PPF- Atlantic Summit on Healthcare and Drug Cost Sustainability

Perry EisenschmidCEO, Canadian Pharmacists Association

October 30, 2014

Challenge

Opportunity

Enigma

Help from Pharmacists

Obstacles

Success Factors

Introduction

Healthcare in Canada at a crossroad

The role of pharmacists

The benefits of pharmacists being involved in managing chronic disease

What is holding pharmacy back?

Status of Health Care in Canada

16 million Canadians live with chronic disease

Indirect costs alone - $122 billion in 2010

PHAC – 58% of annual spending is for chronic diseases

15% of Canadians do not have a family physician

61% of Canadians do not receive preventative care reminders

Canada is ranked LAST out of 11 countries on how readily patients can get an appointment with their regular family physician

RESULT: more Canadians in emergency rooms instead of being managed in the primary care sector

Managing Chronic Disease

Leveraging Accessibility

The 9000 Points of Care Report highlighting how better use of pharmacists could impact our healthcare system: 1.3 million ER visits and 500,000 hospitalizations

could be prevented 6.3 million hours of physician time freed up over 3

years $7-9 billion can be saved through improved access

and use of cost-effective medications

Pharmacists Scope of Practice in Canada

Health Care Innovation Working Group

Enhanced use of pharmacists

Minor Ailments

Medication Reviews

Immunization

Chronic Disease Management

The Role of Pharmacists

Prevention and Screening Services

High Cholesterol (in pharmacy testing)

Diabetes- in pharmacy A1C testing

High Blood Pressure-in pharmacy monitoring and follow-up

The Role of Pharmacists

Immunization Services

Monitoring important disease markers

Initiate, modify and monitor drug therapy

The Role of Pharmacists

Performing Comprehensive Medication Reviews

Patient assessment Appropriateness, effectiveness, safety and

convenience Drug therapy problems Care planning Collaborating and communicating with HCP Evaluating, documenting and following up

Is There Evidence for the Effectiveness of Pharmacists?

Recent research article in CMAJ: hypertension management by pharmacists was

superior to the usual care provided by physicians and nurse practitioners. (Ross Tsuyuki et al)

Numerous studies are available that demonstrate that pharmacists management of chronic disease are cost effective and produce positive patient outcomes

Value for Services Toolkit

Wellness services

Medication reviews

Minor Ailments

Prescription-related services

Comprehensive medication management

What is holding pharmacy back?

Fee for dispensing main source of revenue for pharmacists

Reimbursement mechanisms are short-term focused and not linked to outcomes

Payment for non-dispensing services

Public and private drug plans

Moving Forward

Pharmacists as a primary care provider

Formal referral system

Multi-sectoral discussions need to continue, that incorporate interests of patients, health care providers and employees