SENIORS IN NURSING HOMES NEED ACCESS TO A SPECIALIZED MEDICARE DRUG BENEFIT

The average resident of a skilled nursing facility is more than 83 years old and needs from six to ten different drugs at any one time – and sometimes more. These residents are frail, unable to care for themselves and need specialized pharmacy services unavailable through the typical retail or mail-order drugstore.

As you consider important legislation to expand Medicare to include prescription drug coverage, these seniors deserve your attention.

Most of the approaches under consideration rely on pharmacy benefit managers (PBMs) to deliver a drug benefit to the Medicare population. While PBMs may be effective in managing benefits for the ambulatory population, none have the requisite experience, infrastructure or expertise to manage the complexities of providing safe and effective pharmacy care to the frail elderly who reside in our nation’s nursing homes.

Long-term care pharmacies, on the other hand, specialize in providing quality pharmacy care to nursing-home residents. We provide

• round-the-clock deliveries, seven days a week and in case of emergencies;
• specialized packaging that prevents medication errors;
• clinical consultations to help physicians manage complicated drug regimens;
• intravenous and infusion therapy services (not just pills and capsules); and
• drug formularies designed specifically to meet the complex pharmaceutical needs of the frail elderly

This standard of service reflects the needs of our patients and the regulatory mandates placed upon the nursing homes with whom we work, and goes well beyond that currently provided by pharmacy benefit managers.

Before approving legislation to create a Medicare prescription drug benefit, Congress must

• establish a pathway toward a drug benefit for the institutionalized population that assures continued access to specialized pharmacy care; and
• ensure that a drug benefit for the frail elderly reimburses providers appropriately to maintain current levels of quality pharmacy care.