Healthcare Enterprise: PharmMD Helps Ensure Medication Safety and Lower Costs
Healthcare Enterprise: PharmMD Helps Ensure Medication Safety and Lower Costs | PharmMD, Samuel "Bo" Bartholomew, Samford University, HealthSpring, Belmont University, Nukote, SVP Worldwide
With hundreds of prescription drugs on the U.S. pharmaceutical market, who better than a pharmacist to manage medication therapy? Nobody, according to Samuel "Bo" Bartholomew, chief executive officer of Brentwood-based PharmMD. That simple premise is the foundation of the company, which has seen its business triple in the last year.

"The pharmacist is the most knowledgeable clinician on medications today," Bartholomew said. Thus, PharmMD employs doctorate-level pharmacists full-time, part-time or on contract to serve its clients, which are typically health plans, large self-insured employers and Medicare Part D plans.

"On a given day, we've got access to about 5,000 pharmacists around the country. We typically don't have that many engaged every day, I would say somewhere around 200," said Bartholomew, who co-founded PharmMD with Nashville venture capitalist Clayton McWhorter and Michael Hogue, PharmD, who's on the faculty of the McWhorter School of Pharmacy at Samford University in Birmingham, Ala.

PharmMD specializes in medication therapy management, a term that's come of age since approval of the 2003 federal act that established Medicare Part D, the prescription drug plan for seniors who enroll in an approved prescription-drug plan. The act requires that these plans provide MTM.

"We exist to prevent medication-related health problems. We do that by utilizing the best pharmacist and physician knowledge available, typically known as evidence-based medicine, around drug-therapy protocols all built on a medication therapy management technology platform," Bartholomew explained. With about 20 behind-the-scenes programmers and developers, PharmMD boasts proprietary technology capable of pulling together data from disparate sources, mainly health plans and pharmacy benefits managers, and integrating that information with the medical and pharmacy records of one person. "Then we can highlight likely drug-therapy problems that individuals may be having," he said. "The uniqueness of this is that we have a comprehensive picture that others don't have, because we have the rich data repository from our clients."

Following this HIPAA-compliant protocol, PharmMD makes recommendations to the client based on that client's overall population, while also making recommendations on an individual basis. A PharmMD pharmacist may contact an individual directly if he or she is experiencing recurring drug-therapy problems. Recommendations may be as simple as noting the possibility of a similar drug that would get the same results at less cost or as complicated as noting potential interactions or side effects from obscure drug combinations.

"Medications are more powerful and more toxic in many ways than they ever have been," Bartholomew said. "Prescription drugs can interact with nutriceuticals, herbals, even over-the-counter Advil and Tylenol. There are a lot of people who take high doses of Tylenol at the same time that they're taking prescriptions, and they can end up in the emergency room with an overdose of the common medications that are in both of those."

The goal is the best medication therapy at the lowest cost, Bartholomew said, explaining that physicians usually don't know the drug formulary of each patient's payer. "We help partner with physicians and educate them on the medications that are paid for by your plan but are also the best clinically proven medications for your needs," he said. "We never second-guess the doctors. We never change anything. The doctors are always the prescribers. We simply educate the physician and the patient. In fact, our logo is three intersecting loops, and they represent the connectivity and communication between the patient, the pharmacist and the physician."

Think of it this way: In a hospital, that's nothing new. "Inside the four walls of a hospital, this happens every day. Hospitals have patients obviously under close observation, and they're extremely good at coordinating medications around every individual. The pharmacist and the physician consult on every patient," Bartholomew said. "But the minute you leave a hospital, that coordination goes away, and it's up to individual patients who are the least knowledgeable typically about medications to manage their own meds."

As for the benefit to employers, research suggests a return on investment of $3 for every $1 spent on MTM. And healthy employees miss fewer days of work. Physicians win because they receive a comprehensive medication record of their participating patients that shows all prescriptions from every provider. Also, chances improve that at-risk patients may change behavior.

In October, PharmMD announced that it had nabbed one if its largest clients to date, Nashville-based HealthSpring. HealthSpring is one of the country's largest Medicare Advantage programs, and PharmMD will provide MTM to more than 265,000 of its prescription drug plan members. In September, PharmMD signed three new clients: Belmont University, Nukote Inc. and SVP Worldwide, which is the owner of Singer Sewing Co. and VSM Sewing Inc.

Said Kevin Pataluna, Nukote vice president of human resources, "At a time when businesses across the country are facing continual increases in the cost of providing employee health benefits, PharmMD offers a unique and important service that helps alleviate the financial pressure. In addition to realizing cost savings, we're pleased to offer a new service to our employees that will help keep them healthy and safe from medication-related harm."

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