A prescription for drug cost savings

Abstract

effective palliative prescribing, I find the Hospice of the Bluegrass (HOB) initiative progressive as well as prudent. National hospice economics demand that cost savings and cost reduction issues be addressed using new approaches. The HOB study shows how a clinical pharmacist with a specific expertise in palliative medicine can dramatically affect hospice drug costs without sacrificing quality of patient care. Pharmacy practice, particularly in nonhospital settings, has traditionally focused on fundamental services such as accurate dispensing, recording keeping and profiling, and timely delivery of medications. On occasion, true therapeutic intervention occurs. These services alone add little value to pharmaceutical care and save little money; if they did, drug costs would not continue to escalate rapidly for the majority of hospices. Administrators and supervisors may be lead to believe that nothing can be done about the cost of drug therapy and accept it as a consequence of doing business. What the HOB study clearly shows is that something can be done; in fact, it clearly substantiates the role and value of a clinical palliative care pharmacist solely dedicated to hospice issues regarding formulary development, prescribing habits, ongoing education, and per-member/per-day patient drug costs. Pharmaceutical care and pharmacy itself constitute core services that all hospices must provide. Yet how many hospices have an independent palliative care pharmacist consulting and advocating for their hospice and its patients? A hospice administrator would never consider foregoing legal or accounting counsel in his or her organization. With drug costs frequently representing over 20 percent of direct expenses for patient care, it is practical and responsible to have a clinical palliative care pharmacist available to the hospice team. When considering contracting such a clinician for your hospice, the following check list may be useful in determining a potential candidate’s qualifications and experience: