Tapping the Healthcare Reform Power of Pharmacy

by Steven C. Anderson, IOM, CAE

"Atorvastatin from your cardiologist? Fexofenadine from your allergist? Lansoprazole from your internist? Peace of mind from your pharmacist."

Those words help to tell the story of pharmacies in a National Association of Chain Drug Stores (NACDS) Washington, D.C. advertising campaign. While this ad copy demonstrates pharmacy's role in coordinated patient care, it also symbolizes NACDS' commitment to work with the entire healthcare delivery system for true healthcare reform. After all, the coalition name -- Divided We Fail -- speaks very well to the approach necessary to bring about healthcare reform, and also to that needed to improve patient health.

We have a powerful story to tell about the role of pharmacies as the face of neighborhood healthcare. We realize it is up to us to tell it. Unfortunately, the value of pharmacy and other forms of preventive care is not universally understood. That is part of the reason that we are enthusiastic about contributing to the healthcare reform debate, and participating visibly and productively in the work of Divided We Fail.

The case for pharmacy's role in healthcare policy is logical:

• In addition to its dramatic human costs, chronic disease is responsible for the vast majority of healthcare spending.
• Pharmacist-provided care can improve outcomes for patients with chronic disease, and reduce costs.
• Therefore, public policy strategies should incorporate the value of pharmacy, and certainly should not jeopardize the viability or accessibility of pharmacies.

By one estimate, failure to take medications as prescribed imposes direct and indirect annual costs of $177 billion annually, not to mention the suffering of patients and their loved ones. Pharmacy can help mitigate those consequences, and foster better health. With a community pharmacy, on average, within about two miles of every American home, pharmacies present amazing potential as healthcare resources.

Throughout the healthcare reform debate, as part of the NACDS Principles of Healthcare Reform, NACDS will seek to raise awareness and embracement of medication therapy management (MTM). The Medicare Prescription Drug, Improvement and Modernization Act of 2003 defines MTM as "drug therapy management programs provided to ensure that drugs are used appropriately in order to optimize therapeutic outcomes through improved medication use and to reduce the risk of adverse events."

Here is one example of the power of MTM. A study of MTM programs with186 patients through Blue Cross/Blue Shield of Minnesota found reductions in healthcare costs per person of 31.5%, from $11,965 to $8,197. Interestingly, prescription claims increased 19.7%. The total cost of the MTM services was an estimated $49,490, but total healthcare expenditures for all patients were reduced by 31.5%, from $2,225,540 to $1,524,703. The return on investment was $12.15 per $1.00 of MTM services provided.

Tapping into potential like this will be absolutely vital to the success of any attempt at meaningful healthcare reform. As the NACDS advertisement says: "Peace of mind from your pharmacist." In addition to peace of mind, you can add "quality, accessibility, cost-effectiveness and affordability" as well. We are intent on communicating that message, for the good of patients nationwide.

Steven Anderson is President and Chief Executive Officer of the National Association of Chain Drug Stores.