Independent community pharmacies are operating under what may appear to be perfect storm conditions. Squeezed by rising drug costs, declining reimbursement rates, and increasing competition, they’re battling choppy seas in search of new and diverse revenue streams.
But there is a ray of sunshine. As the healthcare system shifts to value-based payments, the role of the pharmacist as a dispenser of prescriptions is evolving to one of total healthcare provider.
It’s a logical extension of what pharmacists already do, and an opportunity they need to take advantage of, says Patrick Devereux, PharmD, RPh, president of Family Medical Services (FMS) Pharmacy in Bessemer, AL.
“The pharmacies that are going to be sustainable in business—and this applies to chains and independents—are the ones that embrace a model of clinical services to improve patient outcomes and not solely rely on dispensing,” he says.
For Devereux and many other community pharmacists, adding diabetes education to the clinical services they offer to patients is a particularly compelling option.
Diabetes by the Numbers
One-and-a-half million Americans are diagnosed with diabetes every year, according to the American Diabetes Association (ADA), and 30.3 million are already living with it, either knowingly (23.1 million) or unknowingly (7.2 million). Another 84.1 million Americans have a diagnosis of prediabetes. That’s roughly 116 million potential candidates for either diabetes self-management education and support (DSMES) or a diabetes prevention program (DPP).
Translating those statistics into dollars and cents is an eye opener. Earlier this year the ADA announced that diabetes is now the most costly chronic illness in the country, with expenses totaling $327 billion in 2017. Medical expenses for people with diagnosed diabetes average $16,752 per year, with $9,601 of that directly attributed to the condition itself.
“The data indicate one of every four healthcare dollars is incurred by someone with diagnosed diabetes, and one of every seven healthcare dollars is spent directly treating diabetes and its complications,” the ADA says.
Many of those dollars are already being spent in independent pharmacies, where statistics from the Hamacher Resource Group show that diabetes care is the top-selling category, garnering almost 40% of sales.
The 2017 National Standards for Diabetes Self-Management Education and Support states that DSMES is a critical component of diabetes clinical services. Pharmacists have medication expertise that makes them key players in helping patients manage their health. Several studies have revealed the significant impact pharmacy-based DSMES programs can have on lowering A1c levels. Unfortunately, only 5% to 7% of individuals eligible for DSMES through Medicare or private insurance take advantage of it, according to the ADA.