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Results of biologics and specialty pharmacy research confirm knowledge gap
How much do employers know regarding biologics and specialty pharmacy?
How much do employers know regarding biologics and specialty pharmacy? A recent survey indicates that while approximately half of employers had a moderate understanding related to biologics and specialty pharmacy, about one-third did not know how much their claim costs had increased over the last few years.
The Midwest Business Group on Health (MBGH), in partnership with Randy Vogenberg, PhD, principal at the Institute for Integrated Healthcare in Sharon, Mass., will present the initial year results of a employer-driven research and demonstration project that aims to identify and address knowledge and benefit design gaps of employer plan sponsors and other key stakeholders in the area of biologics and specialty pharmacy, during the Pharmacy Benefits Academy event in Chicago on August 24th.
Attendee feedback will be collected and incorporated into a revised survey that will be fielded early 2012 to reevaluate the results toward closing identified gaps. A second presentation will be done on October 6th with the Mid Atlantic Business Group on Health.
About 120 employers from around the country ranging in size from 500 to 25,000 employees responded to the original survey, according to Vogenberg, who is also executive director of the Biologic Access & Finance program at The Jefferson School of Population Health in Philadelphia. An early sample analysis done with MBGH showed that approximately half of employers had a moderate understanding related to biologics and specialty pharmacy; however about one third did not know how much their claim costs had increased over the last few years.
“It’s very different than what most of us who are in this business think about it,” Vogenberg told Formulary. “There are real gaps in the level of understanding and knowledge about this area of medical as well as pharmacy benefits.”
As the data is refined with feedback from the pilot programs and the advisory council, the group will be developing an employer-focused toolkit that can assist employer decision-makers with the complexities inherent in biologics coverage, and help to address the issue of how employers can effectively manage this aspect of their healthcare benefit.
“We’re really trying to look at this as taking a step back and making sure that we have a good baseline for understanding what employers know and understand in this area then we’ll move forward from there to identify what other tools or what other information would be important; what types of benchmarking could be of value to them,” he said.
“I think if we can really understand the commercial market better, it would really help everybody with a stake in paying for benefits, including CMS,” he added.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
