Pharmacy Benefit Management Institute Recognizes Innovation in Drug Benefit Industry
Posted on: Thursday, 28 February 2008, 12:00 CST
The Pharmacy Benefit Management Institute (PBMI) has awarded its 2008 Rx Benefit Innovation Awards to MemberHealth, LLC; Office of Group Benefits (OGB), State of Louisiana with Catalyst Rx, A HealthExtras Company; and the Upper Peninsula Health Plan with the Upper Peninsula Health Care Network.
MemberHealth, LLC, a subsidiary of Universal American Corp., is being recognized for a letter-based initiative that increased HIV patient adherence to antiretroviral therapy among Medicare Part D beneficiaries. The initiative measurably improved medication possession ratios, an indicator of increased patient adherence. The Louisiana OGB and Catalyst Rx are being recognized jointly for a model physician outreach program that significantly increased prescribing and utilization of generic drugs, resulting in a three-year savings of $28 million in drug spend. Rural Michigan's Upper Peninsula Health Plan (UPHP) and the Upper Peninsula Health Care Network (UPHCN) are being recognized for implementing a regional, cooperative formulary management system. The project resulted in improved prescribing as well as cost savings for the health plan and network providers.
"Our 2008 award recipients have collaborated with drug benefit stakeholders -- physicians, pharmacists and patients themselves -- to improve the quality of the drug benefit they offer," says Dana H. Felthouse, MBA, president of PBMI. "Their efforts are truly best practices that should be emulated and adopted by others to improve prescribing and increase patient adherence."
MemberHealth administers benefits for the Medicare Part D Prescription Drug Plan, Community CCRxSM. MemberHealth used pharmacy claims data to identify HIV patients on antiretroviral therapy who had a medication possession ratio (MPR) of less than 95 percent. MemberHealth sent letters to the physicians of 1,285 members with patient-specific MPR data and encouraged them to talk with patients about compliance. Ninety days after the intervention, 46 percent of the targeted health plan members achieved an MPR greater than 95 percent.
The Prescriber Education and Intervention Program implemented by Catalyst Rx for the Louisiana OGB focuses on top prescribing physicians. A partnership approach among Catalyst Rx clinical pharmacists and physicians, use of plan-specific data to model generic drug savings potential, and ongoing prescriber education are integral elements of the program. It has contributed significantly to a 5 percent increase in OGB's generic substitution rate and a 7.2 percent increase in its generic utilization rate.
UPHP and UPHCN partnered to develop a regional pharmacy and therapeutics committee. The ongoing committee includes physician and pharmacist representation from the health plan, the health care network, and 15 network hospitals. To date, the committee has reviewed 25 drug classes, completed 24 comprehensive new drug reviews, and implemented two treatment protocols. Project partners can access the reviews and protocols on the committee's new Website. As a result of revised formularies and informed evidence-based prescribing, UPHP's per member per month drug cost decreased 21 percent from 2003 to 2006. Network hospitals saved $381,000 in drug costs in 2007.
PBMI Educates Industry
The sixth annual Rx Benefit Innovation Awards were presented today at PBMI's 13th annual Drug Benefit Conference at the Pointe Hilton Tapatio Cliffs Resort in Phoenix. Past winners include AmeriHealth Mercy/Perform Rx, Cingular Wireless, Cypress Care, Catalyst Rx, Department of Defense TRICARE Management Activity, ePocrates, Express Scripts, HR Policy Association Pharmaceutical Purchasing Coalition, Medco Health Solutions, Memorial Health System, PharmaCare and the Polk County Board of County Commissioners, Prescription Solutions, SXC Health Solutions, Inc., and University of Michigan.
More than 350 industry professionals involved in the design and administration of drug benefit programs attend the nation's premier meeting dedicated to drug benefit management. PBMI provides research, continuing education, publications and Web resources to help health care purchasers work effectively with pharmacy benefit managers and other industry professionals to improve pharmacy benefit programs and control costs. Read case studies on award winners at www.pbmi.com.
Source: Business Wire
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