Magazine article Drug Topics

Bridge Builder

Magazine article Drug Topics

Bridge Builder

Article excerpt

ValueRx moves

to coordinate

outpatient and

inpatient care

It may be to early to say what it will mean for community pharmacists, but pharmacy benefit manager ValueRx, Minneapolis, is repositioning itself for the future. In an exclusive interview with Drug Topics, Kevin L. Roberg, CEO of the PBM since December 1995, described the new ValueRx.

First of all, the subsidiary of Value Health, Avon, Conn., has started calling itself a "medication management company" instead of a PBM. The difference? ValueRx wants to go beyond merely managing the outpatient drug benefit to coordinating it with inpatient and long-term care pharmacy management.

Keep in mind that before Roberg was named CEO of ValueRx, he was CEO of Medintell, a hospital pharmacy information company that was bought by Value Health. With Medintell on board, ValueRx aims to be able to coordinate its outpatient formulary with its inpatient formulary for institutionalized patients.

The merging of the inpatient formulary with the outpatient one will allow patients who use certain outpatient medications when they enter a hospital to continue using the same drugs during their hospital stay-and afterward. This addresses a common problem for hospitalized patients-the lack of continuity between outpatient and inpatient drug therapy. "I think this is where the industry has to go," Roberg added. "You have to take away the barriers to where the drugs are dispensed."

Disease management

Among other implications, the coordination of formularies means the strengthening of disease management programs. Toward this end, strategic alliances between ValueRx and drug manufacturers are taking on new meaning, he indicated.

Beyond making the usual formulary decisions, ValueRx is now looking at which drug manufacturers offer the best disease management programs. Choosing a formulary drug for long-term disease management deepens and lengthens the commitment by a PBM to a drug manufacturer that provides that drug, he noted. This means strategic, multiyear alliances.

Pharmacist:' role

The growing focus on disease management will impact ValueRx' interactions with community pharmacy-and with its in-house mail-order pharmacists, Roberg continued. ValueRx plans to introduce two or three new disease management programs this year in which pharmacists will play a role.

The firm is scheduled to release a new claims adjudication program in early August that will, among other things, "involve pharmacists more in clinical programs," he said. "It gives them more information at the point of dispensing," and pharmacists who have seen it so far say they like what they see, he added.

To support its programs, on the community pharmacy side, ValueRx has three different pharmacy networks. The largest national one includes about 55,000 pharmacies. The other two are smaller, select networks of pharmacies chosen on the basis of location plus their ability to provide special services-including attaining certain generic drug substitution and brand-tobrand interchange rates.

Mail order

On another front, although ValueRx saw the need to buy the mail-order capabilities of Diagnostek, Roberg claimed the purchase does not mean mail-order pharmacy services will become the PBM's central offering to customers. …

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