Medication costs account for 30% of the overall total cost of care and is rising each year. Cost drivers include increasing cost and utilization of specialty medications and some traditional medication like diabetes. While the cost of medications is an important driver to the total cost of care, medications are also the most common tool for the treatment of chronic conditions, so it is critical to ensure appropriate use to achieve the best outcomes.
VHAN offers pharmacy support to patients and member providers, including medication review assessing each drug to ensure that it is indicated, safe, effective and accessible at a reasonable cost. Pharmacists also assess the patient’s conditions and compliance with evidence-based treatment guidelines, ensuring patients with diabetes are taking a statin and kidney protective drug, for instance.
In 2020, the VHAN Pharmacy Team worked with about 1,400 patients to optimize medications for chronic disease management, transitions of care and polypharmacy. Here’s one example of a patient success story:
Sarah is a 70-year-old former nurse living in rural Tennessee. Struggling to manage complex medical conditions while fighting through impaired cognition and memory loss, Sarah had become a frequent flier at the hospital and had two tackleboxes full of medications.
A lack of communication between specialists and a lack of overall coordination of care had resulted in 27 medication discrepancies for Sarah. The network came to the rescue, with Sarah’s care providers, a VHAN pharmacist and a local pharmacy collaborating to review, update and reduce her medications while also lowering her monthly medication costs. The team also encouraged Sarah to keep a log of her blood sugar levels and consistently followed up to monitor and adjust her medications as needed.
The results have been dramatic. Sarah’s A1c levels improved from 13.6% to 7.7%. She greatly reduced her chronic pain and fatigue. And since the added support from the network, she has not been to the emergency room for an avoidable visit.