The Cleveland Plain Dealer recently reported on the plans of Ohio pharmacists to expand their role in patient health care. This was revealed at the May 9 Health Care Summit on Pharmacist Provided Patient Care held in Columbus. One of the speakers was Debra Parker, an assistant professor at the University of Findlay School of Pharmacy. She believes pharmacists can improve patient health care while lowering costs to insurers. During her presentation, Parker said,
“Pharmacists are trained to understand the actions and interactions of drugs in patients…. Doctors have their own specialties and aren’t necessarily familiar with the drugs prescribed by different specialists.”
Because of this comprehensive knowledge, pharmacists like Parker believe their profession should be used more in patient health care.
“We’re in a profession that sometimes is overlooked and underutilized,” Parker said. “Involving a pharmacist to a greater extent makes us all healthier . . . and decreases the overall health-care costs…. Unlike some doctors’ offices, pharmacists are available to people after work and on weekends, offering patients enrolled in a plan that provides pharmacist patient care easy access.”
Parker also referred to the success of a 10-year study in Asheville, N.C., that includes pharmacist care for patients with chronic problems such as diabetes, asthma, high blood pressure and cholesterol levels is part of the pitch they made to health insurers and others attending the Health Care Summit.
Longitudinal research coming out of the Ashville 10 year project presents empirical evidence that all participants benefit from the increased pharmacist patient care. A 2003 study of patients with diabetes under pharmacist care showed 58% to 82% of patients achieved lower blood sugar levels. Between 18% to 27% more patients whose blood sugar as measured by glycated hemoglobin was reduced to the optimal level as defined by American Diabetes Association.
A 2006 study of pharmacist care of patients with asthma showed consistent reduction of both severe and mild persistent and mild intermittent types of asthma. Before treatment, 82% of patients were classified with severe to mild persistent asthma. After enrollment in the study program, they were reduced to 49%. There were 18% classified with mild intermittent asthma at before and 51% after. Sleep disturbance was reduced as well. Prior to the study, 46 emergency hospital visits had been made by the 272 participants. After enrollment in the study, the number of emergencies were reduced to 6. Prior to the study, 14 of the same group had been hospitalized. After enrollment in the study, only 6 hospitalizations were recorded.
Another study showed improvement of hypertension through pharmacists care. At the beginning of this 2008 study, the average systolic blood pressure of the study group was 137 and diastolic was 83. At the end of the study, the average systolic blood pressure was 126 and diastolic was 79. Thus providing empirical evidence that health care consumers do benefit from easy access to the care of pharmacists.
The same three studies also measured the economic impacts of pharmacist patient care, which proved to be beneficial to both insurer and employer. In the first study of participants with diabetes, the average per patient per year insurance claim was $6,096 at the beginning and at the end claims decreased to $1,584. At the beginning of the study, participants reported missing an average of 12.6 workdays per year. The average was 5.4 by the end of the study.
The second study of asthma patients also showed reduced medical costs and increased cost of medicinal claims. A year before the study the average medical cost per patient per year was $639. Five years later the average cost was $206. Fewer days off from work resulted in less cost for lost productivity. Patients reported missing an average of 2.5 workdays annually due to asthma before entering the program and 0.5 workdays annually after enrollment.
In the third study of hypertension patients, the same cost reduction trends in medical claims and fewer missed days of work were noted. Before enrollment in the study, the annual health plan expenditures averaged $1,362, which decreased to $734 over a 5 year period.
Reduced medical claims costs are attractive to insurers who would pay out less for physician visits, hospitalizations, emergency department visits, and laboratory tests. Paying out less also means insurers retain more revenue. It also means employers may pay less for employee health premiums. Potentially, it could result in lower premiums to employees as well. That is why more self-insurers like municipalities and hospitals are beginning to utilize pharmacists patient care not only Ashville, NC but also in Findlay, OH.
However, it is the pharmacists who benefit the most. As evidenced in the first study of patients with diabetes, the total amount in prescription claims per patient per year at the beginning of the study averaged $1,153. At the end of the study, the average increased to $3,095. The second study of patience with heart disease showed the annual amount in medicinal claims per patient before the study began was $641. The average was $1,379 by the end of the study. The cost of medicine at the beginning of the third study of asthma patients averaged $287 per patient per year, which increased to $846 by the end of the 5 year study. Pharmacists were thus making 333% more on patients with diabetes, 215% more on patients with heart disease, and 295% more on those with asthma. Those figures represent a lot more profits for pharmacists, pharmacies, and drug companies.
In the next posting, the Ohio pharmacist patient care plan will be considered in light of national health care costs and benefits.