CVS Caremark develops Behavior Change Research Partnership
WOONSOCKET, R.I. CVS Caremark is enlisting the help of academic leaders from several leading universities to develop ways to encourage medication adherence and to better understand why consumers may choose a more expensive brand medication when they have access to a generic medication that may provide the same or similar health outcomes.
Through the new Behavior Change Research Partnership, CVS Caremark is working with academic leaders from Carnegie Mellon University, Dartmouth College’s Tuck School of Business and the University of Pennsylvania’s Medical School and Wharton School of Business. These research partners will team with CVS Caremark to develop insights into consumer actions around health challenges by studying the issues through the lens of behavioral economics and social marketing.
For example, patient non-adherence to essential chronic medications is widely recognized as a key barrier to improving health and a cause of increasing medical costs. The partnership will study reasons why people who go to the doctor often choose to not fill their initial prescriptions or prematurely stop taking those medications during treatment and recovery.
“This partnership represents another step in our effort to learn more about how we can help patients understand that effective pharmacy care can impact overall medical costs,” stated Dr. Troyen A. Brennan, MD, MPH, EVP and chief medical officer of CVS Caremark. “While we know there are many reasons people stop taking their medicine — cost, forgetfulness, side effects and others — this research will help us counsel consumers to make the right decision regarding their health.”
According to CVS Caremark, past studies have shown that one-quarter of people receiving prescriptions never fill their first prescriptions, and patients with chronic diseases such as diabetes and coronary artery disease adhere to their ongoing medication regimen about half of the time. Non-adherence to essential medications is a frequent cause of preventable hospitalizations and patient illness, with costs the U.S. healthcare system estimated at about $300 billion annually.
This latest research initiative complements CVS Caremark’s previously announced three-year collaboration with researchers from Harvard and Brigham and Women’s Hospital to study pharmacy claims data to better understand patient behavior around medication adherence.
Why has CVS Caremark chosen to exclude a college of pharmacy from this program?
Turning new corner, Winn-Dixie builds store
COVINGTON, La. —Winn-Dixie Stores in early February celebrated the completion of its new store, the first ground-up store for the grocer since 2004.
“We are very proud to be able to offer this beautiful store to the neighbors and communities of Covington,” stated Winn-Dixie chairman, CEO and president Peter Lynch. “Not only does it provide a best-in-class shopping experience, but it brings 200 new jobs to the area, as well.”
The 55,000-sq.-ft. supermarket, located a little north of New Orleans, features a 24-ft. tall open entrance way highlighted by an outdoor farmer’s market. Inside are a host of “enhanced” features, including a wine department staffed with a wine steward, a peanut butter machine and a full pharmacy department and wellness center.
Winn-Dixie offers several health testing services and immunization opportunities for consumers throughout the year. As a recent enhancement to its pharmacy offering, Winn-Dixie rolled out its WD RxConnect program chainwide. WD RxConnect links all of Winn-Dixie’s more than 400 pharmacies through a centralized prescription record system and also allows patients to access their own records online. “That’s kind of unique in the food store industry,” John Fegan, Winn-Dixie VP pharmacy, told Drug Store News earlier this year. “Under the WD RxConnect program, a patient can walk in, look up their medication history online and see what they’re taking.”
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E-prescribing use soars, but independents unconnected
NEW YORK —American retail pharmacy continued its slow but inexorable journey into the 21st century in 2009 as a mixture of government incentives and trends resulted in a mushrooming of prescribers and pharmacists embracing electronic prescribing and electronic health records.
According to e-prescribing network Surescripts, the volume of e-prescriptions went from 240 million in 2008 to 800 million in 2009, while the number of active e-prescribers went from 78,000—12% of all office-based prescribers—to 150,000 over the same period.
“While this is a positive development, there is much room to build on this growth,” National Community Pharmacists Association associate director of public relations John Norton told Drug Store News. NCPA helped sponsor the creation of Surescripts, along with the National Association of Chain Drug Stores and the pharmacy benefit managers CVS Caremark, Express Scripts and Medco Health Solutions.
By October 2009, 100% of pharmacies in Rhode Island were using e-prescribing, and the statewide system allowed state health authorities to track prescriptions and usage of such antiviral drugs as Roche’s Tamiflu (oseltamivir) to identify possible problems, such as shortages, over-prescribing and misuse by patients.
By the end of 2009, 85% of community pharmacies nationwide were connected for e-prescribing, Norton said, but independent pharmacies have lagged, with 40% remaining unconnected and capabilities varying “tremendously” among independents, particularly in rural areas. Also, given the relatively small number of prescribers electronically transmitting prescriptions, not all community pharmacies with e-prescribing equipment actually use it regularly.
That could change soon, however. The financial incentives for adopting e-prescribing under the Medicare Improvements for Patients and Providers Act of 2008 kicked in at the beginning of 2009, offering qualified prescribers payments of 2% of their Medicare Part B physician fee schedule, and the MIPPA incentives have been cited as a reason for the strong growth in e-prescribing in the last year. The 2% rate will continue through 2010, but will fall to 1% in 2011 and 0.5% in 2013. Starting in 2012, prescribers who have failed to adopt e-prescribing will pay 1% penalty fees, which will increase to 1.5% in 2013 and 2% in 2014.
On the electronic health records side, the American Recovery and Reinvestment Act of 2009 provides physicians with stimulus incentives of between $44,000 and $64,000 if they can demonstrate “meaningful use” of a certified EHR system, and in January, healthcare information technology firm Allscripts launched the Allscripts Stimulus Program, designed to persuade prescribers to adopt EHR. Dozens of states also have received federal matching funds for moving to electronic health records under ARRA, according to the Centers for Medicare and Medicaid Services.
General adoption of EHR and e-prescribing is well on its way to happening in the United States, but it still faces obstacles.
“Challenges include installation and transaction costs, the costs associated with training staff and challenges with physician prescriber management systems, having to call back physicians regarding incomplete information on prescriptions, the incompatibility of technology systems and enhancing two-way online communications with prescribers,” Norton said.
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