Medical Arts Pharmacy in Fayetteville, AR, is the only local provider in the area offering smoking cessation counseling and support to patients. “There are a lot of people who need this service and doctors just don't have time to go through all the things we go through to help people be successful,” said Julie Stewart, PharmD, who has been practicing at the pharmacy for over 15 years. Word is out that pharmacists are in a perfect position to help patients quit tobacco. In January of this year, the Surgeon General released the first report on smoking cessation in 30 years, highlighting the important role pharmacists play in cessation efforts. “All pharmacists, along with other members of the health care team, play a critical role in screening patients for tobacco product use and in providing treatment options and supportive care to help patients quit,” said RADM Ty Bingham, PharmD, chief pharmacy officer with the U.S. Public Health Service. “We can improve access to evidence-based cessation services for individuals seeking to quit.” Evidence has shown that quit attempts are most successful when supported by evidence-based treatments, including pharmaceutical aids and counseling services, and the profession of pharmacy has made major strides to have a prominent role in tobacco cessation efforts over the decades. A new resource from APhA (www.pharmacist.com/tobaccocessation/promising-practices) was developed to highlight the ways in which pharmacists are engaging with tobacco cessation interventions. “These case studies showcase how pharmacists in different health care settings across the nation are maximizing their expertise to assist patients who use tobacco to quit, setting them on course for improved health and well-being,” RADM Bingham said. Across the United States, the pharmacy practice landscape varies for a number of reasons, including state pharmacy acts, patient populations, practice settings, payer relationships, and more. When the smoking cessation program started at Medical Arts Pharmacy in 2019, services were supported by grant funding that lasted for a 4-month period. Today, even without the financial support, pharmacists at Medical Arts still provide the service to patients at no cost. “We wanted to continue with the momentum we had from the program mostly in hopes of building our reputation and confidence in our process so we would have a good program in place when reimbursement does come,” said Stewart. Pharmacists are not recognized on the federal level or on the state level in Arkansas as health care providers who can bill and be reimbursed for services. Pharmacists at Medical Arts are compensated through the sale of tobacco cessation medications only—they are reimbursed for the cost of the medication and provided a nominal dispensing fee. Patients may also pay cash for the nicotine replacement therapies (NRTs) if their insurance does not cover them. For patients without insurance, the pharmacist collaborates with the Arkansas Department of Health, which provides NRTs at no cost to patients. However, the pharmacy does not receive a dispensing fee for the service. Pharmacists like Alexa Valentino who work on a health care team have an easier time with reimbursement for smoking cessation services. Valentino works at PrimaryOne Health, a federally qualified health center (FQHC) in the Columbus, OH, area. She came on board in 2013, a year after tobacco cessation had been established as a core patient care service provided by pharmacists at the FQHC. Pharmacists at PrimaryOne Health have expanded their ability to bill for tobacco cessation counseling services, primarily through payers, and have subsequently increased authority through a collaborative practice agreement for the management of tobacco use disorder. Typically, patients are referred to the pharmacist-provided tobacco cessation program by other practitioners in the center. “Our providers love that we provide this service and it was a great place to start to build relationships with providers and to build their trust in what we can do as pharmacists,” said Valentino, PharmD, BCACP, lead clinical pharmacist at PrimaryOne Health. Over the years, pharmacists there have been able to expand beyond smoking cessation to manage other disease states as additional needs were identified and new billing opportunities presented themselves to Ohio pharmacists. But Valentino said offering smoking cessation services to patients is a great place for pharmacists anywhere to start providing patient care services because other health care providers are eager for pharmacists to take it on.
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