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Long-term savings for health care cannot be ignored

BY Jim Frederick

WHAT IT MEANS AND WHY IT’S IMPORTANT — Almost $8,000 a year in healthcare savings, per patient. That’s how much patients with congestive heart failure could save the U.S. healthcare system simply by taking their medications as prescribed, an exhaustive, three-year study by CVS Caremark concluded.

(THE NEWS: Adherence among chronic disease patients can lead to big savings. For the full story, click here)

Patients with other such chronic diseases as hypertension and diabetes also could generate eye-opening cost savings just by adhering to their prescription drug regimens, the study found: Nearly $4,000 per patient in reduced emergency room visits and acute-care incidents.

It’s the kind of finding that should have policymakers, congressional lawmakers and concerned health officials within the Obama Administration sitting up at their desks and reaching for their health-reform megaphones. For a nation battered by ever-rising health costs, a Medicare and Medicaid health safety net frayed by an unsustainable and out-of-control cost structure, and a population increasingly alarmed about the exploding national debt, the cost-saving potential of improved medication adherence rates should be trumpeted with parades and banner headlines.

CVS reported its findings Thursday in the journal Health Affairs. Company researchers based the study, “Medication Adherence Leads to Lower Health Care Use and Costs Despite Increased Drug Spending,” on a careful, long-term analysis of pharmacy and medical claims data for 135,000 patients with congestive heart failure, diabetes, hypertension and dyslipidemia to determine the direct effect of adherence on costs.

Their conclusions are dramatic. Even with the additional costs associated with full adherence — patients with those chronic conditions who comply with their prescribed medication therapy can generate up to $1,000 in additional drug costs per year — hospital and acute-care expenses for those patients were way down in relation to their nonadherent counterparts.

Consider the ramifications. “Almost half of all Americans, approximately 133 million people, live with at least one chronic disease,” noted the study report’s authors in Health Affairs. “Because ongoing use of prescription medication is a key component of treatment for chronic conditions, medication adherence — or making sure that patients take the drugs prescribed for them — is a matter of great importance to policy makers, insurance plan sponsors, physicians, and patients.”

Indeed, if such federal health programs as Medicare and Medicaid gave adequate support to an aggressive program for boosting adherence rates, it could mean thousands of dollars in reduced health costs for millions of chronic-care patients enrolled in those programs. And if Congress or the White House made adherence a core component of the reformed health system now taking shape through community-based concepts, including medical homes and accountable care organizations, those savings to the beleaguered U.S. health system could accrue to hundreds of billions of dollars a year.

Health regulators and policymakers need to pay heed when CVS lobbyists come calling this winter. The study’s findings should be enough to yank the last bricks out of the foundations underpinning the silos that kept different decision-makers in the healthcare system from looking at the big picture; i.e., public and private healthcare plans that cut pharmacy benefits to achieve short-term savings, without regard for the long-term acute-care costs that result. Under the fast-disappearing silo structure that used to dominate the health payer and provider landscape, those long-term implications were somebody else’s problem.

In an integrated health system, where all stakeholders and, for that matter, all taxpayers and patients are linked in a web of increasingly unsustainable costs, there’s no such thing as “somebody else’s problem.”

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New e-reader cases by LightWedge for NYT available next month

BY Allison Cerra

NEW YORK — LightWedge has created a series of e-reader covers for the New York Times Store.

The e-reader covers are adorned with photographs from NYT archives. Three of the new covers, which feature images of the New York City skyline, Statue of Liberty and Flatiron Building, made their debut at the Consumer Electronics Show in Las Vegas.

The New York Times covers by LightWedge will be priced at $49.99 and will be available next month at the New York Times Store online and through several national retailers.

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While parents turn away from vaccines, U.S. pharmacies make them more accessible

BY Michael Johnsen

WHAT IT MEANS AND WHY IT’S IMPORTANT — In 2011, refusing to inoculate children against dangerous illnesses like measles, whooping cough and even the flu, borders on child abuse. This story should go a long way toward keeping a lot of kids healthy by educating their misguided parents—good news for retail pharmacy, which continues to expand its presence as the local community destination for common vaccinations.

(THE NEWS: MMR vaccine, autism link was fabricated, medical journal says. For the full story, click here)

Retail pharmacy certainly played a key role in addressing the recent outbreak of whooping cough in California this past fall. In response to that epidemic, Walgreens announced that its pharmacists in California were offering pertussis immunizations (tetanus/diphtheria/pertussis-Tdap vaccine) at select stores throughout the state. And more recently, Walgreens exemplified retail’s full potential capacity in administering vaccine to the general public as part of its alliance with the Department of Health and Human Services that offered free flu vaccinations to as many as 350,000 low-income and uninsured Americans.

HHS secretary Kathleen Sebelius in September stated the new alliance with Walgreens was an “important new partnership with the department of HHS and [the Centers for Disease Control and Prevention] to help increase flu vaccination rates across the country. … By making the flu shot more accessible for more Americans, we can prevent the flu from spreading, and certainly save lives.”

Make no mistake, there but for the grace of God goes the United States in terms of an outbreak of measles in this country. The United Kingdom, which, similarly to the United States, had eliminated the epidemic potentiality of measles, saw their vaccination rates dip to 80% of the population and is experiencing a measles outbreak again.

In the United States, there only has been a slight dip in vaccination rates, but still enough to cause concern among the healthcare professionals at the Centers for Disease Control and Prevention. “Between 2008 and 2009, MMR coverage fell from 92.1% down to 90%,” CDC’s director of the National Center for Immunization and Respiratory Diseases Anne Schuchat told reporters during a September 2010 press conference. “That might be a warning sign of larger drops to come,” she said. “You can still have communities with very large pockets of susceptible children. What we saw in 2008 were communities where certain schools had a large number of children who were unvaccinated when the virus was imported from other countries where measles still are very common. The virus could find a vulnerable population to spread in.”

She continued, “Vaccine-preventable diseases are everywhere around the world. We are lucky here in the U.S. that most of these are at record low levels. … With measles, we can never let down our guard in any community where there is a large number of susceptibles. You can see a measles outbreak. While we have been able to maintain our status as having eliminated the indigenous spread of measles, unfortunately, we saw a country like the United Kingdom, which had eliminated measles, unable to break the chains of transmission and now continuing to be facing a large outbreak.”

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