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CVS Caremark Study Finds Integrated Pharmacy-Based Program Improved Diabetes Medication Initiation and Adherence Rates
Monday, January 9, 2012
Pharmacy Advisor™ program improved patient medication behavior through patient outreach and counseling; face-to-face interactions achieve the best results
WOONSOCKET, R.I., Jan. 9, 2012 /PRNewswire/ -- A CVS Caremark study found that the company's integrated pharmacy-based program – Pharmacy Advisor™ – increased medication adherence rates and physician initiation of prescriptions for concomitant medications, improving care for diabetes patients and resulting in savings for health plans.
Pharmacy Advisor™ promotes interactions between diabetes patients and pharmacists, either in face-to-face counseling or on the phone. The study entitled, "An Integrated Pharmacy-Based Program Improved Medication Prescription and Adherence Rates in Diabetes Patients," was published today in the January issue of Health Affairsandhighlights the central role pharmacists can play in improving the health of their patients.
"Ensuring adherence and appropriate treatment has long been the domain of primary care providers," said Troyen A. Brennan, MD, MPH, Executive Vice President and Chief Medical Officer of CVS Caremark, and lead author for the study. "However, as demands on the time of these providers increase, interventions carried out by pharmacists can complement primary care. Indeed, pharmacists are in the unique position to monitor patient adherence and effectively intervene when indicated."
Brennan said the study also added insight into the problem of time-limited health care interventions. "This study showed that patients stay on their medications while they are actively counseled, but once those pharmacist-patient conversations ended, adherence fell quickly. We need to continue these kinds of interventions to make sure patients benefit from the full beneficial impact of their medications."
Researchers from Harvard University and Brigham and Women's Hospital assisted the CVS Caremark researchers in the analysis of the pharmacy claims data of benefit members at a large Midwest manufacturing company and focused on interventions with diabetic patients between October 2009 and April 2010. The study included an intervention group of 5,123 people who were proactively counseled by retail and call center pharmacists and a control group of 24,124 patients with diabetes who did not receive specialized counseling. The researchers measured gains in patient adherence and medication initiation rates of concomitant therapies for diabetes, such as statins, angiotensen converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs).
The research showed that contacts by pharmacists with the patients and their doctors increased therapy initiation rates by as much as 39 percent for the full sample and an even higher 68 percent for the group counseled at retail stores, and increased medication adherence rates by 2.1 percent. The researchers noted that face-to-face interventions by retail store pharmacists resulted in increasing adherence rates by 3.9 percent.
The integrated pharmacy-based program featured counseling by pharmacists at 12 retail stores near the manufacturing client's headquarters, and counseling through a dedicated pharmacist call center for those identified as having diabetes. CVS Caremark launched Pharmacy Advisor for diabetes in 2009 because the cost and prevalence of that disease continues to rise. The American Diabetes Association estimates the cost of the disease to the U.S. in 2007 at $174 billion.
The study estimated that the employer saved more than $600,000 through health care cost avoidance with the intervention group, while expenditures for the counseling totaled $200,000, a return on investment of $3 for every $1 spent on additional counseling. "In a health care system eagerly seeking programs that can reduce costs and improve care, such simple, pharmacist-based counseling programs to improve adherence to existing medication regimens and initiate missing therapies should be of great value," the researchers concluded.
CVS Caremark has been working in a three-year collaboration with Harvard University and Brigham and Women's Hospital to research pharmacy claims data in order to better understand patient behavior, particularly around medication adherence. Annual excess health care costs due to medication non-adherence in the U.S. have been estimated to be as much as $290 billion annually.
The study reviewed data of CVS Caremark's pilot Pharmacy Advisor™ program. That program is being expanded in 2012 to include counseling for patients with cardiovascular disease, in addition to the more than 12 million members who are part of the diabetes-focused counseling. Through Pharmacy Advisor™, CVS Caremark has engaged PBM members who are diagnosed with diabetes, according to their expressed preferences at points when they are most receptive about their prescribed therapy: face-to-face when members choose to fill their prescriptions at a CVS/pharmacy or by phone if the members use home delivery. The use of the integrated tactics drives behavior change in the short term and over time leads to better clinical outcomes. In addition to improving medication adherence, thus saving money and improving the quality of treatment, the program closes gaps in care and directs members with chronic conditions to existing disease management programs where they can obtain additional support.
About CVS Caremark
CVS Caremark is the largest pharmacy health care provider in the United States with integrated offerings across the entire spectrum of pharmacy care. We are uniquely positioned to engage plan members in behaviors that improve their health and to lower overall health care costs for health plans, plan sponsors and their members. CVS Caremark is a market leader in mail order pharmacy, retail pharmacy, specialty pharmacy, and retail clinics, and is a leading provider of Medicare Part D Prescription Drug Plans. As one of the country's largest pharmacy benefits managers (PBMs), we provide access to a network of approximately 65,000 pharmacies, including more than 7,300 CVS/pharmacy® stores that provide unparalleled service and capabilities. Our clinical offerings include our signature Pharmacy Advisor™ program as well as innovative generic step therapy and genetic benefit management programs that promote more cost effective and healthier behaviors and improve health care outcomes. General information about CVS Caremark is available through the Company's website at http://info.cvscaremark.com/.
SOURCE CVS Caremark