Transcript 0508340BSORENSON (Considering Innovative Models of

340B Implementation:
An Opportunity for Improved Health
Outcomes in Communities
Todd D. Sorensen, Pharm.D.
Associate Professor
University of Minnesota
Medication Access - Required
Component of Primary Care?
Access to diagnosis
Access to treatment
Required Component of
Primary Care?
Economic Disparity
• 49 million Americans lacked health coverage in 2002
• 23% of American under 65 have no Rx coverage
• Drug prices paid by those w/o drug insurance are 15% higher
than those with insurance
• UI, non elderly spent an average of $30. 76 for Rxs compared to
$9.96 (insured) and $5.53 (generic) for insured.
Clinical Disparity
• 27% UI said needed a Rx drug but did not get it compared to
10% of insured
• 42% of UI with HTN not taking medication compared to 25% of
UI
• 43% of UI with elevated cholesterol not taking medication
compared to 29% of insured.
The FOUR CORNERSTONES of
Medication Management
Access
Outcomes
Efficiency
Quality
Medication Use vs. Cheap Drugs
MAPs
Patient Safety
Expenses/
Revenues
Patient Education
Medication
Monitoring
Quality
Assurance
340B Meds
Provider
Education
Adverse Rxns
Samples
Formulary
Health
Collaboratives
Westside Community Health
Services - St. Paul
Four Cornerstones at Westside

Medication Access





In-house pharmacy
Samples in pharmacy
Considering expansion to other
sites
Efficient Business Practices



Pharmaceutical Care



3 FTE pharmacists, 2 FTE
technicians
Collaborative Practice
Agreements
Dedicated exam room for
pharmacy


Medicaid negotiation
Bilingual technicians
Separation of clinical and
dispensing time of
pharmacists
Seeking $ for
robotics/telepharmacy
Quality Assurance

DUE
Community-University Health Care
Center - Minneapolis




Medication Access
 Contract Pharmacy
Pharmaceutical Care
 1 FTE Clinical Pharmacist, 1 resident
 CPAs, pain contracts
Efficient Business Practices
 Formulary management
 Oversight of contract pharmacy
Quality Assurance
 Sample meds/MAPs
 Availability of languages
Medication Therapy Management
Services (MTM)

Recognizes the role pharmacists can play in improving
the health outcomes of patients




Example: Clinical Pharmacy Demonstration Projects –
Demonstrated value of pharmacists actively managing diabetes
patients
Component of Medicare Part D (Jan. 1, 2006)
Established in Minnesota Medicaid by legislation passed July
2005
Compensation for collaborating with prescribers and patients to
manage medication use…compensation is independent of
medication dispensing
Take Home Messages…



Commit to more than affordable access
 Strive for high quality, comprehensive pharmacy
services as the standard of care
 The most expensive medication is one that
doesn’t work
340B program can be leveraged to increase access
to medications AND improve health in a community
Expertise and experience is critical to create a
comprehensive program