Ways managed care executives can impact medication spending
Medication is getting pricier.
We know the facts – the Kaiser Family Foundation and Truven Health Analytics calculate prescription drug spending at 10% of the total national health spend. Want to hear an even more shocking statistic? Drug spending alone in employer health plans tops out at a whopping 19% of total spend.
There is some good news, though. We have identified a couple of opportunities that managed care executives have to make a dent in medication spending while simultaneously improving patient outcomes.
1. Done properly, at-risk negotiations with pharma manufacturers should generate positive outcomes for managed care executives.
As I wrote for Managed Healthcare Executive in October 2015, managed care executives have many resources available capable of smoothing at-risk negotiations in a way that aligns all parties for value-based success. If manufacturers and payers would allow them to do so, specialty pharmacies could serve as the conduit that enables both parties to generate value from at-risk agreements.
2. The longest lever available to impact medication spending is still fixing nonadherence.
A study published in 2012 by Curant Health CEO Patrick Dunham and others demonstrated that for a population of patients taking Highly Active Antiretroviral Therapy (HAART), the percentage of patients whose viral loads were considered undetectable increased from 28% to 66% with advanced, high-touch medication therapy management. Overall healthcare costs for the same population of patients decreased by $3,000 per patient per year.
At Curant Health, we focus on innovative medication management programs that include clinically-proven medication therapy management (MTM) protocols for chronic disease states. These programs have proven to drive medication adherence and improve patient outcomes.
If you work in managed care and are concerned about the double-digit rise in the cost of medication, you should consider what steps you can take with medication management partners like Curant to implement specific programs for this patient set and make a substantial impact on your bottom line.