NEHI white paper tackles nonadherence problem
BOSTON — The U.S. healthcare system must address the problem of patients not picking up newly-prescribed medicines if national goals for improved health and reduced costs of medical care will be realized, according to a NEHI white paper issued Thursday.
The paper, “Ready for Pick Up: Reducing Primary Medication Non-Adherence — A New Prescription for Health Care Improvement,” outlines the problem of prescriptions for newly initiated therapy that are not picked up for the first time and, thus, never taken, leading to the possibility of worse health and increased stress on the healthcare system.
The rate of primary nonadherence, that is, the percentage of first-time prescriptions abandoned by patients (and thus not picked up at pharmacies), can range as high as 30% among some classes of medication, according to recent research.
“In recent years, our healthcare system has begun to take action to improve patient medication adherence, and yet primary medication nonadherence — the failure to commence newly initiated therapy — remains a major but largely unacknowledged problem,” said Tom Hubbard, NEHI VP policy research, who authored the paper. “The good news is that potential strategies for reducing primary medication nonadherence are emerging as electronic prescribing becomes common. This paper is a call to accelerate action that will reduce the failure to pick-up newly initiated medication therapy.”
A May 2014 working group convened by the NACDS Foundation, the Pharmacy Quality Alliance and NEHI framed the issues outlined in the paper. The paper addresses key issues in the adoption and utilization of a new pharmacy quality metric on primary medication nonadherence endorsed by the Pharmacy Quality Alliance in November 2013. Prior to the advent of e-prescribing, tracking PMN rates was not feasible.
“The PQA PMN measure introduces a consensus-based, scientifically tested, nationally endorsed metric to the market,” said Laura Cranston, PQA executive director. “This metric brings much-needed consistency in defining PMN, which will help us to identify, test and compare results for PMN interventions across healthcare settings.”
Current adherence policy focuses on patients who have received their therapies at least once — because these patients trigger payment claims processing that allows medication adherence to be tracked.
“Obviously this leaves out patients who never get their newly-prescribed therapy at all,” Hubbard said. “Community pharmacies that receive e-prescriptions can now track primary medication non-adherence by comparing the e-prescriptions they receive to the records of the prescriptions that are actually picked up. This paper outlines the issues pharmacies face in using this data to create effective interventions with patients that will increase the first-fill of new prescriptions.”
NEHI makes eight recommendations that stakeholders, from physicians and pharmacists to insurers and health plans, could do to understand and attack the problem, including pharmacist interventions with nonadherent patients.
High on the list: more dialogue among healthcare payers, the physician community and the pharmacy industry to establish common ground for action.
“Collaboration is key in the face of the challenges that result from patients not taking their medications as prescribed. And to that end, pharmacy works in close partnership with hospitals, physicians, nurses and other healthcare providers in helping patients understand the importance of taking their medications as prescribed,” said Kathleen Jaeger, NACDS Foundation president. “We are pleased that NEHI has raised awareness of primary medication non-adherence — a critical public health gap.”
“As the late Surgeon General C. Everett Koop said, ‘Drugs don’t work in patients who don’t take them,’" Hubbard said. "He might have continued, ‘Drugs never work in patients who don’t take them for the very first time.’”
Center for Healthcare Supply Chain Research and AACP partnering on specialty pharmacy educational tool
ARLINGTON, Va. — The Center for Healthcare Supply Chain Research, HDMA’s non-profit research foundation, and the American Association of Colleges of Pharmacy, the national organization representing the interests of pharmacy education, are partnering to provide the nation’s schools of pharmacy a supply chain educational tool surrounding the distribution of specialty pharmaceuticals. This teaching resource was released Thursday in conjunction with a webinar jointly hosted by the Center and AACP. The webinar was made possible through the support of the Cardinal Health Foundation.
This turn-key presentation, titled, “Understanding Specialty Distribution,” outlines characteristics of the specialty pharmaceutical sector, one of the fastest-growing markets in the healthcare industry. The resource, sponsored by Eisai, provides Center data on the processes supporting the movement of medication from the manufacturer (as a finished product) to the customer (including pharmacies, hospitals and clinics).
The PowerPoint deck can also be used by manufacturer, distributor and pharmacy presenters/trainers to "on board" new personnel, and, through the partnership with AACP, to train student pharmacists. Additionally, a "notes" feature provides speaking points for each slide and allows the presenter to customize each presentation to their audience’s needs.
“This program provides a comprehensive overview of the specialty supply chain, with rich descriptions of the important stakeholder relationships, the economics of bringing specialty products to market and regulatory influences on this unique supply chain,” stated Karen Ribler, EVP and COO of the Center for Healthcare Supply Chain Research. “We are grateful to Eisai and the Cardinal Health Foundation for supporting this resource, and pleased to partner with AACP to help educate America’s future pharmacists on the mechanics of the specialty supply chain.”
In 2013, the Center partnered with AACP to release “Understanding Distribution,” a curriculum on the processes surrounding the distribution of traditional pharmaceuticals. Supported by a grant from the Cardinal Health Foundation, this resource also was offered to more than 120 college pharmacy programs.
“AACP is aware that specialty pharmaceuticals are growing rapidly as powerful tools for patient care,” commented AACP EVP and CEO Lucinda Maine. “Today’s students will be practicing pharmacy well into the middle of this century and must be equipped with the information on supply chain management contained in this valuable Center resource.”
DSNTV: Chasing — and engaging — today’s elusive consumer
BY DSN STAFF
Retailers and suppliers need to work harder to find creative ways to better engage today’s “elusive” consumer and motivate her to want to make a trip to the store, Lisa Paley, chief customer officer for Pfizer Consumer Healthcare, told Drug Store News for the latest edition of DSNTV Executive Viewpoint video interview series.
“The consumer is a little elusive right now,” Paley explained. “They’re in control, but they’re not as identifiable: they’re doing a lot [online] pre-shop before they come to the store; they’re buying online; they’re buying [in] brick and mortar, so they’re a little hard to track and a little harder to engage to want to make the trip into the store.”
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