PHARMACY

Specialty pharmacy utilization continues to rise, Walgreens executive says

BY Michael Johnsen

MIAMI — The utilization of specialty pharmacy is projected to steadily increase, Walgreens VP clinical affairs David Lorber told attendees Tuesday at the Pinsonault Associates Managed Markets Summit, which accentuates a need to augment patient compliance and help payers get a handle on what have become rapidly shifting economics.

“Specialty pharmacy is one of the most rapidly growing segments of total drug spending, which brings both concern as well as opportunity for enhanced efficiencies,” Lorber told attendees. “As more people rely on specialty pharmacy medications, the healthcare industry needs to place an emphasis on cost control, appropriateness of care, adherence and waste management.”

Lorber’s session took a hard look at the impact of specialty pharmacy on payers, including the role of adherence across a number of disciplines: cost management and containment, benefit and coverage decisions, formulary and medical policy, pipeline management, provider network and member satisfaction and disruption.

Because specialty medications include complex treatment regimens and medications that require special delivery, storage and handling, they typically cost about $2,000 for a 30-day supply — about 28 times the traditional retail prescription. Approximately 3% to 5% of the population takes a specialty medication, and that number is increasing.

Lorber discussed a case study that showed consistent patient adherence can result in savings. Walgreens multiple sclerosis patients adherent to medications, when compared to less adherent patients, resulted in savings of about $1.1 million for a large national insurance payer covering the 801 patients over a two-year period. The same case study also found that higher adherence reduced costs related to multiple sclerosis emergency room visits, inpatient stays and use of durable medical equipment.

“Improving the health and well-being of patients can be accomplished by providing convenient access to drugs and ensuring there is a consistent and coordinated care management programs,” Lorber said. “Patient counseling and education by trained pharmacists and nurses, like those at Walgreens and Take Care Health Systems, translates into fewer office visits as a result of improved adherence,” he said. “Proactive patient monitoring also drives early recognition of, and response to, adverse drug reactions and side effects, resulting in improved outcomes.”

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Teva, Active Biotech: Laquinimod reduces relapses, disease progression in MS patients

BY Alaric DeArment

JERUSALEM — An investigational drug made by Teva Pharmaceutical Industries and Active Biotech for multiple sclerosis reduced disease relapses and prevented the progression of disability, according to late-stage clinical trial results announced Monday.

The drug makers said the drug, laquinimod, reduced annualized relapse rates by 23% and disability progression by 36% in the phase-3 “Allegro” study. The drug also reduced brain tissue loss by 33%. In addition, the companies said the drug was safe and well-tolerated, without suppression of the immune system. Laquinimod is a once-daily, orally administered treatment. Teva also makes the injected MS drug Copaxone (glatiramer acetate).

“The Allegro study results are exciting, as they suggest that oral laquinimod is a novel therapeutic option that safely slows MS disease activity and progression,” principal study investigator and medical professor at the University Vite Salute in San Raffaele, Italy, Giancarlo Comi, said.

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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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