Inside This Issue - Opinion
Soul of industry resides in pharmacists
November 5th, 2012
by David Pinto
Thrifty White Pharmacy, an 89-store Minnesota-based drug chain with stores in six prairie states, is rewriting the book on the way community pharmacy is, or could be, practiced in America.
In a series of boldly conceived and flawlessly executed programs, all turning on a well-considered attempt to allow the pharmacist to consult with patients and manage their medication therapy, Thrifty White has created a new pharmacy paradigm, one that at once simplifies the way prescription drugs are distributed to patients, increases the value of the pharmacist by encouraging him to do what he has been trained to do, and advances the often elusive objective of medication compliance.
As a result, the program reduces the ultimate cost of health care by improving patient outcomes.
In its simplest terms, Thrifty White's program turns on three axes:
• Filling maintenance drugs for the entire chain in a state-of-the-art, robotically driven central-fill facility in Fargo, N.D., that both increases and simplifies productivity and accuracy while freeing the in-store pharmacist for the more urgent, yet often neglected or underutilized, role of interacting with the patient.
• Offering customers a program that informs the patient ahead of time when his or her maintenance prescriptions will be available for pickup, then giving that patient the option of picking up the prescriptions at the store or having them delivered to the patient’s home or business address, either by hand or by mail.
• Developing a program wherein patients can pick up all their monthly prescriptions at once, at the same, patient-specified day each month.
These core components are supplemented by a variety of other services, all designed to increase efficiency, clarify the patient’s prescription drug regimen and relieve the pharmacist of the burden of filling prescriptions, and so allow him to spend more time interacting with patients. As a result, medication compliance has been dramatically increased, to double the national average, as has the opportunity for pharmacists to monitor the health of their patients.
By now it’s old news in the medical profession that the failure to follow prescription drug regimes produces staggering consequences. One recent report concluded that “increasing the effectiveness of adherence interventions may have a far greater impact on the health of a population than any improvement in specific medical treatments.” Another study determined that “noncompliance is responsible for up to 26% of hospital admissions as well as 23% of nursing home admissions in our older population.”
Nor is it new news that more than one patient in three in the United States does not take his medication as prescribed, or that nonadherence has been shown to result in some $300 billion each year in excess medical costs. Or that increased medication adherence can lead to healthier outcomes.
With studies routinely confirming these findings, the Thrifty White program is a compelling example of the role pharmacy can, and should, play in reducing health care costs and improving outcomes. To that end, the Thrifty White program has attracted both attention and praise from a variety of health care constituencies.
Yet the reality is that the Minnesota-based drug chain continues to fight a daily battle to convince the larger health care community that what’s good for pharmacy is even better for heath care in this country.
PBMs and other third-party providers have thus far largely ignored the success Thrifty White has achieved and, even worse, many continue to discriminate against the drug chain in favor of larger but less perspicacious, less efficient and often less enlightened rivals. As a result, this innovative drug chain, one whose efforts should be lauded, emulated and fairly reimbursed, finds itself in a position of daily having to defend a program whose results need no further justification.
Meanwhile, pharmacy as a profession continues to languish in the backwaters of the health care community, tolerated as a necessary but unwelcome incursion on larger, more serious and more romantic health care components and thus reimbursed as a commodity service rather than an indispensable component whose efficiency and effectiveness can elevate the entire health care community.
In the end, then, the people at Thrifty White who conceived, built and brilliantly continue to develop, advocate and extol this exemplary program should be congratulated for what they’ve done and recognized for what they believe, rather than questioned daily about the advantages of a program whose value is far beyond any dispute.
In short, Thrifty White has proven what so many other community pharmacies prove daily: The soul of this industry continues to reside in those pharmacy practitioners who are most committed to advancing health care in America — and, by so doing, justify pharmacy’s place in the larger health care community.