Health Dialog launches MTM service for health plans
BOSTON — Rite Aid's Health Dialog on Monday introduced comprehensive Medication Therapy Management services for health plans. The new MTM services combine analytics with skilled health coaching to help patients overcome barriers to proper medication use, identify medication-related problems, promote coordination of care and improve medication management success.
“The barriers to medication adherence are unique to each person,” stated Karen Staniforth, COO Health Dialog. “Our analytics leverage two decades of data and more than 1,500 data points per person to identify highly personalized interventions that address each person’s unique circumstances, attitudes, challenges and preferences," she said. "Combined with highly skilled health coaches, our formula is proven to positively impact patient outcomes, which can have a measureable impact on a health plan’s bottom line.”
In an eight-month study with its first MTM client, Health Dialog found that members who participated in one telephone coaching session vs. those who did not achieved the following:
- 20% higher rate of adherence for members on hypertension medication;
- 15% higher rate of adherence for members on diabetes medication; and
- 15% higher rate of individuals with diabetes filling at least one statin medication.
In addition to helping health plans significantly reduce the substantial cost of poor medication adherence, the new MTM services can also improve HEDIS scores and several Five-Star Quality Ratings associated with medication use and safety. HEDIS and Star Rating adherence measures have become increasingly competitive. Over the past five years, the Five-Star adherence measure cut points have increased between three and seven percentage points for Medicare Advantage Prescription Drug plans and between four and eight points for Prescription Drug Plans.
To help meet these challenges, Health Dialog’s MTM services use proprietary analytics to identify individuals who are both non-compliant to drug therapy guidelines or eligible for comprehensive medication reviews (based on CMS and health plan parameters). Significantly, Health Dialog analytics also prioritize those likely to be receptive to intervention. Once identified, the Health Dialog MTM team assesses these individuals’ medication history and identifies issues that need immediate attention. Registered nurse health coaches, pharmacists and medication specialists trained in chronic disease management, patient education and behavior change methodologies engage with individuals to recognize and resolve medication-related issues and help individuals overcome barriers.
Proposed CMS cuts to 340B will have negligible impact, Walgreens says
DEERFIELD, Ill. — Walgreens Boots Alliance met with various investors to clarify its participation in the U.S. Health Resources and Services Administration 340B drug pricing program.
For the first nine months of fiscal 2017, prescriptions related to the 340B program represented less than 1% of the Retail Pharmacy USA division’s prescription volume, Walgreens noted. The division has around 1,200 340B contracts. During the first nine months of fiscal 2017, 340B prescriptions were filled at approximately 6,100 of the division’s pharmacies.
The Centers for Medicare & Medicaid Services earlier this month proposed for calendar year 2018 to significantly cut payment of drugs purchased through the 340B drug pricing program from average sales price plus 6% to ASP minus 22.5% "to address recent trends of increasing drug prices, for which some of the cost burden falls to Medicare beneficiaries." ASP minus 22.5% is the Medicare Payment Advisory Commission’s estimate of the average minimum discount eligible hospitals received for drugs acquired under that program.
Applicable drugs not purchased under the 340B drug program would continue to receive ASP plus 6% payment, CMS noted.
"The proposal from the U.S. Centers for Medicare and Medicaid Services seeks to address how Medicare pays hospitals for drugs acquired under the 340B program, but does not propose eliminating the program altogether," Walgreens stated. "The hospital market represents slightly more than half of the Retail Pharmacy USA division’s overall 340B prescriptions. As required by law, 340B drug inventory is owned by the covered entity, not by the pharmacy."
On a pro forma basis, for the nine months ended May 31 2017, had the proposed changes to the program been in place throughout the period, the company estimates that the net impact on Retail Pharmacy USA divisional adjusted gross profit dollars would have been less than 0.5%.
Merck’s follow-on biologic Lusdana Nexvue gets tentative FDA approval
SILVER SPRING, Md. — The Food and Drug Administration has given tentative approval to Merck’s follow-on biologic basal insulin Lusdana Nexvue (insulin glargine injection), the company announced Thursday. The tentative approval notes that the drug has met the required regulatory standards, but is subject to an automatic stay, as Sanofi has claimed patent infringement on its insulin product Lantus.
“The tentative approval of Lusdana Nexvue is an important milestone, bringing us closer to offering this medicine to patients,” Merck associate VP clinical research, diabetes, endocrinology and women’s health Dr. Sam Engel said.
Under the Hatch-Waxman Act, Sanofi’s lawsuit, filed in September 2016, automatically invoked a stay on Lusdana Nexvue up to 20 months, or in the event the court finds in favor of Merck — whichever occurs first.
In 2016, Lantus was among the top 20 drugs by sales, according to QuintilesIMS, with an invoice-based spending total $3.3 billion.