Pharmacists and the  Healthcare Puzzle:  Opportunities and Trends

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Pharmacists and the Healthcare Puzzle. Objectives:Describe where pharmacists have demonstrated value and savings to the healthcare system.Explain how services such as MTM have impacted health outcomes and perceptions of pharmacists.Provide examples of opportunities and trends pharmacists are util

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Pharmacists and the Healthcare Puzzle: Opportunities and Trends

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1. Pharmacists and the Healthcare Puzzle: Opportunities and Trends Elizabeth K. Keyes, RPh Chief Business Officer & Senior Vice President American Pharmacists Association Washington, DC [email protected]

2. Pharmacists and the Healthcare Puzzle Objectives: Describe where pharmacists have demonstrated value and savings to the healthcare system. Explain how services such as MTM have impacted health outcomes and perceptions of pharmacists. Provide examples of opportunities and trends pharmacists are utilizing to enhance practice and improve care. Discuss how private and public partnerships have improved medication use and reduced healthcare costs.

3. The Burden of Chronic Disease Includes generally incurable conditions Often preventable and/or manageable Causes 7 out of 10 deaths in the US Causes disability and reduced quality of life Affects 45% of the population – 133 million Americans – numbers are growing Source: Partnership to Fight Chronic Disease/Chronic Disease Fact Sheet, October 2007

5. Chronic diseases account for 75% of the nation’s health care spending Suggested speaking points: Chronic disease consumes 75 cents of every dollar spent on health care in America. For public programs, including Medicare and Medicaid, chronic disease costs consume an even larger part of what is spent. Transition: So what’s driving these costs?Suggested speaking points: Chronic disease consumes 75 cents of every dollar spent on health care in America. For public programs, including Medicare and Medicaid, chronic disease costs consume an even larger part of what is spent. Transition: So what’s driving these costs?

6. The CDC estimates… 80% of heart disease and stroke 80% of type 2 diabetes 40% of cancer …could be prevented if only we were to do three things: Stop smoking Start eating healthily Get in shape Manage medications Managing chronic diseases could also significantly improve patient’s access to preventive health care services (by nearly 56%) The vast majority of cases of chronic disease could be better prevented or managed Suggested speaking points: We can do MUCH better. The CDC estimates that many of our major problems – heart disease, diabetes, stroke, and cancer – could be prevented. And, prevented by doing just three things: Not smoking Eating a healthy diet Getting into shape. We can also do a much better job managing chronic disease once diagnosed to reduce the burden. Today, chronically ill patients get only 56% of the recommended preventive services. Transition: If we think chronic disease is expensive now, the future is far worse.Suggested speaking points: We can do MUCH better. The CDC estimates that many of our major problems – heart disease, diabetes, stroke, and cancer – could be prevented. And, prevented by doing just three things: Not smoking Eating a healthy diet Getting into shape. We can also do a much better job managing chronic disease once diagnosed to reduce the burden. Today, chronically ill patients get only 56% of the recommended preventive services. Transition: If we think chronic disease is expensive now, the future is far worse.

7. Suggested speaking points: The projected costs of just continuing to do what we’ve been doing are staggering, and, frankly, not sustainable. (Note to speaker: “If left unchecked” means we continued on the same path, versus making diet, exercise and eliminating tobacco changes per CDC recommendations that would eliminate so much chronic disease). Transition: So, what can we do about it? I’d like to share with you what PFCD is doing to help.Suggested speaking points: The projected costs of just continuing to do what we’ve been doing are staggering, and, frankly, not sustainable. (Note to speaker: “If left unchecked” means we continued on the same path, versus making diet, exercise and eliminating tobacco changes per CDC recommendations that would eliminate so much chronic disease). Transition: So, what can we do about it? I’d like to share with you what PFCD is doing to help.

8. How Are Pharmacists Improving Care and Reducing Costs? Supporting medication adherence Improving the use of medications Improving treatment outcomes

9. Reasons for Poor Adherence

10. Drug products are essential Use continues to increase Critical weapon in fighting chronic disease Medication Use Process is complex Prescribing, Dispensing, Administering, Monitoring, Systems Management Drug-related morbidity and mortality - 1995 $76.6 billion annually in U.S.* 1:1 ratio with drug spend* Drug-related morbidity and mortality – 2001 $177.4 billion annually in U.S.** Sources: * Arch Intern Med. 1995;155(18):1949-56. ** J Am Pharm Assoc. 2001;41(2):192-9. Medication Use in Society

11. Put patients first Optimize medication use Improve communication Manage information Increase collaboration What’s the best way to improve medication use and adherence?

12. Creating the Basis for a Preferred Future…

13. Project ImPACT: Hyperlipidmia Results for 397 patients, 26 sites, 12 states over two years

14. Diabetes Ten City Challenge hits the bright lights of Broadway… DTCC logo and website were featured on the Reuters billboard in Times Square (New York) 9 times during the week of April 6, 2009.

16. The Diabetes Ten City Challenge Diabetes Triad Clinical Control: A1C < 7%, BP < 130/80, LDL < 100 mg/dL (n = 573)

17. The Diabetes Ten City Challenge: Patient Care Improvements

18. The Diabetes Ten City Challenge Economic – Total Costs

19. Voluntary Participation Education on Controlling Their Diabetes Patients Choose Pharmacist/Care Location Incentives (Established by the City) Free Glucometers Co-Pay Waivers on Diabetes Medications and Supplies On going face to face care with a personal pharmacist The Care Model

20. Patient accessibility Resources to provide advanced level of care Information management capabilities Motivation to expand care Education to provide higher level of care Demonstrated capabilities in existing programs Pharmacists are a Key to Success because of...

21. Other Examples - Pharmacist Services Reduce Costs and Improve Care Depression: Improvement in adherence in patients with depression from 51% to 76% Source: Am J Health syst Pharm 2002;59:1518-26 Anticoagulation: 73% reduction in hospitalizations and ER visits; 77% reduction in bleeding events; $1,600 savings per patient Source: J Manag Care Pharm. 2007;13:475-86 Asthma: Direct cost savings averaged $725 per patient Source: J Am Pharm Assoc. 2006;46:133-47

22. Pharmacy-based Immunizations

23. Opportunities for pharmacists working with older Americans Between 2005 and 2030, number of adults aged 65 and older in US will almost double (to 20% of US population = 70 million) More than ¾ of adults over 65yo suffer from at least one chronic medical condition that require ongoing care and management. Older adults account for approximately 34% of all prescriptions Only about 1% of healthcare professionals have training focused on taking care of seniors

24. What you invest your energy in gets stronger… What you don’t invest your energy in gets weaker… Tony Schwartz Author: “The Power of Full Engagement: Managing Energy Not Time”

26. Thank You! Elizabeth K. Keyes, RPh Chief Business Officer & Senior Vice President American Pharmacists Association Washington, DC [email protected]

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