What A Cut!

What Dramatic Savings! From $8,000 to $97!! The Veterans Administration outpatient clinic in Dothan, AL, traditionally spent more than $6,000 a month at local drug stores for first fill medications for their patients. Now they typically spend less than $100. This dramatic savings was generated by integrating an ADDS point-of-care dispensing system with the VA’s existing nationwide mail order program, which is the most cost-effective in the world.

The VA has contracts to purchase drugs at extremely favorable prices. To cut costs, the VA provides veterans with most of their drugs via an automated mail order system. However, for the week to 10 days it takes for a three-month supply of drugs to arrive via mail order at a veteran’s home, medicines are routinely bought in retail outlets, at non-goverment prices, which is much more expensive. The addition of an ADDS point-of-care dispensing system enables the VA to stock and dispense bulk purchase, low-cost VA contract medications in the Dothan clinic. It also enables the VA to provide lower cost generics when appropriate.

Telepharmacy Solutions also improves the prescription process by providing greater convenience and safety to veterans. At Dothan, AL, located near the GA/FL border, the ADDS dispensing cabinetry is controlled by a pharmacist located in Tuskegee, AL, which is approximately 140 miles away. The prescription is written by a doctor in Dothan, sent electronically to the pharmacist in Tuskegee, who after review and verification sends an electronic OK to the computer in Dothan that controls the ADDS point-of-care dispensing unit. The nurse will gain access to the system via the biometric fingerprint reader or username and password. The patient’s name shows on the computer screen with a question: "Do you want to dispense?" A nurse approves, and the system dispenses the drug.

The nurse then uses a bar code reader to verify the accuracy of the transaction. As a result, patients leave the clinic with their medications and a complete educational monograph in hand, significantly improving cost, convenience, compliance and safety.

Dan Berney, a supervisor at the VA Medical Center in Montgomery, AL, is responsible for managing the ADDS systems in Dothan and in a new clinic in Columbus, GA. He says that his informal poll of patients indicates that veterans greatly appreciate the new process. "The benefits are tremendous," he says. "If veterans leave the clinic with their medications in hand, we know there’s a good chance they will take them. It’s also much more convenient than trotting to a pharmacy. Combined with extraordinary savings, everybody wins." In certain high volume outreach community clinics, ADDS systems have the potential to provide a 5 to 15 fold return on investment to the VA in the first year of operation.