The cheaper choice may improve clinical and equity outcomes
The authors of a study that found aspirin as effective at preventing dangerous blood clots as expensive and painful blood thinners are now talking about equity. They point out that choosing aspirin can support health equity and prevent hundreds or thousands of unnecessary hospitalizations and deaths annually. “When given a choice between two drugs that produce practically the same result … many doctors don’t follow the latest evidence and instead turn to hospital policy, habit, and preference as a basis for decision making. But they should use a health equity lens on a care choice as often as possible,” write Deborah Stein, MD, and Robert O’Toole, MD. (STAT)
Faced with pharmacy crisis, health systems turn to…pharmacists
Health systems are addressing pharmacy closures and financial challenges by automating services and integrating pharmacists into care teams, reports HealthLeaders Media. Pharmacists are increasingly involved in direct patient care, collaborating with healthcare teams to optimize medication therapy, reduce errors, and improve outcomes. They conduct comprehensive medication reviews, monitor patient responses, and provide education on proper medication use. Healthcare executive say the pharmacist can help clinicians better understand what medications a patient should be taking and help with medication management. (HealthLeaders Media)
Practice Transformation
CMM can improve value-based kidney care
The Advancing Kidney Health through Optimal Medication Management (AKHOMM) initiative, launched in 2020 by nephrology pharmacists, sought to improve through optimal medication management, including comprehensive medication management. Three PharmDs make the case that, despite challenges to implementing CMM, nephrologists and primary care practitioners participating in value-based care models can benefit from a clinical pharmacist who operates as an integral part of the patient-chronic kidney disease care team, enhancing patient outcomes and care coordination. (Nephrology News and Issues)
Expanding pharmacy deserts worsen to existing disparities
Nearly half of counties in the United States have at least one ‘pharmacy desert’ where there is no retail pharmacy within 10 miles, according to research published in JAMA Network Open. ” “More and more Americans are left without easy access to medications, with disproportionate consequences on certain communities,” Timothy Pawlik, MD, senior author of the study, said in a prepared statement. “We found that patients in counties with higher social vulnerabilities and fewer primary care providers were up to 40% more likely to reside in a region with a pharmacy desert.” (JAMA Network Open; Ohio State University)
Evidence & Innovation
PCPs suffer value-base overload
Primary care physicians in one large integrated health system had to track an average of 57 different quality measures across multiple insurers under value-based contracts, according to research published in JAMA Health Forum. Medicare contracts imposed the most quality measures on physicians with an average of 13.42 measures compared to 10.07 for commercial insurers and 5.37 for Medicaid. “Value-based contracting is intended to incentivize care improvement, but it is unlikely a clinician or practice can reasonably optimize against 50 or more measures at a time,” they wrote.” (Medscape; JAMA Health Forum)
Policy Solutions
HRSA to J&J: Rebates can’t replace 340B discounts
Johnson & Johnson recently informed 340B hospitals that it plans to replace upfront discounts with rebates for Stelara and Xarelto. However, the Health Resources and Services Administration (HRSA) intervened, stating that J&J’s plan is inconsistent with the 340B statute and lacks approval from the Department of Health and Human Services. The American Hospital Association and 340B Health opposed J&J’s plan, arguing it would harm safety-net hospitals and vulnerable patients. Of note: Stelara and Xarelto will be subject to the negotiated Medicare price cuts, which take effect in 2026. (Healthcare Finance News)
