The growth of expensive specialty medications is driving the overall rise of healthcare costs. Several drivers impact the cost of these medications, including the price charged by pharmaceutical companies, the fact that patients often require help from health professionals to receive particular drug therapies, and inconsistent patient adherence to prescribed therapies.
At Brigham and Women’s, we are implementing efforts to improve the appropriate use of high cost medications, thereby improving the quality of care for patients and reducing costs. We have convened a committee with representation from pharmacy, medical management, and specialty clinics, engaging physicians who prescribe these high cost medications in identifying possible solutions. When evidence-based guidelines exist, we are actively communicating those prescribing guidelines to front line clinicians. Additionally, using prescribing data, we can examine variation in prescribing patterns among clinicians. Sharing these kinds of data in the primary care setting has helped facilitate conversations with providers that promotes behavior change (i.e. encourages prescribing in accordance with accepted guidelines). We are considering using similar strategies with specialty providers.
Results to date
In the winter of 2016, our cardiologists rolled out a new clinical pathway for optimizing lipid management. This is just one project that aims to improve the appropriate use of high cost medications.