URI College of Pharmacy, Dept. of Corrections collaboration results in $12 million savings for taxpayers

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Joint effort wins national award for innovation in pharmacy management

KINGSTON, R.I. – March 27, 2009 – A seven-year old program involving the University of Rhode Island’s College of Pharmacy and the Rhode Island Department of Corrections has saved the correctional system $12 million in prescription medicine costs.

The initiative, which has been in place since 2002, has reduced medication waste by nearly 75 percent and held the trend line on expenditures despite significant drug cost inflation and increases in the inmate population.

While such a successful enterprise is a source of pride for the University and the Department of Corrections, the management model also gained national praise. The Pharmacy Benefit Management Institute presented a 2009 Rx Benefit Award to URI and the Department of Corrections for its new Collaborative Management Model.

It is the first time the institute has honored a collaboration involving a university or college and a state agency. Based in Scottsdale, Ariz., the institute provides research, education, and publication services to help health care benefit executives work with pharmacy benefit managers and other pharmacy professionals to design prescription drug benefit programs.

In its award announcement, the institute said URI’s pharmacy college and the Rhode Island Department of Corrections “are pioneering a new higher education/state agency management model.”

The College’s Healthcare Utilization Management Center, which is directed by E. Paul Larrat, associate dean of the College of Pharmacy and Rita Marcoux, assistant professor of pharmacy research, and the corrections department’s medical staff, manage pharmacy services at the Department of Corrections.

URI’s College of Pharmacy provides an on-site pharmacy manager, Larry Myerson, and extensive data analysis, reporting, clinical support and management resources. Pharmacy students assist with much of the data analysis.

Following a competitive bidding process, the Department of Corrections awarded URI’s College of Pharmacy a three-year, $454,000 contract in 2002 to manage its pharmacy program. The two organizations are now in the midst of a four-year, $682,000 contract.

The prison system’s daily population averages 3,800 inmates, while its intake center processes approximately 18,000 individuals per year. The Department of Corrections’ medication costs, based on pharmaceutical trend data, had been projected to be $13.7M from 2003 through 2006, but its actual costs were $8.8 million thanks to the collaboration with URI. The total overall savings have climbed to $12 million as the program has matured, according to Larrat.

“Our 2009 award recipients have differentiated themselves from industry norms with creative new approaches,” said Dana H. Felthouse, president of the Pharmacy Benefit Management Institute. “Another hallmark of the winners is a passion for collaboration among stakeholders. The solutions are programs that demonstrate success in improving pharmaceutical health care, as well as curbing costs.”

Dr. Michael Poshkus, Department of Corrections medical director, said his agency relies on Larrat, Marcoux, and URI pharmacy students for medication quality review.

“They are a vital aspect to our program,” Poshkus said. “It’s been a very valuable resource for us, having Rita and Paul accessible whenever we have a question about ordering medications and what would be the most cost-effective means to provide pharmaceuticals to our patient population. Also, having the students available is particularly helpful. Their projects involve reviewing our utilization of different drugs and helping us come up with protocols that allow us to better utilize medications for our populations.

“We rely on the University to help us do quality assurance programs, review the use of our medications, the appropriate use of medication, and review any medical errors that may have occurred,” Poshkus said.

Joseph Marocco, associate director of Health Care Services for the Department of Corrections, said because of the work of Larrat and Marcoux, his department’s relationship with the state Board of Pharmacy has improved.

“Rita and Paul have been responsible for helping the Board of Pharmacy understand the complexities of correctional pharmacy care. It’s not a nursing home; it’s not a hospital; it’s not an ambulatory care center. It’s a little bit of everything.”

Larrat said it is unusual to apply pharmacy benefit management strategies to a unique group like the Department of Corrections.

“One of the things that has impressed me in the six or seven years that we have been involved with corrections is the team atmosphere,” Larrat said. “We were very welcomed by the medical team a few years back. That’s helped with access to information and our ability to educate the staff about pharmaceutical care, which hopefully filters down to better care and treatment of the inmates.”

Marcoux said the institute was surprised by the University-state agency collaboration. “They were very excited that we are taking this opportunity to introduce students to a part of pharmacy that often, students are not aware of. They are gaining experience that prepares them for jobs that many organizations in the health care industry are seeking,” Marcoux said.

Matt Coty of Pittsfield, Mass., who will graduate in May after completing his six-year Doctor of Pharmacy degree, made his first visit to the John J. Moran Medium Security unit recently. The students who work on the project spend most of their time on the Kingston Campus analyzing data and prescription trends. “On campus, I reviewed utilization of emergency prescriptions to see where we can maximize the effectiveness of the ordering system.” Coty said. He said such a process minimizes waste and lowers costs.

Coty said the program is important because “everybody deserves appropriate medications, and they should be treated just as any other individual would be treated.”

Brian Touhey, who will also graduate in May with his Doctor of Pharmacy degree, made his second visit recently.

The Albany, N.Y. resident said he would encourage other pharmacy students to make this one of their rotations. “Part of it was being on campus analyzing the numbers and then coming here to see it all come to fruition.

“This helped me not only with my clinical judgment, but my personal judgment as well,” Touhey said. “You can’t always judge people, especially when you are in a position to treat them or care for them. You have to use your professional judgment, your clinical judgment, put everything else aside and to do your best for them.”

Pictured above

NATIONALLY RECOGNIZED: Representatives of the University of Rhode Island and the Rhode Island Department of Corrections display the 2009 Rx Benefit Awards given by the Pharmacy Benefit Management Institute. From left are pharmacy students Brian Touhey and Matt Coty, Rita Marcoux, URI assistant professor of pharmacy research; Dr. Michael Poshkus, Department of Corrections medical director; E. Paul Larrat, associate dean of the URI College of Pharmacy; Joseph Marocco, associate director of Health Care Services for the Department of Corrections and Larry Myerson, the URI on-site pharmacy manager. URI Department of Communications and Marketing Photo by Michael Salerno