Magazine article Drug Topics

Pharmacy Gold Making Move to Disease Management

Magazine article Drug Topics

Pharmacy Gold Making Move to Disease Management

Article excerpt

Pharamcy benefit manager Pharmacy Gold, St. Paul, Minn. is using the disease management route to

encourage the increased use of an ACE

inhibitor to treat congestive heart failure (CHF). The program, called Prime Therapeutics, has demonstrated its ability to persuade physicians, through the efforts of clinical pharmacists, to prescribe ACE inhibitors more appropriately, said Richard Waltermire, v.p. of clinical programs at the PBM. Since it started at the

beginning of this year, the program has been operating in conjunction with the Blue Plus plan of Blue Cross & Blue Shield of Minnesota, of which Pharmacy

Gold is an affiliate.

Prime Therapeutics was launched after it was observed that only one out of three patients who could benefit from the use of ACE inhibitors in the treatment of CHF actually use one, Walternire noted. The goals have been to save on drug costs now and demonstrate

savings in total health-care costs later.

As an overall platform for the program, Prime Therapeutics used American Heart Association guidelines on the use of ACE inhibitors to slow the progression of CHF, reduce the number of emergency room visits, and otherwise improve the health of patients, said Waltermire.

Pharmacy Gold's pharmacy and therapeutics (P&T) committee reviewed the ACE inhibitor class of drugs and chose one as a preferred product, he said. Then, rather than simply announcing the preferred product's status on the formulary, Prime Therapeutics administrators went about changing the prescribing guidelines of the BC&BS health plan and its associated physicians.

Through a review of the prescribing habits of the physicians in Minnesota, 20% were identified as being the ones driving 80% of ACE inhibitor Rxs. They were targeted for one-on-one visits by one of six in-house clinical pharmacists.

The R.Ph.s have been visiting the physicians as representatives of BC&BS rather than of Pharmacy Gold, explained Waltermire. The idea is that the R.Ph.s are encouraging physicians to help the health plan save drug costs.

During the visit, the R.Ph. describes the objectives of the program, pointing out how prescribing the preferred product would save on drug costs for the health plan while not affecting the quality of therapy--and perhaps even improving it. …

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