Here is a quickie from the St. Louis Post Dispatch. It seems to be an interview with the Chief Scientist from Express Scripts, however it is just a series of questions and answers without any reference text. I do think these are interesting questions though, and really makes me think about mail order pharmacies.
Why aren't you doing it? The costs are reduced for 90 day supplies. It makes perfect sense to me, since I am on two maintenance medications, yet I still have not done it - why? I do not really know. I printed out the form, and then it sat on my desk for a week. I think I took it home, then it was put in a drawer and lost it. We have since changed health plans, so maybe I will look into it again.
Enjoy the Q and A:
Can you give a brief explanation of Express Scripts' Center for Cost-Effective Consumerism?
The center brings together leading experts in behavioral economics to gain an advanced understanding of human behavior applied to health care. The center uses this information to help bring about positive health behavior change one consumer at a time. Right now, we're focused on procrastination as one major obstacle to better behavior.
One of the center's recent studies found patients were more likely to take medications as directed when they received those medications through the mail. Can you discuss these findings?
The study found that medication compliance was about 8 percentage points higher at home delivery than retail in key therapy classes: diabetes, high cholesterol and high blood pressure. The study involved more than 70,000 patients followed for nine months, and the design was such that we are confident that the difference in therapy adherence was due directly to home delivery.
Do you know any reasons why patients receiving drugs through mail order are more compliant?
There are at least two issues. First, it's clear that some of the noncompliance is due to procrastination when it comes to getting refills. This leads to gaps in compliance because patients wind up not having their medications. Because home delivery offers 90-day supplies, there are fewer refills needed and thus fewer gaps.
Second, our data show that patients in home delivery are far more engaged; they call us more often, log in to our website more often and increasingly view us as a trusted partner. This helps us communicate more effectively with them about their care.
Why don't more patients choose mail order?
Based on our work with the center's advisory board, we think it's more about procrastination than an active decision not to use home delivery.
In the past, moving to home delivery meant filling out forms, calling the doctor for a new prescription written for 90-day fills, etc. Express Scripts has new programs that take almost all of that work off patients' shoulders, so we expect a lot more of them to take advantage of home delivery going forward.
What should employers and other health insurer purchasers do if they want to encourage their employees or members to use mail order?
Clearly, financial incentives are not enough to drive members to home delivery. In addition to making sure patients save money on their co-payments at mail, employers and insurers should work with a PBM partner that can address the issue of procrastination and communicate effectively with patients.
Showing posts with label Mail-order. Show all posts
Showing posts with label Mail-order. Show all posts
Wednesday, September 24, 2008
Thursday, September 18, 2008
Express Scripts Studies Show Home Delivery Improves Medication Adherence and Generic Sales
Two studies released from by Express Scripts show that home delivery 1) improves patient medication adherence, and 2) increases generic sales. Good for pharmacos for Express Scripts to increase adherence, however bad for pharmacos when Express Scripts wants to increase generic traffic. Good for patients, providers, and payors all around.
It is kind of a duh! revelation when you think that improving access to medication, as well as medication possession will also increase medication adherence. I mean if I have a 90 day supply sent to me at home, I will more likely take my meds on day 32 than I will if I have a 30 day script and need to refill it at my local pharmacy.
The method of introducing the generic was by a letter, another duh! revelation that by increasing patient knowledge of the generic, you increase patient acceptance and uptake. Six months ago my formulary changed and one of my scripts went up to a $75 co-pay. I asked if there was a generic and had my doc prescribe that instead. No one told me of the generic, but if I had been informed, I would have chosen it and lowered my costs earlier. It wasn’t until I was presented with a bill 3x of what I normally paid, that I asked – actually it took two refills to understand the increase, as my wife picked up the first refill and no one told her of the increase.
From MarketWatch
“In one study, compliance, or taking a medication as prescribed by your doctor, was nearly eight percentage points higher for home delivery pharmacy patients taking medications to treat high blood pressure. These patients were 78.6 percent compliant, but those using a retail pharmacy were 70.8 percent compliant.”
“….Cox explained that in addition to cost savings, home delivery promotes better medication compliance through patient communications such as refill reminders by phone or email, renewal assistance, a convenient reorder process, and less frequent re-ordering.”
“In the second study, a letter alerting patients to the availability of a generic alternative, the likelihood of choosing generics in home delivery was 34% greater compared to the impact in retail. The letters were sent following the introduction of generic Ambien(R) (zolpidem) in 2007.”
