McKesson : The Business of Health Care May 2017

The quality and safety of patient care are inextricably linked with the cost of patient care. The following eight industry developments illustrate how that relationship applies in the pharmacy setting as it does in other health care settings. Better pharmacy clinical performance manifests itself as better pharmacy financial performance, creating more value for the entire health care system.

Clinical Programs

Pharmacy-based transitional care program reduces hospital readmission rate by 28%

The use of a pharmacy-based transitional care program significantly reduced the 30-day and 180-day readmission rates at a California hospital, according to a study in the American Journal of Managed Care. Researchers reported the results of using an independent retail pharmacy to help 1,123 Medicaid managed-care plan enrollees discharged from the hospital between April 2013 and March 2015. Pharmacists provided medication reconciliation, medication adherence counseling, behavior counseling, medication therapy management, patient assistance and other services to the patients. The initiative reduced the hospital's 30-day readmission rate by 28 percent and its 180-day readmission rate by 32 percent, the study said. 'Medication-related problems often persist after discharge, which requires further interventions by pharmacists,' the researchers said.

25 million flu shots per week possible when retail pharmacies expand capacity

The time it takes to vaccinate 80 percent of the U.S. population against the influenza virus could be reduced substantially if all retail pharmacies administered flu vaccines. That's according to a study in the journal Disaster Medicine and Public Health Preparedness. In the study, researchers estimated the impact of having all retail pharmacies licensed and pharmacists trained to administer flu shots. They concluded that national flu vaccine administration could reach 25 million doses per week and reduce the time it takes to have 80 percent of the population vaccinated by seven weeks. 'These results support efforts to ensure pharmacist vaccinators are integrated into pandemic vaccine response planning,' the researchers concluded.

Medication Adherence

Benefits design prevented drop in adherence after switch to high-deductible plan

Value-based insurance design (VBID) can help employees stay on their medications for chronic medical illnesses after they switch to high-deductible health plans. That's according to a study in the journal Health Affairs. In the study, researchers from Kaiser Permanente compared the medication adherence rates of 2,482 employees who switched to an HDHP in 2014. Some 87 percent of the employees had one of four chronic medical conditions. Of the enrollees who switched to an HDHP, 1,024, or about 41 percent, switched to a plan that included a VBID incentive. They paid no deductible or co-pay for their medications. From 2013 to 2014, the percentage of days with an adequate supply of medication decreased from 76.1 percent to 73.8 percent for the employees without a VBID incentive. But for employees with a VBID incentive, the percentage of days with an adequate supply of medication remained about the same-from 74.3 percent to 74.1 percent. 'VBID provisions are a potential tool to use in offsetting financial barriers from deductibles and can help maintain low-cost access to high-value health care services and treatments,' the researchers said.

Antibiotic stewardship program reduces antibiotic use at Veterans health facilities by 12%

The Veterans Health Administration decreased the use of antibiotics at its 168 hospitals by 12 percent following the 2010 launch of a system-wide antimicrobial stewardship program, according to a study in the journal Infection Control & Hospital Epidemiology. In the study, researchers studied the impact of the initiative on antibiotic use from 2010 through 2015. In addition to decreasing overall antibiotic use, the program led to a drop in use of three broad-spectrum antibiotics often prescribed for antibiotic-resistant infections. The initiative was voluntary until the VHA made it mandatory for all VA medical centers in 2014. 'The VHA has shown that improving antimicrobial usage in a large healthcare system may be achieved through national guidance and resources with local implementation of antimicrobial stewardship programs,' the researchers said.

Immunizations and Vaccines

82% of adults say healthy children should be required to receive childhood vaccines

Most U.S. adults say schools should require healthy children to receive the measles, mumps and rubella (MMR) vaccine. That's according to a survey of 1,549 adults conducted by the Pew Research Center. Some 82 percent of the respondents said the MMR vaccine should be mandatory. Some 88 percent said the benefits outweigh the risks, and 73 percent said the preventative health benefits of the MMR vaccine are high.

Flu vaccine reduces influenza mortality rate in children by nearly two-thirds

Children with no underlying health risks have a 65 percent less chance of dying from the influenza virus if they get a flu shot, according to a study that appeared in the journal Pediatrics. Researchers from the Centers for Disease Control and Prevention studied the cases of 291 children age six months through 17 years old who died from the flu during four flu seasons from July 1, 2010 through June 30, 2014. Of those who died, only 26 percent were vaccinated against the flu. The researchers calculated that getting a flu shot would reduce the risk of flu death in children with high-risk medication conditions by 51 percent and in children without any high-risk medical condition by 65 percent. 'These results reinforce the need to increase influenza vaccination coverage, especially among children at increased risk of influenza-related complications and death.' the researchers concluded.

Pharmacy Business

Pharmacy revenue from specialty drugs projected to hit $240 billion by 2021

Pharmacy prescription revenue from specialty drugs is projected to reach $240 billion by 2021, more than doubling from $115 billion in 2016, according to a report published by Drug Channels. The report said specialty drugs will represent 42 percent of pharmacies' $572 billion in total prescription revenue by 2021, up from 28 percent of $412 billion in total prescription revenue last year. 'The specialty boom continues to drive the pharmacy industry's revenue growth,' the report said.

30% of adults in upstate New York use pharmacy home-delivery service for their prescriptions

Three out of every 10 adults in upstate New York have their prescription medications delivered to their homes. That's according to a survey of 2,000 adults sponsored by Excellus BlueCross BlueShield, the Blues plan serving that region of the state. The two most frequently cited reasons for getting home delivery were convenience (70 percent) and free delivery (66 percent), with 94 percent of those who do so saying they were 'satisfied' or 'very satisfied' with the services. 'Prescription home delivery is reliable and convenient. It offers the possibility of saving money, and it can improve medication adherence,' the Blues plan said.