PHARMACY

‘Pharmacy home’ can help organize medication management

BY Antoinette Alexander

WOONSOCKET, R.I. — The healthcare system needs to find ways to help patients with such complex therapies as chronic heart disease to simplify and centralize their medication management and create a "pharmacy home" to improve medication adherence, according to a new study conducted by researchers from Harvard Medical School, Brigham and Women’s Hospital and CVS Caremark.

Why is this important? Because, according to researchers, patients with chronic heart disease are likely to have multiple doctors and take nearly a dozen medications that are filled in at least two different pharmacies. This results in many patients struggling to keep their medications straight.

The study, published Monday in the Archives of Internal Medicine, concluded that the healthcare system needs to find ways to help patients simplify, synchronize, centralize and organize their medication management. Among the potential solutions: Create a "pharmacy home" to coordinate pharmacy care from a single point of contact. "Consolidating prescriptions in a single ‘pharmacy home’ may help improve healthcare quality similar to the intended effects of a patient-centered medical home," researchers stated.

In addition, the researchers said there is a need to synchronize medication regimens for patients because "those who make numerous trips to the pharmacy to pick up their medications, or fill prescriptions at different pharmacies, may have difficulty taking their medications as prescribed."

"Some people might look at these results and say it is not surprising that patients who have multiple doctors and take medications purchased from multiple pharmacies are less likely to be adherent," stated Larry Merlo, president and COO of CVS Caremark. "But these findings show that the healthcare system needs to do a much better job helping these patients consolidate and manage their pharmacy care if we are intent on improving their health outcomes."

The study reviewed pharmacy claims from the CVS Caremark PBM book of business for 1.83 million patients taking statins, and 1.48 million patients taking angiotensen converting enzyme inhibitors (ACE inhibitors) or rennin angiotensen receptor blockers (ARBs) between June 1, 2006, and May 30, 2007. According to CVS Caremark, the researchers selected these medicines for review because they are the most widely sold medications for the treatment of cardiovascular disease, which is the condition that imposes the greatest clinical and economic burden in the United States and abroad. During a three-month period, patients filled prescriptions for an average of 11 medications representing an average of six different drug classes, according to researchers.

"More striking, during this 90-day time frame, 10% of these patients filled prescriptions for 23 or more medications … and 11 or more different drug classes, had prescriptions written by four or more prescribers, filled these prescriptions at two pharmacies and made 11 or more visits to those pharmacies," researchers stated.

Among solutions discussed in the study:

  • Creating a centralized pharmacy home, which is similar to the concept of a medical home, where a patient’s pharmacy care is evaluated and renewals and refills are better synchronized and managed. This could include providing financial incentives for patients to fill prescriptions at a single pharmacy so that a single healthcare professional has a full view of the patient’s needs and care;

  • Encouraging programs that reduce complexity of both filling and taking medications by streamlining the number of trips it takes to fill patients’ prescriptions through such programs as 90-day versus 30-day prescriptions and coordination through mail-order pharmacies; and

  • Experimenting with programs and technologies that may make it easier for patients to better organize their medications.

The study is the work of CVS Caremark’s previously announced three-year collaboration with Harvard University and Brigham and Women’s Hospital to research pharmacy claims data to better understand patient behavior around medication adherence.

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PHARMACY

Sanofi, Genzyme get closer to deal

BY Alaric DeArment

CAMBRIDGE, Mass. — It appears that French drug maker Sanofi-Aventis’ efforts to acquire U.S. biotech company Genzyme are getting somewhere, according to company and media reports.

Genzyme said Monday that talks about the acquisition would involve executives from both companies. Sanofi originally voiced its intent to buy Genzyme for $18.5 billion in late July, or about $69 per share. Now, according to The Wall Street Journal, the purchase price may be increased to $80 per share, including a contingent value right, which buyers and sellers might use when they can’t reach a price agreement; Bloomberg reported that the CVR could be worth $5 to $6 per share.

In this case, the CVR would be based on whether or not Genzyme can secure approval of the drug Campath (alemtuzumab) as a treatment for multiple sclerosis. The drug currently is approved to treat leukemia, but according to reports, it may achieve sales of more than $3 billion by 2017 if it wins the approval.

Genzyme had rejected Sanofi’s previous acquisition offers, saying the latter undervalued the former, which in recent years has been troubled by contamination problems at its manufacturing plant in Cambridge. Genzyme specializes in treatments for rare genetic diseases, such as the Fabry disease treatment Fabrazyme (agalsidase beta) and the Pompe disease treatment Myozyme (alglucosidase alfa).

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Aurora appoints Gail Hanson as SVP, CFO

BY Alaric DeArment

MILWAUKEE — Aurora Health Care has appointed a Wisconsin state official as its SVP and CFO.

The nonprofit health system, which runs Aurora Health Care Pharmacy in Wisconsin, announced the appointment of Gail Hanson to the two positions, replacing David Eager, who will continue with Aurora’s finance group under Hanson’s leadership.

Hanson previously served as deputy executive director of the State of Wisconsin Investment Board since 2004, being in charge of accounting, governance and general management functions. The SWIB manages the assets of the Wisconsin Retirement System, the State Investment Fund and other state trust funds, with a total of more than $78 billion in assets as of 2009, according to the organization’s website.

“We in health care are facing a time of many complex financial challenges and opportunities brought about by federal and state reform, the down economy, the competitive landscape and declining reimbursement,” Aurora Health Care president and CEO Nick Turkal said. “Gail’s strong record of financial leadership in the public and private sectors and her strategic capabilities will put Aurora in a position to capitalize on the opportunities ahead of us.”

From 1999 to 2004, Hanson was SVP, treasurer and CFO for Cobalt, a Milwaukee-based health insurer that grew out of Blue Cross Blue Shield United of Wisconsin and since has changed its name to Anthem Blue Cross Blue Shield.

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