PHARMACY

Study: Auto-refill option before receiving Rx improves adherence

BY Antoinette Alexander

WOONSOCKET, R.I. Preliminary findings from ongoing research on how consumers make healthcare choices indicated that if a patient is proactively presented with an option to select automatic versus manual refills before they fill a prescription, they are twice as likely to choose the automatic option than those who are asked after receiving the prescription, CVS Caremark revealed during a presentation on Wednesday at a communications symposium sponsored by the Centers for Disease Control and Prevention in Atlanta.

Punam Anand Keller, a faculty member at the Tuck School of Business at Dartmouth College, and Bari Harlam, CVS Caremark SVP, made the presentation during Wednesday’s symposium. Keller is a member of CVS Caremark’s Behavior Change Research Partnership.

According to Keller, new research by CVS Caremark seeks to address the fact that many healthcare decisions unnecessarily are complicated by the lack of clear and plain language. In addition, choices for such programs as automatic refill of prescriptions or generic alternatives can be overlooked because those options are not readily transparent to the consumer, Keller noted.

“Through this research we are testing options presented through four different communications channels to see how consumers react to different scenarios,” Keller said. “One of our preliminary findings looking at consumers on the Web shows that if we reach out and present a decision to choose automatic refill in advance of renewing a prescription, they sign up at twice the rate of those who were passively presented an opt-in choice after receiving a prescription.”

The BCRP is calling the proactive test “Active Choice.” CVS Caremark is testing Active Choice in four communication channels:

  • Interactive Web sign-ins
  • During in-bound customer calls to care centers
  • Through automated outbound telephone calls
  • Through direct mail

Results for how consumers react in all four channels are not complete; however, Keller said the test using Web-based tools includes an automatic pop-up box that poses the question in clear language before a prescription is filled. The volume of automatic refill requests through that scenario was double the rates the company previously saw.

CVS Caremark launched the BCRP last March to study ways behavioral economics might impact healthcare decisions, and to better understand why some patients stop taking chronic illness maintenance medications prescribed by their doctors. Besides Keller, other behavioral economists participating on the BCRP are George Loewenstein from Carnegie Mellon University and Kevin Volpp from the University of Pennsylvania’s Medical School and The Wharton School of Business.

The ongoing work is focusing on how different communications can encourage consumers to stay on their medications and offering automatic refills — the focus of the Active Choice review — is one way to encourage adherence.

Keller said the BCRP work on the Active Choice option is continuing, and like other CVS-sponsored studies, the BCRP plans to publicly share the findings in the interest of encouraging better understanding of adherence issues throughout the industry.

“We are looking at this issue from all angles because it is well-known that medication nonadherence is costing the healthcare system billions of dollars every year because people who stop taking medications may face unnecessary hospital admissions and other healthcare expenditures,” stated Troyen Brennan, EVP and chief medical officer of CVS Caremark. “Our plan is to develop innovative programs that encourage adherence because good pharmacy care is among the most cost-effective healthcare options.”

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Independent pharmacy lobby weighs in as feds mull ‘grandfather’ status for plans

BY Jim Frederick

ALEXANDRIA, Va. Federal agencies enforcing new health-reform mandates must act to preserve patients’ access to the pharmacy of their choice and lower-cost generic medicines, the independent pharmacy lobby urged the government Tuesday.

In a written appeal to three federal agencies, the National Community Pharmacists Association asserted that health plans seeking Grandfathered Health Plan status under the landmark health-reform law enacted earlier this year must maintain patient freedom of choice and ease of access to generics in a reformed healthcare network. Otherwise, urged NCPA acting EVP and CEO Doug Hoey, those plans should lose their special status.

The NCPA sent a letter Tuesday to three agencies that currently are developing criteria for maintaining GHP status following implementation of the massive Patient Protection and Affordable Care Act. The appeal went to the Internal Revenue Service, Employee Benefit Security Administration and Department of Health and Human Services Office of Consumer Information and Insurance Oversight.

The NCPA’s goal, in its own words: to advance “patient choice and greater utilization of generic prescription drugs” as health plans jostle for a central role in a reformed healthcare system. “Providing quality patient care is vital to healthcare reform, and health plans that want to maintain grandfathered health plan status should not be allowed to alter their structure and benefits in ways that undermine those objectives,” Hoey said.

“For example, the face-to-face interaction patients get in their local pharmacies has a proven, positive track record in terms of health outcomes. Changes by health plans that steer patients against their will toward mail-order pharmacies represent more than just ‘reasonable routine changes’ to an existing health plan and should cause them to lose grandfathered health plan status,” Hoey asserted in his letter today. “Similarly, health plans should not be able to maintain grandfathered status when they change their prescription drug formulary designs by creating or expanding a list of ‘specialty medications’ in order to shift patients to a specific mail-order pharmacy.”

Such changes, Hoey added, would limit access to those drugs by plan beneficiaries, since many specialty drugs aren’t available to independent drug stores. “These are more than ‘reasonable routine changes’ and should also cause them to lose their grandfathered status,” he told the federal agencies.

“On the other hand,” Hoey added, “when generic alternatives become available, the brand-name prescription drug is routinely placed in a higher co-pay tier in the drug formulary to promote the use of the generic. That is indeed a ‘reasonable routine change’ and should not be grounds for a plan losing its grandfathered status.”

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Vaccines sector of healthcare market expands, report finds

BY Alaric DeArment

NEW YORK The global market for vaccines grew to more than $20 billion last year, according to a report by healthcare market research firm Kalorama Information.

 

The New York-based firm’s report, “Vaccines 2010: World Market Analysis, Key Players and Critical Trends in a Fast-Changing Industry,” indicated that the world market for preventative vaccines was $22.1 billion in 2009, compared with $19 billion in 2008.

 

 

“We’ve forecasted a high growth rate for vaccines over the past few years, and market events have matched our predictions,” Kalorama publisher Bruce Carlson said. “The vaccine business is not without its risks, but for some companies, vaccines were the only bright spot in their portfolio in 2009. It’s not a surprise therefore that development is heavy in this sector, and that will continue to contribute to growth over the next five years.”

 

 

Much of the market centers on five companies, namely Merck, GlaxoSmithKline, Pfizer, Novartis and Sanofi-Aventis division Sanofi Pasteur. GlaxoSmithKline took a quarter of the market, thanks largely to the influenza vaccines Fluvarix and Hiberix, Kalorama said.

 

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