Study finds widespread disparities in medication use
LEBANON, N.H. — Medicare beneficiaries’ use of medications — both effective and risky — varies widely across different regions of the United States, according to a new report.
The report, conducted by researchers at Dartmouth College as part of the Dartmouth Atlas Project, is the first report from the project on prescriptions. The researchers also found that the health status of a region’s Medicare population accounts for less than one-third of the variation in total prescription drug use, and that higher spending is not related to higher use of proven drug therapies. The study raises questions about whether practice cultures in different regions explain differences in the quality and quantity of prescription drug use.
"There is no good reason why heart attack victims living in Ogden, Utah, are twice as likely to receive medicine to lower their cholesterol and their risk of another heart attack than those in Abilene, Texas, but this inconsistency reflects the current practice of medicine in the United States," lead author and Dartmouth Institute for Health Policy and Clinical Practice professor Jeffrey Munson said.
The report examines how prescription drugs are used by patients of Medicare Part D, which had 37 million enrollees last year, dividing the country into 306 regional healthcare markets and examining variations among them in the quantity and quality of prescription drug use, spending and branded drug use. It then divides prescription use into three categories: drug therapies proven to be effective for heart attack, diabetes or broken-bone patients; discretionary medications with less clear benefits, but usefulness for some patients; and potentially harmful medications for which risks generally outweigh benefits.
"We need to learn from regions that consistently provide high-quality care and focus attention on regions that appear to offer the worst of both worlds: high-risk and discretionary medications and, in relative terms, low use of effective drug therapies," co-author and fellow Dartmouth Institute professor Nancy Morden said.
The report found disparities in how many prescriptions Medicare Part D beneficiaries filled across regions: Patients in Miami filled an average of 63 30-day prescriptions in 2010, while those in Grand Junction, Colo., filled 39. Lexington, Ky., patients filled 59, while Albuquerque, N.M., patients filled 40. The national average was 49 prescriptions.
When prescriptions were broken down based on effective, discretionary and potentially harmful drugs, the study found, for example, that 91.3% of heart attack patients in Ogden filled a prescription for a statin in the seven to 12 months after hospital discharge, compared with 44.3% in Abilene. For potentially harmful drugs, 43% of patients in Alexandria, La., received at least one high-risk medication, compared with the 14% in Rochester, Minn.
Spending on prescriptions by the Part D program averaged $2,670 per beneficiary, with a high of $4,738 in Miami and a low of $1,770 in St. Cloud, Minn. Overall, 26.3% of prescriptions were filled as branded drugs, with patients in Manhattan, 36% of whom used generics, more than twice as likely to fill a prescription with a branded drug as the 16.5% of patients in La Crosse, Wis.
Walgreens partners with Atlanta’s WellStar Health System on collaborative care linking clinic, pharmacy and hospital
MARIETTA, Ga. — WellStar Health System and Walgreens on Wednesday announced a clinical collaboration agreement that will provide coordinated and expanded healthcare services, while improving access to high-quality, convenient and affordable care for patients in the northwest Atlanta market.
“This collaboration extends quality care directly into our communities to provide greater access for patients,” stated Reynold Jennings, WellStar president & CEO. “We believe our communities will benefit from this type of collaborative model as we join forces with Walgreens to deliver more coordinated care.”
“With the healthcare system today facing a myriad of challenges, Healthcare Clinic at select Walgreens can play an important role in enhancing patient access to quality, convenient and affordable care,” commented Alan London, chief medical officer, Consumer Solutions Group, Walgreens. “Working with a highly integrated health system such as WellStar offers an ideal opportunity to further coordinate patient care in northwest Atlanta. We look forward to working together to help patients in these communities get, stay and live well.”
WellStar Urgent Care Centers and physician practices will work with Healthcare Clinic at select Walgreens to handle serious conditions outside of the clinics’ scope of practice, and to help manage the treatment of chronic diseases. The collaboration will provide WellStar patients access to quality care seven days a week.
The collaboration will include direct communication between WellStar physicians and Healthcare Clinic nurse practitioners to facilitate care coordination and sharing of patient information, as well as enhanced awareness of Healthcare Clinic at select Walgreens and WellStar services.
Deloitte to launch PopulationMiner health-analytics system
NEW YORK — Deloitte plans to launch a data-mining system next month that it said would provide life-sciences organizations more access to the "front lines" of patient care and help them develop more personalized medicines based on clinical data more quickly and at a lower cost than before.
The company announced Wednesday the upcoming launch of PopulationMiner, a real-world data-analytics system for gleaning insights and relationships among drugs and diseases across broad patient populations over time and spanning several therapeutic and clinical areas. The system will draw on a large repository of clinical, financial and operational data stored in a warehouse that supports patient-outcome analysis, owned by Intermountain Healthcare.
"With the shift toward value-based, personalized care, it’s key for life-sciences decision makers to have deep insights into complex, real-world populations," Deloitte Consulting principal and Deloitte Health Informatics general manager Brett Davis said. "PopulationMiner enables a better understanding of health and disease by supporting population stratification and advanced analytics based on disease type, stage and comorbid combinations. With a few clicks, this platform can provide an unprecedented level of nuanced insights from millions of patients, leveraging informatics and clinical expertise form Deloitte and Intermountain Healthcare."
PopulationMiner may allow for the identification of biomarkers using laboratory test results and rapid hypothesis generation and validation across a range of business functions, including drug development, drug safety, pharmacoepidemiology and health economics and outcomes research.
"PopulationMiner aims to provide organizations with an integrated comparative analytics platform so that they can discover opportunities to dramatically enhance the quality of care delivery while reducing costs," Deloitte Consulting principal Scott Kolesar said.