Prescription Solutions Presents Four New Research Reports at Academy of Managed Care Pharmacy Annual Meeting

  • Data Demonstrate Company’s Ongoing Commitment to and Breadth of Research-Based Solutions to Improve Clinical Outcomes and Contain Costs
  • Presentations Point to Need for Clinical Programs to Enhance Quality of Care for Patients with Chronic Heart Failure, Increase Adherence to Antipsychotic Medication and Increase Generic Use of Proton Pump Inhibitors
IRVINE, Calif. — 

Four new studies from Prescription Solutions, a leading pharmacy benefit management organization, will be presented during the Academy of Managed Care Pharmacy (AMCP) 22nd annual Meeting in San Diego, Calif. (April 7-10).

Prescription Solutions routinely conducts original research to uncover and provide high quality, cost-effective treatments for its members. The company, with nearly 11 million members, has an extensive database of real-world claims information, which is examined to uncover gaps in quality of care, unnecessary costs, waste and even fraud and abuse.

“Through a focus on research, we go beyond the prescription to develop and implement programs that improve health outcomes and reduce costs for our members and for the health system,” said Joseph Addiego, M.D., chief medical officer for Prescription Solutions.

Through its strategic, client-centric Clinical Vantage approach, Prescription Solutions creates a range of customized solutions to achieve optimal health for members, while also reducing health care expenditures. Prescription Solutions’ clinical team continually examines claims data to identify gaps in quality of care, then develops programs to address the clinical needs identified in the review. Once implemented, these programs are evaluated to ensure they are closing quality and clinical gaps, and maximizing savings for clients. Program adjustments are made continuously to ensure that the company is providing the highest quality, evidence-based clinical management.

Prescription Solutions’ four poster presentations at the AMCP conference demonstrate this approach:
I.The Prevalence of Inappropriate Use, Polypharmacy and Non-Adherence of Antipsychotic Medications
II.Proton Pump Inhibitor Prescribing and Utilization Patterns in an Era of Generic and OTC Availability
III.Evaluation of a Chronic Heart Failure Medication Therapy Management Program
IV.Evaluation of Impact of Written Educational Materials on Member Medication Adherence


I.The Prevalence of Inappropriate Use, Polypharmacy and Non-Adherence of Antipsychotic Medications

Proactive Monitoring and Clinical Intervention Programs Necessary to Improve Antipsychotic Medication Adherence and Appropriate Use

Since the 1990s, antipsychotic use among the elderly doubled from 2.6 million to 4.3 million prescriptions in the U.S. This rapid growth in utilization has raised questions about the appropriate use of antipsychotic medications.

A Prescription Solutions study measured the prevalence of polypharmacy, non-adherence, and inappropriate use of antipsychotics within Medicare Advantage Prescription Drug (MAPD), Medicare Part D Prescription Drug Plan (PDP), commercial and Medicaid populations. Antipsychotics are most often prescribed to combat the effects of neuro-psychiatric disorders such as schizophrenia.

The study found that antipsychotic medication non-adherence and inappropriate use are prevalent among these patient groups. Specifically, the study found:

  • Approximately 77 percent of antipsychotic users in the Medicare plan and 44 percent of antipsychotic users in the commercial plan did not have an FDA-approved indication for antipsychotics, signifying a high prevalence of off-label use.
  • Non-adherence to the antipsychotic medications was high across all plans. The percentage of patients with a medication possession ratio[i] of less than 80 percent ranged from 47 to 77 percent. Another indicator of non-adherence, a gap in medication therapy of more than seven days, ranged between 71 and 92 percent.

The results suggest that proactive monitoring and clinical intervention programs are necessary to improve antipsychotic medication adherence and appropriate use.


II.Proton Pump Inhibitor Prescribing and Utilization Patterns in an Era of Generic and OTC Availability

Study Reveals Need for Better Options to Increase Generic Utilization of Expensive Proton Pump Inhibitor Drugs

Prescription Solutions researchers examined current Proton Pump Inhibitor (PPI) prescribing and utilization patterns in light of the increasing generic and over-the-counter availability of this expensive class of drugs. PPIs are used for ulcers and gastroesophageal reflux. The study showed that although PPI utilization appeared appropriate for patients with FDA-approved indications, use of these drugs for off-label indications was a significant contributor to overall PPI costs.

