Introduction
Creating and implementing evidence-based drug usage strategies that improve member and community health outcomes while optimizing health care resources is known as managed care pharmacy. Managed care pharmacy companies serve large populations; pharmacists at managed care pharmacies can influence the health of millions of members. A cross-sectional analysis deemed the last pharmacy strategic plan developed by the Saudi Ministry of Health (MOH) to be beneficial during 2013-2016 (Alomi et al., 2018). In view of that success, the MOH has developed a new plan for the next ten years. The managed care pharmacy has outlined six strategic goals (Alomi et al., 2017). Hospital pharmacies and primary care facilities in the MOH and private sectors were among the programs to be created. Managed care Pharmacy is one of the new initiative systems based on the New Saudi Vision 2030 (Alomi, 2017). It includes new investment and the privatization of the health care system to provide managed care pharmacy services that enhance health care for everyone and enable its members to serve society by employing sound medication management concepts and techniques (Alomi et al., 2017). This topic aims to investigate the new initiative system of managed care pharmacy.
Goals of Saudi Managed Care Pharmacy Program
The Saudi managed care pharmacy’s objective is to provide comprehensive electronic services, implement human resources, reducing total cost of care, and eliminate all medication-related issues in all MOH institutions via community or store pharmacies (Alomi et al., 2017). Saudi managed care pharmacy’s mission is to deliver the best-managed care pharmacy and treatment with high quality, current technology, and at the most affordable rate to patients of MOH institutions via community or retail pharmacies.
The Saudi management pharmacy’s strategic goals include providing a fully managed care pharmacy with safe operating procedures. Furthermore, it aims to create and deploy human resources for managed-care pharmacies and provide complete computerized managed care (Alomi, 2017). The objective is to create a safe environment and provide digital support in all managed care pharmacy contexts, based on managed care pharmacy pharmacoeconomics and healthcare management theory.
Benefits of Managed Care Pharmacy
There will be various benefits if MOH implements this approach at the primary care facility level. It lowers the cost of healthcare for everyone who has access to it. As subscribers seek treatment from medical specialists in the network, the information may travel swiftly within and across the network. The use of medications in managed care will preserve and maintain family unity. Managed care pharmaceutical usage makes it much easier to manage prescriptions with some guarantee of care with managed care pharmaceutical usage inside the network. The application of the managed care pharmacy at primary care centers will result in the creation of over six thousand jobs, including those for pharmacists, clinical pharmacists, and pharmacy technicians (Alomi et al., 2017). Health insurance firms will also open up a significant number of jobs. Furthermore, this system’s implementation will enhance pharmacy services at MOH and private pharmacies.
Disadvantages of Managed Care Pharmacy
Access to the Saudi managed care pharmacy is restricted for people who do not have or cannot afford health insurance. The standards for pharmacies are rather high, prompting patients to stand up for themselves. Patients who do not have health insurance face financial difficulties when paying for care services. Furthermore, patients may want a specific brand name medication, but this problem can be solved by community pharmacies offering a special discount (Alomi et al., 2017). There are issues that may arise due to insecure access protocols and staff errors. This security breach may result in patients’ privacy violations.
The US and Saudi Managed Care Pharmacy Comparison
Comparing the Saudi managed care pharmacy to that of the United States of America, the Saudi managed care pharmacy was developed using a modified American Pharmaceutical Association (APHA) and American College of Clinical Pharmacy (ACPCP) ambulatory care business model (Alomi et al., 2017). These systems have been in use in the United States since the 1970s, with substantial updates in the subsequent decades of the 1980s and 1990s. A similar system has been applied in several countries, including Canada, Australia, and the United Kingdom. The same procedure was carried out in the United Arab Emirates, unaware of published publications regarding the system in other Arabic countries, particularly Saudi Arabia. The difference between the United States and Saudi Arabia’s managed care is that to access health care in the United States, one must show evidence of insurance and pay certain upfront expenses. In Saudi Arabia, however, this is not the case.
Impact of Managed Healthcare Pharmacy
Saudi managed care use of pharmaceuticals has significantly impacted patients, physicians, pharmacists, and facilities. Physicians and pharmacists are diversified into different careers created to implement the Saudi managed care pharmacy. The managed care system has greatly impacted the Saudi economy through healthcare insurance firms that created new job opportunities (Alomi et al., 2017). Through managed healthcare, pharmacy facilities can provide pharmacy home deliveries. Patients will be served 24 hours a day, seven days a week as a result of the implementation of community pharmacy standards and the presentation of medicine labels (Alomi et al., 2017). Managing care pharmacy has impacted the monitoring of patient therapy programs, safe medication programs, drug awareness programs, and drug use assessments. Managing care pharmacy has significantly influenced patients by studying and analyzing prescription claim data to detect actual and prospective adverse medication reactions. Managed care pharmacy has improved communication between pharmacists, physicians, and patients on best practices for prescription drugs.
Improvements and Recommendations
The cost of medicine is a contentious issue that restricts program adoption. MOH purchases drugs regularly through local or Gulf tender and receives relatively inexpensive pricing (Alomi, 2017). The initiation of the program may result in a rise in medication expenses. To fix this problem, holding a conference with significant pharmaceutical firms to discuss the difficulties and urge that the medicine amounts not be modified but may increase in the future, encouraging drug companies to keep prices unchanged or reduce expenses by eliminating intermediaries in the supply chain.
Conclusion
Managed care pharmacy is a new model of creating and implementing research-based drug usage strategies to improve community health outcomes. The plan for its enforcement was developed by the Saudi Ministry of Health, based on the American ambulatory model, as part of the New Saudi Vision 2030. It aims to reduce costs, take advantage of new technology, and increase patient safety by eliminating medication-related issues. The long-term benefits of this model include the creation of new jobs for pharmacists and health insurance agents, as well as improved communication between pharmacists, physicians, and patients. However, there are some concerns about security breaches and that access to managed care pharmacies would be restricted to people who can afford health insurance. In order to decrease or at least stabilize prices, a conference should be held between the MOH and other significant pharmaceutical firms.
References
Alomi, Y. A., Alghamdi, S. J., & Alattyh, R. A. (2017). Saudi managed care pharmacy (SMCP): New initiative system of MOH prescriptions dispensed through community pharmacies.Journal of Pharmacy Practice and Community Medicine, 3(3), 145–153. Web.
Alomi, Y. A., Alghamdi, S. J., Alattyh, R. A., & Elshenawy, R. A. (2018). The evaluation of pharmacy strategic plan in past 2013-2016 and forecasting of new vision 2030 at ministry of health in Saudi Arabia.Journal of Pharmacy Practice and Community Medicine, 4(2), 93-101. Web.
Alomi, Y. A. (2017). New pharmacy model for Vision 2030 in Saudi Arabia.Journal of Pharmacy Practice and Community Medicine, 3(3), 194–196. Web.