Prescription Medication

Fellowship Year 2016-2017

Background

One-fifth of U.S. health care dollars are spent on purchasing prescription medications, which excludes the amount spent on avoidable adverse drug events. The cost burden related to prescription medications is associated with both the high price of medications and how medications are used by clinicians and patients. We propose three main solutions that health systems can implement to encourage not only better use of medications but also lower prices spent on prescription medications themselves: improving patient adherence, improving provider prescribing, and tackling medication prices.

Safely reducing per capita spending related to prescription medications while improving patient outcomes, patient satisfaction, and provider satisfaction

CERC’s prescription medication redesign team found three addressable suboptimal points in current care, which are summarized in the table below. Team members address these points via a new care model with three core elements: (1) Offload medication management responsibilities to a pharmacist team; (2) Favor cost-effective medications via active computer assisted prescribing; and (3) Use demonstrated medication market share shift to directly negotiate price discounts with medication manufacturers.

Estimated savings

An estimate of net national savings from implementation of the first two elements of the CERC prescription medication model is approximately $110+ billion annually with the majority of savings due to improved medication management of patients with chronic disease. Additional savings would likely be produced from the medication market share shift to negotiate price discounts with medication manufacturers as described below.

Design Team

Brian Brady, MD; Stephanie Peters, PsyD; Scooter Plowman, MD; Terry Platchek, MD, Arnold Milstein, MD