My mission is to lower the over 1.5 million unnecessary illnesses and deaths caused by medication errors –prescription conflicts/contraindications, wrong doses, and not taking appropriate amounts in required administrative settings (with/without food, etc). What flummoxes me is why the usage of trained pharmacists isn’t higher—after all, you would think more than twice before having your very good primary care physician fill in for your cancer or heart specialist, wouldn’t you?
When it comes to medicine, however, many still seem to think that the primary care physician is THE person who should be managing a patient’s prescription regimen, that somehow cutting out the pharmacist who is a medication therapy management (MTM) specialist saves money and an unnecessary third party involvement. Both these views are incorrect, and even worse, dangerous.
Let’s look at the facts regarding whether having a MTM pharmacist/specialist is an unnecessary third party involvement:
• The number of medications available and being used has increased tremendously. According to the Centers for Disease Control and Prevention, 2.6 billion drugs were ordered/provided by physicians, another 285.1 million drugs ordered/provided during hospital outpatient department visits, and another 271.4 million drugs ordered/provided during hospital emergency department visits in 2010—one year alone—and these numbers do not count what individuals are ingesting in over-the-counter medications or homeopathic treatments. In fact, over 70% of patient visits to each of these treatment sources—doctors, outpatient, and ER—resulted in drugs being ordered/provided in 2010. These are just too many different sources and quantities for one primary care physician to manage, even with the best intentions and unlimited amounts of tracking time.
• The quantity of medications being used by each individual as they age is a large number. According to The Henry J. Kaiser Family Foundation, in 2011 the average number of retail prescription drugs filled at pharmacies annually for individuals ages 65 and older was 28 different medications; ages 19 – 64 about a little less than half that number at 11.9 different prescriptions; and ages 0 - 18 only 4.1 different drugs. However, even at 4 different drugs, let alone 28 different drugs (and, again, these numbers do not count over-the-counter and homeopathic medications the person is taking), that’s a lot of mixing going on. There are just too many possible ways medication errors can creep in without a dedicated MTM pharmacist involved in each patient’s treatment.
• Medication-related problems are among the top threats to the health of seniors with 10.7% of hospitalizations among older adults due to adverse medication-related events, according to Drugs Aging 2005.
• Pharmacists identify and prevent medication-related problems through evaluation of patients’ drug regimens, increasing the frequency of optimal therapeutic outcomes by 43%, according to Archives Internal Medicine 1997.
Now, let’s look at the facts regarding whether adding a MTM specialist, aka pharmacist, is more expensive:
• In the community population, medication-related problems cost $117.4 billion a year. An additional $24 billion is spent on medication-related problems in other settings: $20 billion in acute care facilities, such as hospitals and $4 billion in nursing homes. Even at their current low usage rate, pharmacists identify and prevent medication-related problems through evaluation of patients’ drug regimens, saving $3.6 billion annually in costs from avoided medication related problems, according to J. Am Pharm. Assoc. 2001--just think how much more could be saved if more MTM specialists were utilized.
• According to a recent article Increased Medication Adherence Reduces Health Care Costs, researchers estimated that: 33%- 69% of all medication-related hospitalizations in the U.S. were caused by non-adherence; the total annual health care spending for diabetes patients with the lowest levels of medication adherence was almost twice that of diabetes with high adherence levels, and that patients with higher drug costs actually had overall lower cost of care.
• According to the Centers for Disease Control, heart disease in the U.S. cost $108.9 billion each year, but research reported in the 4/13 issue of the American Journal of Medicine has shown that medication adherence, which leads to better health, can save the health care significant monies. In fact, the 3/19/13 article CVS Caremark Research Finds Medication Adherence Can Improve Outcomes and Reduce Costs for Patients with Coronary Artery Disease, “annual excess health care costs due to medication non-adherence in the U.S. have been estimated to be as much as $290 billion annually.”
• The return on investment of having a MTM pharmacist includes: decreased hospital admissions, reduction in emergency room admissions, elimination of inappropriate or unnecessary therapies, chronic disease management, emphasis on preventive therapies, and documented evidence of improved outcomes. Result: MTM services reduce total annual healthcare expenditures because the MTM savings exceeds the cost of providing MTM services by more than 12 to 1, according to Am J Health-System Pharm. 2010.
It’s time to be safe. It’s time to save money while being safer. Insist upon the inclusion of MTM pharmacists as a part of routine patient care to gain the most from medicinal treatments in our healthcare systems…and, if your system doesn’t offer MTM pharmacists and you’re taking numerous medications, hire a MTM pharmacist direct for your own health and safety. The facts are there; now let’s get our actions in line with saving more lives and money.
References:
Bates D.W., Spell N., Cullen .J. et al. The Costs of adverse drug events in hospitalized patients. JAMA 1997; 227:307-11.
Bootman J.L., Harrison D.L., Cox E., The healthcare cost of drug-related morbidity and mortality in nursing facilities. Arch Int Med 1997; 157:2089-96.
Ernst F.R., Grizzle A.J. Drug-related morbidity and mortality: updating the cost-of-illness model. J Am Pharm Assoc 2001; 41:192-9.
Kong Kaew, C, et.at. Hospital admissions associated with adverse drug reactions: a systematic review of prospective observational studies. Annals Pharmacotherapy 2008; 42:1017-25.
