Health Reform: Will Congress Pass Hearing Test?

June 14, 2009

(As appeared in The Gazette, Cedar Rapids, IA)

By Bruce Roberts, R.Ph., NCPA Executive Vice President and CEO
Steven C. Anderson, IOM, CAE, President and CEO, National Association of Chain Drug Stores
Thomas R. Temple, R.Ph., M.S., Executive Vice President and CEO, Iowa Pharmacy Association

As Congress and the Obama Administration craft their policy proposals, they are taking steps to avoid repeating the mistakes of prior health reform efforts. In particular, they are going to great lengths to prevent the legislation from being written by a select few behind closed doors. By emphasizing openness, policymakers stand to help themselves more than politically. They may discover concepts that can help them achieve their policy objectives of improving patient care, expanding access and reducing costs.

The challenge, of course, is to listen to the public and to healthcare providers, distilling helpful ideas while preventing over-analysis that leads to paralysis. They want to craft healthcare reform correctly, but they also want to ensure it gets done.

On June 9, Congressman David Loebsack (D-IA) attended a Congressional briefing that has the potential to help Congress pass both the hearing test and the IQ test on health reform. He opened the House of Representatives' doors to experts on the topic of medication therapy management (MTM). For that, he gets credit for listening, and for highlighting an opportunity to help make healthcare work better for less. We know he will be with us when it counts - as he has been - to ensure that access to rural healthcare remains at the top of the reform agenda.

MTM is a system of pharmacist-provided services that helps ensure that drugs are used appropriately to improve health and to reduce adverse events. MTM builds on the pharmacist's role as the medication expert. It includes consultations with patients, development of a personal medication record and action plan, working with other healthcare providers to resolve any medication problems, and documentation of progress and follow-up.

This ultimate medication "how-to" can be very powerful for improving lives and addressing some of the significant threats to healthcare delivery. Failure to take medications appropriately has been estimated at $177 billion annually in direct and indirect healthcare costs. The seven most common chronic diseases in the nation inflict a $1.3 trillion annual drag on the economy - and that could reach nearly $6 trillion by the middle of the century.

By fostering proper medication use, and preventing more costly forms of care such as hospitalizations over the long-term, MTM can actually reduce costs. For example, in one research project involving patients with diabetes, MTM decreased average direct medical costs $1,200 to $1,872 per patient per year, decreased use of sick days by 50 percent, and decreased annual average insurance claims by $2,704 per patient in the first follow-up year and by $6,502 in the fifth year.

MTM has popular appeal. One survey showed 81 percent of respondents supported the concept of offering MTM for Medicare patients, when it was explained to respondents that MTM can prevent extra doctor's visits and hospitalizations and save money.

Congress has an opportunity to take advantage of strategies such as MTM to make healthcare reform work. But before MTM can be enhanced, it needs to be understood and appreciated. Congressman Loebsack deserves credit for listening, for sharing the news, and for contributing to an earnest approach to healthcare reform. If healthcare reform succeeds during this Congress and Administration, it will because of the political wisdom and substantive merit of pursuing opportunities that will reduce costs while improving quality of care—opportunities like MTM.

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John Norton
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