Employers and pharmacists team up to drive down healthcare costs

Health care is once again front and center in the national political debate. Four years ago, Republicans pushed through the Medicare Part D drug benefit in part to bolster their credentials before the election. Now attention has turned to the health insurance plans proposed by the leading Democratic candidates, Hillary Clinton (D, N.Y.) and Barack Obama (D, Ill.). Still, whoever wins the November election, it is clear that healthcare and medication costs will continue to rise faster than inflation, placing increased pressure on employers, employees, and the entire healthcare system.

Just how bad is it? According to the Kaiser Family Foundation, health insurance premiums have increased 78% between 2001 and 2007, four times faster than wages, which have grown just 19%. The foundation's annual survey reported that premiums for both single and family health plans have more than doubled since 1999.

With the help of pharmacists, these companies are focusing on earlier intervention and looking at the long-term ramifications of healthcare expenditures. "Cutting-edge employers are focused on the low hanging fruit: management of chronic disease," explained Andrew Webber, president and CEO of the National Business Coalition on Health. "We think that if we can do a better job of chronic care management, there are opportunities and interventions that can make that happen."

Taking control

The moment of truth for the University of Southern California (USC) came about 15 years ago, according to Lisa Macchia, the director of health plans for the university. With 12,000 eligible faculty and staff, the school was seeing double-digit growth in its healthcare expenses. Most of the beneficiaries were in a plan run by Kaiser Permanente and the university felt its medical pharmacy, occupational therapy, and physical therapy schools were under-utilized. "Medical school faculty did not even have a private hospital where they could admit patients," explained Macchia.

Control over the health plan has also allowed USC to get involved in more innovative programs. In 2006, USC signed on for the Diabetes Ten City Challenge (DTCC), a program developed by the American Pharmacists Association Foundation. DTCC offers beneficiaries intensive in-person disease management sessions with pharmacists in return for reduced or eliminated copays on medications and supplies.

"It seemed like we should stand up and invest our resources for something that we believe in," explained Dean Pete Vanderveen, Ph.D., R.Ph. "In 1950 USC went to a Pharm.D. program and in 1968 the school first added a clinical component to the program. There is a rich history of being innovative and pushing the clinical boundaries at USC."

According to Macchia, close to 100 of the 400 to 500 diabetics in USC's self-funded plan have already signed up for the challenge. "Once we have more data, it will be easier to communicate its benefits and as people talk about it, I think we will increase participation," she added.