PHARMACY

Older public exchange base fills 13.6% more prescriptions than those on commercial plans

BY Michael Johnsen

ST. PAUL, Minn. — During the first year public health exchanges existed, Prime Therapeutics’ members who enrolled in plans on these exchanges filled an average of 11.7 prescriptions, exceeding fills by commercial members by 13.6%, according to a recent report released by Prime Therapeutics
 
Public exchange members were also 2.5 times more likely to have hepatitis C or HIV, driving an almost 200% higher spend on related medicines. Prime’s analysis found that while only 0.7% of public exchange members had hepatitis C or HIV, the amount spent for treating these conditions among this population was significantly higher than the amount spent for commercial members with the same conditions. More specifically, nearly $1 out of every $5 spent on drugs for public exchange members was spent to treat hepatitis C or HIV.
 
However, public exchange members chose lower-cost medicines — generic drugs and 90-day supplies — more frequently than Prime's commercial members. 
 
“We entered the first year of public health exchanges like others in our industry – with many unanswerable questions,” stated Michael Showalter, SVP and chief marketing officer for Prime. “This report confirms our initial expectations that public exchange members would be, on average, older and have more health care needs than our commercially insured members. Having this full year data will help us better serve our members and clients.”
 
Prime's 2 million public exchange members were, on average, eight years older (42.6 years old on average), more likely to be women (56.1%) and had a per member per month cost 4.1% higher than Prime's commerical members. 
 
The full analysis is based on more than 13 million public exchange claims and more than 143 million commercial claims administered by Prime between Jan. 1, 2014 and Dec. 31, 2014. Prime Therapeutics serves more than 26 million people and is collectively owned by 13 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans. 
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L.A. Times: USC pilot program illustrates importance of clinical pharmacists

BY Antoinette Alexander

LOS ANGELES — A University of Southern California pilot currently underway at several clinics belonging to nonprofit clinic AltaMed is illustrating the important role that pharmacists can play in improving patient outcomes and easing the burden of the nation’s shortage of primary care physicians, according to a Los Angeles Times article.

The initiative, run by USC clinical pharmacy professor Steven Chen, is currently running at 10 clinics belonging to AltaMed, which serves largely low-income populations in Los Angeles and Orange counties, according to the article.

With team-based medical care as a central feature of the Affordable Care Act, the pilot is proving effective as, according to the article, the clinical pharmacists in the USC program are finding, on average, 10 drug-related problems per patient and are also acting much like a medical counselor.

The clinical pharmacists are paired with patients suffering from chronic illnesses and they typically see their patients once a month. Plus, each visits is typically longer — lasting up to an hour.

According to the LA Times report, early data from the pilot shows that clinical pharmacists can help lower overall healthcare costs by reducing hospitalizations and other costly medical treatments. This is critical as today’s payment models under the Affordable Care Act are shifting to penalize providers if patients do not stay healthy.
 

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Diplomat Pharmacy celebrates four decades

BY Michael Johnsen

 
 
FLINT, Mich. – Diplomat Pharmacy is celebrating 40 years of providing quality pharmacy services to its patients nationwide, the company announced Friday.
 
Diplomat, founded in 1975 by Dale Hagerman and son Phil Hagerman, its current chairman and CEO, has grown into the nation’s largest independent specialty pharmacy. Founded on the philosophy “take good care of patients, and the rest falls into place,” Diplomat is committed to helping patients with complex chronic conditions.
 
Today, Diplomat relies on its history of innovation to set the standard for patient care. What started as a small, regional operation has since led to a national enterprise focused on customized solutions for each patient’s individual needs. At the root of the company’s expansion is the desire to help more patients find health. “We remain committed to our philosophy by taking care of one patient at a time for happier lives and health that lasts,” Phil Hagerman said.
 
“Our patients are more than customers; they are remarkable stories of human triumph. It is our honor to support their health, helping them thrive in their lives,” Hagerman added. “Our philosophy continues to be as it was when my dad had the pharmacy almost 40 years ago and we look forward to upholding for the next 40 years to come.”
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