Saving for a More Secure Future

APRIL 01, 2007
Fred M. Eckel, RPh, MS, Pharmacy Times Editor-in-Chief

As health care spending continues to surge, it is not surprising that so much attention is being focused on the cost of prescription drugs.

A recently published federal study estimates that drug spending grew by 6.5% to reach $213 billion last year, and that growth will accelerate over the next decade, driven partly by new approvals and higher drug use overall. It also concludes that even though more blockbuster drugs are due to become available as generics, generic dispensing rates are likely to level off, reducing the potential for further savings.

Of course, rising drug costs should be a matter for concern—but are they the biggest problem? For years, studies have pointed to the massive expense resulting from the way drugs are used, rather than what they cost to buy.

Lyle Bootman, PhD, dean of the College of Pharmacy at the University of Arizona and former president of the American Pharmaceutical Association, and coresearchers analyzed the cost of drug-related morbidity and mortality, including factors such as the additional care needed in hospitals, long-term care facilities, and other settings. Dr. Bootman argues that even a conservative estimate puts the real annual cost at $90 billion to $100 billion, and that the figure could be far higher, at around $180 billion. In other words, for every dollar spent on drugs, almost as much may be spent treating the consequences of drug misadventures.

Clearly, if we can reduce these problems, the potential to save money as well as lives is enormous. This is an area where we can play a key role—although a major obstacle presents itself. Today, financial incentives in health care are structured mainly to drive short-term savings in areas such as generic use. If those incentives were restructured to reward approaches that prevent medication problems, they could drive much bigger savings than those achieved by trimming the cost of individual drugs.

The emerging medication therapy management programs provide a glimpse of the possible future. Using these early programs as examples, payers could develop incentives that would reward community pharmacies for assuming a critical advisory role in the health care system. This would allow us to rely more on these services and less on dwindling prescription reimbursements. It is also up to us, however, to show our willingness to participate. By doing so, we will help ensure a future that is both more secure and even more valuable to others.

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.