Decision Support Systems Often Miss Drug–Drug Interactions
A study conducted at the University of Arizona College of Pharmacy found that only 28% of clinical decision support software systems used by pharmacies correctly identified potentially dangerous drug–drug interactions.
For the study, which was conducted at 64 pharmacies across Arizona, members of the research team tested the pharmacy software using a set of prescription orders for a standardized fictitious patient. The prescriptions consisted of 18 different medications that posed 13 clinically significant drug–drug interactions. Of the 64 pharmacies, only 18 correctly identified all of the eligible drug–drug interactions and noninteractions.
“These findings suggest that we have a fundamental problem with the way interactions are evaluated by drug knowledge databases,” said Daniel Malone, PhD, University of Arizona professor of pharmacy and lead investigator on the study. “The weakness of these systems could lead to medication errors that might harm patients.”
It is critical that pharmacists become familiar with how their computer system identifies medication interactions, said Dr. Malone, who also urged patients to inform their pharmacist and physician about all of the medications and other therapies they are using.
“The risk of harm from dangerous combinations can be reduced when patients create and maintain a medication list,” he added.
Diabetes Drugs Dominate the Market
Diabetes and specialty medications continue to drive growth in drug spending, according to a report from Medco Health Solutions, Inc, which found that diabetes medications contributed 16.7% to overall growth in spending in 2010. Unit costs for diabetes medications—which includes insulin, hypoglycemic drugs, glucose-elevating agents, and supplies—increased by 5% and utilization increased by 2.5%, the 2011 Medco Drug Trend Report stated. Drug treatments for diabetes, central nervous system conditions, and cardiovascular conditions are the top drivers for growth in spending.
Demand for diabetes drugs will continue to grow as the number of patients diagnosed with the condition continues to increase, said Glen Stettin, MD, chief medical officer of Medco Health Solutions. “The number of people in the US being treated for diabetes is expected to increase from nearly 25 million today to 44 million by 2035,” he stated.
The report found that respiratory drugs contributed 15.1% to overall growth in drug spending, and medications that treat rheumatoid arthritis, lupus, Crohn’s disease, ulcerative colitis, and other autoimmune diseases accounted for 14.7% of growth.
The demand for oncology drugs increased by 6.7%, a factor that Stettin attributed to the high costs of oncology medications, combined with an increasing number of patients diagnosed with cancer. These factors could cause cancer drug spending to increase by as much as 15% per year through 2013, according to the report, which projects that the cost of cancer care will rise from $124.6 billion to as much as $207 billion by 2020.
“New cancer drugs reaching the market are expected to double during the next several years,” said Dr. Stettin. “Early diagnosis, evidence-based treatment, and enhanced coordinated care have essentially turned some forms of the condition into chronic illnesses that can be managed longer-term.”
NCPA Endorses Community Pharmacy Fairness Act
Last month, Representative Anthony Weiner (D, NY) introduced the Community Pharmacy Fairness Act of 2011 (HR 1839), a bill designed to facilitate a more competitive marketplace by improving the ability of independent community pharmacies to negotiate with pharmacy benefit managers.
The bill aims to “ensure and foster continued patient safety and quality of care by making the antitrust laws apply to negotiations between groups of independent pharmacies and health plans and health insurance issuers (including health plans under parts C and D of the Medicare program) in the same manner as such laws apply to protected activities under the National Labor Relations Act.”
Specifically, HR 1839 would allow independent community pharmacies to collectively negotiate the terms and conditions of insurance contracts to produce plan designs that better protect the patient’s choice of pharmacy and are fairer to pharmacy providers, according to the National Community Pharmacists Association (NCPA), which recently announced its support of the bill.
“Patients rely on independent community pharmacists for expert medication [advice] and other cost-saving health services,” said B. Douglas Hoey, RPh, MBA, executive vice president and chief executive officer of NCPA. The legislation, he stated, will help local pharmacists and small business owners by leveling the playing field for independent community pharmacies when negotiating contracts with corporations, and by enabling patients to enjoy the benefits of a more competitive marketplace.
“We strongly commend Rep. Weiner for introducing this bipartisan legislation and we urge his colleagues to support it,” Hoey said.
PT iPAD EXTRA: Diabetes affects 25.8 million people, or 8.3% of the US population. For exclusive tools and tips on caring for this growing community, download our free iPad app from iTunes and go to Pharmacy Insights.
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