Pharmacists as Doctors
It’s called medication therapy management:
In one recent study of 573 people with diabetes, 30 employers in 10 cities waived copayments for diabetes drugs and supplies for those employees or family members willing to meet regularly with a pharmacist. People in the study, financed by the drug maker GlaxoSmithKline, took part in at least two sessions with pharmacists who helped them track their blood sugar, blood pressure and cholesterol level and offered diet and exercise advice. After a year, blood pressure, blood sugar and cholesterol levels typically improved — and saved an average $593 a person on diabetes drugs and supplies.
The obstacles: doctor groups and the federal government.
If the pharmacists can competently do this, what’s the problem?
A lot of people can so some of the things doctors do — nurses, paramedics, EMTs, even clerk typists. The question is: are they aware of the limits of their own competence?
Pharmacists are a great resource and are willing to take on more care-related tasks. The question is: do we allow this to happen now or do we let the competing professional associations fight each other through state legislatures for years to come before we admit we have a shortage of patient care providers and pharmacists could help?
Why not let the free market decide these questions?
Did I read this right?… This should be a slam dunk: (1) Significantly lowered health care costs (to patients as well as insurance providers), (2) Healthier people who live better lives thanks to improved quality of care. And I’m guessing this post doesn’t even add in the savings from reduced surgeries, sick days, etc. associated with well-managed chronic disease states. I believe pharmacists graduate with a 4-year advanced degree (Pharm.D. – similar to an M.D.), so I’m pretty sure they’re competent. They are the most accessible provider of health care without making an appointment, and all we need to do is let them do it! Medication therapy management all the way…
It isn’t a slam dunk. The actual paper leaves more questions than answers. In fact, it reads a lot like a special interest exercise published, where else, in the Journal of the American Pharmacists Association.
How much did the regular pharmacist consults, the tracking, and the other meetings cost in total including the value of patient time? We don’t know. How did these patients compare with other patients? We don’t know. The savings were calculated from the previous year baseline and the patients were self-selected.
Were these patients “new” diabetics learning to manage so that we would expect costs to fall in the second year? We don’t know. Would other people do just as well with waived copayments and no consults? We don’t know. What were the results for the 259 people dropped from the study? We don’t know.
The project cost increase against which the actual cost increase was compared to declare success was “the projected costs for period calculated by applying mean market increases in health care costs for each type of expense (increases of 13% for medical costs and 14% for medication costs between 2006 and 2007).”
Actual costs for actual people? Jury is still out.
Isnt selection bias grand?
Steve