How medication management saves cost

AT this time when there is a global economic retardation, which borderlines on a recession in some developed countries, and a simultaneous exponential increase in global healthcare cost, predominantly due to the pandemic, all cost-savings interventions should be explored.

In all healthcare expenditures, both at the individual and institutional levels, the budgetary allocation for medications is significant. Hence, medication management will not only optimize the use of such commodities for best therapeutic outcomes but also save cost.

Studies designed to measure the impact of pharmacists’ interventions to detect, resolve and prevent medication errors and medication non-adherence will establish that there are definite cost benefits to patient medication management, an evolving responsibility for clinical pharmacists in the advanced countries.

With respect to medication errors, clinical data collated over a period of eleven months from an out-patient health institution overseas, showed that there was 43.4 percent of medication errors due to therapeutic duplication and 25.7 percent due to drug interactions. The main drug classes highlighted in this group were antibiotic (24.23%), proton-pump inhibitors (13.27%) and analgesics (12.34%).

There were various responses to such interventions where 53 percent of the prescribers stopped the treatment, 21 percent changed the brand of the drug and 20 percent altered the frequency of the dosage. Noteworthy from an audit trail on patient records was that the revised directions were not documented; only verbal instructions were issued.

With respect to medication non adherence, data from studies showed that as high as 50 percent of the medications prescribed were not taken as directed due to various objections such as side effects experienced, affordability, pill burden, patient not being convinced on its effects or other barriers such as medication taste or pill size.

The dollar value of medication non-adherence is $100 billion in the United States. Worldwide this phenomenon is considered an economic burden, hence medication management by clinical pharmacists is gradually being appreciated as an asset and a win-win, reducing cost and enhancing the effectiveness of patient treatment in the process.

Hence special training for pharmacists focused on winning patients’ confidence for disclosure of critical information so interventions can be made for positive outcomes.

From another study done, the usual medical care cost compared with those services run by pharmacist showed cost savings to the value of US$647,024 by preventing emergency visits and hospital admission, especially when managing chronic diseases.

These trained resources are severely limited locally. Though piloted in a specialised department at the hospital, it has not become the universal practice. It is no secret that Guyana’s health system has been compromised by the migration curse to greener pastures over the decades, amplifying work load on the limited number of healthcare professionals who remained to serve their country.

But a succession plan must cater to this loss of our trained professionals to yield the favorable results discussed.

So, a critical review of the current mode of operation and an evaluation of how much time is spent with an individual patient can address the way forward, to maximise the use of our restricted resources and to make an impact at the budgetary level of an institution as well as the patient level. Countries that utilised the intervention of pharmacists were able to get better medication management by reducing prescription errors and save on overall healthcare costs.

Modernising our healthcare systems by computerizing patient records and fixing the gaps will not only allow departmental and institutional connectivity to trace patient history but will address duplication, polypharmacy, especially in the elderly with chronic illness and ultimately eliminate wastage.

Medication management demands spending time to educate and explain new lifestyle modifications and lobbying for more cost-effective drugs. There must be a statutory structure to systematically rationalise drugs having acquired empirical evidence to justify the recommendations.

For further discussion, contact the pharmacist of Medicine Express PHARMACY located at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg. Tel #225-5142.

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