Results revealed that while there is a high generic utilization rate (65 percent) for PPIs, there is still additional opportunity to impact the cost of the other 35 percent. The findings suggest that PPI cost containment efforts should focus on increasing the use of generics and reducing off-label usage.


III.Evaluation of a Chronic Heart Failure Medication Therapy Management Program

Study Results Point to Need for Programs to Improve Quality of Care for Medicare Part D Patients with Chronic Heart Failure

Chronic Heart Failure (CHF) is a major public health problem in the U.S. and the most common diagnosis in the Medicare population, with more Medicare dollars spent for CHF diagnosis and treatment than any other condition. The Prescription Solutions study results highlighted the need for programs to improve quality of care for Medicare Part D patients with CHF.

Prescription Solutions evaluated whether communicating with physicians directly via mail would result in more appropriate treatment of eligible patients with the most commonly used drugs for CHF -- angiotensin converting enzyme inhibitors (ACEIs), angiotension receptor blockers (ARBs), and beta blockers (BBs). The care provider-targeted intervention included an introductory letter, a care provider specific pharmacy utilization report and an educational piece on the management of CHF. The evaluation focused on enrolled Medicare members with a medical diagnosis of CHF but without a pharmacy claims history for an ACEI, ARB, or BB during the identification periods, meaning that they did not appear to be on appropriate CHF therapy according to American Heart Association and American College of Cardiology guidelines.

While the study found no statistical significance on the impact of intervention, there was a slightly greater proportion of resolved gaps in therapy among the majority of the intervention groups. The study findings also suggest that future care provider-intervention programs may have greater clinical impact by focusing on members with CHF and co-morbidities such as diabetes, coronary artery disease, high blood pressure or respiratory disease. In addition, the study found that these programs may also be more beneficial when targeted towards a younger population, as adding medications may be more of a challenge to consider for physicians of older people with greater disease and medication burden. This evaluation highlights the need for future interventions to resolve gaps in CHF therapy to be more comprehensive, such as direct patient interventions via a medication review with a pharmacist and recommendations communicated to care providers.


IV.Evaluation of Impact of Written Educational Materials on Patient Medication Adherence

Patients with Arthritis or Dyslipidemia Most Likely to Respond Favorably to Written Educational Materials

This study sought to determine patient satisfaction with written educational materials (WEMs) provided as part of Prescription Solutions Medication Therapy Management (MTM) clinical education program. It also aimed to assess whether favorable responses to the clinical education program were influenced by differences in personal characteristics, such as age, gender, disease state and chronic disease score.

Based on the survey results, the majority of those surveyed had favorable ratings of the WEMs provided as part of a MTM program. Members were asked to evaluate how easy or hard the materials were to 1) read; 2) understand; 3) remember; 4) locate important information; and 5) keep for future reference. Approximately 69 percent of respondents rated all five categories as “very or quite easy.” Differences in characteristics appeared to influence satisfaction with WEMs, with people with arthritis or high cholesterol having the highest likelihood of a favorable response.

About Prescription Solutions
Prescription Solutions is an innovative pharmacy benefit management company managing the prescription drug benefit of commercial, Medicare and other governmental health plans, as well as those of employers and unions. A UnitedHealth Group company, Prescription Solutions serves customers through a national network of 64,000 community pharmacies and state-of-the-art mail service pharmacies in Carlsbad, Calif., and Overland Park, Kan., both of which have earned the prestigious Verified Internet Pharmacy Practice Sites (VIPPS®) accreditation by the National Association of Boards of Pharmacy® (NABP®). The company was recently named by WilsonRx® as the No. 1 National Top-Tier PBM, and No. 1 National Mail Order Pharmacy for customer satisfaction two years in a row. Prescription Solutions also won two Silver Awards for URAC’s Best Practices for Consumer Empowerment and Protection Awards – Geriatric RxMonitor Program (2008) and the Drug Interaction Alert Program (2009). Additional information can be found at www.prescriptionsolutions.com.

About UnitedHealth Group

UnitedHealth Group (NYSE: UNH) is a diversified health and well-being company dedicated to making health care work better. Headquartered in Minneapolis, Minn., UnitedHealth Group offers a broad spectrum of products and services through six operating businesses: UnitedHealthcare, Ovations, AmeriChoice, OptumHealth, Ingenix, and Prescription Solutions. Through its family of businesses, UnitedHealth Group serves 70 million individuals nationwide.  

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Prescription Solutions Presents Four New Research Reports at Academy of Managed Care Pharmacy Annual Meeting