Practitioners, Prescribers AND Patient Advocates Call on Oregon Legislature for Improved Medication Therapy Management

The Arizona Journal of Pharmacy’s Winter 2014 issue notes that across the U.S., “poor medication adherence leads to poorer health, more frequent hospitalizations, higher risk of death and costs our medical system as much as $290 billion each year.” Here in Oregon, providers, pharmacists, and patient groups are addressing this growing issue by bringing forth legislation to help all Oregon patients better manage their medications. Medicare Part D plans starting doing this in January.

Physicians, providers, patients and groups are asking the Oregon Legislature to pass Senate Bill 1579, the “Medication Synchronization” bill.  This simple legislation allows patients to synchronize their medication refills all on a certain day during the month/or cycle, or according to the patient’s plan.  This bill will allow half or portioned refills to be authorized to bring all the refill dates together as one. The bill makes a way for health plans in Oregon to uniformly implement the policy,  and cover partial refills in accordance with the patient’s current prescription drug plan/benefits.


Supporting the bill is Sen. and physician Alan Bates (D- Dist 3, Medford).  “This bill is designed to improve patient health by helping ensure that patients take their medications as and when they should. It will allow the pharmacist to synchronize the filling of multiple prescriptions so patients are not constantly running out of one medication or another. An example would be when a patient has five prescriptions on different schedules and has to go in two to three times a month to get them filled; this bill will allow the person to receive all of their prescriptions at the same time. In addition, it streamlines and reduces paperwork in the doctor’s office.”


Medication synchronization is a timely opportunity for Oregon as it complements and builds upon two successful and emerging models of care that are already widely adopted in Oregon: The Appointment-Based Model and the Patient-Centered Medical Home.  Both models engage the patient in a more meaningful way using the Triple Aim to improve quality and patient experience. This bill aims to:

·       Improves patient education, adherence and compliance by engaging the patient more closely with his/her health care provider for more optimum and coordinated care.

·       Reduces time and worry for patients who are managing one or a multiple medication regimen.

·       Reduces duplicative interactions between pharmacists and physicians by creating a “one-stop” authorization  and dispensing process.

·       Reduces the need for unplanned provider intervention in potential cases of negative medication interactions or improper patient dosing.

·       Creates more efficiencies and a checks-and-balances system with providers in tracking, charting and monitoring patients’ medication usage and refill status. 


Supporters also add that with this practice, a patient meets at time-certain intervals with the pharmacist, so the patient can obtain education on each medicine (dosing, side effects, optimal usage, etc). He/she also receives disease state intervention and education, so adverse outcomes can be reduced, and ultimately eliminated.  And, other patient health needs, such as getting updated on immunizations and needed health screenings, can be discussed and resolved.


Said Eugene-area rheumatologist and leader of The Oregon Rheumatology Alliance, Cody Wasner, M.D., “The Oregon Rheumatology Alliance supports this bill wholeheartedly.  Since the majority of our rheumatology patients are chronic long-term patients, many with multiple disabilities, Senate Bill 1579 will help ease the burden that many patients bear with repeated visits to the pharmacy because of insurance administrative rules.  It is about time that the medical care system starts to orient the care toward patient concerns and away from the financial convenience of the insurance companies.”


Beginning last month, all  Medicare Part D plans will be required to institute daily cost sharing to enable medication synchronization. And, although some commercial health plans in Oregon have a provision for synchronizing patient prescriptions, this bill will align this important practice as an important component of the emerging and successful patient-centered care model.


The National Community Pharmacists Association has already endorsed language to create a Medication Synchronization approach and the Appointment-Based Model among their various chapters.  Also, effective this month, the State of Connecticut passed Medication Synchronization legislation mandating that neither individual nor group health insurance plans deny coverage for applicable refills for treatment of a chronic illness. Other states are also considering such measures.


Adds Debi Johnson, executive director of the Oregon Urological Society, “The Oregon Urological Society commends Senator Bates continued effort to improve patient health while streamlining the simplifying the administrative burden placed on healthcare professionals.  We strongly support SB 1579 and would like to see the bill be amended to extend to a 3-month supply.”

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Auditing would also become easier. As big-data scrutiny accelerates, the state can ensure that changes from adverse-event studies get into practice quickly. Having had relatives come into this state from out of state, I have found providers here to be far more cognizant of metabolism changes in elders and the need to adjust dosages. Oregon can exercise the opportunity to get outcome-research into practice as quickly as possible. We will avert excess disability and other dysfunctions in our systems if we make sure prescriptions are not too much, and in the case of pain, not too little. We are already ahead on pain-relief, cutting the adverse events on body systems from not sufficiently dealing with pain. A friend who is a community-health nurse has witnessed what goes on with this in other states. She is pleased to be practicing here.