Medication Dedication Initial Observations

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Medication DedicationInitial Observations

• North Carolina Alliance for Healthy Communities
• October 2, 2008

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Medication Adherence

• Non-adherence is the 1 cause for readmission to
  hospitals.
• According to the WHO, increasing the
  effectiveness of adherence interventions may have
  a far greater impact on the health of the
  population than any improvement in specific
  medical treatments.
• Healthcare costs related to poor medication
  adherence are estimated to approach 100 billion
  a year.
• Despite all of the evidence showing the benefits
  of taking prescription drugs as prescribed,
  studies have shown that only 50 of people are
  adherent to medications as directed by their
  physician.

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Reasons for poor adherence
BCG analysis, Harris Interactive 10,000 Patients
Survey, 2002
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Medication Dedication - Overview
Intervention One Value-Based Benefit Designs

• Drug Tier Changes
• Generic Copayment Waiver
• Partnerships with Pharmaceutical Industry

Cost
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Initial Observations

• Pace of generic use in these categories is
  outpacing the overall generic rate
• Consistent with previous programs, the medication
  possession ratio (MPR) for generics is higher
  than brands
• Program is demonstrating a positive impact on
  prescribing patterns and member behavior

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Impact of Generic Copayment Waivers

• 12.1 of members who used brand medications prior
  to the program have switched to generics
• Generic dispensing rates have increased by over 7
  percentage points from 2007 to 2008 in the
  targeted classes, compared with a 4 percentage
  point increase among all classes
• Generic increase equates to over 6 million in
  reduced drug costs annually

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Program Impact on Behavior

• Almost 10 percentage point increase in members
  filling a generic after the initial diagnosis in
  2008 than in 2007

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Our Experience with Copay Waivers and Adherence

• Based on prior BCBSNC generic copayment waiver
  results, medication possession ratio (MPR) was
  higher for members who switched to a generic than
  those who remained on a brand.

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Medication Possession Ratio

• The primary measure of medication adherence, the
  Medication Possession Ration or MPR, is
  calculated on a rolling 12 month basis
• MPR of generic users is significantly higher than
  that of brand users

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Program Impact on Behavior

• Medication Dedication program has significantly
  impacted physician prescribing patterns and
  member behavior following diagnosis
• 4.6 improvement in the rate of members filling a
  prescription within 90 days of the initial
  diagnosis
• 2007 41.6 filled within 90 days of initial
  diagnosis
• 2008 43.5 filled within 90 days of initial
  diagnosis

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Thank You!
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