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Pharmacists can help manage drug costs if state and federal laws just let them

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For decades, our government has attempted to address one of the most pressing health care problems in our country — skyrocketing drug prices — to little avail. This week, Secretary of Health and Human Services Alex Azar testified before the Senate Finance Committee addressing the challenges of prescription drug affordability for millions of Americans.

But there is another high cost of prescription drugs often overlooked: The most expensive drug may be the one not taken, or not taken as recommended by physicians and pharmacists. The good news for patients is that they are not alone when dealing with medication challenges. Pharmacists are in a good position to assist, if state and federal laws would allow.

{mosads}More than $500 billion in health care spending results from so-called “drug-related problems.” These problems include patients simply not taking their medications as prescribed. According to research recently published in the “Annals of Pharmacotherapy,” only half of medications prescribed for treating acute and chronic conditions are taken as originally recommended.


Some patients elect not to fill a prescription or use only a few doses without finishing the course which can lead to hospital readmission, adding to health-care costs.

However, the most frequent drug-related problem occurs when an individual has a condition (for example, high blood pressure or asthma) that could be remedied but who, for an array of reasons, doesn’t initiate treatment.

The conditions may be quite mild or episodic, not rising to the level of concern that might prompt a person to seek medical care. Alternatively, people may not seek medical attention because of the scarcity of primary care clinicians, high out-of-pocket costs, or lack of insurance.

Given the prevalence of chronic disease and the ramifications on U.S. health and productivity, the importance of saving lives through better prevention and treatment cannot be overstated. The American Association of Colleges of Pharmacy has long advocated for legislative and regulatory changes to professional practice that would help some 200 million Americans better manage their chronic diseases so that more lives could be saved.

Increasing public access to and coverage for pharmacists’ medication management services is an essential component of the formula for achieving a healthier and more productive society. As the nation’s third largest health profession with frequent direct contact with patients, pharmacists are well situated to intervene on patients’ behalf.

For example, consider the administration of influenza and other vaccines by pharmacists practicing in more than 60,000 community pharmacies around the nation. According to the Proceedings of the National Academy of Sciences, even when the seasonal influenza vaccine is just 20 percent effective, it can reduce the number of doctor visits due to illness by an estimated 20 million in a year.

Pharmacists today graduate with the Doctor of Pharmacy degree, equivalent in terms of years of study to physicians, dentists and other health professionals. They are experts in the selection, dosing, and monitoring of prescription and nonprescription medicines, often working closely with other health professionals in delivering team-based care.

They are increasingly connected with other care providers through shared electronic records, making it more feasible to look comprehensively at all of their patients’ medications regardless of who has prescribed them.

This is especially important when an individual is making transitions from home to hospital and then potentially to a rehabilitation facility before returning home. And in some states pharmacists are now able to prescribe hormonal contraceptives and opioid reversal agents to make these important therapies as accessible as possible.

There is so much more pharmacists can do to improve outcomes and reduce costs but are prevented from doing so largely because of limitations imposed by state and federal regulations including lack of access to essential patient information.

While the Medicare program does pay for outpatient prescription drugs, federal regulations fail to include pharmacists as approved providers of other essential services, including comprehensive medication management. Medicare beneficiaries, the elderly and disabled are exactly the populations most likely to experience one or more chronic conditions and use medications the most.

The Pharmacy and Medically Underserved Areas Enhancement Act, which now is co-sponsored by the majority of U.S. Senators and Representatives, aims to remedy this deficiency in Medicare policy. The result would be expanded consumer access to pharmacists’ patient care services.

The Trump administration outlined some possible solutions to reducing our nation’s crippling drug cost problem and we will not solve this problem overnight. However, one simple and effective step in the right direction would be empowering our nation’s 300,000 pharmacists to expand their ability to contribute to the goal of decreasing the incidence and cost of chronic illness.

Empowering pharmacists to be a larger part of the solution will not only help reduce costs, but more importantly it may also help save lives.

Lucinda L. Maine, PhD, RPh is the executive vice president and CEO of the American Association of Colleges of Pharmacy.

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