Pharmacist prescribing for hypertension could save billions and millions of lives, study finds

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If pharmacists played a larger role in prescribing blood pressure medications, they could prevent more than 15 million heart attacks, nearly 8 million strokes, and more than 4 million cases of angina and heart failure in the United States over 30 years. New Virginia Commonwealth University-led research.

The study, “Cost-Effectiveness of Pharmacist Prescribing for Hypertension Management in the United States,” was released Friday. JAMA Network Open, details how pharmacists’ ability to directly treat patients with hypertension can have both a positive impact on the health and quality of life of Americans and a significant economic impact on the US health care system. The study is the first to explore the economics of pharmacist prescribing to improve blood pressure control.

The research team, led by corresponding author Dave Dixon, Pharm.D., of the VCU School of Pharmacy, found that the US health care system could save more than $1.1 trillion over 30 years, a cost savings of $10,162 per patient. Moreover, the study authors found that over 30 years, patients could gain more than 30 million “quality-adjusted life years,” or years in which their quality of life was significantly higher than if they had had a health emergency.

Dixon, Nancy L. and Ronald H. McFarlane, professor of pharmacy and chair of the VCU School of Pharmacy’s Department of Pharmacotherapy and Outcomes Sciences, said the findings support steps that could increase access to care for millions of people across the country.

“Because high blood pressure affects so many Americans — we’re talking about over 100 million people in the U.S. — I think the impact is tremendous because everyone knows someone with high blood pressure,” said Dixon, who serves as a core faculty member of the VCU School of Pharmacy and former director of the Center for Pharmacy Practice Innovation. “It’s one of the leading causes of heart disease and kidney failure in the world.”

A 2022 survey in the Journal of the American Pharmacists Association found that more than 95% of Americans live within 5 miles of a community pharmacy. And according to the Centers for Disease Control and Prevention, patients visit their community pharmacist 12 times more often than their primary care provider. Because there is a shortage of primary care professionals in the U.S., Dixon said pharmacists can fill that gap.

“The role of pharmacists as health care providers is underutilized in the community, and this is really how pharmacists can provide for their community in ways that improve access to hypertension care.” said Dixon, who also serves as an associate professor of internal medicine in the cardiology department at the VCU School of Medicine.

Most states currently offer certain benefits to pharmacists; However, current federal laws make it difficult for pharmacists to receive reimbursement for the clinical services they provide.

Although pharmacists currently have some form of scheduled benefits in 49 states and Washington, DC, they are not recognized as providers under the Social Security Act. This is one of the major barriers to implementing these life-saving – and cost-saving – measures for patients.”

Dave Dixon, Pharm.D., VCU School of Pharmacy

Dixon and his team identified $1.1 trillion in health care savings over 30 years from preventive measures, such as educating patients about high blood pressure and prescribing antihypertensive drugs, as well as helping patients better manage their blood pressure. The ability to offer these services means a reduction in cardiovascular emergencies, which is crucial given the rising death rates surrounding hypertension. From 2010-19, the death rate from high blood pressure increased 23.1%, according to a 2022 study from the Journal of the American Heart Association.

It can also address poor outcomes for racial and ethnic minority groups, Dixon said. According to a 2020 study in the journal Hypertension, for people aged 35-64, black patients had the highest death rate from hypertension of any racial or ethnic group in the United States. Dixon and his co-authors stated in the study, “Pharmacist-led interventions have been shown to significantly improve blood pressure control among black individuals and individuals from racial and ethnic minority groups.

The team of researchers who contributed to the study included co-author Karissa Johnston, Ph.D., of Broadstreet Health Economics and Outcomes Research in Canada. Julie Patterson, Pharm.D., Ph.D., of the National Pharmaceutical Council and formerly of the VCU School of Pharmacy; Carlo A. of the School of Pharmacy at the University of Otago in New Zealand. Mara, Pharm.D., Ph.D.; and Ross T., Faculty of Medicine and Dentistry, University of Alberta, Canada. Tsuyuki, Pharm.D.


Journal Reference:

Dixon, DL, etc. (2023). Cost-effectiveness of pharmacist prescribing for hypertension management in the United States. JAMA Network Open.

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