Are Drugs More Than Commodities?

JANUARY 01, 2006
Fred M. Eckel, RPh, MS, Pharmacy Times Editor-in-Chief

Last month, I suggested that many groups were not paying attention to pharmacy's main message that pharmacists are important to help people make the best use of their medicines. I suggested some reasons why our message may be ignored. Let me suggest another reason why our message is ignored. Could it be that what we do speaks louder than what we say?

What pharmacist practices could lead to viewing drugs as another commodity product? Pharmacists say that they should be helping patients achieve pharmaceutical care outcomes because the drug product can cause adverse events. Many patients are taking a statin product for lipid management. Although rare, patients may experience muscle weakness. If pharmacists consider the statin product more than a commodity, wouldn't they ask the patient, when dispensing a refill prescription, if he or she had experienced any muscle weakness in the past month? When I asked my students if they were taught that this was a good practice, they all agreed. When I asked them if they ever observed this practice, however, no one had.

Let me use the statin drug to illustrate why our actions may speak louder than our words. Statin drugs must be taken continuously for best results. We all recognize that many patients who start statin therapy stop therapy early for a variety of reasons. If the drug product is an important tool to achieve pharmaceutical outcomes, than it would seem that the pharmacist would be concerned that patients comply or adhere to the dosage schedule and continue therapy. I once heard a speaker say that medication compliance was a problem looking for an owner. We all know continuous statin therapy is critical to achieve desirable goals in disease management. It is well-known that patients do not adhere as they should. Recently, the National Quality Forum stated that it was creating standards that would change the way health care providers interact with patients to improve medication adherence.

Yet, how many pharmacists even know when patients do not return for a refill, or, even worse, care that the patient has apparently discontinued his or her chronic disease therapy? Yes, what we do speaks louder than what we say. If we want legislators, consumers, or other health professionals to pay attention to what we say, we need to change our practices and stop treating drug products as a commodity. If we do not, then we can expect that many will not pay attention to our message.

Mr. Eckel is professor and director of the Office of Practice Development and Education at the School of Pharmacy, University of North Carolina at Chapel Hill.