Private sector to drive health reform 2.0

WHAT IT MEANS AND WHY IT'S IMPORTANT — This is part of the future of health care that Walgreens envisioned when it first began to make a major commitment to specialty pharmacy — it knew it could save payers and patients a whole lot of money.

(THE NEWS: Walgreens promotes big savings via monitored oncology Rx therapy. For the full story, click here)

This also is the future Drug Store News envisioned when we told readers that the next version of health reform — health reform 2.0, if you will — will likely favor more private-sector-driven solutions. How could it not?

Americans have been lukewarm about the Patient Care and Affordability Act since before it was actually signed into law, and while it was not the only reason conservatives were able to retake the House of Representatives in November, it was certainly on the list. There remains too much uncertainty about what it actually means for the average American who already has employer-provided insurance — how will the changes affect him or her?

Common sense dictates that the new group of lawmakers — not to mention members of Congress who managed to survive the mid-term elections — will be listening loud and clear for any suggestions the private sector might have about how to improve and expand health care, while also reducing costs and improving health outcomes.

The cost to treat cancer practically doubled between 1987 and 2005 to approximately $48 billion a year, according to data from the Centers for Disease Control and Prevention. During that time, in-patient costs dropped from about 64% of total cancer treatment costs to 27.5%. Meanwhile, the percentage of costs related to cancer drugs had risen from 1.8% to 6.1%.

Now Walgreens says it can trim the cost per patient by $2,000 to $4,000 a year by managing adherence among cancer patients more closely. According to the American Cancer Society, almost 12 million Americans suffered from cancer in 2007. That means there could be tens of billions of dollars at play, just for getting cancer patients to take their medications as they are supposed to.

Ironically, the fact that cancer still only represents about 5% of total healthcare costs in America is a further suggestion of what a big problem drug adherence is in this country, and the total role such retail health providers as Walgreens can have by giving health reform real teeth.