“With age comes wisdom,” or so the saying goes, but a number of less desirable things also come with age, such as health issues. Chronic health conditions, like diabetes and hypertension, are common among the growing number of seniors in San Francisco, who make up nearly twenty percent of the City’s population.
Most seniors with chronic health conditions require multiple drug prescriptions. According to the Centers for Disease Control and Prevention (CDC), more than 76 percent of Americans over age 60 use two or more prescription drugs per month and 37 percent use five or more.
For these seniors, medication adherence, or taking prescriptions as directed, is critically important for keeping their conditions from growing worse and preventing complications.
But drug adherence is not as simple as it seems. Half of all patients do not follow their doctor’s orders regarding their prescription medications. Some never have the prescription filled; others skip doses, forget to take the medication or fail to obtain a refill. Lack of adherence can lead to disability and premature death, and costs America $290 billion in unnecessary health spending each year.
It is a costly problem and more must be done to fight it.
Neighborhood pharmacists play an important role in assisting seniors and other patients with medication adherence. They offer individualized counseling, specialized medication therapy management (MTM) programs and reminder phone calls to keep patients on track.
Another proven-beneficial way to promote adherence is to fill prescriptions for 90-days, rather than 30. Patients take home a supply that lasts longer, and they do not need to return to the pharmacy as often for refills. As a result, they are more likely to continue taking the medicine. Pharmacists would like to be able to offer this option this more often, but are stymied by a provision in California law requiring them to dispense medications exactly as written.
For example, if a physician writes a prescription for a 30-day supply with two refills, a pharmacist cannot use his or her judgment to dispense a 90-day supply without first contacting the physician for approval. Because this costs time and money for the pharmacy, the doctor’s office and the patient, and is inconvenient for all, it doesn’t usually happen.
Fortunately, Senator Ed Hernandez has authored a simple legislative remedy for this problem. Senate Bill 1301 would allow pharmacists to dispense 90-day supplies, if, in their judgment, a patient would benefit and if the amount dispensed is no greater than the total amount prescribed by the doctor.
Enactment of this legislation would be particularly beneficial for seniors and those with limited mobility. For these people, a trip to the pharmacy can be a challenging event.
The State Assembly should pass this needed reform bill—the Senate already has —without delay. It will save consumers time, effort and money. And it will increase medicine adherence and reduce over-all health care costs.
