Pharmacists Are Now Recognized as Health Care Providers

OCTOBER 01, 2004
Eileen Koutnik, Assistant Editor, Pharmacy Times

For the first time since Medicare's inception, pharmacists are finally being recognized as health care providers. Part of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 includes proposed rules to regulate Medication Therapy Management (MTM) programs that would entitle Medicare beneficiaries access to these services from pharmacists.

"This is the first time in our nation's history that the pharmacist has ever been acknowledged in federal legislation as a health care provider. After all this time, the nation's largest payor of health care services is now recognizing the vital role of the pharmacist as a medication therapy manager and is willing to compensate pharmacists for their services," Kerr Drug's Executive Vice President, Pharmacy and Logistics Ralph Petri said during the National Association of Chain Drug Stores (NACDS) Pharmacy and Technology Conference on August 29, 2004, in San Diego, Calif.

The purpose of MTM is to optimize therapeutic outcomes, improve medication use, reduce the risk of adverse drug events and drug interactions, and increase patient adherence and compliance with prescribed regimens. "Effectively delivering MTM services to our nation's Medicare beneficiaries will be one of community pharmacy's most effective and important ways of demonstrating the importance of the pharmacist in improving the effective use of prescription medications," Petri told conference attendees.

He stressed, however, that "if we do not effectively deliver MTM within the Medicare benefit, we not only risk losing this important opportunity but the much larger opportunity to effectively demonstrate the pharmacist's vital role in health care to the American public."

Successfully delivering MTM programs requires changes. "It means positioning our pharmacists to utilize their expertise more actively than ever before. If we are to succeed, we, as a profession, must do things differently," Petri added.

Petri also highlighted the pressing issues that will challenge the continued success of community pharmacy in the coming months. He said that community pharmacy, along with the NACDS, is hard at work making sure that the role of community pharmacy is properly recognized as a key contributor to safe, cost-effective health care. A majority of this year's focus has been on 4 fundamental areas:

  • Striving toward a meaningful prescription drug benefit for Medicare beneficiaries
  • Involving all stakeholders in the drug importation debate to ensure the right of all patients to quality medications
  • Working to support patient choice in the prescription medication mail-order debate
  • Working for adequate reimbursement from state Medicaid agencies and other payors for pharmacy services

Petri further pointed out that working on these areas poses 2 underlying challenges. "The American public does not fully appreciate the value of medications, nor do they understand the role of the community pharmacist in helping to maximize the safe and effective benefits of their medications."

Despite pharmacists repeatedly ranking at or near the top of the annual Gallup Poll measuring trust among American pharmacists, he said that "trusting a pharmacist" is not the same as "understanding what a pharmacist does"?or "appreciating (placing value) on the positive impact a pharmacist has on improving health care outcomes."

Petri, who has been encouraged by the discussions regarding the value message, said, "A crucial ingredient in the value message is the quality of care provided by the pharmacist." He emphasized that value messaging cannot be done single-handedly. It requires that organizations in every area of health care join together.

One vital way of working together is having each pharmacy make a commitment to educate the public at every chance. "But we must do more than simply talk about it, we must demonstrate that value, every day, at every opportunity, as we work with patients and their physicians on maximizing their health medication therapy and their health care dollar," he said.

The Sarasota Group, a coalition of community pharmacy groups and drug manufacturers, has spent the last year working to raise public awareness of the "dual value of prescription medications and the role of the community pharmacist."

Addressing the audience of pharmacy and pharmaceutical industry leaders, Petri said, "The value message, most simply communicated, is that prescription medications are the most valuable aspect of health care if those medications are accompanied by the knowledge and expertise of a pharmacist that enables one to realize their total benefit."

"Changing the American public's views about prescription medications and the value of community pharmacists is a goal of enormous magnitude that requires an industry-wide effort," he added.