Healthcare Reform: Drug Topics readers speak out

November 3, 2009

With the subject of healthcare reform on the front burner in Washington and across the country, Drug Topics invited members of its Frontline editorial advisory board to share their thoughts. A selection of their responses is presented here.

Key Points

Recently Drug Topics invited readers to join its new Frontline editorial advisory board, whose members, pharmacists who "practice in the trenches," will share their opinions, knowledge, and experiences regularly as they address issues of the day. The first subject the Frontline board addressed was healthcare reform; responses ranged widely, as can be seen below.

A look at Austria's one-payer system

The uncomfortable thought arises that, if the one-payer system were enacted as proposed by some of our senators and representatives in Congress, pharmacists in the United States might become highly educated cosmeticians.

Michael J. Schuh, BS, PharmD, MBA
JACKSONVILLE, FLORIDA

Completing the care team

As pharmacists we are aware of the growing demand for pharmaceuticals, the implications of complex regimens, and the affordability and safety issues that patients face. The aging of the population plus the increase in prescription use is adding to an already significant need for pharmacist involvement before, during, and after the prescription is written.

From medication use through medication therapy management, pharmacists have proven time and time again that they improve the outcomes. Best practices that involve a pharmacist will justify healthcare reform through improved outcomes, improved patient safety, improved adherence leading to overall lower healthcare cost, reduced drug errors, better prescribing, and most important, direct patient care.

The single most significant challenge that clinical pharmacists face today is the sustainability of their practice. Once patients receive diagnosis and verification, the process is broken if their treatment is inappropriate or the patients don't follow it. Including pharmacists in the care team will contribute to closing the loop so that patients ultimately receive comprehensive care. This can occur only if a commitment is made to a team structure that always includes the pharmacist.

Sandra Leal, PharmD, CDE
DIRECTOR OF CLINICAL PHARMACY,
EL RIO HEALTH CENTER, TUCSON, ARIZONA
CONSULTANT, HRSA PHARMACY SERVICES SUPPORT CENTER, APHA

New PharmDs could lead vaccination drive

It might also be a good time to explore prescriptive authority for pharmacists, even though a few years and some changes (including, probably, a mandatory post-PharmD residency) stand between that goal and its realization. Inside our Veterans Affairs Medical Centers, pharmacists have long made the prescription pad their weapon of choice against hypertension, hypercholesterolemia, and diabetes mellitus (in conjunction with lab privileges for efficacy and safety monitoring). Ambulatory care pharmacists would be an invaluable resource in the ongoing outpatient management of the above "trifecta" of disease states afflicting so many Americans. This prescriptive authority could be expanded to other specialties as positive data come streaming in - and they certainly will.

Brandon Eldridge, PharmD
RETAIL PHARMACIST, SIKESTON, MISSOURI