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Primary care organizations often view themselves as a “Medical Home” for their patients, focusing on resolving patient health problems through their medical services. However, a significant challenge for providers lies in the inability to monitor and influence a patient’s behavior in the time between medical visits. Surprisingly, pharmacy professional services, designed to address this need, remain underutilized and are rarely integrated into medical workflows.
Understanding Pharmacy Professional Services
Pharmacy professional services can be defined differently by practice setting, but they encompass a range of activities performed by pharmacy resources to improve the outcomes of medication therapy. Essentially, these services eliminate barriers to drug therapy failure which can be categorized into three main buckets:
- Poor access or affordability
- Educational gaps
- Clinical effectiveness and side effects
Despite the pressing need for addressing these barriers, the current primary care infrastructure does not fully integrate these aspects into a multidisciplinary approach. However, this is beginning to change with the expansion of on-site pharmacies.
Do I Need to Establish a Pharmacy Program?
Entities participating in the 340B program may not realize that they likely already possess a pharmacy program. Whether through an in-house pharmacy or a contract pharmacy network, these entities are already performing the functions of running a pharmacy and providing pharmaceutical care. The lack of awareness stems from the outsourcing of most of these functions to third-party administrators (TPAs) and contract pharmacies. To unlock the true potential of the 340B program, covered entities must broaden their view of their 340B program. A good first step would be referring to it as, “the pharmacy program”.
The Difference Between a Pharmacy Program and a 340B Program
The question arises: What can a pharmacy program achieve that a 340B program alone cannot? In short, the answer lies in a more substantial impact on patient outcomes. The healthcare landscape has evolved significantly in just the past few years, with increased integration among payors, providers, and data systems. More progressive payor models now reward providers for quality care, and enhanced data accessibility enables providers to better monitor patient progress between office visits.
The cornerstone of patient care outside of the provider’s office is pharmacy services. Pharmacists are the healthcare professionals with whom patients interact most frequently, often seeking their medical advice as the first point of contact. Additionally, drug compliance—filling the prescription and taking the prescription as prescribed—influences healthcare costs more than any other healthcare service. To truly manage patient outcomes, providers must integrate professional pharmacy services, extending beyond drug therapy and into comprehensive treatment plans.
Key Elements of Integrating Professional Pharmacy Services
- Access to comprehensive documentation related to patients’ drug history, not just limited to the medication profile but the entire drug history including prescribed, filled, and administered or taken medications.
- Recognizing that navigating the pharmacy system can be overwhelming for many patients, pharmacists are experts in this area.
By recognizing and embracing the inherent pharmacy program within the 340B framework, covered entities can tap into a powerful tool for enhancing patient outcomes and addressing key barriers to medication therapy success.
Rob Johnson is the founder and president of RPh Innovations. He can be reached at rjohnson@rphinnovations.com
