How Pharmacists Make a Difference in the Managed Care Setting
As the School of Pharmacy’s inaugural resident in the new post-graduate year 1 program in managed care, Vickie Pon has experienced first-hand how pharmacists can play an integral role in these health care settings.
Pon demonstrates this empirically in her study, “Medicare Part B Injectable Drug Utilization in a Medicare Advantage Part D Plan: Pharmacist-Driven Utilization and Cost Management Opportunities,” which won the best poster award for residents, fellows and graduate students at the Academy of Managed Care Pharmacy (AMCP) 25th Annual Meeting & Expo.
The yearly event, which took place April 3-5 in San Diego, was attended by more than 3,000 pharmacists and other health care professionals, and is the nation’s largest meeting devoted to managed care pharmacy.
Pon’s poster specifically focused on Medicare B drug utilization, as it accounts for a huge portion of current health care dollars.
“Medicare Part B drug spending totaled $11.5 billion in 2010, and spending is predicted to continue to increase,” she explains.
Pon’s study examined how Part B drugs are utilized in a Medicare Advantage Part D plan health maintenance organization, and explores how pharmacists could aid in utilization management and cost-effective prescribing.
“Among our study’s conclusions, we found that within these organizations, health care providers agree that pharmacists can play a role in improving appropriate use and decreasing drug costs by implementing utilization management strategies with teams of providers,” says Pon who received her PharmD degree from the University of California at San Francisco.
As part of her residency, Pon currently works at CareMore, where she interacts with patients each day, doing medication therapy management and other telephonic work, as well as interfacing with nurses and physicians about various queries. She is responsible for understanding and analyzing the financing aspect of pharmaceuticals, as well as drug information and pharmacy operations.
Pon wants to continue to work in managed care upon completion of her residency program.
“I hope to go onto a leadership track that integrates clinical pharmacy programs into various managed care models,” she explains.
In addition to Pon’s win at the AMCP Annual Meeting & Expo, the School of Pharmacy student team consisting of Brian Chou, Kevin Hong, Kevin Wu and Justin Yu placed third in the National Pharmacy and Therapeutics Competition. The faculty advisor for the team is Shetal Desai, PharmD.