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Friday, October 1, 2004

Pharmacists seek to add paid-consultant services



By Marc Levy
The Associated Press

CAMP HILL, Pa. - Jaime White helps her diabetes patients understand how to manage their blood sugar, checks their blood pressure and sometimes examines their feet for signs of nerve damage.

Her patients are West Virginia state employees participating in a program offered by Rite Aid Corp., the nation's third-largest drugstore chain. They meet with White at a drugstore, and their insurer pays the bills: $80 for initial visits, $20 for follow-ups.

Customers have long called on pharmacists like White to do more than fill prescriptions. But drugstores, from giants like Camp Hill-based Rite Aid to smaller regional chains, are looking to expand their counseling programs and boost revenue - a trend that could be bolstered by the prescription drug benefit that will become available to Medicare enrollees in 2006.

"Many of (the chains) have started to look at how they can transform a pharmacy from a place where one can obtain drugs into a place where you deliver health care," said John M. Coster, vice president of policy and programs for the National Association of Chain Drug Stores.

The chains say regular patient consultations help patients because many patients don't take their medication correctly. As a result, they say, both patients and insurers will save money.

But to provide time and private rooms for consultations, stores need to be reimbursed by insurers, the companies say. The hurdle is getting insurers to agree.

Under the law President Bush signed in December, insurers providing Medicare drug plans must provide a medication consulting service for patients whose illnesses and prescription use meet certain thresholds. The federal government has not finalized how the consulting programs will work, and there are conflicting ideas over the shape of final regulations.

Drugstores and pharmacist groups want retail pharmacies to play a significant role. Insurers generally support the idea of pharmacist checkups, but want more flexibility.

People who have consulted with pharmacists say they like having an extra health care resource.

Bill Wilmer, 68, a retired city worker in Asheville, N.C., said his physician takes care of him when he has a problem, but his pharmacist is like a coach who works to keep him healthy. Wilmer, who takes medication for diabetes, high cholesterol and congestive heart failure, has seen a pharmacist at a Kerr Drug store a few times a year since the late 1990s, with his insurer picking up the tab.

"I think I am far better off in the program with the pharmacist than on my own, trying to learn, hit or miss," Wilmer said. "I wouldn't feel uncomfortable asking my doctor any question, but what I'm saying is that the coach is there."

The 102-store Kerr Drug chain, based in Raleigh, N.C., has installed consultation rooms in 10 stores, and its pharmacists take part in counseling programs, said Rebecca Chater, Kerr Drug's group manager for clinical services.




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