PHARMACY

CVS Caremark employs strategies to improve adherence among heart failure patients to help avoid re-hospitalization

BY Antoinette Alexander

WOONSOCKET, R.I. A CVS Caremark study has found that non-adherent heart failure patients are nearly twice as likely to be re-hospitalized within a year; however, strategies employed at CVS Caremark to improve adherence have proven benefits for both patients and payers, the company stated.

According to the findings, released on Tuesday, nearly half of patients hospitalized for heart failure may not be adherent to recommended drug therapies, significantly boosting their risk for subsequent hospitalization within 12 months. The study found that among those patients who were non-adherent to drug therapy, average subsequent hospitalizations per patient in a 12-month period (1.1 re-hospitalized) were almost twice that of adherent patients (0.6 re-hospitalizations).

The study evaluated de-identified data for more than 1,000 heart failure patients from CVS Caremark’s Medical Claims Research Database who had in-patient hospitalization for heat failure between April 1, 2006, and March 31, 2007. The follow-up period for subsequent hospitalizations was for the 12 months following the initial hospitalization date.

“The ongoing challenge of medication non-adherence for patients with heart conditions is well known and, as we see with many chronic conditions, medication adherence for heart failure patients is a significant driver of both long-term clinical outcomes and cost impact,” stated Troyen Brennan, M.D., M.P.H., EVP and CMO, CVS Caremark.

To address this issue, the company provides its PBM clients with adherence to drug therapy programs through its CVS Caremark Proactive Pharmacy Care approach. This approach focuses on changing patient behavior to encourage medication adherence and involves clinical interventions throughout the treatment cycle. The Adherence to Drug Therapy solution is a mail and retail-based program designed to impact patient behavior through face-to-face first fill counseling; IVR and Web refill reminders, renewals and pick up prompts; outreach calls to potentially non-adherent patients from their local CVS pharmacist; and letters about the importance of staying on a prescribed therapy sent to those patients who have stopped filling a maintenance prescription. According to CVS Caremark, the solution helps about 88% of heart failure patients maintain optimal adherence to their medications.

In addition, the company offers PBM clients the AccordantCare Health Management Program for Heart Failure, which provides an evaluation of clinical tests and procedures based on nationally recognized guidelines that are recommended to enrolled patients and their healthcare providers.

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Urging stronger grassroots efforts, NACDS unveils RxIMPACT initiative

BY Jim Frederick

CHANDLER, Ariz. Addressing the organization’s 28th annual Regional Chain Conference, leaders of the National Association of Chain Drug Stores exhorted smaller-chain pharmacy operators to help defend the industry from burdensome patient-privacy regulations and other threats, and to rally behind a new grassroots advocacy initiative.

That initiative, called RxIMPACT, marks an acceleration of NACDS efforts to “engage members and the communities they serve by learning how to interact with lawmakers through advocacy and training programs, pharmacy tours, Capitol Hill visits and other personalized grassroots services,” noted an organization spokesperson. NACDS will hold its first RxIMPACT Day on Capitol Hill on June 16 to 17, 2009.

The need for effective and sustained grassroots lobbying won’t wait that long, however, NACDS president Steven Anderson and newly elected chairman Andy Giancamilli told regional chain members at the conference here. And among the most critical and immediate priorities is the campaign by NACDS and other advocacy groups to slow the rush in Congress to adopt new privacy provisions that industry leaders say would damage pharmacist-patient relationships, slow the adoption of health information technology and hike business costs for pharmacy retailers.

Those tougher privacy laws are contained in new legislation to spur the adoption of HIT as part of the massive economic stimulus bill now under consideration in the Senate. But given the patient confidentiality protections already in place under HIPAA regulations, those privacy provisions are ill-conceived and unnecessary, NACDS leaders told members at the conference.

“Sometimes,” Anderson asserted, “an issue is propelled by the political sails of what I call ‘faulty nomenclature.’ Faulty nomenclature is the use of politically popular terms to describe what is in reality poor policy. In this case, that term is ‘privacy.’”

Anderson reiterated NACDS’ support of HIT, but noted the unintended consequences of so-called “privacy” provisions that he said would impact the entire healthcare delivery system. “We need to assure Congress that we know privacy, and this isn’t it,” he said. “We need to let Congress know that the unintended consequences of what they are considering could actually hinder HIT adoption, stunt economic stimulus and, most importantly, harm patient care.

“Does Congress really want to stifle prescription refill reminders? That could make even worse the $177 billion in annual costs – and health consequences – from failure to take medications as prescribed,” Anderson added.

In his first address as NACDS chairman, Giancamilli appealed to members to engage directly with the political process as a new, Democratic majority in Congress grapples with the complexities of healthcare reform and technology. “The future direction of the industry hinges on the willingness of NACDS members to engage in the public policy debates of the day, since affecting our short- and long-term future is the primary reason we all choose to participate in associations like this one,” said Giancamilli, who is CEO of Katz Group North America and its U.S. subsidiary, Snyder’s Drug Stores. “But now we need even more members to engage in powering the NACDS advocacy engine.”

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Pfizer discontinues phase 3 trial of axitinib as treatment for pancreatic cancer

BY Alaric DeArment

NEW YORK Pfizer has discontinued a phase 3 trial of a drug it was investigating as a treatment for pancreatic cancer, the drug maker announced Friday.

The company said an investigative board found no evidence that patients treated with axitinib and gemcitabine did better than those treated with gemcitabine alone. Gemcitabine is a standard treatment for pancreatic cancer.

“These results were disappointing, given the trend towards prolonged survival seen in a phase 2 study of axitinib in this extremely difficult-to-treat patient population,” Pfizer Oncology Business Unit’s SVP clinical development and medical affairs Mace Rothenberg stated. “However, we remain steadfastly committed to continued investigation of axitinib in renal cell carcinoma, where it is currently in phase 3 for second-line treatment.”

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