NACDS Urges Improved Care for Medicare, Medicaid Patients in Statement to U.S. Senate Panel



March 1, 2013

Cites Community Pharmacy’s Increased Role in Healthcare Delivery through Immunizations, Medication Counseling

Arlington, Va. — The National Association of Chain Drug Stores (NACDS) today submitted a statement emphasizing the importance of advancing policies to improve care for Medicare and Medicaid beneficiaries to the U.S. Senate Finance Committee. The committee held a hearing today titled “Delivery System Reform: Progress Report from [Centers for Medicare & Medicaid Services] CMS.”

In its statement, NACDS highlighted the many patient services that community pharmacies and pharmacists provide, including immunizations, medication counseling, including medication therapy management (MTM) and disease screenings. In addition, NACDS emphasized expanding pharmacists’ abilities to practice to their fullest capabilities to maximize patient care.

“Through personal interactions with patients, face-to-face consultations and convenient access to preventive care services, local pharmacists are helping to shape the healthcare delivery system of tomorrow — in partnership with doctors, nurses and others,” NACDS stated.

NACDS’ statement cite pharmacists increased role in patient immunizations. In 2010-2011, 18.4 percent of adults nationwide received their influenza vaccine in a community pharmacy — second only to a doctor’s office. And the Centers for Disease Control and Prevention (CDC) reports that vaccines have reduced or eliminated many infectious diseases that once routinely killed or harmed thousands each year, and cite pharmacists as instrumental in increasing the vaccination rate in the United States.

In addition, NACDS highlighted the cost-savings for patients and the healthcare system in expanding pharmacists’ vaccination authority.

“As noted by the Department of Defense in a 2011 final rule, significant savings were achieved under the TRICARE program when the program was first implemented to allow beneficiaries to obtain flu & pneumococcal vaccines at retail pharmacies,” NACDS said in its statement.

It was estimated that for the first six months that TRICARE beneficiaries could obtain their vaccinations at retail pharmacies, 18,361 vaccines for H1N1, flu & pneumococcal were administered at a cost of nearly $300,000 in a community pharmacy. Had those vaccines been administered under the medical benefit - rather than the pharmacy benefit - the cost to TRICARE would have been $1.8M.

NACDS also emphasized that policymakers have begun to recognize the vital role that local pharmacists can play in improving medication adherence, and how MTM can help lower healthcare costs in Medicare Part D.

NACDS cited the Congressional Budget Office (CBO) report revising its methodology for scoring proposals related to Medicare Part D. CBO found that for each one percent increase in the number of prescriptions filled by beneficiaries there is a corresponding decrease in overall Medicare medical spending.

In addition a recent report by CMS found that Medicare Part D beneficiaries with congestive heart failure and COPD who were newly enrolled in the Part D MTM program experienced increased medication adherence and discontinuation of high-risk medications. Specifically, monthly prescription drug costs for these Medicare Part D beneficiaries were lowered by approximately $4 to $6 per month and that they had nearly $400 to $500 lower overall hospitalization costs than those who did not participate in the Part D MTM program.

Culminating this increased role of community pharmacy in healthcare delivery, NACDS makes a strong case for expanding the role of pharmacists in patient-centered healthcare models, such as accountable care organizations (ACOs), medical homes and community-based transitions of care programs.

“Permitting pharmacists to practice to their maximum capabilities within these new delivery models would help increase medication adherence and coordination between healthcare settings, result in higher rates of vaccinations, and reduce the burden of the physician shortage, particularly with the influx of new patients in 2014 through the Health Care Marketplaces and the expansion of Medicaid eligibility,” NACDS said in its statement.

“As we move forward with the reform of the healthcare delivery system, it is imperative for all healthcare providers to practice to their maximum capabilities, working in partnership to provide accessible, high quality care to patients,” NACDS summarized in its statement.

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