Fragmented Drug Distribution


In an era when we want to make our health care system more coherent, we continue to see efforts, perhaps with the goal of saving money, that actually promote fragmentation.

Why has our drug distribution system become so fragmented? In an era when we want to make our health care system more coherent, we continue to see efforts—I guess with the goal of saving money—that actually promote fragmentation.

At first, it was specialty pharmaceuticals that created limited distribution of select medications. We were told that this was to assure compliance and/or improve quality of care. Now, we hear that Tricare for Life beneficiaries soon will receive letters guiding them to Tricare Pharmacy Home Delivery or a military pharmacy for some prescriptions as part of a congressionally mandated pilot program. It seems that this requirement does not apply to acute care or generic medication. This means that Tricare for Life patients may get their medications from more than one pharmacy.

Will the pharmacies know about all the medications a patient is taking? Who will educate the patient, monitor for drug interactions, or even evaluate compliance? Why did Congress think it was acceptable to create disruption in the drug distribution system for patients? Could it be that drug products are viewed as a commodity and not really a component of health care services?

As pharmacy keeps pushing for medication therapy management payments or provider status, could pharmacists be contributing indirectly to the view that drugs are just another commodity where price is the key consideration?

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