PHARMACY

CVS Caremark study: Pharmacy Advisor improved diabetes Rx initiation, adherence rates

BY Antoinette Alexander

WOONSOCKET, R.I. — A CVS Caremark study found that the company’s integrated pharmacy-based program — Pharmacy Advisor — increased medication adherence rates and physician initiation of prescriptions for concomitant medications, improving care for diabetes patients and resulting in savings for health plans, the company announced on Monday.

Pharmacy Advisor promotes interactions between diabetes patients and pharmacists, either in face-to-face counseling or on the phone. The study entitled, "An Integrated Pharmacy-Based Program Improved Medication Prescription and Adherence Rates in Diabetes Patients," was published Monday in the January issue of Health Affairs and highlighted the central role pharmacists can play in improving the health of their patients.

"Ensuring adherence and appropriate treatment has long been the domain of primary care providers," stated Troyen A. Brennan, EVP and chief medical officer of CVS Caremark, and lead author for the study. "However, as demands on the time of these providers increase, interventions carried out by pharmacists can complement primary care. Indeed, pharmacists are in the unique position to monitor patient adherence and effectively intervene when indicated." 

Brennan said the study also added insight into the problem of time-limited healthcare interventions. "This study showed that patients stay on their medications while they are actively counseled, but once those pharmacist-patient conversations ended, adherence fell quickly. We need to continue these kinds of interventions to make sure patients benefit from the full beneficial impact of their medications.”

Researchers from Harvard University and Brigham and Women’s Hospital assisted the CVS Caremark researchers in the analysis of the pharmacy claims data of benefit members at a large Midwest manufacturing company and focused on interventions with diabetic patients between October 2009 and April 2010. The study included an intervention group of 5,123 people who were proactively counseled by retail and call center pharmacists and a control group of 24,124 patients with diabetes who did not receive specialized counseling. The researchers measured gains in patient adherence and medication initiation rates of concomitant therapies for diabetes, such as statins, angiotensen converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs).

The research showed that contacts by pharmacists with the patients and their doctors increased therapy initiation rates by as much as 39% for the full sample and an even higher 68% for the group counseled at retail stores, and increased medication adherence rates by 2.1%. The researchers noted that face-to-face interventions by retail store pharmacists resulted in increasing adherence rates by 3.9%.

The integrated pharmacy-based program featured counseling by pharmacists at 12 retail stores near the manufacturing client’s headquarters, and counseling through a pharmacist call center for those identified as having diabetes. CVS Caremark launched Pharmacy Advisor for diabetes in 2009 because the cost and prevalence of that disease continues to rise. The American Diabetes Association estimates the cost of the disease to the U.S. in 2007 at $174 billion.

The study estimated that the employer saved more than $600,000 through healthcare cost avoidance with the intervention group, while expenditures for the counseling totaled $200,000, a return on investment of $3 for every $1 spent on additional counseling. "In a healthcare system eagerly seeking programs that can reduce costs and improve care, such simple, pharmacist-based counseling programs to improve adherence to existing medication regimens and initiate missing therapies should be of great value," the researchers concluded.

The Pharmacy Advisor program is being expanded in 2012 to include counseling for patients with cardiovascular disease, in addition to the more than 12 million members who are part of the diabetes-focused counseling.


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Diplomat gains distribution rights for Eylea

BY Allison Cerra

FLINT, Mich. — Diplomat Specialty Pharmacy has received limited distribution rights for a neovascular age-related macular degeneration treatment.

The specialty pharmacy chain said it has received distribution of Eylea (aflibercept) injection from Regeneron Pharmaceuticals, the drug’s manufacturer. Macular degeneration is diagnosed as either nonvascular (dry) or vascular (wet) and is a leading cause of blindness in older adults. The vascular AMD usually leads to more serious vision loss, Diplomat said.

"Eylea represents an important new therapy in the treatment of AMD," Diplomat president and CEO Phil Hagerman said. "AMD is becoming more and more prevalent in Americans 60 years of age and older; Diplomat looks forward to providing services to help treat this growing population of patients to slow the progression of this disease."


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CVS Caremark looks to purchase Health Net’s stand-alone Medicare Part D Rx drug plan business

BY Antoinette Alexander

LOS ANGELES and WOONSOCKET, R.I. — CVS Caremark has entered into a definitive agreement to purchase the stand-alone Medicare Part D prescription drug plan business from Health Net for approximately $160 million in cash.

The transaction is anticipated to close in the second quarter of 2012, subject to customary closing conditions and applicable regulatory approvals, including approval from the Centers for Medicare and Medicaid Services.

According to CVS Caremark, the acquisition will add approximately 400,000 members to CVS Caremark’s Medicare Part D program, which served more than 3.4 million members in 2011.

“This acquisition furthers CVS Caremark’s position as a leader in Medicare Part D, one of the fastest growing segments of the PBM industry,” CVS Caremark stated in a statement sent to Drug Store News.

Health Net stated that it expects to realize approximately $140 million in net cash proceeds from the transaction, after the effect of freed-up capital, taxes and transaction- and transition-related costs.

Health Net will continue to provide prescription drug plans as part of its Medicare Advantage plan offerings.

“We believe this proposed transaction is in the best interests of our Medicare PDP members and our stockholders,” stated Jay Gellert, president and CEO of Health Net. “Our Medicare PDP members, who have received certain services from CVS Caremark for five years, will now be affiliated with one of the nation’s largest Medicare PDP sponsors.

“Given our ongoing relationship with CVS Caremark, we are confident that the transition of members will proceed smoothly with no disruption in services,” Gellert added.


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