HEALTH

Once again, study results underscore need for broader role of pharmacy

BY Jim Frederick

WHAT IT MEANS AND WHY IT’S IMPORTANT Add another plank to the increasingly solid platform that supports pharmacy’s long-standing fight for a full seat at the healthcare table.

(THE NEWS: ASHP: Healthcare teams with pharmacists improve patient care. For the full story, click here)

Anew health-outcomes study — this one from the American Society of Health-System Pharmacists — yet again demonstrates the unmet potential of community pharmacy as its leaders work to convince policy-makers and health plan payers that pharmacists can do far more than dispense drugs, provide basic counseling and monitor drug interactions. When published in the October edition of the journal Medical Care, the study will add to the growing mountain of evidence supporting pharmacy’s longstanding argument that it brings improved patient outcomes and real cost savings to a fractured healthcare system in dire need of solutions.

The ASHP study, called “US Pharmacists’ Effect as Team Members on Patient Care: Systematic Review and Meta-Analyses,” analyzed the impact on patient health and safety of numerous interventions by pharmacists. Researchers cast a wide net, tracking the results of dozens of pharmacy-care initiatives by reviewing nearly 300 articles and professional papers on the topic.

It was a worthwhile documentation project. Looking at the overall impact of pharmacist interventions and integrated-care programs from the 30,000-ft. level, ASHP found a clear pattern: Community pharmacists working in concert with other members of a patient’s healthcare team can make a big difference in healthier patients and reduced health costs.

One example: An analysis of those many interventions and disease-management efforts found that patients who worked with their pharmacist were 47% less likely to suffer an adverse drug event. And early 90% of studies tracking pharmacists’ impact on managing hemoglobian A1c showed favorable results.

Industry leaders at last week’s National Association of Chain Drug Stores 2010 Pharmacy and Technology Conference made impassioned pleas on behalf of a broader role for pharmacy in a new, reformed U.S. healthcare system. Among them was NACDS president and CEO Steve Anderson, who noted that the pharmacy profession and industry are undergoing a “historic paradigm change” as pharmacists and pharmacy leaders expand their patient-care and clinical capabilities and provide new solutions to a “broken” healthcare system undergoing rapid change.

Also issuing a call to action at the San Diego event was NACDS chairman and CVS/pharmacy president Larry Merlo. “We must ensure that the value of the pharmacy industry and its pharmacists are recognized by payer reimbursement policies — not just for the products we sell but for the services we provide,” Merlo told NACDS members. “We’re positioned to help control the costs of health care by advocating for the value of … pharmacy care.”

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‘Multifaceted strategies’ can improve medication adherence among patients

BY Alaric DeArment

SAN DIEGO Improving medication adherence will require bringing multiple methods together in order to be successful, Pharmacy Quality Alliance senior director for research and performance measurement David Nau said Tuesday in an education session at the National Association of Chain Drug Stores’ Pharmacy and Technology Conference in San Diego.

 

“You need to have a multifaceted strategy around adherence if you want to have an impact on adherence,” Nau said.

 

 

According to last year’s study by the New England Healthcare Institute, poor medication adherence increases medical costs by up to $290 billion. The estimated one-third of patients who do not take their medications properly fail to do so for a number of reasons, which Nau boiled down to five social-economic, patient-related, therapy-related, condition-related and healthcare system-related factors, including costs of medications, fear of side effects and dependence, complexity of regimens, comorbidities and lack of incentives.

 

 

Complexity of medication regimens can be a particular problem for patients with chronic conditions. According to a study of patients using statins for cardiovascular disease, the average user studied took 11 medications, including nine maintenance medications, and often had to visit multiple pharmacies and had multiple prescribers; 10% of statin users studied took 23 or more medications. But according to another study, conducted by Harvard University and CVS Caremark, patients demonstrated greater adherence when they synchronized their refills and were able to fill all their prescriptions at one pharmacy.

 

 

All these factors mean that combating nonadherence requires a number of different approaches rather than simple interventions, Nau said. “It’s not just about counseling; it’s not just about slashing co-pays — it’s about having a multifaceted strategy,” he said.

 

 

Future trends that could affect adherence include deals between drug companies and pharmacy benefit managers, integration of medication reminders into social networking sites and medication-delivery technologies allowing delivery of multiple drugs in one pill, or implants that automatically administer doses. The last trend already is under way, to an extent, with the introduction of combination drugs for hypertension, such as Novartis’ Tekamlo (aliskiren and amlodipine besylate), which the Food and Drug Administration approved in late August.

 

 

Following Nau’s presentation, Rite Aid director of clinical services Rick Mohall took the stage to show some of the retail pharmacy chain’s adherence programs, such as automatic refills, reminder calls, medication therapy management and the Wellness+ rewards card. “Generally, what’s good for the patient is good for the pharmacy as a business,” Mohall said.

 

 

Both presenters emphasized the role of pharmacists in solving the nonadherence problem, with Nau citing a study from this year showing that physicians are “rather ineffective” in promoting medication adherence. “The greatest intervention tool, the thing that all these things need to point to, is the pharmacist,” Nau said.

 

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Walgreens to acquire assets of 18 ApothecaryRx pharmacies

BY Allison Cerra

DEERFIELD, Ill. Walgreens has reached a definitive agreement with Graymark Healthcare to acquire the company’s assets of 18 retail pharmacies across five states.

Graymark Healthcare’s subsidiary, ApothecaryRx, is an independent retail pharmacy business. Affected ApothecaryRx patients in Colorado, Oklahoma, Minnesota, Missouri and Illinois will be notified upon the transaction’s closing. The deal is expected to close in fourth quarter 2010, Walgreens said.

“We have a long history of providing high quality pharmacy services in these markets,” said Walgreens operations VP Bill Miller. “Our staff is dedicated to making the transition as seamless as possible for our new customers. We look forward to introducing them to the unique offerings that have made Walgreens one of the country’s most trusted providers of pharmacy, health and wellness services and daily living needs.”

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