Acro, Armada host third annual Regional Payer/Managed Care Symposium
PHILADELPHIA Acro Pharmaceutical Services, in conjunction with Armada Health Care, hosted the third Annual Regional Payer/Managed Care Symposiumm here on Dec. 11 at the Hyatt Regency-Penn’s Landing.
Anchored by an in-depth panel discussion with representatives from top national and regional payer organizations — including, Aetna Specialty Pharmacy, Amerigroup, Health Partners of Philadelphia, Independence Blue Cross/Future Scripts, Johns Hopkins Health Plan, Passport Health Plan and Perform Rx — the event also featured a dual keynote presentation from Mark Thierer, president and CEO at SXC Health Solutions, and Mark Adkison, the company’s SVP mail and specialty. Thierer and Adkison focused their remarks on healthcare reform and how integrated healthcare data can help drive compliance rates and optimize the drug spend for payer groups.
Key points from the panel discussion, which focused on management strategies for high cost specialty drugs and how health reform will likely affect managed care pharmacy utilization, included —
- Specialty pharmacies, whether in-house or outsourced to vendors, are important partners for health plans in terms of implementing formulary and utilization management
- Health plan priorities for managing specific specialty categories are based on two factors: category spending; and opportunity for category management (e.g., categories with multiple competing products present a greater opportunity)
- Payers’ specialty management perspectives can vary by lines of business (commercial vs. Medicaid vs. Medicare)o For commercial plans, employers (especially those who are self-funded) drive benefit design decisions and the general cost control philosophy for specialty drugso For Medicaid plans, there might be constraints within the context of state regulations (states may legislate preventing implementation of formulary or utilization management in select therapeutic areas)o For Medicare plans, population dynamics (e.g., prevalent conditions in elderly population) is an important factor
- Management of specialty drugs relies on effective coordination between pharmacy and medical benefitso Ability to coordinate between these benefits may vary among plans; for some plans division between pharmacy and medical benefits might be rather artificial, while for others it is driven by benefit design
- Key specialty management strategies focus on network/distribution channels, formulary management, benefit design, as well as utilization, disease, and case managemento Regardless of what specialty management strategies are used, it is critical to maintain alignment between stakeholder incentives; any imbalance can shift utilization to more costly sites of care and/or create provider network disruptionso Payers expect greater use of formulary and utilization management techniques in the area of specialty drugs (including oncology)
- Payer experience shows that most savvy account managers serve as effective liaisons between their accounts and their corporate teams in adequately representing interests of their customers.
Sanofi-Aventis to acquire OTC maker Chattem
NEW YORK This is further substantiation that the business of over-the-counter medicines, particularly those sold in the U.S. market, is a key growth driver for pharma companies. If you weren’t convinced when Pfizer re-entered the OTC market with its acquisition of Wyeth, then you certainly should be convinced now.
Sanofi is no stranger to the business of OTC. The international pharmaceutical conglomerate generated $2 billion in OTC sales worldwide in 2009, none of which out of perhaps the largest market in nonprescription medicines, representing more than 25% of worldwide marketshare, the United States.
With the Chattem acquisition, Sanofi acquires a number of second-tier OTC brands in Gold Bond, Icy Hot, ACT, Cortizone-10, Selsun Blue and Unisom. However, that status of fielding second-tier brands won’t last long. Sanofi is expected to push its own second-generation antihistamine Allegra through the prescription-to-over-the-counter switch process very soon. Through an agreement with Barr Laboratories, a generic version of Allegra D-12 was to have launched last month, making the timing for an OTC switch paramount.
“The transaction is expected to be accretive to Sanofi-Aventis’ earnings as early as year one,” the company stated in making the announcement. “This acquisition will allow Sanofi-Aventis to optimize and retain the full value of the Allegra switch to an OTC product.”
Another potential switch product includes NasacortAQ. That’s a corticosteroid, however, and GlaxoSmithKline was reported to have considered and abandoned switching its nasal allergy treatment, Flonase, some years ago.
Rite Aid to launch loyalty program by mid-2010
CAMP HILL, Pa. Rite Aid is poised to launch its new loyalty program, called “wellness +,” nationally by mid-2010 as the chain experiences initial positive results from its four-market test, launched in mid-October, chain executives reported during a conference call with analysts last week.
“While we’ve been in those markets for only about two months now, I’m pleased to report, our new tiered benefit customer rewards program is doing very well in test,” said Mary Sammons, Rite Aid chairman and CEO. “We expect to aggressively launch ‘wellness +’ nationally next year, and are excited about the potential it offers our business.”
In the week leading up to the conference call, almost half of all front-end sales in the four test markets were generated from customers using the “wellness +” card. “In the three markets were [prescriptions] are include [as part of] the program, 41% of scripts filled … week were for customers using the wellness+ card,” added John Standley, Rite Aid president and COO. “This level of customer usage is very impressive, given that we’re only eight weeks since the rollout, and shows good customer acceptance of the program. Besides building customer loyalty with our existing customers, ‘wellness +’ will provide its valuable customer data and help us attract new front-end and pharmacy customers.”
If you were to extrapolate initial participation across the entire Rite Aid base of stores, there would be 12 million participants within those eight weeks, noted Frank Vitrano, Rite Aid CFO and chief administrative officer, “so it’s really gotten off to a very solid start.”