CVS Caremark’s Pharmacy Advisor seeks to improve diabetes care for PBM clients
WOONSOCKET, R.I. CVS Caremark has launched a new program, Pharmacy Advisor, which is aimed at strengthening pharmacy care for diabetes patients by improving member engagement through enhanced interactions with their pharmacists.
The program is being offered to the company’s PBM clients for implementation in 2011 based on positive results from a recently completed pilot. In addition to improvements in medication adherence rates and closing gaps in care, preliminary data also suggested the program can save employers on their healthcare-benefit costs, with an estimated annual savings of nearly $600 per member with diabetes. In general, a client with 50,000 employees — whose population has an average prevalence of diabetes — could save approximately $3.3 million a year, or up to $6 million a year if there is a high prevalence of the disease, the company stated.
The six-month pilot of the Pharmacy Advisor program was conducted in partnership with a large global steel company in which participating members with diabetes achieved significant improvements in closing gaps in care and medication adherence rates. The pilot program used a multi-step process to identify and counsel members about gaps in care and adherence issues. Results demonstrated that this process closed a significantly higher number of gaps in care compared with a control group who were not counseled (58% and 90% higher for phone and face-to-face counseling, respectively). In addition, members receiving counseling were more likely to be adherent in every targeted medication class.
“Diabetes is one of the most prevalent and expensive chronic diseases in the nation, costing the U.S. an estimated $174 billion a year,” stated Troyen Brennan, chief medical officer of CVS Caremark. “The Pharmacy Advisor program improves clinical care because we are able to identify and address pharmacy-related care issues that if left unattended could result in disease progression and increased health care costs. We are also better able to engage the member in their care through multiple contact points, providing counsel that can improve adherence and help members optimize their pharmacy benefit and find the most cost effective options.”
The Pharmacy Advisor program integrates the benefits of the PBM and the retail pharmacy to improve pharmacy care. The program applies health-information technology to identify members who are being treated for diabetes and engages them with targeted counseling and support through the channels they choose. Member outreach includes educational information, pharmacist-initiated phone calls, or face-to-face counseling with a pharmacist at a local CVS/pharmacy. In addition, evidence-based protocols are applied to review the member’s current treatment and determine if there are gaps in care or issues with medication adherence. Members are also presented with options and solutions to enable them to get the most out of their pharmacy benefit and identify opportunities for cost savings.
The company plans to expand Pharmacy Advisor program offerings to include other chronic diseases and types of interventions in the near future.
Genentech, Evotec to collaborate on drug development
HAMBURG, Germany U.S. biotechnology company Genentech and German drug maker Evotec hope to develop drugs using Evotec’s drug-discovery platform under a collaboration announced Monday.
Evotec will use its platform combined with its disease biology background to develop drugs for diseases nominated by Genentech. Evotec develops drugs for pain, cancer, inflammation and neurological conditions. Financial terms of the deal were not disclosed.
“We are proud that Genentech, one of the premier biopharmaceutical companies worldwide, has selected Evotec’s scientists and innovative drug-discovery platform to support their research efforts,” Evotec CEO Werner Lanthaler said in a statement. “We look forward to working closely with Genentech’s scientists and achieving success together.”
Study: Retail clinics save nonemergency patients money
INDIANAPOLIS Allergy sufferers can save money and receive quality, convenient care by skipping the emergency room and instead visiting a retail-based or urgent-care clinic, according to a recent study.
The study conducted by HealthCore, WellPoint’s outcomes research subsidiary, found that patients can save anywhere from $50 to $400 in out-of-pocket costs per visit by skipping the ER and heading to a retail health- or urgent-care clinic when they are unable to see their primary care physician.
“When possible, we recommend that our members visit their primary care physicians for non-emergency treatment,” stated Dr. Manish Oza, WellPoint medical director and emergency room physician. “If that’s not an option, in cases where patients are looking for treatments related to allergies and colds — such as sinus infections, sore throats, ear infections and bronchitis — it just makes more economic sense to go to a retail health clinic or urgent-care clinic.”
In addition, the study found that few patients who received care at retail health clinics or urgent-care clinics needed follow-up care for their ailment, implying that they received the appropriate level of care, stated John Barron, HealthCore director for health-plan research.
The study of members in WellPoint’s affiliated health plans in 14 states found that nearly 1-in-5 ER visits (19.4%) were for non-emergencies, including conditions such as upper respiratory infections, sore throats or urinary tract infections. This is during a time when ER visits have increased 31% in 2005 compared with 1995, and ER waits to see a physician have increased from 38 minutes in 1997 to 56 minutes in 2005, according to federal government statistics provided by WellPoint.
Bronchitis, one of the more expensive conditions to treat, cost $646 to treat in the ER, compared with $97 for an urgent-care visit and $54 for a retail health-clinic visit, according to the study. Average costs for ER visits for all conditions studied ranged from $441 for the ER to $98 for urgent care and $52 for retail care. These costs represent total costs, including the portion paid by the health plan member.
The study showed that for every member treated at retail health clinics, about 15 others are treated in the ER for the same conditions.
The study also looked at overall costs to treat individual episodes over a two-week period for ailments associated with allergy, cold and flu, along with conjunctivitis and urinary tract infections. In this case, ER episodes cost an average $500, while urgent care cost $150 and retail health clinic cost $90.