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Walmart offers unique healthcare solutions

BY Mike Troy

BENTONVILLE, Ark. —With major changes looming for the nation’s healthcare system, recent actions by Walmart suggest the company intends to prepare for the uncertainty of health care’s future by helping define it through cost reduction and efficiency initiatives.

Two recent examples stand out, with one involving a novel prescription drug-pricing arrangement with heavy equipment manufacturer Caterpillar, and the other a Sam’s Club undertaking to accelerate physician adoption of electronic medical records.

The Caterpillar pricing initiative is only a pilot program, but it already has captured the attention of pharmacy benefit managers and major employers due to the potential to reduce prescription drug costs. Meanwhile, Sam’s Club worked with software developer eClinicalWorks and Dell to create a turnkey electronic medical records solution for physicians that soon will be available in all 50 states.

Both initiatives address the issue of healthcare cost and efficiency from different angles, and illustrate how Walmart has emerged as an unlikely innovator in the world of health care. The arrangement with Caterpillar, which was initiated by Caterpillar last September, is noteworthy because it could prove disruptive to the PBM if more employers adopt the so-called “cost plus” pricing model that is central to the arrangement with Walmart.

According to Caterpillar, there is between 10% and 20% waste in the prescription drug supply chain that is complex, confusing and inefficient. In fact, Caterpillar grew interested in pursuing a new pricing model after its prescription drug expenditures rose an average of 14% annually from 1996 to 2004. The company began to more actively manage drug spending in 2005 by focusing on generic usage, formulary and supply chain management. But then it decided to go a step beyond and work directly with a major pharmacy, bypassing normal PBM pricing processes.

According to a presentation last month by executives from Walmart and Caterpillar and the Pharmacy Benefit Management Association, both companies would like to see broader adoption of the cost plus model. The model calculates the price Caterpillar pays for a drug by using the real price that Walmart pays for a drug as a basis to determine the final cost to the payer, as opposed to the industry practice of a discount off of the average wholesale price. Although the pilot program isn’t due to end until January 2010, it would appear to be heading toward a more permanent arrangement, considering the companies are participating in joint presentations and industry events. They also have indicated that metrics regarding cost savings and utilization rates are being met or exceeded.

While Walmart’s pharmacy executives were busy creating an alternative to the traditional PBM model, the company’s Sam’s Club division addressed the issue of electronic medical records through a partnership with eClinicalWorks and Dell. The comprehensive package, which includes EMR and practice management software and hardware, is available for a small practice of one to three providers. For a three-provider practice, it will cost less than $25,000 for the first provider and up to $10,000 for each additional provider.

For that price, eClinicalWorks provides physicians with 12 weeks of project management, data center support, e-prescribing integration and comprehensive primary care and specialty-specific templates with decision support. In addition, the eClinicalWorks staff provides five days of on-site training, free unlimited online Webinars and eClinicalWorks software support for this first year. The package hardware components include three Dell OptiPlex desktops, one Latitude XT convertible tablet, one fax server, one laser printer and applicable switches.

Although the benefits of such systems—improved care, reduced errors, less paperwork—are well documented, adoption among practitioners has been slow due to the cost and complexity associated with converting a paper-based system to an electronic one.

“We have thousands of members in the medical field today that buy products and services at Sam’s Club to help them run their businesses, and they tell us that cost is a significant barrier to adopting electronic medical records,” said Charles Redfield, SVP at Sam’s Club.

The cost barrier also has been addressed by the fact that the American Recovery and Reinvestment Act of 2009 contains funding that allows the Centers for Medicare and Medicaid Services to pay physicians $44,000 to $64,000 over five years, beginning in 2011, if they deploy and make meaningful use of certified EMRs.

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Kroger to serve as exclusive supermarket sponsor of Fiesta Atlanta ’09

BY Allison Cerra

ATLANTA Kroger will serve as the exclusive supermarket sponsor of Fiesta Atlanta ’09, an outdoor Cinco de Mayo festival celebrating Latino culture, music and food.

Fiesta Atlanta ’09 takes place on Sunday, May 3 at Centennial Olympic Park in downtown Atlanta. For Kroger, the partnership represents the company’s commitment to the Hispanic community.

“We are very excited and looking forward to Fiesta Atlanta,” said Glynn Jenkins, director of communications and public relations for Kroger’s Atlanta Division. “Kroger has always made exceptional efforts to serve the Hispanic community and joining this celebration is another commitment to our Hispanic customers.”

Atlanta’s largest Hispanic outdoor family festival, Fiesta Atlanta attracted over 40,000 attendees last year. This year’s event will once again feature authentic food from many Latin-American countries, arts and crafts, sponsor displays with many free product samples and continuous live musical performances by national and local recording artists.

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AARP cites big jump in Rx prices

BY DSN STAFF

NEW YORK A report by AARP indicated that prices for branded drugs have increased at a rate outpacing the rate of inflation by more than six percentage points.

 

The report found that manufacturers’ prices for branded drugs increased by 9% last year, compared with the general inflation rate of 3.8%. Meanwhile, prices of generic drugs decreased, on average, by 10.6%.

 

 

Generic drugs have already grown significantly over the years, accounting for 69% of all prescriptions dispensed in the United States, but 16% of money spent on prescriptions, according to IMS Health. In 2007, according to the National Association of Chain Drug Stores, the average price of a generic prescription drug was $34.34, compared to $119.51 for a branded drug.

 

 

Price increases for branded drugs significantly higher than the overall rate of inflation, mixed with the recession, are likely to drive more consumers to generics. According to AARP, nearly a quarter of all older Americans skip medication doses because of the cost, while other studies have shown that many Americans facing economic hardship don’t have prescriptions filled at all.

 

 

At the same time, many branded pharmaceutical drugs – not to mention biologics – don’t yet have a generic version. This could create difficulties for elderly and other patients who may be able switch to medications that are cheaper, but different from what they take, or who take biologic drugs or newer drugs that have no equivalent on the market.

 

 

The Generic Pharmaceutical Association said the report indicated that generic medicines are “the right choice for better health.”

 

 

“During these difficult economic times, it is truly disturbing to hear reports that our nation’s seniors cannot afford their prescription drug costs,” GPhA president and CEO Kathleen Jaeger said in a statement responding to the report. “No one should be forced to choose between putting food on their table and paying for needed medicines.”

 

 

Jaeger also said the report illustrated the need for a regulatory pathway for biosimilars.

 

 

“It’s time to do right by our seniors and all Americans struggling with healthcare costs by approving legislation that brings safe, effective and affordable biogeneric medicines to patients sooner rather than later,” Jaeger said. “GPhA also strongly believes that increasing funding for FDA would ensure the more timely approval of generic medicines, increasing the opportunity for consumers to save immediately.”

 

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