McKesson Pharmacy Optimization® Team Identifies Five Hospital Pharmacy Trends to Watch in 2012

The need for increased connectivity between the inpatient and the outpatient settings will intensify. The hospitalreimbursement paradigm has changed as we move toward a payforquality system. Key market dynamics, such as outcomebased payments, emphasis on the patient’s continuum of care beyond hospital discharge, and the actualization of accountablecare organizations, are forcing hospitals to maximize existing hospital assets to manage the paradigm change. This includes the role of its pharmacy.

Focus on Ambulatory Pharmacy: Ambulatory pharmacies are unique environments capable of generating revenue for health systems as well as contributing significantly to the care and outcome of the patient. Leading, visionary health systems fully understand the importance of connecting patient data between the inpatient and outpatient settings.

The Pharmacist’s Role in Meaningful Use: A large component of meaningful use is the closedloop medication cycle. The pharmacy touches all the components in the loop and as a result, can and should be involved in implementing the most effective computerized physician order entry (CPOE) for the hospital. Not only do pharmacists understand how physicians order drugs in their organizations, but the pharmacy information system has the ability to help reduce transcription error and confusion.

Focus on Attaining 100% Dispensing of Barcoded Medications: Many hospital pharmacists are heavily involved in the implementation and rollout of barcode medication administration (BCMA) at their organizations because every medication that they stock needs to have a barcode. This is being driven by incentives contained in the American Recovery and Reinvestment Act (ARRA). As part of meaningful use Phase II contained in the Act, these medications need to be barcoded for scanning at the bedside. However, the challenge is that not all medications purchased have a barcode and pharmacists are looking at costeffective solutions to repackage them.

There will be a spotlight on the hospital pharmacy to help reduce readmissions. Hospital executives need to have a better understanding of the pharmacy’s role in reducing or eliminating hospital readmissions. Many studies have shown that the primary reason patients visit an emergency room or are readmitted to the hospital is due to nonadherence with medication therapy once the patient is at home. The hospital pharmacy can have a significant impact on the reduction of hospital readmissions by proactively educating patients on the proper use of their medications.

The hospital pharmacy will be closely scrutinized and expected to decrease costs and increase revenues.

Offsetting IndigentCare Costs: Hospitals are treating more uninsured patients and looking for ways to recover the cost. PharmacyAssistance Programs (PAPs) offered by manufacturers are available to help offset the cost, but many hospitals find them too complex to manage.

340B Contract Pharmacy: The multiplecontract pharmacy option that is part of the 340B program offers an opportunity for hospitals to expand their reach in the community to capture a greater number of prescriptions. While the option to have multiple contractpharmacy relationships is relatively new, McKesson customers who have implemented a contractpharmacy strategy are capturing prescription fills nearly five times more than with a single pharmacy.

Expect the growth in the specialtypharmaceutical segment to influence the pharmacy’s revenue and profits. Specialty pharmaceuticals, while impacting only a small population of patients with specific diseases, represent the largest average cost at $1,500 per dispense. Estimates are that growth in the specialty segment will range from 16–20% each over the next several years, until 8 out of 10 of the nation’s top prescriptionrevenue items are considered specialty pharmaceuticals. With access to group purchasing organization prices, its breadth of drugdistribution services and enhanced reporting solutions, McKesson is helping customers to develop strategies around the unique set of challenges emerging from the growth of specialty products.