PHARMACY

Express Scripts: Aligning patient behavior, intentions could save money for healthcare system

BY Alaric DeArment

ST. LOUIS — The road to waste reduction is paved with good intentions.

That’s the conclusion of pharmacy benefit manager Express Script’s "2010 Drug Trend Report," which found that 33% of annual pharmacy-related waste can be eliminated by encouraging patients to improve common behaviors linked to their prescription drugs by harnessing their good intentions.

The report, a Harris Interactive study commissioned by the PBM, found what the company called a gap between patient intentions and patient actions. In one example, 82% of patients using branded drugs would rather use generics. The report found that if all patients consistently used generics, low-cost brands and home delivery of medications when available and appropriate, it would save the country’s healthcare system as much as $403 billion per year.

“Don’t let behavior fool you,” Express Scripts chief scientist Bob Nease said. “Patients’ behavior is often misleading and doesn’t represent their underlying intention. Our research and experience show that most patients, when presented with a choice, make decisions that lower costs and improve their health — decisions that also are in the plan sponsor’s best interest.”

Other findings in the report included a 19.6% increase in the specialty drug trend, showing a consistent double-digit increase in trend every year since 2004. Meanwhile, trend for traditional medications fell by more than 50%, and overall drug trend increased by 3.6%, compared with a 6.4% increase in 2009.

Diabetes drugs also saw an increase in trend growth, by 12.5%, while drug spend on ulcer disease treatments fell by 13.7%, thanks to more generic and over-the-counter drugs entering the market.

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SXC to acquire MedMetrics

BY Alaric DeArment

LISLE, Ill. — Pharmacy benefit manager SXC Health Solutions will acquire “substantially all” assets of Worcester, Mass.-based PBM MedMetrics Health Partners, SXC said Tuesday.

The companies expect the acquisition to be completed in second quarter 2011. Financial terms were not disclosed. MedMetrics manages about $200 million in annual drug spend.

“We are very pleased to welcome MedMetrics and its employees into the SXC fold,” SXC chairman, president and CEO Mark Thierer said. “We have worked with MedMetrics as a client and a partner over the past seven years; they began with SXC as a healthcare IT client and later expanded the relationship to include PBM services.”

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Study: POS electronic safety check can reduce heart attack risk among diabetes patients

BY Alaric DeArment

ST. PAUL, Minn. — A point-of-sale safety check may reduce the risk of patients unsafely receiving a drug for Type 2 diabetes that may increase their risk of heart attack, according to a new study conducted by pharmacy benefit manager Prime Therapeutics and scheduled for presentation at the 23rd annual meeting of the Academy of Managed Care Pharmacy in Minneapolis.

The study found that a POS automated electronic safety edit designed to require prior authorization from a provider for patients using GlaxoSmithKline’s Avandia (rosiglitazone) concurrently with an insulin or a nitrate reduced the chances of their receiving the drug, use of which with a nitrate could put them at risk of myocardial ischemia, a condition in which the arteries in the heart become blocked.

For the study, one of Prime’s Blue Cross and Blue Shield clients implemented an edit that required a prior authorization for Avandia if a nitrate drug supply already existed. As a result, between January and June 2009, 168 members had their Avandia claim denied at the POS. Researchers then compared those members with a control group of 222 for whom the safety edit was inactive. After six months, 78.6% of the 168 members in the study group were using a diabetes drug other than Avandia, compared with 25.6% of those in the control group. Thirteen percent of patients in the study group abandoned antidiabetic drug therapy altogether, compared with 15% in the control group.

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