PAM DELAGARDELLE. President and CEO of UnityPoint Health – Waterloo
On the top challenge
"The affordability of prescription drugs is one of the primary areas of focus at UnityPoint Health. Medications help keep many conditions, such as diabetes, hypertension thyroid dysfunction and asthma, under control. Common medications that have been out for a long time and relatively inexpensive have been going up in price as drug manufacturers look for ways to maintain or increase profitability and meet Food and Drug Administration requirements. A new group of medications now referred to as 'specialty medications' are also growing; these medications can cost up to $70,000 for a treatment course. As prices go up and we see insurance shifting more of that cost to consumers, we start to see more out-of-pocket expense for patients. Meanwhile, Medicare data shows that adherence to medications plays a major role in keeping patients out of the hospital and emergency department. If adherence rates decrease, it may result in more trips to the ED or hospital, which would result in even greater expense to the healthcare system and patients in the long-term."
On the hospital's response
"UnityPoint Health reviews the cost of medications used in our facilities through a formulary process. If we see significant changes in the cost to treat patients, we look at alternative medications in the same drug class or that yield the same results, and we make changes to that formulary as necessary. We have a patient assistance program that looks at costly medications to see if the drug manufacturer has a discount program that patients can sometimes qualify for to reduce out-of-pocket expenses. We see this in some areas such as cancer therapy, and our organization qualifies for the 340B Drug Pricing Program. 340B has served as a critical federal resource for our safety-net providers and the patients we serve in Iowa, Illinois and Wisconsin to help curb drug costs and out-of-pocket expense to patients.
We are also focusing on adherence rates and affordability of individual patient care plans. We are using our pharmacy team to help coordinate discharge medications to make sure the discharge plan is affordable and available to patients before they leave our facility. We are also positioning pharmacists in our primary care clinics to assist our providers in developing medication plans that are affordable and effective for patients. All of these efforts help to improve outcomes and help control the total cost of care."