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INTRODUCTION

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Health professionals are given significant responsibilities in our health care system. These roles may be taken for granted by patients until a pharmacist, nurse practitioner, physician assistant, physician, or others perform assigned tasks that make major impacts upon patients and patients’ families lives in countless ways. The exemplary manner in which health professionals provide necessary care to patients is a hallmark of health professional practice and delivery of US health care. Patients are thus well served, and fellow health professionals share knowledge and expertise specific to their profession. However, there are significant problems remaining in the US health care system from a structural standpoint. The United States spends 17% to 18% of the gross domestic product (GDP) on health care, yet the United States ranks 37th in the world considering outcomes of care. Comparing the United States to similar industrialized countries, we rank 11th out of 11 comparator contries.1

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The uninsured remain a major concern. There were close to 45.2 million uninsured individuals in the United States in 2012, representing 16.9% of the population.2 This significant number exists despite the institution of health care reform in the United States beginning in 2010. Even with health care reform, the number of uninsured younger than 65 years has decreased only 1.3%. Simply stated, this uninsured segment of the US population is simply staggering in scope and implications for the future collective health of the US population.

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Countless other Americans in our midst are underinsured. They may have partial coverage after a fashion, but for these Americans the high price of deductibles, co-pays, and monthly payments for insurance create an economic dilemma for individuals each time they seek care or pay premiums. Recent expenditure data indicate that in 2013, $3.8 trillion was spent on health care in the United States during 20133 and $329.2 billion was spent for prescriptions.4

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There are tremendous opportunities for health professionals due to the implementation the Patient Protection and Affordable Care Act (PPACA). For the first time in the structure of the US health care system, there is a tangible, significant effort to enhance the quality and outcomes of health care delivered. Now payment mechanisms are in place to demand the evidence of quality of health care delivered, regardless of point of delivery of services. If the quality is not there, reimbursement will be decreased, increased, or stay static in monetary values provided to providers.5 The intent of these measures is to reduce and/or eliminate unnecessary expenditures and duplicative health care service in the United States.

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The use of medications in the health care system provides enormous help to many; lives are saved or enhanced, and life spans are lengthened. Many other uses of medications lead to significant side effects, worsening states of health, and premature deaths. So, how to separate these disparate pictures of drug use outcomes? You, within your practices and ...

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