PHARMACY

CVS Caremark study finds PBM design optimizes generic utilization

BY Allison Cerra

WOONSOCKET, R.I. CVS Caremark presented data at the Academy of Managed Care Pharmacy’s annual educational conference, which illustrated how innovative pharmacy benefit plan design can impact generic utilization. The study further underscored how pharmacy benefit managers can work with plan sponsors to manage costs and improve health outcomes by working to change plan participant behavior through increased engagement.

The study was designed to evaluate the results of plan design changes, including implementation of a $0 copay for generic medications, on the generic dispensing rate, plan participant cost and impact of plan participant behavior changes on health outcomes. During the study period, participants were allowed to fill prescriptions for generic medications at a preferred retail pharmacy network at a $0 copay. The study included 15,000 plan participants covered by a self-funded employer group who were continuously enrolled under the benefit for the duration of the study period (Dec. 1, 2007, through July 31, 2009).

The study found that implementing a $0 copay structure for generic medications can be an effective strategy to increase generic dispensing, with the generic dispensing rate increasing to 60.8% (a 4.2% increase) during the study period.

In addition to an improvement in GDR during the study period, the analysis found that the average participant cost share for generic medications decreased 9.4%. In addition, the average plan cost per 30 days of therapy also exhibited a slight decline, despite the reduction in generic copayment rates. Prevalence of use in three key preventative drug classes also increased significantly (participants on cholesterol lowering therapy increased 13%, on antihypertensive therapy increased 7% and on diabetic therapy increased 9%) as a proportion of eligible patients.

“Our 2009 Benefit Planning Survey found that clients are more interested in identifying opportunities to change plan participant behavior, rather than shift costs,” said CVS Caremark EVP Jack Bruner. “The data presented at AMCP illustrates an example of how we can work with our plan sponsors to change and optimize participant behavior in order to achieve increased generic utilization. These types of partnerships enable us to effectively reduce costs for both our client and their plan participants without compromising quality or access.

“While some plan designs work to drive generic utilization by increasing brand medication copayments, this study demonstrates that lowering the generic copayment can also be an effective strategy to increase GDR,” Bruner added. “In addition, the data indicates that lowering the generic copayment may also be associated with an increase in participants taking key preventative drugs, which could positively impact adherence and overall health outcomes.”

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IMS Health forecasts growth in U.S., global pharmaceutical markets

BY Alaric DeArment

NORWALK, Conn. Strong near-term growth in the U.S. pharmaceutical market will drive growth in the global pharmaceutical market, according to a forecast by market research firm IMS Health.

In its IMS Market Prognosis report, the firm forecasted market growth of 4% to 6% on a constant dollar basis next year, exceeding $825 billion, with an expansion of up to 7% through 2013, when the total market value will expand to at least $975 billion. Growth in the United States, likely to be 3% to 5% in 2010, is expected to drive global growth.

“Overall, market growth is expected to remain at historically low levels, but stronger-than-expected demand in the U.S. is living both our short- and longer-term forecasts,” IMS SVP healthcare insight Murray Aitken said in a statement. “The economic climate will continue to be a dampening influence in most mature markets, particularly in those countries with rising budget deficits and publicly funded healthcare systems.”

Blockbuster drugs that generate $137 billion in sales a year – particularly Pfizer’s Lipitor (atorvastatin calcium), GlaxoSmithKline’s Seretide (fluticosone propionate and salmeterol xinafoate) and Plavix (clopidogrel bisulfate), by Sanofi-Aventis and Bristol-Myers Squibb – will lose patent protection over the next five years and face generic competition. At the same time, new drugs that treat diseases such as cancer, osteoporosis and multiple sclerosis are unlikely to generate the same sales as the blockbuster drugs. These two factors will combine to dampen growth prospects, according to IMS.

Still, growth prospects in the United States have improved, the report said. Pharmacy chains have more tightly managed their inventory levels based on expectations of patient demand, which has increased purchasing volatility but also created higher-than-expected sales growth in first quarter 2009. Meanwhile, papers have sought to limit price increases and boost the use of generic drugs.

“In the U.S., pricing flexibility and inventory management actions are contributing to much higher growth than anticipated earlier this year and are the main reasons for the upward adjustment to our five-year forecast,” Aitken said.

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Sanofi Pasteur: H1N1 shot boosts immune response

BY Michael Johnsen

LYON, France Sanofi Pasteur, the vaccines division of the Sanofi-Aventis Group, on Thursday announced that a single dose of influenza A (H1N1) 2009 monovalent vaccines, Panenza (15 mcg dose, non-adjuvanted) or Humenza (3.8 mcg dose, adjuvanted), administered to children (3 years of age and older) and adults just one time induces a robust immune response that is considered protective in 93% or more of adults 18 to 59 years old and in 83% or more of adults 60 years of age and older, according to results from clinical trials conducted in Europe.

In children 3 years of age through 17 years of age, 94% or more of study participants achieved seroprotective antibody response.

“These significant clinical data concerning Sanofi Pasteur’s pandemic influenza vaccines will help build public confidence in the vaccine and will support efforts by health authorities to face the challenge posed by pandemic influenza,” stated Wayne Pisano, president and CEO of Sanofi Pasteur.

The results are based on interim analysis following the first vaccination dose from clinical trials conducted in France and Finland. No serious adverse events have been observed to date in these clinical trials. Local injection site (redness, swelling and pain) and systemic complaints of mild fever, headache and fatigue were reported.

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