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Concierge pharmacy practice: RxVIP and your future

By: Lameesa Dhanani, PharmD Candidate c/o 2019

*Disclaimer: In November 2018, the FDA issued a Safety Communication against changing a patient’s medications solely based on the genetic test results since these genetic tests have not been reviewed by the FDA.

In a competitive market where pharmacy jobs are scarce, I always remind myself why I started my journey into the pharmacy world.  My life goal has always been to help others.  As a junior in high school, I knew I wanted to make my life goal my career.  The question was how?  I remembered my middle school teacher telling me that healthcare professionals will always be in demand. At the time, I had many family members on medications that I couldn’t even pronounce.  What did these medications do and why were they taking them?  I was determined to find out and help patients better understand their medications.  I wanted to help patients gain control of their health and live better quality lives. As a sixth-year pharmacy student nearing the end of my training, I’m unsure how to move forward. Now that I have chosen a career path to accomplish my goal, which aspect of pharmacy would make me excited to go to work in the morning?

Enter RxVIP.

Founded due to the need to connect with patients, RxVIP is a network of pharmacists and pharmacy students looking to advance their careers.  They work collaboratively with physicians at the physicians’ offices to deliver a suite of value-based services that enhance patient outcomes.  RxVIP offers services such as pharmacogenetics counseling and testing, chronic care management, remote patient monitoring, and wellness prescription checkups that help patients manage their medications.

Ken Sternfeld, RPh, is a concierge pharmacist and the founder of RxVIP as well as a St. John’s University alumnus. He started RxVIP by working collaboratively with a primary care physician to help his patients once a week on Fridays at the physician’s family practice. When Mr. Sternfeld practiced as a community pharmacist he wanted to connect with patients, however, he had a difficult time doing so in the community setting.  According to Mr. Sternfeld, RxVIP is an extension of the care team that is already in place at a primary care physician’s practice. He states, “As pharmacists, we are the medication experts.  We take the time to counsel patients on cost-saving and life-saving solutions right in the physician’s office and remotely.”

Participating in an Advanced Pharmacy Practice Experiential (APPE) rotation at RxVIP opened my eyes to other possibilities and ways pharmacists can serve the healthcare community.  With pharmacogenomic testing, patients have the opportunity to optimize their medication therapy by taking a simple, two-minute cheek swab. Pharmacists and pharmacy students review the pharmacogenetic reports and explain to the physician how the results may affect his or her patients.  For example, the medication atorvastatin (Lipitor ®) requires metabolism which is regulated by the expression of the genes KIF6 and ABCB1. Without these genes, patients are unable to properly metabolize the medication and do not benefit from its cholesterol-lowering actions. They may also experience more adverse effects such as myalgia.  If the patient is experiencing adverse effects, as a pharmacy team, our intervention would be to suggest to the physician to switch the patient from atorvastatin to rosuvastatin (Crestor ®) which, in many patients, is metabolized normally1.  These explanations allow for the intricate incorporation of three key players in the healthcare industry – the physician, the pharmacist, and the patient.  The pharmacist is no longer solely a dispenser of medications, but instead, a crucial member of a patient’s overall wellness team.

The APPE rotations that RxVIP offers give Ken Sternfeld and his team opportunities to mentor dedicated pharmacy students who are future leaders of the profession. Following the educational pathway that Mr. Sternfeld has created allows the healthcare industry to recognize pharmacy students and pharmacy interns as healthcare providers.  Providing all the services that RxVIP offers allowed my fellow rotation interns and I to become patient-centric professionals.

As the end of my rotation with RxVIP neared, I asked Mr. Sternfeld what message he wanted to deliver to pharmacy students. He very astutely stated, “The message that RxVIP hopes to deliver is that students can practice at the height of their license as concierge service providers.  I want to assist students in any way that I can in this process”.

SOURCES:

  1. Gelissen IC, McLachlan AJ. The pharmacogenomics of statins. Pharmacol Res. 2014; 88:99-106. doi: 10.1016/j.phrs.2013.12.002

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