Category: Uncategorized

It will be interesting to watch as recent legislation in Washington State has given pharmacists provider status for commercial (non-medicare) health plans. This is a step in the right direction for pharmacy as reimbursement for drug product reaches record lows. Pharmacists need to step up to this challenge and utilize their clinical knowledge to advance patient care and enhance outcomes. With success, this baby step will help propel the 600 pound gorilla in the room (Medicare) into a similar direction. Click thru to read the release from APhA.

One of the more interesting aspects of writing a blog for public consumption is the great conversations that can take place as a result. One such conversation took place this evening when two delightful gentlemen called me to discuss some of my observations in The Rewards of Performance. These gentlemen represented the plan that I discussed in the post and they wanted help clarify a few points I had made.

While some of their discussion centered around things that were corrected previously in some spots but not updated throughout the post (I am a pharmacist, not a copy editor), they had one very important clarification surrounding my logic on 90 day fills.

As it turns out, the plan in question (that was not named) does not, in fact, have a reduced dispensing fee for 90 day supplies. This invalidates the math done (since struck from the post) and changes one of my concussions. Based on this new information, the pharmacy would indeed benefit marginally from increasing their 90 day fill rate. The trade-off now is $150 for achieving a 25% rate for 90 day fills versus a loss of eight dispensing fees (down from 12 with monthly fills).

The logic behind incentives for 90 day refills, however, is still something that this author disagree with. While 90 day fills may be associated with better estimated compliance (based on claims data) with 90 day fills, this also creates a  difficulty for pharmacists to spot actual adherence problems (see Claims Data is not Clinical Data). They also decrease the number of potential interactions the pharmacist can have with the patient to collect information that can improve outcomes beyond simple compliance. These interactions are where pharmacists can have the greatest impact on patient care and savings in healthcare expenditures.

I look forward to future conversations with these gentlemen, and other readers of this blog. One of the main reason this blog exists is to encourage a thoughtful conversation about many of the issues in pharmacy.

Awhile back, I was involved in a discussion with some colleagues and the topic of pharmacist centric blogs was broached. A quick search on Google showed a variety of blogs. After exploring some of these, it became obvious to me that few, if any, of these blogs were dedicated to growing and nurturing the profession.

Pharmacy practice is changing, and not always for the better. We want to use this blog to share our experience, our successes, and our failures. We want to create an ongoing discussion of what needs to be done improve the pharmacy, the pharmacist, and the profession.

Over the past decade, we have spent many thousands of dollars and thousands of hours improving and defining our practice. During that time, hundreds of visitors, from all over the country, have come to see what we have done. One of the most intriguing comments a visitor has made sums up the theme of this blog.

A few years back, we had an executive from an insurance company visit our pharmacy. This executive started out our meeting by telling us…

When we pulled into your parking lot, we were concerned that you would be struggling to survive…

You see, our independent pharmacy is immediately surrounded by three large chain pharmacies. I often remark that “I could hit all three with a golf ball and a 9-Iron from our parking lot.” After stepping inside our practice, however, this same executive proclaimed…

Not only are you surviving, you are thriving!

Over the years, we have been asked for input by pharmacies across the country on how they might improve their practices. This blog will try to highlight the changes we see coming, how we are addressing the challenges and what you can do to become a thriving pharmacist.

Stay tuned, the train will soon be leaving the station.