Improving medication adherence in specialty pharmacy could be equivalent to introducing a new blockbuster drug. That’s how Diplomat Specialty Pharmacy president and CEO Phil Hagerman put it at Drug Store News’ Specialty Pharmacy Roundtable two years ago.
And he was only talking about specialty and the disease states it covers. The most commonly cited cost of poor medication adherence comes from a study published in the New England Journal of Medicine, which put it at about $290 billion; the latest drug trend report from pharmacy benefit manager Express Scripts has it pegged at more than $300 billion.
One of the ways retailers are improving medication adherence is medication therapy management. Last month, Rite Aid announced a collaboration with health insurer UnitedHealth Group as part of the Diabetes Control Program, itself a part of UnitedHealth’s Diabetes Prevention and Control Alliance. The collaborative program is now available to residents of Long Island in New York state who are enrolled in UnitedHealthcare’s employer-sponsored health plans. Diabetes patients enrolled in the program are able to connect with Rite Aid pharmacists at 27 stores who are trained in diabetes care and MTM, and offer consultations, education and support. The pharmacists also consult with enrolled patients to evaluate their success adhering to their drug therapies and review their test results for blood pressure, blood glucose and cholesterol.
Also last month, Walgreens announced WellTransitions, a program that creates a coordinated care model involving health systems, hospitals and the retail pharmacy chain to reduce re-admissions and costs, while improving outcomes and adherence. Under the program, Walgreens pharmacists work with hospital staff to oversee medication therapies and provide such services as medication review, whereby pharmacists review prescriptions upon admission to the hospital and after discharge, checking for potential interactions and simplifying regimens; bedside medication delivery, which includes medication education and instruction; medication counseling with patients and caregivers; follow-up calls to discuss patient progress and discuss regimens; and pharmacist support available 24 hours per day. WellTransitions is available at locations in Florida, Maryland and Indiana, and there are plans to roll it out throughout the United States.
CVS Caremark has some new plans for improving adherence as well. Currently, its Maintenance Choice program — which was launched in 2009 and offers patients the choice of picking up their drugs at the store or having them shipped to their homes at no increase in co-pay or payer pricing — covers 10.7 million lives under 880 plans. But during the company’s second-quarter earnings call in August 2012, president and CEO Larry Merlo discussed plans for Maintenance Choice 2.0, a version that will include less restrictive and voluntary plan design options. Maintenance Choice 2.0 is currently in pilot testing and is expected to become more widely available in January 2013.