Students and faculty from the University of Maryland School of Pharmacy have an important message for the Maryland General Assembly this year: Empower pharmacists to perform a greater role as health care providers in order to improve health care quality and reduce costs.
The abundance of chronic diseases such as diabetes, chronic obstructive pulmonary disorder, and hypertension coupled with improper medication use adversely impacts patient outcomes, costs and the health care system as a whole, putting patients at risk.
The data related to the state of health in the United States is staggering. According to several sources, including the Centers for Medicare and Medicaid Services, the Mayo Clinic and the New England Healthcare Institute:
•The U.S, spends almost $300 billion annually on medication problems including non-adherence.
•Chronic diseases account for $2.6 trillion in health care expenditures and 91 percent of prescriptions filled.
•Nearly 70 percent of Americans are on at least one prescription drug, and more than 50 percent are on at least two.
As a result of the Patient Protection and Affordable Care Act of 2010 (ACA), approximately 30 million more Americans are now eligible for health insurance. The health care delivery system will have to meet the demands of these newly insured.
Fortunately, the ACA aims to change how care is delivered by providing incentives for expanded and improved primary care and by creating interprofessional team-based models of service delivery.
Pharmacists, with their unique education and qualification as medication experts, can play a major role in optimizing patient care and reducing health care dollars in these new models. We have a successful model that is already making a difference for Marylanders.
Students and faculty from our School of Pharmacy have been collaborating with physicians and other health care professionals to provide medication therapy management in an interprofessional model under a program from the Health Resources and Services Administration's Patient Safety and Clinical Pharmacy Services Collaborative.
In our program, a patient with — or at risk for developing — multiple chronic conditions and on multiple medications is referred to pharmacists to review his or her medication regimen and receive counseling about the importance of taking medications as prescribed. In the first nine months of the program, 78 percent of the diabetic patients saw a reduction in their "A1c," which is an indication of blood sugar levels. Pharmacists also identified and addressed 514 medication-related problems.
Congress has considered bills to recognize pharmacists as providers and allow them to bill Medicare Part B for clinical pharmacy services three times in the last nine years; thus far, all bills have died in committee.
If Congress is too gridlocked to make a difference at the federal level, pharmacists can make inroads on the state level. Maryland and other states such as Florida, Iowa, Minnesota, Missouri, Mississippi, Ohio and Virginia have implemented medication therapy management programs and pharmacy-assisted disease management programs for state employees and Medicaid beneficiaries, which may eventually lead to policy changes to achieve better health, better care and lower health care costs.
California recently passed legislation that goes even further, authorizing pharmacists to administer drugs and biological products that have been ordered by a prescriber, provide hormonal contraceptives, nicotine replacement products and even some prescription medications. The bill also allows pharmacists to order and interpret tests to monitor the efficacy and toxicity of drug therapies and to independently administer some routine vaccinations.
We have a range of providers that can work in concert to serve patients' diverse health care needs, and we should empower them to do so.
I encourage our lawmakers to remove the barriers that exist in recognizing pharmacists' clinical services so that Marylanders can have the same access to care that the citizens of California now enjoy. Enacting laws that recognize pharmacists as health care providers will allow us to meet the increasing health care needs of the citizens of our state by practicing at the top of our license in collaboration with our health care partners, ultimately helping to make Maryland the healthiest state in our country.
Natalie D. Eddington is dean and professor of the University of Maryland School of Pharmacy in Baltimore. Her email is firstname.lastname@example.org.
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