Medication adherence report reveals need for patient-specific interventions
RIDGEFIELD, Conn. The 2009 “Medication Adherence” study, commissioned by Boehringer Ingelheim Pharmaceuticals, finds that medication nonadherence and noncompliance transcends demographics and a majority of known disease states, suggesting that nonadherence and noncompliance behavior could be about a patient’s attitudes and beliefs relating to taking prescription medication.
“Adherence is critical right now,” said Mare Lynn Fitch, associate director of pharmacy development, trade relations, BIPI.
The 2009 Medication Adherence study was conducted online between Feb. 26 and March 1, and is based on 1,015 completed interviews. Because adherence and compliance issues are greater among adults with chronic illnesses, and because the incidence of chronic illness increases with age, the survey sample consists of individuals ages 45 and older who were taking medications for one or more chronic conditions.
According to the National Council on Patient Information and Education, the effects of medication non-adherence are far-reaching, with financial implications for the pharmaceutical and medical industries and potentially deadly consequences for some patients.
Fitch explained that a strategy is being developed to implement a pilot program in targeted markets that will assess a tool to assist pharmacists in administering patient-specific interventions to increase medication adherence and compliance.
“We commissioned the study to gain a better understanding behind the reasons why an individual patient may not be adherent or compliant, and then identify patient-specific intervention strategies tailored to those reasons,” Fitch said.
A full report of the survey results are found in the Boehringer Ingelheim Pharmacy Satisfaction 2009 Medication Adherence Report, which will be available at the NACDS 2009 Pharmacy & Technology Conference in August, and online in the early fall.
Military cutting costs via Rx negotiations; NACDS hails finding as pharmacy victory
NEW YORK It was one of those clear “ah-ha!” moments that don’t come around nearly often enough.
In recent days, the Pentagon affirmed what the retail pharmacy industry has been saying all along: that leveling the playing field between community pharmacies and big, impersonal mail-order prescription outlets does more than just expand freedom of choice for military health plan beneficiaries, and eliminate a competitive disadvantage for drug retailers. It also saves the taxpayers money.
The proof of that assertion came with the Defense Department’s revelation that its TRICARE health benefit program for military members and their dependents is spending significantly less on prescription medicines than called for by original spending projections for fiscal year 2010. How much less? Roughly $1.67 billion, according to Defense Department projections.
TRICARE is squeezing those savings out of its expanded power to negotiate prices directly with drug manufacturers. Before its procurement rules were changed earlier this year, the military health program could only negotiate lower prices for drugs purchased for mail-order and military-base pharmacies. The result was higher prices for drugs dispensed to TRICARE beneficiaries who opted to have their prescriptions filled at a local drug store, supermarket or mass merchant pharmacy.
For years, retail pharmacy leaders have cried foul, arguing that the higher out-of-pocket costs put their stores at an unfair competitive advantage by steering the nation’s more than 9 million TRICARE beneficiaries to mail order and PX pharmacies. The industry won a huge victory when the Pentagon agreed that the old procurement system reduced freedom of choice for those patients.
The program’s expanded negotiating power will yield will result in “remarkable savings” for Defense, asserted NACDS president and CEO Steven Anderson.
The projected savings for TRICARE’s drug procurement program could also be enough to lend new ammunition to arguments by liberal lawmakers in the House and Senate who want to toughen the drug-price negotiating provisions in Pres. Obama’s health reform plan. As things now stand, the president is reassuring the pharmaceutical industry lobby that the White House will stand behind its earlier agreement to extract a maximum of $80 billion in negotiated savings from drug makers over the next decade for federal health programs.
Many Democratic lawmakers want far more, and they argue that direct and ongoing price negotiations with drug makers could save taxpayers additional billions. Are they looking at the savings wrung out of TRICARE’s expanded negotiating power? It’s a safe bet they are.
Washington, Mo., considers repealing recently passed PSE legislation
NEW YORK The objective here is closing down clandestine methamphetamine labs. The question is: Who is going to bear the cost? And the answer, ultimately, is the consumer.
It seems that one of the primary reasons behind legislation like this, which is also under consideration by the California state legislature as well as several local municipalities throughout Missouri, is cost shifting.
Indeed, one solution that would prevent the practice of “smurfing,” a practice whereby meth addicts exceed their legal purchase limits in pseudoephedrine products by buying across several nearby pharmacies, is electronic logbooking. By granting access to PSE logbooks to law enforcement in real time, law enforcement officers would not only be made aware of a “smurfer” as they were driving between pharmacies, but would also identify who that smurfer was and where they lived.
Setting up that comprehensive electronic logbooking system requires resources, however. State coffers have traditionally been tapped for that purpose, and at least in the case of California, the Consumer Healthcare Products Association has offered to help defray that cost. In the case of Missouri, more than $500,000 has already been earmarked for the implementation of an electronic logbooking system at the state level.
However, a not-as-much-talked-about cost is also borne by law enforcement, as pointed out by Franklin County Sgt. Jason Grellner in Missouri. After all, it requires additional resources to actually apprehend and prosecute those criminals, he suggested. And a system that better defines who those criminals may be, by his estimation, could cost the state as much as $350,000 per criminal per year.
Therefore, Grellner argues, it’s a fiscal responsibility to take PSE off the OTC market altogether, and require a prescription for the popular decongestant.
That, in a nutshell, is cost-shifting. Because reverse switching PSE translates into less revenue for retailers (and consequently less taxable revenue, as well) for those consumers who choose to forego PSE-provided relief, and for those who don’t, it’s a greater healthcare cost because now consumers have to schedule an appointment with their primary care practitioner and pay the co-pay for that doctor’s visit on top of the cost of the PSE product.
Regardless of how the consumer ultimately pays for the elimination of meth labs — whether through increased taxes to cover escalating law enforcement budgets or through increased personal healthcare costs — there is another argument to be made here. Switching PSE to prescription-only status may result in fewer meth labs busted, but it’s not going to do anything about those meth addicts still on the street. Necessity is the mother of invention, and for addicts, that simply means sourcing their meth from somewhere else.