By Bradley J. Arthur
Forging political consensus to improve America’s health care system is challenging. However, I am optimistic that meaningful change is coming thanks to coordinated health care pilot programs as well as promising bipartisan legislation that taps into the full potential of pharmacists.
Pharmacists can help produce better health outcomes and reduce costs. According to the Network for Excellence in Health Innovations (NEHI), approximately $290 billion a year is wasted on the improper use of medications.
Evidence suggests pharmacists can be primary drivers to help patients stick with their medication regimens (also known as “adherence”). A study called “Adherence in America – A National Report Card” found the biggest predictor of medication adherence was patients’ personal connection with a pharmacist or pharmacy staff.
Community pharmacists have been proven to help ensure patients properly take their medications in many hospital-led initiatives.
A successful program in Asheville, N.C., targeted employees, dependents and retirees with chronic health conditions.
The participants were educated at the outset and monitored by pharmacists who helped to maximize their medication’s benefits. After one year, for example, participants with diabetes achieved improved blood glucose control levels, reduced total health care costs (from $7,042 to $4,000 per patient), and took fewer sick days (from 12.6 a year to 6).
Despite these successes, pharmacists often are limited from being full participants in delivering better care in Medicare, which does not recognize them as health care providers under the Social Security Act. As a result, pharmacists are not eligible for individual reimbursement under Medicare Part B, and many state and private health plans often cite the Part B omission as justification for not covering or compensating pharmacists for providing expanded care.
So what’s the solution? The Pharmacy and Medically Underserved Areas Enhancement Act of 2015 – gaining momentum in the U.S. Senate and House of Representatives – needs to be passed and signed into law. If enacted, pharmacists would be recognized and reimbursed as health care providers, and Medicare beneficiaries in medically underserved areas would have access to expanded pharmacist services. This would be a boon for millions of Americans who lack adequate access to health care.
The time to empower pharmacists has come; we just need to seize the opportunity.
Bradley J. Arthur, R.Ph., is president of the National Community Pharmacists Association and co-owns Black Rock Pharmacy and Brighton-Eggert Pharmacy.