Medication nonadherence counts as one of the nation’s most dangerous and expensive—yet solvable—health problems.
Public awareness, especially as it translates to individual patient awareness, will help. But increasingly pharmacists are stepping into a more collaborative role with physicians to reduce medication nonadherance, says Doug Donaldson, pharmacist and director of product management for McKesson Pharmacy Systems and Automation.
“Pharmacists are playing a greater and greater role in helping ensure that therapies are being followed and that the outcomes are positive,” Donaldson says.
Americans’ failure to follow medication prescriptions costs the country between $100 billion and $289 billion annually, according to a recent study in the Annals of Internal Medicine. It found that up to 30% of prescriptions are never filled and about 50% are not taken as directed. Nonadherence causes up to 10% of all hospitalizations and a staggering 125,000 deaths annually.
Pharmacy-specific tools are emerging that can help patients achieve better medication compliance, including programs that automatically refill prescriptions and generate mobile pick-up alerts for patients via text, email and outbound calls, Donaldson says. Data mining applications used with electronic health records can also flag noncompliant patients.
Those technologies are combined with patient counseling, education and coaching services. This kind of comprehensive, case management approach is aimed at getting patients more engaged in their own medication management, particularly people with chronic disease.
Pharmacies’ shift to a more service-based business model is reflected in McKesson’s Sponsored Clinical Services Network. The initiative provides a range of pharmacy-based software applications and services aimed at improving medication adherence. The network includes McKesson’s Health Mart franchise and other pharmacies nationwide, including many independents.
In addition, the service model is becoming an important source of revenue for community pharmacies. McKesson reported that in 2011, pharmacies in its Sponsored Clinical Services Network collectively generated $1 million in fees for services provided to a population of approximately 250,000 patients. Increased prescription volume can further add to revenues. Along with help developing patient coaching and education services, the network provides pharmacies with refill reminder and notification tools.
Donaldson says that with margins under continued pressure, pharmacy operators are looking for value-added opportunities that capitalize on pharmacists’ clinical training. At the same time, providers and payers are enlisting pharmacists to help reduce the enormous costs associated with medication noncompliance and the hospitalizations that often result.
“What we’re seeing now, in my opinion, is just the first wave of pharmacy-based clinical services,” Donaldson says. “As pharmacies continue to look for new revenue opportunities and providers and payers seek additional ways to cut costs, I believe we’ll see this segment just explode.”