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Take Care study: Adherence better in worksite patients

BY DSN STAFF

CONSHOHOCKEN, Pa. —Worksite health clinics are not exactly a new concept, but there’s no doubt that their prevalence has skyrocketed in recent years as employers look to curb rising healthcare costs and bolster employee productivity. Further underscoring the importance of this growing clinic model is a new study by Take Care Health Systems, which found that those patients using workplace primary care and pharmacy services have higher adherence rates to medications for chronic conditions—nearly 10% higher—compared with patients treated in the community.

The findings are significant in that they suggest that investing in integrated workplace health and pharmacy programs can help employers realize healthcare savings, while improving patient outcomes.

It is estimated by Fuld & Company that there are some 1,200 firms currently operating on-site clinics, which, taking into account their multiple campuses and multiple clinics, results in an estimated 2,200 on-site clinics. That number could reach 7,000 by 2015.

“This study truly demonstrates the value of the workplace healthcare model in addressing medication adherence—one of the most challenging and costly obstacles faced by providers and payers of health care,” stated Sharon Frazee, an author of the study and VP health research for Take Care Health Systems, which is owned by Walgreens. “Having care accessibly located at the worksite allows employees to build a trusted, face-to-face relationship with both their clinicians and pharmacists, providing an opportunity to engage in a dialogue about their condition and treatment plan, and ultimately, promote patient adherence through education and communication.”

With an estimated price tag of $177 billion a year, nonadherence is a major drain on the U.S. healthcare system. That is a significant financial burden especially when Congress is in the midst of weighing the pluses and minuses of ObamaCare, particularly the question of how to pay for the $1 trillion cost of reform.

While employer-sponsored workplace health programs have been in existence for several decades, initially focusing on occupational and health safety, the study was the first of its kind to examine the relationship between the use of employer health offerings at the worksite and adherence to medications, according to Take Care Health Systems, which manages about 380 worksite clinics. Medications used to treat diabetes, heart arrhythmia, hypertension, heart disease and thyroid disorders were included in the study.

The findings, published in the American Journal of Managed Care, show that overall adherence to medication was 9.72% higher among patients treated in the workplace than those treated in the community.

Added Allan Khoury, chief medical officer for Take Care Health Systems, “The increased use of generic medications, along with increased adherence, decreases overall medication expense. This leads to better health at a lower cost. This approach is an important lesson for all of American health care.”

Truly validating the strength and growth potential of the industry was Walgreens’ acquisition of workplace-based healthcare providers I-trax/CHD Meridian Healthcare and Whole Health Management in spring 2008. The acquisitions instantly catapulted Take Care into the largest operator of worksite clinics.

The study was the second portion of a two-part series on the value of integrated workplace primary care and pharmacy services. Take Care Health Systems previously authored a study published in the April 2007 Journal for Health and Productivity illustrating that when doctors and pharmacists work together in a workplace primary care health center, prescribing practices favor older, first-line antibiotics that produce significant savings and provide important therapeutic benefits. The approach, studied at four onsite facilities of an existing Take Care Health Systems client, translated into an estimated potential $1.5 million in savings on antibiotic prescriptions for the host company over three years.

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Washington, Mo., considers repealing recently passed PSE legislation

BY DSN STAFF

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.

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