Is A Pharmacy Driven Adherence Program The Holy Grail?

February 16, 2010 by George Van Antwerp 1 Comment

Perhaps surprisingly to some of you, I would say yes BUT…

There are lots of issues why it isn’t.  But, before I go there, what do I mean by a Pharmacy Driven program?

Ideally, the pharmacist would be a critical part of the care team for patients.  They would interact with the patient to educate them on side effects, discuss drug-drug interactions, warn them about side effects, discuss trade-offs, help the patient to stay adherent, and address their barriers.

BUT..

  1. Less than 20% of patients know their pharmacist’s first name.  (Mine is Renee…by-the-way)
  2. Retail pharmacists don’t have access to scripts not filled at their store / chain.
  3. 40% of people who pick up prescriptions aren’t the patient using the prescription.
  4. Pharmacists aren’t rewarded for cognitive services.
  5. There’s a shortage of pharmacists and you often speak with the pharmacy tech.
  6. Moving the “counseling window” over 24″ really doesn’t create a private environment for discussing your drugs.

Can many of those items be addressed – yes?  Should they be – I don’t know.

Even if we could, we’re still missing two important things:

  1. You have to go further upstream to the physician – patient interaction to really address some of the issues that drive non-adherence; and
  2. You have to find a way to reach out and effectively engage patients to refill their medications (which isn’t cost effectively done with the pharmacy staff).
PBM / Pharmacy

One Response to “Is A Pharmacy Driven Adherence Program The Holy Grail?”

  1. Unknown's avatar
    RxCzar Reply February 17, 2010 at 11:44 am

    Over 10 years ago I helped implement a program that would identify non-adherent patients for the pharmacies and pay them to talk to the patient. Less than 5% of eligible pharmacies took advantage of this program that paid them to increase their own business. Why?

    The #1 reason centered on not wanting to change or interrupt their daily workflow for an occasional opportunity to counsel a patient on adherence.

    Though I know pharmacists can make a huge difference through their clinical services I understand that most of them don’t work in an environment that rewards them for their efforts.

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