July 20, 2010 – Pharmacists should be allowed to fill some of the traditional oversight roles of physicians to help care for the estimated 30 million more patients who will be insured under the health reform law passed earlier this year, the dean of the School of Pharmacy at the University of Southern California argued yesterday in an essay in The Wall Street Journal.
R. Pete Vanderveen’s op-ed was published by the Journal on the same day that hundreds of pharmacists, drug industry representatives, and other 340B stakeholders met in Washington to discuss the implications of health reform at the 340B Coalition’s annual conference.
“For patients with chronic diseases such as diabetes, hypertension and asthma who typically must take multiple drugs, pharmacists’ knowledge of drug interactions can be life-saving,” he wrote. “Yet pharmacists typically do little to help these patients. If they were allowed to take on some oversight duties, they could help alleviate the burden on physicians.”
Pharmacists, Vanderveen said, could review test results, adjust the dosages of prescribed drugs, keep an eye on patient use of other medications to avoid complications, teach patients to conduct self-administered tests, and order lab tests when indicated, among other duties.
“At safety-net clinics in Los Angeles, Minneapolis and Pittsburgh, pharmacists have teamed with physicians to care for patients with chronic diseases while saving hundreds of thousands of dollars in treatment costs,” he continued. “This is remarkable because many of these patients struggle with homelessness, low literacy and unemployment. Now the federal Health Resources and Services Administration’s Patient Safety and Clinical Pharmacy Collaborative is pushing for the presence of pharmacists at every community clinic in the nation.”
Such projects are limited in scope because pharmacists are not considered health-care providers by Medicare and Medicaid, Vanderveen noted. “The next, critical step is to change the reimbursement codes of the Center for Medicaid and Medicare Services to allow pharmacists to play a larger role in patient care,” he wrote. “Doing so may initially increase overall medical costs. But in the long run … it will save money and improve patient health.”