By: Emily Crisano and Jason Peterson, Clinical Pharmacists at Emry Health
Managing multiple medications is a complex and often overwhelming task for many patients. According to the Kaiser Family Foundation (KFF), about three in ten adults report not taking their medicines as prescribed at some point in the past year because of the cost, and six in ten adults report currently taking at least one prescription medicine, with one quarter taking four or more. These statistics underscore the importance of effective medication management. At the heart of this effort are clinical pharmacists, whose role in making medication management simple brings groups—and their members—significant cost savings. Keep reading to learn how clinical pharmacists’ involvement is indispensable on a benefit navigation team.
Making Medication Management Easier
Patients often see multiple providers—specialists, primary care physicians, and virtual doctors—making it crucial for all providers to have an accurate and complete picture of the patient’s medication regimen. Clinical pharmacists engage in detailed conversations with patients or their caregivers to gather a comprehensive list of all prescription drugs, over-the-counter medications, supplements, and herbs the patient uses daily. This summary includes dosages, prescribing doctors, pharmacies and costs.
Why This Matters
Improved Communication with Providers
Many patients struggle to keep track of their medications, especially when dealing with multiple prescriptions from different doctors. A written, organized medication summary ensures that all healthcare providers are aware of what their patient is taking, facilitating better-coordinated care. This is particularly beneficial for patients with complex conditions, like cancer, who may find it overwhelming to manage their medication lists themselves.
Identifying and Resolving Discrepancies
Clinical pharmacists often discover issues such as using multiple pharmacies, which can complicate a patient’s medication regimen and lead to non-adherence. By investigating why a patient might use multiple pharmacies—whether due to cost, convenience, or simply outdated information—pharmacists can streamline the process, making it easier for patients to adhere to their prescribed treatments. Considering that many patients do not take their medications as prescribed due to cost, this proactive approach can significantly improve adherence and outcomes.
Managing Over-the-Counter Medications
Patients often overlook the significance of over-the-counter drugs and supplements, which can interact with prescribed medications, affecting their efficacy. Clinical pharmacists assess these interactions to prevent adverse effects, such as increased respiratory depression from combining over-the-counter melatonin with a prescribed sleep aid. This comprehensive review is essential given the high percentage of adults who take multiple medications and supplements.
Preventing Duplicate Therapies
Duplicate therapies occur when patients are prescribed multiple medications for the same condition by different doctors, often without realizing it. This can lead to double dosing and potential harm. By reviewing the patient’s medication list, clinical pharmacists can identify and rectify these duplications, ensuring safer and more effective treatment. This not only improves patient safety but also reduces unnecessary costs for payers.
An Added Bonus? Cost Savings for Payers
Optimizing a patient’s medication regimen can lead to significant cost savings for payers. For instance, switching to a preferred medication that is clinically similar but less expensive can reduce costs for both the patient and the self-funded payer. Additionally, consolidating therapies from multiple drugs into a single, combined medication can also lower expenses. With many adults managing multiple prescriptions, the potential for cost savings through optimization is substantial.
The Top 3 Value Propositions Clinical Pharmacists Bring to Benefit Navigation
Having clinical pharmacists integrated into a benefit navigation team provides a layer of clinical expertise that goes beyond what a regular benefit navigator can offer. Clinical pharmacists can:
- Assess Side Effects and Clinical Responses: They monitor how patients are responding to their medications and can suggest adjustments to avoid side effects or improve efficacy.
- Evaluate and Recommend Alternatives: Based on a patient’s clinical and financial situation, pharmacists can propose alternative medications and guide discussions with doctors.
- Proactively Manage Medication Lists: With access to claims data, clinical pharmacists on a navigation team can keep patients’ medication information up to date, reducing the administrative burden on patients.
The inclusion of clinical pharmacists in benefit navigation is not just a luxury but a necessity. Their expertise in managing detailed medication lists translates into significant cost savings, improved patient adherence and better health outcomes. As the statistics show, medication management is a critical issue for many patients, with cost and complexity often leading to non-adherence. By integrating clinical pharmacists into benefit navigation teams, both patients and payers receive the maximum benefit from their pharmacy investments.
