SEPTEMBER 01, 2006
Barbara Sax

PHARMACY TIMES RECENTLY held a student/retailer roundtable on the Future of Pharmacy to discuss some of the key issues affecting pharmacy.

The impact of Medicare Part D was a topic of huge interest among all panelists. Participants said that after the initial struggles of the enrollment period, they see some benefits. They are proud of the way pharmacists served their communities, and they are hopeful that an increased focus on medication therapy management (MTM) can raise the profession's profile.

JT Leatherwood, director of college relations and professional recruitment at Rite Aid, said he was impressed with the level of assistance community pharmacists gave to patients during the enrollment period. "The training that went into it was impressive, but the greatest thing was that it was a time when pharmacists stepped up and did what was right. It was overwhelming," he said."Pharmacists as health care professionals stepped up and did the right thing and worked with the patients."

Pharmacists were proud of the job they were able to do in the face of many enrollment challenges. "I think that the first month of 2006 we all learned to be very adaptable very quickly," said Scott A. Miller, director of clinical education and medication services at Walgreens Health Services. "Pharmacists, especially the people out in the trenches, they were definitely the heroes of January 1, 2006."

Leatherwood and Miller agreed that, from the implementation standpoint, Medicare Part D posed challenges.They see the plan as a positive force, however, for the industry and for patients.

"There are a lot of people who traditionally were not getting medications or would go without.What we're seeing now is, even though there are a lot of problems getting people enrolled into the proper plan and having them understand the plan they are in, they are at least getting their medications," said Miller.

"It is a benefit that finally allowed us to break down those financial barriers for low-income seniors, as well as others who just did not have the coverage to take care of their patient needs," said Papatya Tankut, vice president of pharmacy professional services for CVS Corp."I think we are proud, as an industry, to have served our patients to be able to get the medications they needed."

Tankut believes that Medicare Part D's effect on the industry is just beginning." Part D in itself is one single event that is forever going to change our industry," she said. She believes pharmacists will be providing more support to patients as they consider different plans and as more enroll.

"I think it just becomes ingrained in what we do as professionals and health care providers to incorporate Part D. It is just what we do now. It is our business, and we will incorporate it into the daily struggles that we may have," she said.

The infamous "doughnut hole," when patients will actually begin to see how much they are paying for their medications, will be another challenge for pharmacists.Walgreens'Miller said pharmacists should be preparing to educate patients by showing them how much they saved and how their plan is working. "It is always going to come back to the pharmacist, because they are going to be the ones front and center," said Walgreens'Miller.

Panelists credited Medicare Part D with turning the spotlight on MTM. They agreed that pharmacists need to find ways to maximize the opportunity for the industry.

"We've been struggling and arguing for years that we need to be paid for our services, for our cognitive abilities, and we have never really made it anywhere until we got Medicare Part D. This is our opportunity," said Walgreens'Miller.

Students agree that MTM services are a boon for the industry. Thomas Gage, a student at University of Texas at Austin College of Pharmacy, said that since the curriculum has changed to a more clinically-based, disease-oriented focus, more students are excited about providing these services. "I can have more of an impact in the community setting," he said.

Corporate panelists agreed. Rite Aid's Leatherwood said that pharmacists "miss the joy of the job when they are standing behind a counter."

Tankut said CVS is looking at ways the chain can provide MTM services to its patients without disrupting work flow. "An average pharmacist should be able to provide these services," she said. " Pharmacists are health information providers. We can change our destiny. We are a key part of the health care team. Automation and technicians will allow us to get there."

Increasing the use of pharmacy technicians is a strategy all panelists supported. Jenny Tuttle, a student at Drake University, advocates "using the technician to do everything that they can legally." "We have to embrace services," she said. "We are not just pill dispensers."

Most students said that they are comfortable with the level of training of techs they have encountered and say they feel comfortable relinquishing dispensing duties to techs in order to take on expanded patient care responsibilities.

Tankut advocates training techs to "allow them to shift the prescription dispensing, the systems functions, the production, and technical functions of our job away from the pharmacist so we can allow our pharmacists to do what it is they do best, which is patient care. That is the ultimate goal."

Gage even advocates empowering technicians to get into the community and educate patients. Howard Kramer, director of pharmacy human resources at Kmart Pharmacy, also supports the expanding role of technicians and continues, "I think that the time is right to make better utilization of pharmacy technicians." He emphasized that states are steadily increasing pharmacist-to-tech ratios and allowing them to take on additional tasks, such as taking a prescription from a physician's office over the phone. Lastly, Kramer added, "I believe the pharmacist should be the one involved in MTM, but the use of technicians will free up the time to do that."

Ms. Sax is a freelance writer based in Chevy Chase, Md.

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