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Op-Ed: Medication Synchronization Would Benefit Chronically Ill

Making it possible for patients to pick up all prescriptions -- even partial ones -- on the same date could drive up our healthy outcomes

terry malanda
Terry Malanda

It's no secret that here in the U.S., we struggle mightily related to managing healthcare costs and spending. Just last year, a Commonwealth Fund survey that focused on health-related "efficiency, equity, and outcomes" placed us dead last among a field of 11 wealthy nations, despite our having the planet's most expensive healthcare system.

When compared to other high-income countries, we have a surprisingly low overall life expectancy. Recent National Academy of Sciences research identified an expanding "mortality gap" among American adults older than age 50, as compared to those of the same age in other advanced countries.

Runaway costs for healthcare and a low relative life expectancy are dire problems within our country's healthcare sector, and it would seem that any potential and reasonable solution warrants extremely serious consideration. And that brings us to the important matter of medication synchronization – which, in New Jersey, is currently associated with Senate Bill S-3111 and Assembly Bill A-3331. In broad strokes, this proposed legislation would contribute to cutting medical costs throughout our state, while simultaneously having a significant positive impact on patient outcomes.

For the uninitiated, medication synchronization refers to a requirement that health plans permit early or partial prescription refills, thus enabling individuals to pick up from the pharmacy all their medications at once, on the same day, each month. The barrier to such synchronization is that most insurance providers don't currently allow the process, despite its clear benefits of improving the health of chronically ill patients and reducing costs. It's understandable that insurance companies may be less than enthusiastic about reconfiguring proven systems that manage the refill process, but the upside, in terms of improved public health and reduced overall healthcare costs, certainly justifies the effort.

The strong push to pass S-3111/A-3331 -- which is supported by my organization, as well as by the National Community Pharmacists Association, New Jersey Pharmacists Association, and American Society of Interventional Pain Physicians -- is founded on tangible facts. The primary benefits offered by these bills, sponsored by Sen. Nia Gill (D, District 34) and Assemblyman Daniel Benson (D, District 14), are as follows:

+Would prompt more patients with chronic illnesses or conditions to take their medications -- even when they change frequently -- exactly as prescribed. The lack of a pharmacy synchronization program often requires patients to make multiple monthly or even weekly pharmacy visits, a hardship that -- along with additional expenses related to some partial prescriptions not being covered through insurance -- frequently results in individuals either taking insufficient amounts of a medication or skipping doses entirely.

  • Would enable many chronically ill patients to recover more quickly, through proper adherence to medication schedules. In turn, this would curtail multiple costs related to ongoing, long-term treatment, including those associated with the volume of prescribed medication, visits to the doctor or the emergency room, and stays in the hospital or a care facility.

  • Would decrease the frequency of medication waste (a serious, ongoing issue), particularly when a prescription needs to be changed while some portion of a 30-day supply remains.

Despite the widespread support it enjoys, both from leading professional associations and members of the Legislature, S3111/A3331 still must negotiate multiple twists and turns in Trenton before it can become the law. It's quite likely the next step will be consideration by the New Jersey Senate. The bill passed the Senate Commerce Committee overwhelmingly on October 19, having passed the New Jersey General Assembly by a wide bipartisan margin back in June. We applaud these expeditious actions.

Medical synchronization is a reasonable, strategic means of addressing two very serious problems, and its time has quite definitively come. This critical legislation, S3111/A3331 needs to be signed into law as quickly as possible, without delay, before the lives of more chronically ill citizens are put at risk, and before we waste additional financial resources that could be put to better use elsewhere in the healthcare system.

Terry Malanda is president of the board of trustees of Garden State Pharmacy Owners, Inc.

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