Michael S. Langan, MD
Assistant Professor-Clinical and Lead Physician at CarePoint East
The Ohio State University Wexner Medical Center
Division of General Internal Medicine
543 Taylor Avenue #3176
Columbus, OH 43203
(614) 688-6470
Testimony of Michael Langan, MD
IN SUPPORT OF SB 141:
Pharmacists-consult agreements/dispense drug-no Rx
Before the Senate Health & Human Services Committee
June 10, 2015
Good Morning Senate Health & Human Services Committee, thank you for taking the time to read my testimony. My name is Dr. Michael Langan and I am writing to show my support for Senate Bill 141. Everyday, I practice as a primary care physician within the patient-centered medical homes of The Ohio State University Division of General
Internal Medicine. I also serve as the lead physician at CarePoint East, a primary care office in Central Ohio. I am fortunate to work alongside a multitude of healthcare professionals daily, and have had nothing but positive experiences from working with pharmacists. Today I urge you to support Senate Bill 141.
I wanted to:
First: Highlight some current problems in Ohio’s health care
Second: Describe my personal experiences working with pharmacists
Third: Explain why we have not yet engaged with formalized collaborative drug therapy management
Fourth: Rationalize how this bill can benefit the state and the patients within it
To start, I wanted to remind you all of some staggering statistics. Currently our state spends more on healthcare than all but 17 others. Unfortunately, our clinical outcomes

Michael S. Langan, MD
Assistant Professor-Clinical and Lead Physician at CarePoint East
The Ohio State University Wexner Medical Center
Division of General Internal Medicine
543 Taylor Avenue #3176
Columbus, OH 43203 don’t correlate; we rank 40 th
(614) 688-6470
in the country. It has been known that poorly controlled chronic disease is the real clinical and economic burden of our healthcare system today.
As a physician, I can diagnose, triage, and choose what I feel to be the best option of treatment for a patient. Unfortunately, once the patient walks out of the door, the choice to engage in the treatment plan is up to them. Research shows that over 1 in 4 patients stop one important medicine after a heart attack. Research also shows that patients who have poor adherence to their diabetes medications are 2.5 times more likely to end up with a hospitalization. Drug related morbidity and mortality is estimated at over 177 billion dollars annually. Clearly medication management is a huge concern.
Next, I wanted to tell you about my experiences working with pharmacists. The closest that I have worked with pharmacists has been within my current role. I was able to be a part of overseeing an interprofessional diabetes clinic, where first year medical residents work right alongside pharmacists in order to manage diabetes for complex patients. It is evident that the pharmacists are up to date on clinical diabetes guidelines, evidence for therapies, and really are able to develop relationships with patients. Patients have improved outcomes, are more satisfied, and the physicians are able to spend their normal office visits with these patients focused on their other health care concerns. The medical residents are actually put into this clinic as part of their education in order to learn from the pharmacists about how to care for this chronic disease in a patient-centered manner. If

Michael S. Langan, MD
Assistant Professor-Clinical and Lead Physician at CarePoint East
The Ohio State University Wexner Medical Center
Division of General Internal Medicine
543 Taylor Avenue #3176
Columbus, OH 43203
(614) 688-6470 collaborative drug therapy management were to be expanded, pharmacists could touch more patients within the clinic more efficiently. This is just one example of the many ways in which pharmacists provide care to my patients.
I consider the pharmacists at our clinics to be invaluable resources of drug information, safety concerns, and complex medication management. They are able to identify and resolve drug therapy problems, help to optimize medication regimens, counsel patients on adherence and proper medication administration, and more. Patients see real benefit and are satisfied from the interprofessional team environment; it becomes more patientcentered and results in safer and more effective outcomes. It cannot be argued that pharmacists are the most accessible healthcare providers in the state. They have the largest ability to make an impact on medication adherence as they learn more about medications than any other health care provider.
Currently at our practice site, we do not follow the formal collaborative drug therapy management agreements under consult agreement statute ORC 4729.39 but that is in no way because we are not trusting of the medical decision making of the pharmacists with whom we work. It is strictly due to the cumbersome amount of paperwork that this entails for our practice. The changes outlined in Senate Bill 141 would simplify the consult process for those who welcome assistance from pharmacists. As with all legislation, there will be opposition. Physicians who do want to participate can still do so up to the point

Michael S. Langan, MD
Assistant Professor-Clinical and Lead Physician at CarePoint East
The Ohio State University Wexner Medical Center
Division of General Internal Medicine
543 Taylor Avenue #3176
Columbus, OH 43203
(614) 688-6470 that they are comfortable with. The bill allows for an immense amount of flexibility in how physicians may incorporate pharmacist collaborative drug therapy management into their practice. It can be as general or as specific as one if comfortable with. If there are physicians who do not support expansion of this bill, they are by no means required to participate in collaborative drug therapy management pending its passing.
What I find to be the biggest assets of passing Senate Bill 141, are the improvements in productivity and time that it can provide for physicians along with the improvement in care and patient satisfaction. With physician time freed up for acute care concerns, diagnosing, triaging, and more, I will be able to care for more patients in a more comprehensive manner if chronic disease management concerns are left up to those that know the medications the best, the pharmacists. Medications can be used in a safer and more effective manner, saving costs and improving clinical outcomes. I truly believe that this bill can help to enhance patient care, leading to reductions in healthcare costs, improved clinical outcomes, and improved patient satisfaction within the state of Ohio.
Therefore, I urge the committee to support Senate Bill 141. Thank you again for your time and consideration.