There is growing recognition of pharmacists’ contributions to whole-person healthcare, especially in the wake of the COVID-19 pandemic. Pharmacists supported other healthcare workers on the front lines by providing drug information, promoting telehealth services, and helping to manage drug shortages. Physicians and patients alike relied on pharmacists to educate, counsel, and administer vaccines. The value they brought to their communities in a time of crisis was immeasurable. But their value doesn’t, and shouldn’t, start and stop with a global pandemic. Every day, pharmacists impact public health in numerous in and out-patient settings by educating patients and doctors on the appropriate use and safety of medications, vaccinations, disease states, and management of side effects and drug interactions. As we consider how to use lessons learned from the pandemic to create a better healthcare ecosystem, we should ensure pharmacists play an active role in patient care. Here’s why:
Pharmacists know drugs. Gallup polls consistently show pharmacists are among the most trusted professionals in the medical field. There’s no question that doctors and pharmacists are complementary partners in healthcare, both playing an integral role in improving patient health. An overload of information and an ever-expanding drug pipeline make it very challenging for the physician community. Aggressive advertising campaigns for new medications (which are not always clinically superior) further compounds the issue of information overload for physicians. The deep pharmacology-related expectations of a physician are overwhelming and not conducive to an effective healthcare delivery model. By contrast, pharmacists receive deeper education in chemistry and drug development, for example, learning significantly more about medication ingredients, including how they are absorbed and metabolized. Their level of understanding drug interactions and the effectiveness of therapies is bar none. Pharmacists monitor the drug pipeline and are fully prepared for new-to-market brand and generic drug activity to advise healthcare professionals and predict future drug utilization patterns. Pharmacists can and should play a very complementary role in tandem with the physician.
Leveraging the pharmacist as healthcare quarterback. Condition-oriented wellness programs gained momentum as the HMOs of the 1990s phased out. The incentive structures of HMOs aside, centralizing care and services under a primary care provider (PCP) was a key advantage to their care approach. The PCP’s coordination of services for patients afforded a complete picture of a patient’s health. Conversely, programs that focus primarily on a dominant health condition forced patients to act as their own healthcare coordinators and led to gaps in care. The central problem with these programs is the narrowed focus applied to a single health condition ignores a patient’s comorbidities and other health conditions and drug utilization.
Pharmacists, however, are uniquely positioned to view and assess all medication therapies, both individually and in combination, prescribed by the various healthcare providers a single patient may have. The pharmacist is frequently the only professional that sees the patient’s full medication picture and understands its implications. Leveraging their unique skillset and training, pharmacists can help patients avoid adverse drug events, improve the quality of prescribing and medication appropriateness as well as improve the management of chronic conditions. Indeed, medication interventions by pharmacists are most effective when they collaborate with prescribers. Thus, advocating for pharmacists to be more involved in patient care teams is a significant way healthcare organizations can improve patient health.
Pharmacists Promote Value-based Care. With roughly four out of every five patients getting prescription benefits through a pharmacy benefit manager (PBM), there is no reason patients should miss out on pharmacists’ medication management expertise. In addition to improving care, pharmacists are in a prime position to drive out wasteful pharmacy spending for both patients and benefit plan sponsors. By identifying individual doctors that prescribe mostly non-preferred drugs or costly brand drugs, and educating them about appropriate and proven alternatives, pharmacists can prevent excessive cost without sacrificing care. To reap these benefits, however, the healthcare industry must demand greater value from PBMs.
Every PBM can look for new ways to insert pharmacists into multidisciplinary care teams and create a value-based, whole-person approach to care. It starts with recognizing that every patient has unique healthcare needs, and one-size fits all clinical programs do little to improve health or costs.
EmpiRx Health, the industry’s only value-based PBM, embraces a practical population health management strategy where pharmacists work in a multimodal fashion to improve patient outcomes and reduce healthcare costs. This approach involves stratifying at-risk patient populations in a condition-neutral manner using an EmpiRx Health engine powered by the Johns Hopkins ACG model. It guides pharmacists to identify those patients who would benefit from enhanced interventions. Pharmacists review unique patient clinical risk profiles, research evidence-based medicine, then collaborate with prescribers to influence more cost-effective, precise prescribing choices through a whole-person health lens.
While all patients are likely to benefit, those with complex or costly chronic conditions may benefit most. In one case, for example, a nine-year-old boy was prescribed weekly Humira® injections to manage his Crohn’s disease. Our pharmacist recognized the drug dosage and frequency were unusually high for someone the boy’s age and contacted the child’s physician. Working together, they decided to conduct lab tests to see how well the treatment was working. Lab results showed the costly treatment plan wasn’t working as hoped. The pharmacist and physician consulted again and chose a new treatment plan with a different medication that also happened to be less costly. Within three months, further lab tests indicated positive clinical outcomes. The new regimen afforded the boy a higher quality of life at a lower overall cost.
This kind of story should not be the exception in patient care, but the rule. For too long pharmacists have been relegated to the sidelines to count pills and staple labels to bags. High-quality healthcare is unequivocally a team sport. COVID-19 has further underscored that deep expertise in medicine must come together with pharmacists squarely at the center as experts in medication management. Care teams that welcome their collaborative expertise undoubtedly will be the ones best able to optimize patient health outcomes and achieve true value-based care.
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EmpiRx Health partnered with Canal Barge Company on the creation of an innovative glucose monitoring system, allowing our Clinical Pharmacists to assess and identify risk and work with the member and their healthcare provider to deliver the right intervention.