Closer cooperation of doctors and pharmacists

Patient care: Doctors and pharmacists work together more closely

13/04/2011

The National Association of Statutory Health Insurance Physicians (KBV) and the Federal Association of German Pharmacist Associations (ABDA) have developed a new concept to improve patient care while making it more cost-effective. According to the plan, patients who have to take five or more medicines will in future be jointly provided by a doctor and a pharmacist.

The new concept for the drug supply of the patients provides for a close cooperation of the physicians and pharmacists in the care of the patients. From 2013, one doctor and one pharmacist each should take care of the patients for one year and prepare a corresponding medication plan. As a result, patients with five or more active ingredients at the same time can be assured of better medication and the risk of side effects is minimized, explained ABDA President Heinz-Günter Wolf. In addition, the new concept would bring significant financial savings, according to the associations.

Future concept of drug supply
The new model will bring significant benefits in the care of patients who need to take at least five drugs at the same time and should also be reflected in the future health care law, said the KBV Board, Dr. med. Carl-Heinz Müller. Around seven million people insured under the law permanently take five active substances at the same time, on the one hand the lack of loyalty (about 50 percent), on the other hand, the impending side effects represent a serious problem in the opinion of ABDA President Heinz-Günter Wolf. Together, the lack of revenue and loyalty cause „adverse drug events“ about five percent of all hospital admissions in Germany, stressed the ABDA President. In addition, according to the expert, annually unused medicines worth about one billion euros in the trash. In order to take into account the abuses mentioned, the doctors and pharmacists now have that „Future concept of drug supply“ submitted. According to the associations, physicians and pharmacists will jointly manage two-thirds of drug sales from 2013 as part of the new model. Thus, according to the ABDA President already saved in 2014 about 2.1 billion euros.

Prescription of active ingredients, medication catalog and medication plan
The concept of doctors and pharmacists can essentially be divided into three areas, which, building on each other, should ensure better and more cost-effective care for patients. For example, the National Association of Statutory Health Insurance Physicians and the Federal Association of German Pharmacists' Associations propose that physicians in the future merely prescribe the active ingredients, strength, quantity and dosage form rather than specific drugs. The selection of the preparations is then made by the pharmacist. The name of the active ingredients should also be clearly visible on the packaging for older patients. A second pillar of the new concept is the establishment of a medication catalog to ensure nationwide uniform cross-fund, guideline-compliant care. According to the plans of the KBV and the ABDA, this will include the drugs of choice as well as reserve agents for supply-relevant indications. In addition, the pharmacists and doctors want to jointly control the medication management of patients on the basis of the aforementioned changes. For this purpose, a doctor and a pharmacist will each take over the continuous care of the patients for one year and jointly develop medication plans in order to meet the individual needs of the patients and to minimize the health risk.

Legal insurance skeptical of new model
The statutory health insurance companies showed up from the presented „Future concept of drug supply“ but less enthusiastic. „With their proposals, doctors and pharmacists are building a smoke screen behind which it is all about another increase in fees for both“, said the spokesman for the GKV-Spitzenverband, Florian Lanz. In addition, most of the supposed innovations, such as the cooperation between physicians and pharmacists or the prescription of active ingredients instead of product names, should already be the order of the day, Lanz emphasized. The cash registers also critically assess the medication catalog. For although KBV and ABDA tried very hard to give the impression of a „positive list“, which excludes exclusively certain medicines, remains a blatant aftertaste for statutory insurances when physicians and pharmacists have such a significant influence on the permissible regulations. Therefore, KBV Board member Dr. Carl-Heinz Müller at the presentation of the concept again that the medication catalog is not a positive list, but rather „a treatment corridor“ for evidence-based medicine. But the accusation of the statutory health insurance companies that doctors and pharmacists actually go for a hidden salary increase, can not easily be rebutted. In fact, € 700 million of the planned savings of around € 2.1 billion in 2014 will flow directly to physicians and pharmacists as a fee. (Fp)

Image: Viktor Mildenberger