improve outcomes. Even something as simple as convincing a patient of the importance of taking their maintenance medications consistently can improve outcomes and save money. But in so many instances in the retail and hospital settings pharmacists have been reduced to being over-trained distributors of medications. We are simply the supplier and nothing more. And that is a shame.
If you want to look into a window of the possible you’ll need to look no further than the results of a study out of Ohio detailed in this Dayton Daily News article. The pilot program that is described in this article involved workers from the city of Cincinnati as well as participating Kroger employees. The employees included in the program were coached by, you guessed it: pharmacists. The results speak for themselves. Over the two years of 2009 and 2010 when the pilot program was being done those employees with hypertension who participated in the pharmacy coaching program netted a cost saving of around $400-$500 each according to Anthem Blue Cross and Blue Shield in Ohio.
So how were those cost savings realized? Well, you have to factor in the increased cost of office visits and medications for participating workers. Those costs went up presumably as more plan participants went to their doctors for checkups and more frequently picked up their blood pressure medications from their pharmacy. But even factoring in the increases in those costs there was still a net cost savings per person thanks to a 40% decrease in overall emergency room visits and hospital admissions. And while $400 or $500 savings per plan participant may not sound too impressive think of what the overall cost savings could be for an insurer who covers millions of patients with hypertension. The savings could quickly add up at a time when all of us are trying to find ways to lower healthcare costs.
You might notice that the article also mentions the fact that the diabetes patients involved in the study didn’t net any cost savings over the two years of the pilot program. This may seem like a defeat for the pharmacists. But average hemoglobin A1Cs of the participants in the program with diabetes dropped from 7.9 to 7. And we all know that those lower A1C numbers are associated with a reduced risk of long-term complications from diabetes. My guess is that if a similar study was done on diabetic patients over a longer period of time the overall costs savings would reveal themselves as fewer of those patients would suffer from the long term complications of diabetes. I realize I’m speculating on this point but one can’t deny the advantages of keeping a diabetic patient’s A1C numbers lower rather than higher.
And you might expect a vigorous coaching program would be required to meet those cost savings numbers found among the hypertensive patients enrolled in this pilot program. But the reality was that pharmacists helped patients in monthly or bimonthly counseling sessions with their medication and treatment plans. They would go over the importance of taking the blood pressure medications and even discuss things like meal planning and foods to avoid. Hardly an intensive and difficult program to expand, if you ask me. And best of all it worked while saving money at the same time.
So what do I think of this study and any like it that might be going on right now all across the country? Personally, I’ve grown to have a love/hate relationship with studies such as this one out of Ohio and their highly publicized results. Why? Well on the one hand I take pleasure in seeing pharmacists prove the worth of our profession. We are capable of so many things it is amazing when you stop and think about it. And I love these studies for proving the value of pharmacy services not is some abstract questionnaire results from patients who describe themselves as better off with our help. These studies have hard cold numbers objectively showing potential cost savings to insurers and better outcomes in real numbers like emergency room visit frequency of the participating patients. Those numbers reveal money that doesn’t have to be spent. And after all, money usually gets the attention of even the most skeptical pharmacy detractors.
But on the other hand I hate these studies and their wonderfully published results with a passion. Why? Because I know that the chances of those programs being implemented on anything close to a widespread scale is slim to none. Retail pharmacy is caught in a numbers game. Employers don’t care about expanding counseling services to save money by better serving patients with hypertension. They want to make the most money possible with the least amount of pharmacists. If they could eliminate us from the equation entirely they would do it!
So while I applaud the pharmacists in Ohio who obviously made a difference in the lives of the workers participating in this pilot program and I’m impressed with the resulting cost savings I know that most pharmacists are trapped in a working environment that affords little to no time for any kind of extensive patient counseling. We are running around trying to handle huge volumes of prescriptions while already juggling additional pharmacy services such as vaccine administration. And I can’t help but ask myself if I have barely enough time to run to the bathroom during a shift at work how am I going to find the time to do the counseling sessions explained in this article? The answer will usually be we don’t have the time as professionals because we are too busy meeting our latest metrics. And that is a shame.
So for anyone who wasn’t fully convinced of what could be simply by learning about The Asheville Project here is another example of pharmacists making a difference. To me this article highlights our ability as a profession to impact lives and help control costs at the same time. But if we don’t have the time or aren’t given the opportunity to show the world what we can do results from programs such as this one out of Ohio are bitter sweet. Why? Because I know the day I have in store for me today behind the counter at work. And it won’t involve lengthy counseling sessions with hypertensive patients to make sure they understand their therapy and eat right. It will mostly be running around filling prescriptions as fast as humanly possible. That is why pharmacists are like a hidden gem within the healthcare system. Except we aren’t hidden at all. We work in plain view everyday. So why does it seem like we are hidden? Maybe we aren’t hidden but we sure seem to be invisible to the rest of the healthcare system. Why is that?
The Redheaded Pharmacist
The Redheaded Pharmacist has been working full time in retail pharmacy for more than a decade. He is in his mid 30s, and, yes, he has red hair.
Disclaimer: This blog represents the opinions of the author and the author alone. It does not represent any pharmacy group or organization. I also will leave out or change the names of patients/customers to protect their privacy and comply with government regulations regarding patient privacy rights and personal information.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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