Transcript A Prescription for Success

A Prescription for Success
…expanding your PBM know-how
2009 Retiree Symposium
Making the Prescription Drug Benefit Work for You
Presented by:
Ashley Blevins
Peter Orlaskey
Judi Middleton
World Bank Catalyst Rx Team
• Ashley Blevins, Director of Client Services, 7 years
of healthcare experience
• Judi Middleton, Sr. Client Services Manager, over 25
years of healthcare experience
• Peter Orlaskey, Pharm D., Clinical Manager, 5 years
of pharmacy experience
• Erin Picariello, Client Services Representative, 6
years of healthcare experience
A Prescription for Success
…expanding your PBM know-how
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Catalyst Rx Corporate Overview
• Catalyst Rx is a full-service national pharmacy
benefit management company providing benefits
since 1994
• 4th largest publicly traded PBM (NASDAQ: CHSI)
• Manage pharmacy benefits for 6 million members
Our mission is to deliver unbiased pharmacy benefit management
solutions that improve patient safety, achieve the highest standards
of care, and effectively manage our clients’ drug costs
A Prescription for Success
…expanding your PBM know-how
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Catalyst Rx Customer Service
•
Dedicated team of experienced Nationally Certified Pharmacy
Technicians via fully integrated 24/7/365 service centers located in
Las Vegas, NV, Ft. Lauderdale, FL, San Juan, PR, Avon Lake, OH, and Des
Moines, IA
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Immediate access to benefit parameters, eligibility, retail and specialty
data
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Q1 2009 Service Level Validation
– Consistently exceeding industry standards in all key categories
• Average speed to answer : <22 seconds
• Call abandonment rate: < 2.8%
• First call resolution: 99.7%
• Comprehensive prior authorization processing: < 24 hours
A Prescription for Success
…expanding your PBM know-how
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Mail Order Statistics
• January 1, 2009 – April 30, 2009
– 5,706 Total Scripts Filled
– 1.32 Average Days in House
– 96.41% 2-day Turn Around
A Prescription for Success
…expanding your PBM know-how
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Generic Medications
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Accounted for over 72% of all drugs filled in 2008 vs.
56% for World Bank
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Saved an estimated $121 billion for the healthcare
system in 2008
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Regulated by the Food & Drug Administration (FDA)
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Contain the same active ingredient as the Brand drug
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Manufactured in FDA approved facilities
A Prescription for Success
…expanding your PBM know-how
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Cholesterol Drugs
• Generics
– Simvastatin, Pravastatin, Lovastatin
– Average Yearly Cost: Member - $0, World Bank - $105
• Preferred Brand Names
– Lipitor, Crestor, Advicor, Simcor
– Average Yearly Cost: Member - $228, World Bank - $913
• Non-Preferred Brand Names
– Lescol, Altocor, Vytorin, Altoprev
– Average Yearly Cost: Member - $333, World Bank - $776
A Prescription for Success
…expanding your PBM know-how
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GERD/Heartburn Drugs
• Generics
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Omeprazole, Pantoprazole
Average Yearly Cost: Member - $0, World Bank - $882
Omeprazole: $407
Pantoprazole : $ 1200
• Preferred Brand Names
– Nexium, Prevacid
– Average Yearly Cost: Member - $413, World Bank - $1,700
• Non-Preferred Brand Names
– Aciphex, Protonix
– Average Yearly Cost: Member - $632, World Bank - $1,500
A Prescription for Success
…expanding your PBM know-how
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Chronic Disease Non-Compliance
• What percentage of prescriptions written
for chronic diseases are never picked up?
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A. 25%
B. 50%
C. 75%
D. 100%
A Prescription for Success
…expanding your PBM know-how
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Non-Compliance leads to:
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Unnecessary disease progression
Disease complications
Reduced functional abilities
Lower quality of life
Increased medical costs
Premature death
A Prescription for Success
…expanding your PBM know-how
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Reasons for Non-Compliance
I forgot to take the drugs.
64%
I had no symptoms/symptoms went away.
36%
I wanted to save money.
35%
I didn’t believe the drugs were effective.
33%
I didn’t think I needed to take them.
31%
I had painful or frightening side effects.
28%
The drugs kept me from doing what I wanted to do.
25%
Nobody reminded me to keep taking them or to get refills.
20%
I had trouble getting the script filled.
20%
The drugs tasted or smelled unpleasant.
19%
I had trouble opening the bottle or swallowing the drug.
16%
I was confused by all the drugs I had to take.
15%
A Prescription for Success
…expanding your PBM know-how
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How Catalyst Improves Compliance
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Education
Generics
Simplify the medication regimen
Patient reminder aids
– Auto-refill
– Refill reminders
– Behavioral support
– Devices/Programs
A Prescription for Success
…expanding your PBM know-how
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Three Things to Remember!
• Share your Preferred Drug List with your
Doctor
• Always ask for Generics when possible
• If you are prescribed a non-preferred drug,
ask if a generic or preferred brand is
available
A Prescription for Success
…expanding your PBM know-how
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