The payment model in large pharmacies sacrifices patient safety and puts unreasonable demands on pharmacists, Scott Knoer, PharmD, chief pharmacy officer of the Cleveland Clinic wrote in an op-ed published Feb. 24 in STAT.
Responding to a recent article in The New York Times that highlighted concerns from pharmacists at top retail pharmacy chains like Walgreens and CVS, Dr. Knoer argued that the payment model for prescriptions is "damaged beyond repair" and must be "rebuilt from the ground up."
"Intense financial pressure combined with the volume-based reimbursement that drive the constant push for more pills are compromising patient care and pharmacist well-being," Dr. Knoer wrote.
Dr. Knoer said that pharmacies should focus on replacing a volume-based reimbursement system with a value-based model, saying a value-based model represents "an important philosophical concept that patients are better served when the system pays for a desired outcome instead of the completion of a service or transaction."
Many players in the drug supply chain push for volume-based systems because more pills means more money for them, Dr. Knoer said, but the pharmacists' main priority should be delivering safe, high-quality medicines to patients.
"Pharmacists need to take back control of their profession from those who seek to exploit their talents to merely pump out more pills and drive short-term quarterly earnings," he wrote.
Dr. Knoer said pharmacies need to create incentives for their pharmacists to reward high practice standards and punish pharmacists who cut corners on safety and quality.
"Solving the problems in pharmacy should start by elevating the role of pharmacists from one resembling fast food workers to the clinical, patient-focused positions they trained for and dedicate their professional lives to," he wrote.
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