PHARMACY

CVS Caremark releases annual insights report on drug spend

BY Antoinette Alexander

WOONSOCKET, R.I. — The increased availability of generics combined with CVS Caremark’s generic dispensing rate of 77.4% helped reduce spending on traditional medications by 3.6% for the company’s commercial clients, according to its newly released annual insights report, which reviews drug trend and highlights key issues in pharmacy care.

CVS Caremark’s GDR is the result of two elements.  First, 2012 marked a high point in the flood of generic launches, with the estimated market value of brands that lost their patents in 2012 exceeding $35 billion. 

Second, CVS Caremark worked closely with PBM clients to maximize the cost-saving opportunities posed by generics as broadly as possible, using strategies such as formulary management and step therapy plan designs to encourage the use of cost-effective generic drugs. In fact, the retailer stated that 70% of its plan sponsors use generic step therapy or are considering implementing it in the near future.

While spending for traditional medications decreased, spending on specialty medications grew by 18.1% for commercial clients, becoming the main driver of overall drug trend of 0.3%. Specialty drugs treat more complex diseases such as multiple sclerosis, rheumatoid arthritis, hepatitis C and cancer. Overall, specialty drugs now represent nearly 20% of total drug spend among CVS Caremark clients, growing by three percentage points and representing the largest increase in the past six years.

"As the generic wave begins to subside in the coming years, the impact of specialty pharmacy on client spend will only increase," stated Jon Roberts, president of CVS Caremark’s PBM business. "We know that specialty pharmacy trend is driven by the same forces – utilization, price and drug mix – a trend for more traditional drugs. Although biogenerics are not yet a factor in helping to manage costs, CVS Caremark is still able to provide a variety of solutions to help our clients effectively manage their specialty pharmacy spend while continuing to ensure access to these medications for the patients who need them."

In addition to tracking drug trends, CVS Caremark analyzed the impact of improved medication adherence for its PBM clients. "In 2012, CVS Caremark’s commercial clients benefited from cost savings of more than $643 million on their overall healthcare spend as the result of improved medication adherence for chronic conditions," added Roberts.

The adherence cost savings were calculated using the company’s Pharmacy Care Economic Model, which enables CVS Caremark to calculate the financial value of improved pharmacy care by taking a holistic approach to reviewing adherence, gaps in care and use of generic alternatives, the company stated. CVS Caremark’s pharmacy care programs such as Pharmacy Advisor are succeeding in moving a significant portion of PBM members to optimal levels of medication adherence, the company noted.  The savings calculated using the PCEM are due to medical cost avoidance, closing gaps in care, drug cost savings and productivity loss avoidance.


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Maryland state legislature shelves biosimilars legislation

BY Alaric DeArment

WASHINGTON — Legislation designed to limit the use of biosimilars has met defeat in Maryland.

The legislation, which would limit the ability of pharmacists to substitute follow-on biologics for branded biotech drugs, failed to go forward in the state legislature. Last month, Virginia Gov. Bob McDonnell signed a similar bill into law, but the bill contained a sunset clause that will cause it to expire after five years, while the Florida Senate Committee on Health Policy passed a similar bill, also with a sunset clause. So far, North Dakota is the only state to pass such a bill intact.

"We applaud the Maryland state legislature for making this wise decision," Generic Pharmaceutical Association president and CEO Ralph Neas said. "After hours of testimony, members of the House were convinced that now is not the time to take action."

Similar legislation has also met rejection in the state legislatures of Arizona, Mississippi and Washington.


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Cardinal Health Foundation helps combat Rx drug abuse with Generation Rx University

BY Michael Johnsen

DUBLIN, Ohio — With the growing concern of the abuse of prescription stimulants like Adderall on college campuses, the Cardinal Health Foundation and the Ohio State University College of Pharmacy on Wednesday introduced Generation Rx University, the fourth in a series of interactive toolkits designed to help reduce the abuse of prescription drugs. 

"The average age when prescription drug abuse starts is around 21,” stated Ken Hale, assistant dean for professional and external affairs at the Ohio State University College of Pharmacy. “It’s critical that our colleges and universities do more to help prevent this potentially deadly behavior, and this new toolkit is designed to help them do that.”

According to the National Survey on Drug Use and Health, full-time college students aged 18 to 22 were twice as likely as their counterparts who were not full-time college students to have used Adderall nonmedically in the past year. And the White House Office of National Drug Control Policy reported at least one study showing that 34% of students at a large university used a prescription stimulant drug when they felt academic stress, believing that these drugs increased reading comprehension, cognition and memory.

Generation Rx University was created by college students for college students and includes discussion-based and performance-based resources intended to help deliver programs on college campuses. The collegiate-focused material includes PowerPoint presentations and scripts, facilitator notes, workbooks, handouts, and posters to help foster conversation and educate participants. The toolkit also includes a guide for creating a reality skit and encourages actors to remain in character for a question-and-answer session following a theatrical performance.

The collegiate toolkit was piloted in August at the 2012 Collegiate Prescription Drug Abuse Prevention Conference at Ohio State University in Columbus, Ohio. The two-day conference, sponsored by the Cardinal Health Foundation and other drug abuse prevention organizations, brought together 120 students, faculty and staff from 28 colleges and universities nationwide and featured panels of experts, breakout workshops and networking opportunities. 

“The Collegiate Prescription Drug Abuse Prevention Conference at the Ohio State University generated incredible awareness and enthusiasm to tackle this issue,” commented Dianne Radigan, director community relations Cardinal Health. “We’re pleased to be able to support schools that are pioneering a concerted effort to prevent prescription drug abuse, and we look forward to collaborating with them again in 2013 to celebrate the results of their work and share best practices.”

Cardinal Health has again collaborated with the American Pharmacists Association Academy of Student Pharmacists to promote Generation Rx University. Since 2010, the organizations have worked together to provide a comprehensive education program to aid pharmacists and student pharmacists in educating their communities about the dangers of prescription drug abuse. 

Generation Rx University can be found at cardinalhealth.com/generationrx. The original Generation Rx toolkit, a second toolkit aimed at youth, and another aimed at helping seniors prevent medication misuse can also be found on the site.


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