Recently my colleagues at the National Community Pharmacists Association and I were in one of our regular strategy sessions working to move the ball forward on health reforms that empower pharmacists help patients live healthier lives at lower cost. Soon the conversation turned to three numbers that summed it all up: 290. 50. 13.
$290 billion is the estimated cost that arises each year from patients who do not take their medicines as prescribed, according to the New England Healthcare Institute (NEHI). That’s serious money even in a $2 trillion health care system that is 16% of the U.S. economy. To put that into perspective, $290 billion is larger than the Gross Domestic Product of Ireland. NEHI goes on to estimate that one-third to one-half of all patients fall into this category.
Think about that. Nearly every other patient who’s provided with highly regulated medicine – medicine that carries enormous therapeutic potential AND significant risk – does not use it as he or she should. In no other sector of our economy would we tolerate such waste (of dollars and potential) or such peril to patient wellbeing. What makes the wasteful spending and diminished patient outcomes all the more tragic is that it’s 100% preventable.
50% is the dramatic cost reduction one company realized through the use of a pharmacist-driven, preventative approach to diabetes.
Smith Drug Company of Spartanburg, South Carolina was hit by wave after wave of higher costs for treating its employees and their dependents suffering from diabetes. Smith Drug’s leaders committed themselves to prevention and medication adherence. Patients who volunteered for the new program received complimentary supplies and other incentives. In just one year, treatment costs were slashed from $11,637 to $5,406.
13% is the increase in health care costs resulting from the status quo, again, as experienced by Smith Drug. Many of its employees joined the incentive-laden, preventative plan. Others remained in the traditional model of largely leaving the patient to his or her own devices, hoping for the best and then treating costly complications if they emerge. The cost of treating these individuals went up $1,500, to $13,139 each.
Other industrialized nations get this. Japan, for example, invests 50% more of its health care budget in pharmaceuticals than we do, but our overall health care costs are far greater (15.2% of gross domestic product vs. 8.2%).
Our hope is that Congress gets this, too. Pharmacist-led medication therapy management (MTM) programs such as these hold enormous potential to improve health outcomes and reduce costs. The Medicare Part D program utilizes MTM and we’re encouraged that the Senate Health, Education, Labor and Pensions Committee included an MTM grant program in its health care reform proposal. NCPA will continue working with lawmakers to encourage greater support for MTM during this next phase of the health reform process.