Frist foresees technology advances as health care confronts challenges

BY Jim Frederick

BOSTON Fast-rising health care costs, the patient self-care movement, extended life spans and unsustainable growth in the costs of Medicare will drive an explosion of new technology, electronic communications and other innovations in health care over the next decade, one of the nation’s highest-profile lawmakers said here Sunday.

Former Republican Senator Bill Frist of Tennessee, who served as Senate majority leader from 2003 to 2007, addressed NACDS members at the opening general session Sunday. Speaking on health care reform and the outlook for the U.S. health system, Frist laid out a possible future scenario for how health care might be delivered, tracked and paid for in the year 2015.

Frist cited looming advances in medicine like nanotechnology, health information technology, e-prescribing and patient self-care, and how those advances will play out in improving the health and lifespan of a hypothetical patient named he named Rodney.

One such advance, he said, is likely to be a tiny computer chip, about the size of a grain of rice, that within a few years could be implanted under a patient’s skin to monitor blood glucose levels, heart rate, blood pressure and other current conditions in real time, and communicate that information to an uplink for physicians and patients themselves.

“It would inconspicuously and instantaneously monitor things like blood sugar, heart rhythm, and even blood pressure, amazingly enough,” said Frist. The data-driven monitoring device could even “ping” a patient’s cell phone to deliver a warning when his or her blood glucose goes over safe levels.

“It’s monitored wirelessly, anonymously and continuously,” Frist told NACDS attendees. That capability enhances to ability of his hypothetical patient of the future, Rodney, to do “an excellent job of his own self-care.”

In addition, he said, “Rodney’s community-based retail pharmacist provides him with his pharmacy services. Why? In large part because he trusts her. He knows that is the person he can go to to get the information.”

That pharmacist of the future’s ability to handle that “huge responsibility,” in Frist’s words, will be due in large part because pharmacy leaders today, at NACDS and elsewhere, will do the “hard work” in assuring “that there would be appropriate compensation for the value added to the quality of health care” by pharmacists performing disease management, drug therapy oversight and other services.

The former Senate leader acknowledged the advances community pharmacy has made in promoting electronic prescribing and other health information technology initiatives. Buy physicians remain, by and large, an impediment to progress on those fronts, he agreed. At this point, said Frist, only about 16 percent of physicians use electronic medical records and e-prescribing.

“What is going to happen…to attract doctors to use electronic medical records? They’re going to have to see that better documentation actually improves the quality of care. They’re going to have to see that fewer systems errors occur. They’re going to have to realize that for the first time, they can be at home and go to their IPod or their computer, and be able to access patients’ records. They’re going to see reduced costs. It’s going to have to hit their pocketbook.

“Patients today prefer providers that use electronic health records, it’s been shown in a recent Rand study,” Frist said. Under new and still-emerging pay-for-performance standards, he added, “It may well be that people who engage in electronic health records or e-prescribing will be reimbursed more in the future to accelerate innovation and change.”

And while evidence-based medicine “is still slow to come,” Frist noted, he remains a strong proponent of fostering preventive care, prescription drug therapy and competition in all aspects of health care delivery as a tool to lower and hold down costs. During his tenure as Senate majority leader, he said, “We tried to inject competition, a little bit, into our Medicare system…because health premiums are rising three times faster than wages today.”

The fast-rising costs in health care—which have grown at roughly two-and-a-half times the gross domestic product over much of the past three decades—”simply cannot be sustained over time,” Frist asserted.


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Cardinal Health bolsters clinic program


INDIANAPOLIS —Many industry observers may not be familiar with Corner Care Clinic, but that is likely to change as Cardinal Health has formed an alliance with, and is a minority investor in, the clinic operator.

Cardinal Health teamed up with Indianapolis-based clinic operator MindGent Healthcare Clinic’s Corner Care Clinic to open in October 2006 the first retail-based clinic. Today, there are 27 walk-in clinic locations.

Corner Care Clinic operates locations in Indiana, Ohio, Connecticut, New Jersey, Pennsylvania, North Carolina, South Carolina, Illinois and New York.

The clinics are located within select Medicine Shoppe, Medicap and independent Leader pharmacies, as well as two Kerr Drug stores and, coming in September, two Drug Fair locations.

The goal: to open an additional six to 12 clinics by year’s end. Going forward, Corner Care Clinic would like to open between 60 and 100 clinics a year.

“When we first made the decision to throw our hat into the ring…we wanted to find a partner whom we felt shared the same vision and mission that we had,” health care veteran and president and chief executive officer of Corner Care Clinic, Julie Beckner, told Drug Store News.

