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Rx’s role in health care reform

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Tom Ryan brings his customary concentration of thought and clarity of purpose to the issue of health care reform in an op-ed piece that recently appeared in The Washington Times.

“As the debate on this important initiative moves forward, I believe the guiding principle should be to build on what works,” the chairman, president and chief executive officer of CVS Caremark Corp. writes, in a bid to convince members of Congress to apply to public policy the philosophy that has enabled him to transform a regional drug chain into a company whose operations now span the complete continuum of pharmacy care.

Ryan lays out five propositions for legislators to consider:

• “Increase government support for businesses to implement wellness, prevention and drug adherence programs to enable us to better manage chronic but treatable conditions like diabetes, hypertension and heart disease.”

• “Encourage the use of comparative effectiveness research to inform clinical decision-making and encourage procedures that are most effective at less cost.”

• “Increase incentives for health care providers to invest in state-of-the-art, interoperable health care information technology that will help eliminate unnecessary administrative costs, reduce errors and lead to higher quality care.”

• “Continue to encourage the use of cost-saving generic drugs by having Congress create a path for the efficient approval of safe and effective generic biologics.”

• “Bring basic health care to people who now use more costly services, or do without, by more broadly encouraging the use of convenient and cost-effective retail-based health clinics.”

If those concepts align with CVS Caremark’s business plan, they also reflect the thinking of most members of the pharmacy profession. Other industry leaders have made similar arguments, particularly for the first and third points, where there is near unanimous agreement.

In the article, Ryan never loses sight of the issue of health care expenditures, an area that represents a real opportunity for community pharmacy and a cause for deep concern as the reform bills make their way through the House and Senate.

He cites a New England Health Institute study that puts the cost of patients’ failure to comply with prescription drug regimens at close to $300 billion a year, a significant amount even in a system that, according to projections by the Centers for Medicare and Medicaid Services, ate up $2.4 trillion, or 16.6% of GDP, in 2008.

Community pharmacy’s ability to drive down the number noted by Ryan cannot be reiterated often enough. Although the industry is suffering from its past failure to support research that would have conclusively demonstrated the return on an increased investment in pharmacy care, evidence from the Ashville Project and other similar initiatives provides some hard evidence that supports that position.

To come out on top in health care reform, pharmacy must show that it can be part of the solution.

The question of costs looms over the entire process. The bills under consideration would go a long way toward achieving the estimable goals of expanding access for many people who currently lack health care coverage and setting more reasonable standards for the way insurance companies operate. They won’t do much to rein in expenditures that, in good times and bad, continue to grow faster than both the economy and the overall rate of inflation.

Unless meaningful action is taken on that score, health care reform will fail to fix, and may even exacerbate, one of the most urgent problems the country faces.


NACDS 90th

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