Non-optimized medication regimens cost 275,000 lives and $528 billion every year. The Get the Medications Right Institute (GTMRx) is issuing a call to action and convening a panel of healthcare policy leaders this February to address the problem.
There’s no denying that prescription medications can be a financial burden for patients—especially those with chronic conditions. Nearly 30% of adults in the United States take more than five medications every day. However, the cost often extends beyond patients’ pharmacy bills. How so? Consider this fictional example:
After feeling ill for a few days, Betsy visits her primary care physician who diagnoses her with bacterial pneumonia and prescribes an antibiotic. However, Betsy can’t afford the medication, so she chooses to take an over-the-counter cold medicine instead. Her symptoms don’t improve. In fact, she starts to feel worse and ends up in the emergency room, where she receives oxygen treatments and intravenous fluids. This leads to an even higher cost than the original medication—not only for Betsy, but also for the hospital and her insurance provider.
Though this example is fictional, it’s certainly not uncommon. It’s estimated that between 50% and 75% of patients do not take their medications as prescribed.
But nonadherence isn’t the only challenge. Non-optimized medication regimens—when a medication’s dosage is too high or too low; when a different or additional drug is needed; or when a medication causes an adverse event or new health problem—contribute to 275,000 deaths every year and cost the healthcare industry approximately $528 billion annually.
That’s why comprehensive medication management (CMM) is so vital. CMM is a systematic approach where physicians and pharmacists assess medications to determine if they are appropriate for the patient, effective for the medical condition, safe given the comorbidities and other medications being taken, and able to be taken by the patient as intended.
Research suggests that CMM is most effective when delivered through a team-based, systematic approach. For example, Geisinger Health System, headquartered in Danville, Pennsylvania, offers a medication therapy management (MTM) service to eligible patients who meet a specific criterion: if they have multiple chronic conditions that cause them to take more than eight medications and spend more than $4,255 on medications annually. Free consulting is provided by a team of clinical pharmacists and other healthcare professionals. A clinical pharmacist reviews prescriptions and over-the-counter medications, discusses side effects and drug interactions, talks about the proper use of medications, identifies potential cost savings, and answers questions.
This type of patient communication can help increase medication adherence, empower patients to be more engaged in their healthcare and improve drug safety.
Putting Change Into Action
Research shows that medications are involved in 80% of all treatment plans and affect nearly every aspect of a patient’s life. That’s why the Get the Medications Right Institute (GTMRx) is issuing a call to action as it convenes a panel of healthcare policy leaders in Washington D.C. on February 6, 2020.
“Fixing the current trial-and-error approach to medication use is probably the single largest and most achievable thing we can do to improve health, lower costs and enable each member of the care team to focus on what they do best,” said Katherine H. Capps, co-founder and executive director of the GTMRx. “With more than 10,000 medications available on the market, we simply can’t continue to provide care the way that we have been. The time has come to scale what we know works to get the medications right.”
The GTMRx, along with the Bipartisan Policy Center, is hosting a live broadcast at the Bipartisan Policy Center from 8:30–10:30 a.m. on February 6, 2020, to talk about why comprehensive medication management matters and discuss what the healthcare industry can do to optimize medication use. Together, the two organizations will showcase proven strategies across the healthcare industry—and call for healthcare stakeholders to optimize medication as a way to save both lives and money.
Elizabeth Fowler, of the Commonwealth Fund, and Gregory Downing of Innovation Horizons and Health Datapalooza, will keynote the livestreamed public event. Susan Dentzer, senior policy fellow at the Duke-Margolis Center for Health Policy, will also moderate a panel of healthcare leaders whose organizations are implementing personalized, comprehensive, team-based approaches to medication management. The panel will be made up of Veterans Health Administration’s Carolyn Clancy, M.D., deputy under secretary for discovery, education and affiliate networks; Michael Evans, RPh, vice president for enterprise pharmacy and chief pharmacy officer for Geisinger; and Daniel Rehrauer, PharmD, senior manager, medication therapy management program at HealthPartners.
Capps hails trailblazers like the VA, Geisinger and HealthPartners for significantly reducing needless suffering and cost by using coordinated, team-based, patient-centered care models that integrate medication experts from day one. “Because of their leadership, we have a roadmap to achieve delivery system transformation,” Capps said. “Our role is to broadly disseminate evidence, provide a platform for change, and create the sustainable energy needed to overcome practice, payment and policy barriers.”
After the public event, leaders from academia, the healthcare industry and government will work with GTMRx to develop a blueprint for change.
To learn more or register for the GTMRx and Bipartisan Policy Center event, click here.