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CONTACT SCBJ Kurt Batdorf, Editor kbatdorf@scbj.com

The Everett Clinic generic drug model praised

At The Everett Clinic, patients are getting the medications they need at a more affordable price.

The Snohomish County-based medical group has been prescribing generics for more than a decade. A recent Puget Sound Health Alliance report - The Community Checkup - revealed that significant variation exists between medical groups when it comes to prescribing generic versus brand-name drugs.

Prescription drugs are an important part of health care for many patients and generic drugs usually cost less and often work just as well as brand-name drugs.

The Puget Sound Health Alliance encourages other medical groups to learn how The Everett Clinic has improved health care value within its own organization by getting more patients to take generic rather than brand-name prescription drugs, when a generic alternative is readily available.

"The Puget Sound Health Alliance has a two-fold goal in focusing on local success stories like The Everett Clinic," said Executive Director Mary McWilliams. “We want to shine the light on innovative practices in this region and we want to encourage local health care organizations to share ideas with each other so more groups adopt practices that improve health care value.”

The Everett Clinic, a multi-specialty medical group with 310 physicians and 100 midlevel providers, provides care for 275,000 patients in north and central Snohomish County. More than a decade ago its top officials began to weigh changing old habits. The results have been far-reaching across the entire medical group.

Rick Cooper, The Everett Clinic's Chief Executive Officer, said “as early as 1997 we decided to hire clinical pharmacists to ensure we could provide quality health care even as we optimized the use of medications which we believed would result in the lowest costs.

“The focus on utilizing generics began then and has continued as our market has changed.”
One way to reflect the value of these efforts is to calculate the difference between what insurance plans pay for The Everett Clinic patients' prescriptions and what they pay for non-Everett Clinic patients in Washington state. Given this, The Everett Clinic saves an estimated $88 million a year by prescribing generic drugs and using other interventions.

In order to optimize the use of generic drugs where appropriate, The Everett Clinic hired clinical pharmacists and closed pharmaceutical representatives' access to the clinics. Distribution of free drug samples was disallowed.

The Everett Clinic provided on-going education to clinical staff and provider teams on the best use of medications. They evaluated new and current drugs carefully, utilizing an evidence-based medicine approach.

Doctors and other health care providers were provided comparative and individual feedback on prescribing patterns based on health plan data. There was a focus on common categories of drugs where many generic options are available. The Everett Clinic also ensured that doctors and pharmacists had useful materials on generics to share with patients.

The approach, said Jennifer Wilson Norton, Pharmacy Director of The Everett Clinic, validated the initial belief that quality care could be delivered with lower-cost generics. Overall, generic use rate at The Everett Clinic is now 80 percent, up from just 41 percent in 2001.

According to the Alliance, at some clinics only 15 percent of patients are on a generic statin to lower cholesterol, for instance.

“The little purple pill and other ads on TV can be very persuasive even though there are much more affordable medicines that work just as well for many people,” said Diane Stollenwerk, Director of Communication for the Alliance.

April Zepeda, The Everett Clinic's Media and Communications Manager, said “most of our patients are very appreciative of our focus on generics first. Our pharmacist and doctors talk to them about it ahead of time -and they are usually understanding and happy that we are taking measures to reduce medication co-pays and overall healthcare costs.”