Signifying not only a shift in the health care industry toward convenient health and wellness offerings, but also signifying the key role Corner Care Clinic will play in the Cardinal Health portfolio, Corner Care Clinic participated in the Cardinal Health Retail Business Conference held last month at the Hynes Convention Center in Boston.

As is common of the acute care retail clinic model, Corner Care Clinics are staffed by nurse practitioners that treat such common ailments as strep throat and pink eye, and also provide vaccinations, physicals and screenings for such conditions as diabetes and blood pressure. The average cost ranges between $55 and $75.

Aiming to educate its independent pharmacies on the opportunity, Cardinal Health introduced the clinics, as well as other offerings, at the 18th annual RBC. Touted as the latest addition to Leader Total Pharmacy Manager, Cardinal’s suite of services to help independent pharmacies bolster revenue and drive productivity, the in-store clinics provide yet another way for its retail pharmacy customers to expand their health care reach and better serve their communities. Currently, more than 3,000 independents are part of Cardinal’s Leader pharmacy network.

Meanwhile, Corner Care Clinic has been working to bolster its management team, last month announcing two key executive moves.

Assuming the role of corporate director of marketing for Corner Care Clinic is Mike Milakis. Previously, he served as owner, president and creative director for M&M Advertising for 11 years. During his career, Milakis has worked with more than 50 different hospital, insurance, pharmaceutical and health care-related clients, including Eli Lilly,I.U. Medical Center and University of Chicago Hospitals.

Corner Care Clinic also has promoted Mark Rollins to chief medical officer of the company. Previously, he served as Corner Care Clinic’s medical director.

Prior to joining Corner Care Clinic, Rollins, a board-certified physician, served as chief of medicine at Marion General Hospital in Marion, Ind.

In a recent interview with Drug Store News, Keith Cook, who joined Medicine Shoppe International in late 2006 as vice president of pharmacy solutions, said the partnership is important to Cardinal Health’s MSI division because there is a real “need in the community” for convenient and affordable acute care.

“There are some counties where there is not even a hospital within a 30-mile radius of our store. So ER visits are very difficult for some of our regular patients that we see every day. And there’s also the current health care situation in America. It isn’t easy to get in and get an appointment immediately when you need minor care. So the need was there, and it fit very nicely into our business model,” Cook said. “The reason we like [Corner Care Clinic] as a partner is that they do a very good job of working with the local physician community, and that was really important to us.”

Added Beckner, stressing the importance of working with the local medical community, “[Corner Care Clinics] addresses a real need, but we also are a physician advocate.”


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Respiratory drug sales climb as asthma, COPD cases rise

BY Laura Klepacki

The global respiratory drug market is projected to exceed sales of $44 billion by 2010, according to market research firm Kalorama Information.

As the incidence of lung and breathing-related illnesses climb around the world, drug sales in the segment have continued to rise as well. Kalorama researchers report that sales have increased at the rate of 11 percent annually, from $19 billion in 2000 to $32 billion in 2005.

Asthma, a leading respiratory disease, was diagnosed in 19.8 million people in the United States in 2003, with 11 million experiencing an asthma attack in the previous year, according to the most current statistics from the Centers for Disease Control. In 2002, asthma accounted for 12.7 million doctor visits, 1.2 million hospital outpatient visits, 1.9 million emergency room visits and 484,000 hospitalizations.

An illness that affects the lungs, asthma is the most common long-term disease of children. Symptoms include wheezing, breathlessness, chest tightness and nighttime or early morning coughing. Asthma always is present, but a patient will suffer attacks only when the lungs are stimulated. Triggers include: tobacco smoke, dust mites, air pollution, cockroaches and their droppings, furry pets and mold. Also, physical exertion, high emotional states or extreme temperatures can lead to an attack.

Treatments fall into two categories: long-term control drugs and quick-relief drugs, such as inhalers. Asthma cannot be cured.

Meanwhile, another respiratory disease that often is confused with asthma is chronic obstructive pulmonary disease, and that afflicts another 20 million Americans.

Top-ranked treatments for asthma and COPD posted strong global sales results last year. Advair grew 11.7 percent to $6 billion, Singulair climbed 20 percent to $3.6 billion, Zyrtec rose 12 percent to $2.5 billion, Spiriva shot up 48.5 percent to $1.6 billion, Pulmicort rose 11.2 percent to $1.3 billion and Flixotide increased 4.5 percent to $1.2 billion, according to market research firm Wood Mackenzie.


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