PHARMACY

CVS Caremark research identifies optimal elements of effective VBID plans

BY Antoinette Alexander

WOONSOCKET, R.I. — New research conducted by CVS Caremark and Brigham and Women’s Hospital identifies five key features of Value-Based Insurance Design plans that are associated with the greatest impact on medication adherence.

The study, which is published online Thursday in Health Affairs and also will appear in the journal’s March issue, was funded by a grant from the Robert Wood Johnson Foundation’s Changes in Health Care Financing and Organization Initiative.

A variety of pharmacy benefit structures — including copayments, co-insurance and deductibles — help payers contain healthcare spending by encouraging patients to actively consider and bear the cost of prescription medications. VBID plans take a different approach by reducing the cost to the patient for medications that offer higher clinical benefit with the intent that increased medication use would improve health outcomes and reduce overall healthcare spending. For example, patients in a VBID plan who have a chronic disease, such as high blood pressure, may have their out-of-pocket costs (e.g., copay) significantly reduced or eliminated for essential medications to treat their condition.

"For the first time, this research offers high-quality, empirical data on the VBID plan features that appear most effective for stimulating greater medication adherence," said Niteesh Choudhry, associate physician in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital, associate professor at Harvard Medical School and the lead author of the study. "The results show that several specific features can improve adherence from between two to five percentage points, and this information can help influence how future co-payment reduction plans are structured for optimal benefit."

The researchers evaluated 76 VBID plans provided by CVS Caremark to 33 plan sponsors and involving more than 274,000 patients. Based on the analysis, five key features were found to have a greater impact on adherence. These included:

  • More generous VBID plans (e.g., those plans that had no cost-sharing for generic drugs and low monthly copayments of < or = $10 or co-insurance rates of < or = $15 for brand-name medications);
  • Plans that targeted high-risk patients;
  • Plans that had concurrent wellness programs;
  • Plans that did not have concurrent disease management programs; and
  • Plans that made the benefit available only by mail order, offering 90-day prescriptions.

"VBID plans have been popular with employers and health plans as a way to use financial incentives and other methods to encourage medication adherence, improve health outcomes and reduce overall healthcare costs," said William H. Shrank, SVP and chief scientific officer of CVS Caremark and a study co-author. "In order to optimize the benefits of VBID plans, these findings encourage more generous coverage for generics, greater use of 90-day prescriptions, more careful intervention targeting and expansion of wellness programs, all of which are active initiatives at CVS Caremark."

CVS Caremark is focused on developing programs to help improve medication adherence. The study described here helps improve the industry’s overall understanding of medication adherence and enables CVS Caremark to develop more targeted, measureable programs to address the underlying behaviors that contribute to nonadherence.

CVS Caremark plans to use these research results, along with other key information, to identify, develop and pilot interventions that will help improve medication adherence for patients. The company is currently evaluating and piloting a number of interventions ranging from model development and prediction of adherence behavior to the use of medication reminder devices to help combat forgetfulness and improved labeling to address health literacy difficulties to digital interventions that engage patients to encourage adherence.

CVS Caremark has been supporting a multi-year research collaboration with Brigham and Women’s Hospital to better understand patient behavior, particularly around medication adherence. Annual excess healthcare costs due to medication nonadherence in the United States have been estimated to be as much as $290 billion.

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Rite Aid names winners of 2013 Favorite Pharmacy Team Member contest

BY Michael Johnsen

CAMP HILL, Pa. — Rite Aid on Wednesday named the two winners of the 2013 Favorite Pharmacy Team Member contest — a pharmacy cashier from Cliffside Park, N.J., and a loyal customer of the company’s store in Mansfield, Mass. Both were selected at random from more than 14,000 entries in the 10th annual contest honoring Rite Aid’s pharmacy team members for their commitment to customer care and service.

To enter, customers submitted mail-in nominations, in-store forms and online ballots during American Pharmacists Month in October. The names of one customer and one pharmacy team member were each randomly drawn to receive $2,500 in Rite Aid gift cards. And every nominated "favorite" pharmacy team member receives an official pin and letter of commendation from John Standley, Rite Aid chairman and CEO, and Robert Thompson, Rite Aid EVP pharmacy.

