Optum Study Documents Pivotal Role Specialty Pharmacy Plays in Improving Health Care Outcomes, Lowering Costs
A study published in the Journal
of Managed Care Pharmacy measures how clinical management and
adherence programs at a specialty pharmacy add value beyond what
patients experience acquiring medications at conventional retail
pharmacies.
The study, which followed for one year two groups of people enrolled in
employer-sponsored benefit plans and who had kidney transplants, found
that the specialty pharmacy program group showed consistently lower
costs and higher therapy adherence compared with those using retail
pharmacies, including a 30 percent reduction in transplant-related
medical costs and a 13 percent reduction in overall health care costs.
“This research should be of great interest to stakeholders in health
care who want to improve health outcomes and lower overall costs,” said
Kevin Host, Pharm.D, senior vice president for Specialty Pharmacy,
OptumRx. “It underscores the value of ensuring that patients have a
positive experience and receive outstanding support to help ensure
adherence.”
“We’ve seen similar outcomes in improving medication adherence and
clinical results and lowering medical service costs through our
specialty pharmacy programs in oral oncology, rheumatoid arthritis and
multiple sclerosis,” said Suzanne Tschida, Pharm.D, BCPS, lead author
for the study and vice president, Specialty Benefit & Outcomes Strategy,
OptumRx. “We have found that, by delivering a simpler, more personalized
and convenient member experience, we empower members to manage their
medications and take ownership of their conditions.”
The study authors noted that medication adherence or compliance –
defined as the extent to which patients take their medications as
instructed by a physician – is a well-recognized problem in transplant
medicine, and concrete solutions are hard to find. Based on available
literature on the topic, the study authors found between 20 percent and
70 percent of patients who have received an organ transplant do not
adhere to therapy – the rate varying with definitions of adherence
measures and study populations. Moreover, the rate of nonadherence is
highest at one to three years post-transplant, but it may happen at any
point during lifelong therapy.
Study Design
The study matched
one group of 519 people enrolled in an employer-sponsored benefit plan
who filled at least 80 percent of their renal transplant
immunosuppressant medication prescriptions at the specialty pharmacy in
its specialty program, with another group of 519 plan participants who
filled at least 80 percent at retail pharmacies.
The study was a one-year retrospective claims analysis after the
implementation of a transplant specialty pharmacy program that, in
addition to medication dispensing, includes adherence and clinical
management programs, member education, and counseling services provided
by specialty pharmacists trained in transplant pharmacology.
Primary outcomes included pharmacy medication costs, medical inpatient
and outpatient costs and overall health care costs. Patient adherence to
transplant medication therapy and health care resource utilization was
also evaluated. One-year outcomes post-specialty pharmacy program
implementation were compared between the two groups with t-tests for
continuous variables and chi-square tests for nominal variables. Results
included:
-
13 percent lower total mean cost during the first follow-up year –
$24,315 vs. $27,891 (P=0.03)
-
30 percent lower transplant-related medical costs – $5,960 vs. $8,486
(P=0.04)
-
More transplant-related prescriptions dispensed – 18.67 vs. 17.90
(P<0.05)
-
A higher weighted medication possession ratio – 0.87 vs. 0.83 (P=<
0.001).
About OptumRx
OptumRx is part of Optum, a leading
information and technology-enabled health services company dedicated to
making the health system work better for everyone. OptumRx is an
innovative pharmacy benefit management business managing the
prescription drug benefits of commercial, Medicare and other
governmental health plans, as well as those of employers and unions
through a national network of 66,000 community pharmacies and
state-of-the-art mail service pharmacies in California and Kansas, both
of which have earned the prestigious Verified Internet Pharmacy Practice
Sites™ (VIPPS®) accreditation by the National Association of Boards of
Pharmacy®. Visit www.optum.com
for more information.
About Optum
Optum (www.optum.com)
is a leading information and technology-enabled health services business
dedicated to helping make the health system work better for everyone.
Optum comprises three companies – OptumHealth, OptumInsight and OptumRx
– representing more than 35,000 employees worldwide who collaborate to
deliver integrated, intelligent solutions that work to modernize the
health system and improve overall population health.
Click
here to subscribe to Mobile Alerts for UnitedHealth Group.
![](http://cts.businesswire.com/ct/CT?id=bwnews&sty=20130627005180r1&sid=ntxv4&distro=nx)
Copyright Business Wire 2013