Pharmacy coalition formed to push healthcare reforms

Twelve pharmacy groups have formed a coalition to promote common pharmacy principles for healthcare reform. The coalition was officially launched this week at the National Press Club in Washington, DC, but backers have been lobbying Congress and the Obama administration for weeks.

The key message: Pharmacy can play a pivotal role in improving healthcare outcomes and reducing costs. “Pharmacy organizations are united behind these principles,” said John Coster, senior vice president of government affairs for the National Community Pharmacists Association (NCPA).

“We have been meeting with key staffers as a group. Given the pressures on staff time, they appreciate that we come in with a unified position.” Pharmacy leaders are calling on policy makers to:

• Improve the quality and safety of medication use

• Ensure patient access to needed medications and pharmacy services

• Promote interoperability of pharmacy and health information technology

The U.S. healthcare system generates more than 1.5 million preventable adverse drug events annually and $177 billion in avoidable costs, noted Tom Menighan, executive vice president and CEO designate of American Pharmacists Association (APA).

Pharmacists can identify potential medication risks before they occur, prioritize the risks, communicate risks and benefits to patients and prescribers, and help manage risks to improve outcomes and reduce adverse events.

“ADEs and noncompliance could be minimized with more support from pharmacy and pharmacists,” Menighan said. “The data show that that adverse drug events and costs can be reduced with medication therapy management in any practice setting.”

Public-sector agencies such as the Veterans Administration (VA), Indian Health Services, and military health services have already recognized the key role that pharmacy can play. Pharmacists are creating and implementing programs to manage hypertension, hypercholesterolemia, anticoagulation therapy, and other conditions.

Private-sector demonstrations such as the Ashville Project have shown that active pharmacy management can dramatically improve patient outcomes in chronic conditions such as diabetes while reducing the financial impact of disease. But private payors have been reluctant to take advantage of pharmacy involvement. Payers have been even slower to adjust reimbursement models to offer incentives for pharmacists and patients to involve pharmacy.

“Our medication and pharmacy service delivery is the most efficient part of the entire healthcare system,” said Bruce Roberts, NCPA executive vice president and CEO. “We need to impress upon policymakers the need to continue to support this community infrastructure.”

The need for efficient, reliable delivery of pharmacy services is set to mushroom as baby boomers age and increase consumption of both medications and medication-related services. More than a quarter of adults over the age of 55 take five or more medications daily, which puts them at high risk of interactions and other medication misadventures.

“We need policies in place to assure the adequate supply of pharmacists, adequate pharmacy reimbursement, and adequate access to pharmacies,” Roberts said. “People want to know that those pharmacists are there and available. Our patients support these principles. It is up to us to let Congress and policymakers know just how strongly the public supports pharmacy.”

NCPA is trying to rally public support with www.fight4rx.org, a new pharmacy advocacy website. Access to clinical information is key to managing medication therapy. The success of pharmacy-based disease-management programs in the VA and other settings rests largely on pharmacists’ ability to access and use information such as diagnosis, lab values, and test results, said Steve Anderson, president and CEO of the National Association of Chain Drug Stores (NACDS).

Community pharmacy must have similar access to healthcare information technology (HIT). “Electronic information plays a key role in pharmacy,” Anderson said. “HIT and electronic prescribing help pharmacists ensure that patients are taking medications as prescribed, they help reduce medication errors, they help pharmacists and patients make better decisions, they improve medication therapy management, they reduce healthcare costs.”

Of every 100 prescriptions, only 25 to 40 are taken properly, Anderson noted, and only 15 to 20 are refilled as prescribed. “Improving those numbers will improve healthcare outcomes, save lives, and reduce healthcare costs,” he said. “We call on Congress and the Obama administration to promote pharmacy and HIT interoperability. The promise of HIT will not be realized if we substitute electronic silos for paper silos.”

Organizations backing the three pharmacy principals include the Academy of Managed Care Pharmacy, American Association of Colleges of Pharmacy, American College of Clinical Pharmacy, American Society of Consultant Pharmacists, American Society of Health-System Pharmacists, Food Marketing Institute, National Alliance of State Pharmacy Associations, Rite Aid Corp, and Walgreen Co.