The role of pharmacists

An interesting piece in the New York Times points out the growing role for pharmacists as part of the health care system in the United States.  In addition to providing prescriptions, some pharmacists are now helping to monitor unsafe drug interactions more carefully, to monitor refills of prescriptions (as a proxy for whether the drugs are being taken), offering more counseling, teaching patients in individual and group sessions, and even offering classes that feature exercise.

Is this a good use of their time?  For the entire health care system it is probably a great deal as long as the activities of the physician and the pharmacist are coordinated.  In systems that are truly systems (where someone stands to benefit from the coordination) this should decrease costs as someone has the incentive to control the sum of the costs.  However, in unorganized systems it is not clear.

To study the incentives, we could simply determine whether there is a way to decrease costs while achieving the same objective (i.e. a cost minimization exercise focused on the patient's health) or we could do a cost-effectiveness analysis and ask whether giving the pharmacist more responsibility (and thinking about what training might be necessary to do so) results in higher or lower expenditures and better health.  Lower costs and better health--of course give them more responsibility.  Higher cost and better health--have to ask whether it is worthwhile.

As a side note, if extra training is required, someone has to bear the cost of extra training.  Note that the pharmacist and owner of at least one store have started a business to educate others.  This suggests that they see this as a profitable opportunity that should be adopted by others.  It will be interesting to follow the developments.