Rising medication costs are a significant concern nationwide and in skilled nursing. Today, prescription drug expenditures account for nearly 20 percent of healthcare costs, and prescription spending is growing faster than any other part of health care. Consider these facts:
- American spending on prescription drugs increased 13.1 percent in 2014—the largest annual increase since 2003.
- This uptick was largely driven by an unprecedented 30.9 percent increase in spending on specialty medications. In 2015, spending rose another 12.2 percent.
- Specialty drug pricing alone is far outpacing the Consumer Price Index, and specialty drugs increased to 44 percent of overall drug spending in 2017.
- Prescription spending in long-term care is approaching the $17 billion level with nearly 400 million prescriptions dispensed in 2016.
Making the Transition to Grane Rx LTC Pharmacy ServicesSeveral years ago, the decision was made at the Jewish Association on Aging to change providers to Grane Rx. As with any program, changing pharmacies is a huge undertaking. “Grane Rx staff were here throughout the transition, assisting with protocols, policies, procedures, and staff training,” says Mary Anne Foley, RN, MSN, Chief Operating Officer with the Jewish Association on Aging. “The transition and onboarding was very good. They had a team here that helped facilitate—they literally lived in the building.” While adapting to a new LTC pharmacy services provider can be difficult, often the problems come after the initial transition. That hasn’t been the case for the Jewish Association on Aging. “Over the years, Grane Rx has proven to be a true partner within our organization, providing ongoing support, education, and consultation to our staff, residents, and physicians,” Foley says. “Pharmacy staff have been incorporated into our Quality and Infection Control Committees and during this past year were instrumental in assisting with our organization-wide emergency management procedures.”
How Grane Rx LTC Pharmacy Services Made an ImpactThrough a combination of competitive Grane Rx pricing and cost-cutting measures, the Jewish Association on Aging, which provides both skilled nursing and assisted living, saw a 12 percent decrease in pharmacy spend. That’s substantial on its own, but the Grane Rx LTC pharmacy services team also impacted the Jewish Association on Aging facilities in other ways.
Cost ReductionGrane Rx did more than just offer lower prices on prescription medications. They also impacted positive change for the Jewish Association on Aging by helping them enact guidelines and procedures in-house. “We didn’t have a good process for the formulary,” Foley says. “Of course, our physicians, like most physicians, will just order anything, because they don’t really pay attention to costs.” Members of the Grane Rx team are regularly on site, brainstorming and helping with the process of reducing costs and realizing savings where appropriate. Because Grane Rx pharmacists were willing and able to sit and discuss the topic of formulary processes, they were able to explain the benefit of therapeutic interchanges to physicians. “When we transitioned to working with Grane Rx, our cost savings over the previous year were in the thousands,” Foley says. “They’ve worked with us on cost reduction and the creation of a formulary that our physicians buy into, which makes a tremendous difference.”
Clinical SupportBeyond making a direct impact on pharmacy spend, Grane Rx also helps facilities prepare for surveys, compliance reviews, and continuing education. “They actually help prepare us for Department of Health surveys, for personal care and assisted living,” Foley says. “They do specific training—if we’ve identified specific issues, they’ll come work on those with us.” With the help of Grane Rx clinical staff, the Jewish Association on Aging nursing home achieved better than benchmark status on quality measures. In 23 out of 26 months, they earned a 5-star quality rating, and many of those measures are related to the use of medications, such as:
- Percentage of residents who report moderate to severe pain, which is minimized by the timely delivery of meds by Grane Rx and access to medication cabinets.
- Antipsychotic medication use, which is monitored through weekly Grane Rx antipsychotic/antianxiety/anti-hypnotic monitoring reports and recommendations.
- Falls/Falls with major injury, which are limited through Grane reports and monitoring of anticholinergic/antipsychotics with reductions in these meds with high fall risk.