Simonson W., Feinberg J. Medication-Related Problems in the Elderly. Drugs & Aging 2005;22 (7):559-569.
When it comes to medicine, however, many still seem to think that the primary care physician is THE person who should be managing a patient’s prescription regimen, that somehow cutting out the pharmacist who is a medication therapy management (MTM) specialist saves money and an unnecessary third party involvement. Both these views are incorrect, and even worse, dangerous.
Let’s look at the facts regarding whether having a MTM pharmacist/specialist is an unnecessary third party involvement:
• The number of medications available and being used has increased tremendously. According to the Centers for Disease Control and Prevention, 2.6 billion drugs were ordered/provided by physicians, another 285.1 million drugs ordered/provided during hospital outpatient department visits, and another 271.4 million drugs ordered/provided during hospital emergency department visits in 2010—one year alone—and these numbers do not count what individuals are ingesting in over-the-counter medications or homeopathic treatments. In fact, over 70% of patient visits to each of these treatment sources—doctors, outpatient, and ER—resulted in drugs being ordered/provided in 2010. These are just too many different sources and quantities for one primary care physician to manage, even with the best intentions and unlimited amounts of tracking time.
• The quantity of medications being used by each individual as they age is a large number. According to The Henry J. Kaiser Family Foundation, in 2011 the average number of retail prescription drugs filled at pharmacies annually for individuals ages 65 and older was 28 different medications; ages 19 – 64 about a little less than half that number at 11.9 different prescriptions; and ages 0 - 18 only 4.1 different drugs. However, even at 4 different drugs, let alone 28 different drugs (and, again, these numbers do not count over-the-counter and homeopathic medications the person is taking), that’s a lot of mixing going on. There are just too many possible ways medication errors can creep in without a dedicated MTM pharmacist involved in each patient’s treatment.
• Medication-related problems are among the top threats to the health of seniors with 10.7% of hospitalizations among older adults due to adverse medication-related events, according to Drugs Aging 2005.
• Pharmacists identify and prevent medication-related problems through evaluation of patients’ drug regimens, increasing the frequency of optimal therapeutic outcomes by 43%, according to Archives Internal Medicine 1997.
Now, let’s look at the facts regarding whether adding a MTM specialist, aka pharmacist, is more expensive:
• In the community population, medication-related problems cost $117.4 billion a year. An additional $24 billion is spent on medication-related problems in other settings: $20 billion in acute care facilities, such as hospitals and $4 billion in nursing homes. Even at their current low usage rate, pharmacists identify and prevent medication-related problems through evaluation of patients’ drug regimens, saving $3.6 billion annually in costs from avoided medication related problems, according to J. Am Pharm. Assoc. 2001--just think how much more could be saved if more MTM specialists were utilized.
• According to a recent article Increased Medication Adherence Reduces Health Care Costs, researchers estimated that: 33%- 69% of all medication-related hospitalizations in the U.S. were caused by non-adherence; the total annual health care spending for diabetes patients with the lowest levels of medication adherence was almost twice that of diabetes with high adherence levels, and that patients with higher drug costs actually had overall lower cost of care.
• According to the Centers for Disease Control, heart disease in the U.S. cost $108.9 billion each year, but research reported in the 4/13 issue of the American Journal of Medicine has shown that medication adherence, which leads to better health, can save the health care significant monies. In fact, the 3/19/13 article CVS Caremark Research Finds Medication Adherence Can Improve Outcomes and Reduce Costs for Patients with Coronary Artery Disease, “annual excess health care costs due to medication non-adherence in the U.S. have been estimated to be as much as $290 billion annually.”
• The return on investment of having a MTM pharmacist includes: decreased hospital admissions, reduction in emergency room admissions, elimination of inappropriate or unnecessary therapies, chronic disease management, emphasis on preventive therapies, and documented evidence of improved outcomes. Result: MTM services reduce total annual healthcare expenditures because the MTM savings exceeds the cost of providing MTM services by more than 12 to 1, according to Am J Health-System Pharm. 2010.
It’s time to be safe. It’s time to save money while being safer. Insist upon the inclusion of MTM pharmacists as a part of routine patient care to gain the most from medicinal treatments in our healthcare systems…and, if your system doesn’t offer MTM pharmacists and you’re taking numerous medications, hire a MTM pharmacist direct for your own health and safety. The facts are there; now let’s get our actions in line with saving more lives and money.
References:
Bates D.W., Spell N., Cullen .J. et al. The Costs of adverse drug events in hospitalized patients. JAMA 1997; 227:307-11.
Bootman J.L., Harrison D.L., Cox E., The healthcare cost of drug-related morbidity and mortality in nursing facilities. Arch Int Med 1997; 157:2089-96.
Ernst F.R., Grizzle A.J. Drug-related morbidity and mortality: updating the cost-of-illness model. J Am Pharm Assoc 2001; 41:192-9.
Kong Kaew, C, et.at. Hospital admissions associated with adverse drug reactions: a systematic review of prospective observational studies. Annals Pharmacotherapy 2008; 42:1017-25.
Simonson W., Feinberg J. Medication-Related Problems in the Elderly. Drugs & Aging 2005;22 (7):559-569.
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