Thursday, May 9, 2019

What The Pharmacist Can Do to make Medicines more Affordable ?




Figure 1 shows Pharmacist is providing service to a patient

Pharmacy services, activities in which pharmacists provide direct patient care, are an important foundation for a successful medication-utilization-management program that can make medicines more affordable. Pharmacists have a major role in reducing costs by critically checking on the pharmacotherapy of multimorbid old patients. The reduction of inappropriately prescribed medicines not only produces savings in the cost of each individual medicine but also reduces the risk of adverse drug events (ADEs) that often contribute to prolonged and expensive hospital admissions.

Pharmacists play an important role interfacing patients and medical experts. Pharmacist can take interference often include discontinuing unnecessary medicines, change to cheaper agents, or altering the route of administration. This can cut off the prices of medicine to be consume by a patient which can make the cost more affordable. Moreover, pharmacists are valued practitioners, as they can provide advice to physicians regarding complex pharmaceutical regimens in critically ill patients, often involving high-cost medicines. Thus, this can narrow down the medicine that should be taken by a patient. This is because some of the medicines can be used to treat multiple diseases. For example, Chlorpheniramine is taken for relieves red, itchy, watery eyes; sneezing; itchy nose or throat; and runny nose caused by allergies. Pharmacists have a positive impact in this high-risk environment by preventing ADEs, reducing morbidity and mortality, and limiting medicine costs. 

Apart from that, community pharmacists offer a confided condition in which to decrease medication errors and improve safety, while reducing costs and improving the quality of care which can make medicine more affordable to the patients. Community pharmacies may suggest a prescription savings plan or serve a list of generic medications valued within a discounted price extend, according to the day supply. Besides that, GoodRx which is a marketing company offers coupons that may provide a considerable discount and can be used to compare prices between pharmacies. Other than that, medication cost depends on patient factors and practice setting. Community pharmacists can assist patient in prescribing cheaper therapeutic alternatives, cut down the regimen, storing a clinic dispensary or samples, receiving medications from charitable medication distributors, using over-the-counter (OTC) medications, indicating non -pharmacologic approaches, and helping patients choose cost-effective plans. Overall, helping patients with medication expenses can make medicine more affordable.

Figure 2 shows Prescription drug discount coupon

Moreover, pharmacist’s role in order to ensure affordability of medicines is to provide or offer generic medications to the patients instead of brand name drugs. Generics drugs are similar to the brand name because they have the same active ingredients, therapeutic effects, performance characteristics, strength and safety. However, most of the patients are not aware and familiar with the generic drugs, which could help them push down the costs. Generic drugs frequently offer lower prices rather than branded drugs.
          
 By increasing the availability of generic drugs as alternative, price competition would happen. According to (Samih, 2018), studies show that greater generic competition is associated with lower price. In fact, Food and Drug Administration (FDA) publishes the names of drugs that have no competitors, to motivate manufacturing and bring prices down. Their analysis has found that the price of a drug falls most dramatically with the entry of the first couple of generic competitors and continues to fall incrementally as additional generic competitors enter the market (refer to Figure 3). 

Apart from generic drugs, biosimilar drugs also offer lower prices compared to biologic drugs.  (Mortimer, White, & Frois, 2017) state that biosimilars are describe as the generic versions of biologics drugs which is complex medications, manufacture within living systems such as animal cells and plants.  The complexity of biologics increases the costs and challenges. Hence, biosimilars are the best alternative for certain innovative biologic drugs.

(Fong, 2018) reports that The Health Ministry has approved the biosimilar version of trastuzumab, a monoclonal antibody, a targeted therapy for women with HER2-positive breast cancer. With the biosimilar version, the total medicine is about RM42,500 for 17 cycle treatment instead of RM130,00. With this huge amount differences, patients would benefit from the reduced price. 
According to the latest new written by the same reporter, (Fong, 2019), trastuzumab has dropped by more than half in the tender to the Health Ministry, resulting in more patients expected to be treated in the ministry hospitals. The originator pharmaceutical company drops the price of that drug by about 52% due to presence of their competitors, a local drug company, that bring in a biosimilar version of the drugs which cost about 50% of the original price. 

Figure 3 Relationship between the prices offered by brand name drugs and 
the number of competitors.

So, now that we have seen many other initiatives that could be taken to make medicines more affordable, there’s few other ways to do it so. One of the ways is to create a transparent supply chain in biopharmaceutical industry in terms of finance. The pharmacists in the pharmaceutical bureau of the government should take initiative to increase the financial transparency while monitoring the margins of profit preferably in every corner of the whole industry of biopharmaceutical. So, if we take a look at the major reason for the increase in price because many who are involved in the supply chain tend to point other participants or specifically other pharmacists to make up to higher drug costs. They don’t really look into the root of the problem to curb the problem all at once, instead they just want to divert the problem away from them for a short period of time.

 In order to make this known to everybody and to understand the root cause, the pharmaceutical congress, should demand full information about the total amount of prices paid for drugs across country to the main channels involved in this. To make this far more effective, congress could also demand average net prices for the drugs which includes the patients’ cost sharing. To make this far more effective, for example, the U.S department of Health and Human Services comprising the pharmacists should ask biopharmaceutical companies to present sales, rebates and discount to payer, therefore, producing the collected information at National Drug Code level publicly maybe for every quarter with the help of Federal Trade Commission to examine and identify anti-competitive pattern in the market.

Moreover, modifying insurance benefits can also aid in this case. Pharmacists can request the Centres for Medicare & Medicaid Services to alter plans offered through government health insurance exchanges to limit patients' expenses for drugs when it points directly to the treatment associated with a specific indication which can reduce the total amount for care and treatment dramatically. Other initiatives also include the pharmaceutical congress, where direct-to-consumer advertising should be monitored because this eventually leads manufacturers to spend more on marketing than on R&D of new drugs and it can have adverse effect on consumer choice by wrongly influencing them. Manufacturers and suppliers involving pharmacists can avoid direct-to-consumer advertising by instead driving their focuses on public awareness of diseases preventions. The acceptance and use of free drug samples, special payments, and other inducements paid by biopharmaceutical companies can also be tightly restricted by hospitals and other medical practitioners.





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What The Pharmacist Can Do to make Medicines more Affordable ?

Figure 1 shows Pharmacist is providing service to a patient Pharmacy services, activities in which pharmacists provide direct pa...