Rewriting health reform

Last issue I wrote about the 9-in.-by-12-in. box on my desk, in which I keep my own personal copy of Congress’ Patient Protection and Affordable Care Act.

Lately, I have been pondering something heavier than that 25-lb. box of paper. What would health reform look like if I could light it on fire and start all over again?

I think I would take a page from what works about specialty pharmacy. I was reminded of this as I read the findings from two recent surveys that CVS Caremark released in April, about a week apart from each other, around the topic of adherence.

In one, a telephone survey of more than 700 of CVS Caremark’s specialty pharmacy patients, the company reported that 70% believed their specialty pharmacy team played an important role in getting them to take their medications as prescribed. Depending on the course of therapy they were on, patients who felt this connection to their specialty pharmacy teams were as much as 36% more likely to remain persistent with their medications.

The other study sought to examine some of the reasons, aside from just cost, that cause a person to stop taking their medications. Among the findings:

24% of respondents believed that taking their medications interfered with their personal lives;

21% believed taking their medications made them feel they were losing control of their lives;

17% said taking their medications made them feel “old;”

16% said they thought they knew better than their doctors;

16% were “wary” of the healthcare and pharmaceutical industries and didn’t want to be dependent on their medications or suffer from any side effects; and

6% just didn’t want to change the pace of their lives by taking their medications.

It makes you wonder: What’s different about these two studies? What is the one discernible variable that you know you can put a finger on—the one factor—without knowing anything else about the hundreds of patients that took part in these research projects?

In this case, it was the impact of the specialty pharmacy team. It’s the human touch. That’s the secret sauce.

It is no secret that medication adherence represents the “leaky bucket” of healthcare spending, leading to as much as $300 billion a year in unnecessary costs related to surgeries, hospitalizations and emergency room visits. How much would health reform really cost if, just to throw a number at it, we could make patients 36% more likely to take their meds the way they are supposed to?