Drug Benefits Should Be Part of Any Health Reforms: Giaquinta

Article excerpt

Note the extraordinary interest in managed care, invited Diane Giaquinta, Pharm.D., president, Academy of Managed Care Pharmacy, at the group's recent Educational Conference in Orlando, Fla. "Two years ago, we had 400 attendees at this meeting. Now, that attendance has more than doubled to more than 900."

For managed care pharmacists, as for most Americans, health-care reform is a major concern. Addressing that fact, Giaquinta, v.p.-pharmacy and vision, Blue Cross of California, said emphatically, "Pharmaceuticals are an important component of the entire health-care delivery system. It is essential that coverage for prescription drugs be included as a component of any health-care reform proposal.

ACCESS FOR ALL: There should be universal access to pharmaceuticals "through any basic set of benefits," the speaker continued, asserting that "managed pharmacy practice should be the vehicle to administer the benefit through the use of formularies, selective contracts, drug use evaluation, and provider education. Managed care pharmacy possesses the automated technology of on-line systems that decrease administrative costs, track providers and prescription use, and administer formularies and prescribing protocols."

Appropriate use of prescription drug therapies, Giaquinta told the audience, is "one of the most cost-effective methods for treating medical conditions. Outcomes research is an important part of proving this concept....Outcomes research should be an important component of health-care reform."

The speaker emphasized that today's pharmaceutical companies need to understand that "cost-benefit and other outcome studies must be performed as a requirement for selection on formulary." The industry must therefore demonstrate the value of pharmaceuticals rather than focusing on cost-minimization and price controls. "Managed care is an excellent research laboratory for outcome studies," she noted, adding that many managed care pharmacists in the room were working on such studies.

But, in bringing about healthcare reform, change will be difficult, Giaquinta emphasized. "Caught in the middle of the health-care reform debate is the public that believes certain changes in the system are necessary. Yet there is no consensus among our citizens on what this new system should look like; and freedom-of choice and access to new technologies are critical elements demanded by Americans.

"Any reform policy must take into account cultural differences and social values," she emphasized. "We must examine our own experiences and those of other nations to see what has and has not worked."

ORGANIZATIONAL GOALS: Moving on to another topic, Giaquinta discussed the major goals of AMCP. Goal No. 1, she said, is to "promote AMCP as the resource for information on pharmacy practice issues in managed health care. …