Danny Sanchez, Chief Executive Officer of EmpiRx Health, a leading clinically-driven, pharmacist-led pharmacy benefits management company.
In the healthcare industry, the term “frontline workers” most often refers to the physicians and nurses who treat patients in hospitals, offices or home healthcare settings. Pharmacists are oftentimes mischaracterized as pill dispensers who work behind the pharmacy counter and play a comparatively minor role in patient health and well-being.
I’ve found nothing could be further from the truth. The reality is that pharmacists, particularly those in roles that enable them to operate at the top of their license, play a significant role in helping patients manage their healthcare needs, and not just lifesaving prescription drugs.
The Role Of Pharmacists
An estimated 58% of Americans say they are likely to first seek non-emergency healthcare at a pharmacy, and according to a survey taken in 2022, pharmacists rank among the most trusted medical professionals. This is a distinction that carries significant weight given the fact that patient trust in healthcare professionals and institutions has slipped in recent years.
Pharmacists are highly trained healthcare professionals with unique expertise in drug therapy, dosage optimization and medication management. Unlike other healthcare providers who may see patients on an irregular basis, and typically only spend a few minutes with each patient, pharmacists engage with patients on a regular basis. As a result, they can often have more transparent conversations with patients due to the nature of these trusted, localized relationships. Pharmacists can provide guidance on personalized treatment options, side effects and the affordability of different medications.
By appropriately utilizing pharmacists and tapping their unique expertise, I think we can transform healthcare for the better, reducing costs and improving patient health outcomes. This becomes especially important when pharmacists are integrated as central players in the pharmacy benefits manager (PBM) operating model.
Tapping Into Pharmacists’ Knowledge To Improve Health Outcomes
While physicians are often only required to take courses on pharmacology during a portion of medical school, pharmacists must take between two and four additional years of pharmacology-focused education after completing undergraduate coursework. Clinical pharmacists, who specialize in medication management and patient care, typically complete about six to eight years of additional coursework before they are considered fully qualified.
Clinical pharmacists’ thorough understanding of medication management is especially valuable in today’s evolving pharmaceutical environment, which includes lower-cost medication options like biosimilars that are becoming viable alternatives to expensive brand-name and specialty drugs. In the case of biosimilars, these products are available instead of their biologic reference product and offer the same therapeutic benefits, but usually at a significantly lower cost.
When prescribing a treatment, a physician may not be as aware of all the available treatment options as compared to clinical pharmacists, who are exposed to new medications regularly due to the hands-on nature of their work and their in-depth pharmaceutical training.
Additionally, clinical pharmacists have a comprehensive understanding of a patient’s medication history and current therapies, which is not always the case for other healthcare providers, including primary care physicians. By having a holistic view of a patient’s health, clinical pharmacists can easily identify potential risks, flag harmful drug interactions and offer tailored medication therapy recommendations.
In a system where fragmented care can lead to costly and sometimes dangerous health complications, clinical pharmacists are a vital resource who can help prevent medication-related issues from occurring.
Transforming Traditional Models To Put Clinical Pharmacists At The Center
Many PBMs will claim that they have clinical pharmacists on staff, but I’ve found few truly leverage the wealth of knowledge these pharmacists possess or equip them with the necessary tools to play a more active role in managing pharmacy benefits programs.
Through my work as CEO of a pharmacist-led pharmacy benefits management company, I’ve found that enabling clinical pharmacists to collaborate peer-to-peer with prescribing physicians can be an effective approach to helping patients. This means not just leveraging the pharmacists’ expertise and talents but placing them right at the center of the care model.
As an industry, I think we need to empower clinical pharmacists to recommend medication changes that are not only clinically appropriate and beneficial for patient health but also help to reduce costs.
By enabling clinical pharmacists to address the problem of rising drug costs “at the pen”—when the physician writes the prescription—we could transform the PBM industry for a healthier, more transparent and healthcare-centric future. The fact is that when a PBM company takes a holistic view of a patient’s pharmacy care instead of focusing on driving drug volume and rebates to maximize profits, everyone can win—the patient, the plan sponsor and the healthcare system overall.
To enable effective patient care and cost reductions, I suggest more healthcare organizations assess their priorities and employ healthcare experts, such as clinical pharmacists, who will help drive improved patient outcomes by utilizing their expertise to inform decisions. When organizations empower credentialed professionals who have real-world experience to collaborate directly with other experts and utilize advanced technology tools, they can enhance quality of care and cost efficiency.
Additionally, healthcare organizations should aim to foster collaboration across different specialties. Make it easier for professionals from various disciplines to work together to develop holistic care plans for patients. Consider how you could better use technology to facilitate seamless communication and data sharing between teams to enhance coordination, support evidence-based decision making across the organization and reduce health complications due to fragmented care.
Conclusion
Adopting a clinically-driven pharmacy care approach means that patients receive the right drug, at the right time, at the right cost. A pharmacist-led PBM approach helps ensure that these trusted healthcare experts—rather than financial considerations—are at the forefront of vital care decisions.
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