Opinion - northwest_view

POSTED: Tuesday, Jul. 28, 2009

Pharmacists important to health care reform

You've run out of antacid for the terrible stomach aches you keep having, so you head to your pharmacy. While there, you also tell the pharmacist about your chronic knee pain, noting that the regular ibuprofen isn't cutting it. The pharmacist suggests that the chronic ibuprofen usage could actually be causing your stomach aches. She encourages you to see the doctor right away.

At the doctor's office, you discover you have a minor ulcer likely caused by ibuprofen overuse. The doctor treats you accordingly and tells you it was a close call.

The pharmacist's insight prevented you from being hospitalized later with a more serious ulcer. By recommending that you see your doctor, she also ensured you received the appropriate treatments for your knee and your stomach aches. You saved money, improved your quality of life and avoided a dangerous medical condition.

Pharmacists provide such services in Washington state and around the country every day. Considering that more than $177 billion is spent annually in the United States on avoidable medication-related health problems, according to the American College of Clinical Pharmacy, one might think our health care system would value pharmacists' services enough to pay for them. But almost exclusively, they are only paid to sell more medications - not for their routine work identifying and resolving medication-related risks.

As discussions of health care reform take place, it is time for pharmacists to start being recognized - and reimbursed - for the services they provide. Reform talks are currently placing emphasis on the importance of preventing disease, improving health outcomes and employing cost-saving measures.

All of these have long been priorities for pharmacists.

In addition to dispensing medicines that cure illnesses and improve health, pharmacists provide education about medicines, help people manage and adhere to complex regimens, ensure drug safety, avert dangerous drug interactions, prevent overmedication, offer immunizations and screenings, advocate for access to medications and provide extensive health resources and educational services to the public. The practice of pharmacy involves so much more than merely counting pills.

Furthermore, these services are offered in community pharmacies, clinics, hospitals and nursing homes nationwide. In fact, 92 percent of Americans live within five miles of a community pharmacy, according to the National Community Pharmacists Association. Pharmacists do not require an appointment. Many pharmacies are open on evenings, weekends and holidays. Some are even open 24 hours a day.

No other health care provider offers this level of accessibility. As such, pharmacists must be recognized for the significant contributions they make to their communities, to the public's health and to the entire health care system.

Economically, it makes sense to compensate pharmacists for providing crucial health services - especially when they are preventing dangerous drug interactions or unnecessary hospitalizations. Ethically, it makes sense to value the role they play in preventing accidental, drug-related deaths. Fundamentally, it makes sense to discontinue the archaic system of financially rewarding pharmacists only when they sell a product and not when they promote health or identify a medication risk.

Recently, House Energy and Commerce Committee Chair Henry Waxman (D-Calif.) stated that pharmacists should be involved in the discussions on health care reform. He told members of the National Community Pharmacists Association that pharmacists are a critical link in the health care chain. He further underscored that they do much more than sell a product; they provide an important public service.

He was right on all counts.

We support the kind of health care reform that reinforces pharmacists' efforts to provide these vital services to the public. Pharmacists make an essential contribution to improving health outcomes and improving medication safety. It is time for the health care paradigm to shift to a model fully recognizing and integrating their broad expertise.

Don Downing is a clinical professor and Peggy Odegard is an associate professor at the University of Washington School of Pharmacy. They are both licensed, practicing pharmacists.