"Each year, the number of ‘favorite’ pharmacy associates nominated continues to grow and that’s a true testament to the top-notch care our teams are providing to their customers," stated Dan Miller, Rite Aid SVP pharmacy operations. "I’d like to congratulate and thank all of our pharmacy associates for their continued service to our customers and for helping us deliver on our mission of improving the health and wellness of our communities by providing our customers with the best products, services and advice."

Rite Aid’s winning Pharmacy Team Member is Jacqueline Vargas Pagan, a pharmacy cashier for more than 10 years at the store in Cliffside Park, N.J. Pagan was nominated for being considerate, patient and thorough in recognizing customer needs and explaining insurance concerns.  

"I was elated to see Jacqueline receive this award," commented Jayshree Patel, Rite Aid pharmacy district manager. "Jacqueline is very personable with our customers, which in turn makes them feel welcome each time they visit our store. She makes a point to get to know each shopper by name and what they need to provide optimal customer care."

Rite Aid’s winning customer, meanwhile, is James Walsh, a retired accountant who has been a customer of the Mansfield Rite Aid "forever." Due to the excellent customer service he receives, Walsh enjoys frequently visiting Rite Aid’s pharmacists and store manager, Bill Pereira.

"I was very excited to find out I had won this contest," said Walsh. "Over the years, I have found Rite Aid’s customer service to be more respectful and considerate than other drug stores."

 

 

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Janssen Biotech: Second indication won for cancer drug Imbruvica

BY Michael Johnsen

HORSHAM, Pa. — Janssen Biotech on Wednesday announced the Food and Drug Administration has approved Imbruvica (ibrutinib) capsules for the treatment of patients with chronic lymphocytic leukemia who have received at least one prior therapy. Imbruvica was first approved in November 2013 for the treatment of patients with mantle cell lymphoma who have received at least one prior therapy. Both indications are based on an overall response rate. An improvement in survival or disease-related symptoms has not been established.

Imbruvica is the first once-daily, single-agent, oral Bruton’s tyrosine kinase inhibitor for patients with CLL who have received one prior therapy and is being jointly developed and commercialized by Janssen and Pharmacyclics. Both indications were granted priority review and were approved under the FDA’s accelerated approval program; in addition, Imbruvica is one of the first medicines with the FDA’s Breakthrough Therapy Designation to receive U.S. approval.

According to the American Cancer Society, CLL accounts for about one-third of all new cases of leukemia.

CLL is a slow-growing blood cancer of white blood cells called lymphocytes, most commonly B cells. CLL is an orphan disease (which is defined as a disease impacting fewer than 200,000 Americans3) and is primarily diagnosed in those over 70 years old. In the U.S., an estimated 16,000 people are diagnosed with CLL each year and it is estimated that nearly 4,600 will unfortunately die due to this disease. The U.S. prevalence of CLL is approximately 114,500 people.

"CLL is a challenging disease and many physicians switch their patients from therapy to therapy as their disease relapses. There has been a significant need for new alternatives for these patients," stated John Byrd, director, Division of Hematology, The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital & Richard J. Solove Research Institute and lead investigator for pivotal CLL trial PCYC-1102-CA.+  

"The speed at which we were able to bring Imbruvica to this point epitomizes the sense of urgency that drives oncology drug developers to bring important new medicines to patients in need," commented Craig Tendler, VP Late-stage development and global medical affairs for oncology, Janssen. "We’re delighted and proud of today’s approval, because it represents our commitment to making a difference for patients. We appreciate the ongoing collaboration between the companies and the FDA, which made this possible."

Five specialty pharmacies have been authorized to dispense Imbruvica, including Avella Specialty Pharmacy, Biologics, Diplomat Specialty Pharmacy, Onco360 and Total Life Care.  

“Relapsed or refractory chronic lymphocytic leukemia can be challenging to treat and therapy options currently available are not ideal for all patients,” noted Gary Rice, VP clinical services at Diplomat. “Imbruvica … represents a major achievement in drug development and an important option for patients with this disease.”

“It is truly exciting to hear of such promising potential in a drug that could improve the lives of so many individuals,” stated Leslie Yendro, VP business development of Avella. “Along with providing access to Imbruvica, Avella provides comprehensive support and education to patients that receive this therapy.”

 

 

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