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According to the Network for Excellence in Health Innovation (NEHI), up to approximately $290 billion a year is wasted on the improper use of medications. Evidence suggests the most effective way to drive medication adherence is to strengthen the relationship between patients and pharmacists.
Bradley Arthur, NCPA president
In fact, a study commissioned by the National Community Pharmacists Association (NCPA) determined that “patients’ personal connection with a pharmacist or pharmacy staff is the top predictor of medication adherence.” As a longtime independent community pharmacy owner in New York, I take pride in helping my patients achieve better health outcomes. However, even more could be done if certain bureaucratic barriers were removed, which is my main focus in my current role as president of NCPA.
How should we begin to help New York’s more than 2,200 and America’s 22,000-plus independent community pharmacies continue making a difference in the lives of their patients? The answer is to identify a clear problems with simple, fair-minded solutions.
For example, the proliferation of exclusionary Medicare Part D “preferred pharmacy” prescription drug plans can undermine the health of seniors. These plans advertise discounted co-pays at a “preferred pharmacy” and, not surprisingly, many seniors — especially those on fixed-incomes — are attracted to them.
Regrettably, deceptive marketing leaves many seniors unaware that continuing to utilize their pharmacy of choice will result in higher co-pays. Once enrolled, seniors or their caregivers have to pay more for medication or to travel to an unfamiliar pharmacy or use an impersonal mail-order pharmacy, instead of continuing the adherence-driving bond they have formed with their community pharmacists.
Thankfully, companion bills in the U.S. Congress — the Ensuring Seniors Access to Local Pharmacies Act (H.R. 793/S. 1190) — offer a free-market, consumer-friendly fix. The legislation would allow patients in medically underserved areas to use their chosen pharmacy without financial penalty, if the pharmacy is willing to accept the drug plan’s terms and conditions.
Despite years of education and training in prescription drugs and patient care, pharmacists are still not fully recognized by Medicare as health care providers. This effectively limits our ability to provide basic care services to which that many underserved patients need access. This is especially frustrating in the evolving health care marketplace, where laws such as the Affordable Care Act offer tremendous opportunity for creating more efficient and effective methods of delivering patient care services.
The Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592/S.314) would allow pharmacists in medically underserved communities to provide — and be reimbursed for — patient care services they are authorized to deliver.
Independent community pharmacies are often located in underserved communities. More than 70% are located in towns of 50,000 people or less, and these community pharmacies are the sole health care provider in approximately 1,800 rural towns. In urban areas, community pharmacies also play a disproportionately large role in serving patients. With the doctor shortage in America projected to worsen, having pharmacists to help fill the care void is critical.
These two legislative solutions will help expand patient access to health care and their prescription drugs. Empowering pharmacists to expand the services they offer is in the best interests of patients. Now the goal should be to get the House of Representatives and the Senate to act because that, too, is in the best interests of patients.
Bradley Arthur is president of the National Community Pharmacists Association and co-owner of BlackRock Pharmacy and Brighton-Eggert Pharmacy in Buffalo, N.Y.
