How three hospitals are countering rising drug prices

Rising drug costs are a big problem at St. Louis, Missouri-based Ascension, the largest nonprofit health system in the United States. Despite efforts to monitor the drugs used by the health system, the cost of many older generic drugs has increased by as much as 10.5% in the last year, says Roy Guharoy, PharmD, vice president and chief pharmacy officer for The Resource Group at Ascension. This cost increase, which only includes older generics, cost the health system as much as $70 million between May 2015 and May 2016.

These and other drug price increases are untenable, especially in the midst of the transition from fee-for-service to value-based care, he says. And it’s particularly challenging, given that Ascension is a faith-based healthcare organization that provided approximately $1.8 billion in charity care in 2015.

GuharoyAscension monitors price changes in as close to real time as possible, so that leadership can take immediate action, such as switching to generic drugs or another drug at a better price, says Guharoy. Integral to this process is having physician leaders and specialists in the field review the literature to look at the efficacy of certain drugs to determine their appropriate usage for Ascension’s patients.

Once a particular drug is approved for use across the health system, physicians have 90 days to implement the medication change. Ascension then tracks the implementation at each hospital.

One of the drugs involved in Ascension’s work is a cardiac drug, which increased in price by 1,000%, says Guharoy. This work involved eliminating the drug from crash carts throughout Ascension’s facilities. In cases when the drug must be used, clinicians minimize waste by getting multiple doses from each vial, says Guharoy.

As a result of Ascension’s approach, the health system has saved approximately $1.5 million dollars.

Guharoy says it’s relatively easy to convince doctors of a medication change when you present them with the evidence to back up the change and the reality that the health system can’t continue to provide charity care at current levels if it doesn’t monitor the cost of drugs and make changes accordingly.

The science is there to support these prescribing decisions, it’s just a new way of practicing medicine, he says. “These decisions should be based on science and on delivering the most effective, high-quality and cost-effective care.”

Internal server error