The transition to value-based care models means your pharmacy is under pressure to improve clinical outcomes while reducing operating expenses. Achieving both those objectives can be challenging, particularly as reimbursement tightens.

Eight recent industry studies, reports and surveys suggest a number of ways you can drive more value from your pharmacy operations.

Antibiotic Stewardship

Boosting antibiotic stewardship programs with a multidisciplinary approach

That’s one of three lessons for your hospital or health system pharmacy from a study in the Journal on Quality and Patient Safety published by The Joint Commission.1 The study is based on interviews with 12 leaders of antibiotic stewardship programs (ASPs) at four academic medical centers. ASPs that were managed collaboratively and included pharmacists and physicians outside of the infectious disease department were the most effective in promoting the proper use of antibiotics. Those that used health IT were more efficient and effective. Further, the lack of interoperability between health IT systems and limited analytics capabilities were barriers to ASP success.

Collaboration between pharmacists and physicians can enhance antibiotic use

A suggestion on how your independent pharmacy can improve patients’ antibiotic use comes from a study published in the International Journal of Pharmacy Practice.2 Researchers surveyed 120 pharmacists, most of who worked at community pharmacies in Australia. Sixty percent said they would not fill and dispense an antibiotic prescription if the patient came in less than 24 hours after seeing a physician. Instead, the pharmacist would tell the patient to come back if they still were not feeling well. Pharmacists would use this “wait and see” approach in collaboration with the patient’s doctor.

Medication Adherence

Tapping into digital technology to improve patient care and refill rates

If your pharmacy wants to improve patients’ medication adherence, you can try sending them individualized text messages that remind them to refill their prescriptions. That’s the lesson from a study in JMIR mHealth and uHealth.3 Researchers compared the medication refill rates of two groups of Medicare beneficiaries. Forty-four percent of the beneficiaries who received a customized text message from their pharmacy refilled their medications. Only 30 percent of those who didn’t get a text refilled their medications.

Med sync as pathway to increase patients’ adherence to heart meds

A study in Health Affairs4 suggests that your retail pharmacy can use appointment-based medication synchronization programs to increase patient adherence to their heart medications. Researchers studied how two retail pharmacies used med sync programs to dispense drugs to Medicare beneficiaries with high blood pressure, diabetes or high cholesterol. Beneficiaries enrolled in med sync had 87 percent of their days covered by their medications. They also had fewer adverse cardiac events, physician office visits and hospitalizations or emergency room visits. Beneficiaries not enrolled in med sync had 84 percent of their days covered by their medications.

Specialty Pharmacy

An uptick in specialty drug purchases through distributors

The boom in the specialty drug market may be helping your outpatient pharmacy. A specialty pharmacy distribution report from the HDA Research Foundation5 said specialty pharmacies, including mail-order pharmacies, were responsible for 8 percent of the specialty drug purchases made through distributors in 2016. That’s up from 6 percent in 2015. Retail pharmacies made 2 percent of specialty drug purchases in 2016, up from 1 percent a year earlier. Most specialty drug purchases through distributors continue to be made by physician practices and hospitals.

How higher patient out-of-pocket costs could affect cancer drug fill rates

Pharmacies that offer financial assistance programs to cancer patients likely are helping many of them access high-cost oncology drugs. That’s the takeaway for your pharmacy from a study in the Journal of Clinical Oncology.6 Researchers studied the first-fill abandonment rate of 38 oral oncology drugs prescribed to more than 38,000 cancer patients. Overall, 18 percent of the patients never filled their first prescription. The abandonment rate varied by patients’ out-of-pocket costs. For example, 10 percent of the patients who paid $10 or less didn’t fill their prescriptions. The rate jumped to 41 percent for patients who had to pay $500 to $2,000 for their medications.

Pharmacy Business

Projections of modest increases in drug spend on the horizon

Working on next year’s budget? Your hospital or health system pharmacy may expect to see a 7.4 percent increase in drug spend from July 1 through June 30, 2019. That’s according to a drug price forecast report from Vizient.7 The report is based on anticipated price changes in the most common medications that hospitals and health systems purchase. You may see the biggest price hikes for rheumatoid arthritis, immunotherapy and anemia drugs. Vizient projected little or no increases in prices for antibiotics and drugs to treat Hepatitis C. As the report suggested, your pharmacy leaders should collaborate with your c-suite leaders to “strategically address these issues by implementing cost-saving and quality optimization measures.”

The rising impact of direct and indirect remuneration (DIR) fees

If you’re an independent pharmacy, you may be starting to feel the effects of increasing DIR fees. A survey of independent pharmacies by the National Community Pharmacists Association suggests you’re not alone.8 Eighty-four percent said DIR fees “hinder their ability to plan for the future of their business.” Seventy-eight percent said DIR fees “make cash flow unpredictable,” and another 75 percent said they “make it hard to predict operating revenue.” The pharmacies also said DIR fees are starting to affect patients. Sixty-nine percent of the respondents said DIR fees “inflate patient cost-sharing levels.” The ability to link fees to specific claims and to specific performance measures can help your pharmacy manage the process and minimize the impact on operations.

Related: Learn more about McKesson’s pharmaceutical distribution services

1The Expanding Role of Antimicrobial Stewardship Programs in Hospitals in the United States: Lessons Learned from a Multisite Qualitative Study,” Journal on Quality and Patient Safety, 2018
2An underutilised resource for Antimicrobial Stewardship: a ‘snapshot’ of the community pharmacists’ role in delayed or ‘wait and see’ antibiotic prescribing,” International Journal of Pharmacy Practice, 2018.
3Improving Refill Adherence in Medicare Patients With Tailored and Interactive Mobile Text Messaging: Pilot Study,” JMIR mHealth and uHealth, 2018.
4Medication Synchronization Programs Improve Adherence to Cardiovascular Medications and Healthcare Use,” Health Affairs, 2018.
5 Specialty Pharmaceutical Distribution, HDA Research Foundation.
6Association of Patient Out-of-Pocket Costs With Prescription Abandonment and Delay in Fills of Novel Oral Anticancer Agents,” Journal of Clinical Oncology.
7 Drug Price Forecast Executive Summary, Vizient, 2018.
8NCPA Survey: Pharmacy DIR Fees Plague Both Community Pharmacies and Their Patients,” National Community Pharmacists Association, 2018.

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McKesson editorial staff is committed to sharing innovative approaches and insights so our customers can get the most out of their business solutions and identify areas for operational improvement and revenue growth.