“Express Scripts estimates that use of generic sleeping aids will increase to 70 percent of all sleeping aid prescriptions in 2008. However, even that increase will not capture the $1.5 billion in additional savings available nationwide for commercial and government-paid plans from realizing the category's full generic potential of 95 percent.”
“The Center was inspired by research showing that a targeted communications program implemented around the 2006 introduction of generic Zocor (simvastatin) was nearly two to three times more effective than financial incentives alone. The greatest impact came among consumers using the company's home delivery pharmacy. The campaign generated over a billion dollars in savings for Express Scripts' pharmacy benefit plan sponsors and consumers.”
MY COMMENTS
8% is a fair amount in the adherence game. Congrats Express Scripts. Also in saving BILLIONS of dollars for their clients, Express Scripts should be commended. And an increase of 34% in generics from home delivery v. retail is outstanding.
At HealthCampDC, we had a short discussion about generics v. brands. The public does not actually know generic names, just the brand. “Oh, give me the generic of Zocor” not “I want simvastatin”. It is up to doctors, PBMs, and pharmacies to alert the patients as to what exists in the generic market to lower health care costs.
I wish two of my meds had generic equivalents, as they are $40 a month – not that this is so much, but it adds up, plus my wife’s scripts, plus our son’s script, and doctors’ bills and specialists. It was so much easier and inexpensive when I was single and did not go to the doctor. I can only imagine what the downturn in the economy is going to do to the average family and their healthcare costs.
It is kind of a duh! revelation when you think that improving access to medication, as well as medication possession will also increase medication adherence. I mean if I have a 90 day supply sent to me at home, I will more likely take my meds on day 32 than I will if I have a 30 day script and need to refill it at my local pharmacy.
The method of introducing the generic was by a letter, another duh! revelation that by increasing patient knowledge of the generic, you increase patient acceptance and uptake. Six months ago my formulary changed and one of my scripts went up to a $75 co-pay. I asked if there was a generic and had my doc prescribe that instead. No one told me of the generic, but if I had been informed, I would have chosen it and lowered my costs earlier. It wasn’t until I was presented with a bill 3x of what I normally paid, that I asked – actually it took two refills to understand the increase, as my wife picked up the first refill and no one told her of the increase.
From MarketWatch
“In one study, compliance, or taking a medication as prescribed by your doctor, was nearly eight percentage points higher for home delivery pharmacy patients taking medications to treat high blood pressure. These patients were 78.6 percent compliant, but those using a retail pharmacy were 70.8 percent compliant.”
“….Cox explained that in addition to cost savings, home delivery promotes better medication compliance through patient communications such as refill reminders by phone or email, renewal assistance, a convenient reorder process, and less frequent re-ordering.”
“In the second study, a letter alerting patients to the availability of a generic alternative, the likelihood of choosing generics in home delivery was 34% greater compared to the impact in retail. The letters were sent following the introduction of generic Ambien(R) (zolpidem) in 2007.”
“Express Scripts estimates that use of generic sleeping aids will increase to 70 percent of all sleeping aid prescriptions in 2008. However, even that increase will not capture the $1.5 billion in additional savings available nationwide for commercial and government-paid plans from realizing the category's full generic potential of 95 percent.”
“The Center was inspired by research showing that a targeted communications program implemented around the 2006 introduction of generic Zocor (simvastatin) was nearly two to three times more effective than financial incentives alone. The greatest impact came among consumers using the company's home delivery pharmacy. The campaign generated over a billion dollars in savings for Express Scripts' pharmacy benefit plan sponsors and consumers.”
MY COMMENTS
8% is a fair amount in the adherence game. Congrats Express Scripts. Also in saving BILLIONS of dollars for their clients, Express Scripts should be commended. And an increase of 34% in generics from home delivery v. retail is outstanding.
At HealthCampDC, we had a short discussion about generics v. brands. The public does not actually know generic names, just the brand. “Oh, give me the generic of Zocor” not “I want simvastatin”. It is up to doctors, PBMs, and pharmacies to alert the patients as to what exists in the generic market to lower health care costs.
I wish two of my meds had generic equivalents, as they are $40 a month – not that this is so much, but it adds up, plus my wife’s scripts, plus our son’s script, and doctors’ bills and specialists. It was so much easier and inexpensive when I was single and did not go to the doctor. I can only imagine what the downturn in the economy is going to do to the average family and their healthcare costs.
Subscribe to:
Posts (Atom)
Posts
