Potential Cost Savings for a Health System–Based Employee Outpatient Pharmacy

Abstract

Hospitals everywhere are faced with the same dilemma as other companies, struggling to manage rising health care expenses while providing optimal care for their employees. One of the often overlooked drug expense is the drugs consumed by the facility's employees. Although the average pharmacy department manager has a considerable amount of experience and expertise in dealing with drug expense issues for inpatients or even classic outpatients, the path to optimizing the drug expense investment strategies for their fellow employees can be difficult and elusive to discern. This article should provide a pharmacy manager with a few examples of how to contain costs for employee outpatient pharmacies.Hosp Pharm-2010;45(6):472-477 M any facilities do not outsource the filling and resource management of employee prescriptions to outside pharmacies or a pharmacy benefits manager, therefore they are looking for strategies to ensure that the facility gets a good return on the investment it incurs in paying for its portion of employee prescriptions. For facilities that are selfinsured, the task takes on an increased level of urgency. This article should provide a pharmacy manager with a few examples of how to contain costs for employermanaged pharmacies.A key concern for employer-managed pharmacies is the need to develop treatment guidelines for outpatient services offered to their employees. Many hospitals have several years of experience in developing and using treatment guidelines for inpatients but are unsure how to manage treatment guidelines for outpatient areas. As the outpatient services provided by health systems grow and as the number of covered lives with medication benefits increases, medication costs for outpatients will continue to escalate rapidly. 1 The ability for employers to offer pharmacy services to employees grows more difficult, with obstacles consistently emerging to increase overall costs. Acquisition costs of prescription medications are rising, advertising may lead to inappropriate prescribing of more expensive medications, and the quantity of both prescriptions filled and prescription products available is increasing. 2 Outpatient medication costs account for 80% to 85% of the total medication cost to treat a population of patients; they are increasing at a rate of 10% annually and currently represent 11% of all health care expenditures. 2,3 Although medication spending remains relatively low for health care expenditures nationally, the share is much higher (20% to 25%) for working-aged adults with low rates of hospitalizations. 4 One of the most common ways to rein in prescription medication costs and to execute treatment