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Specialty pharmacy utilization management programs and 30-day supply claims may improve patient outcomes, reduce waste
Date:4/4/2013

SAN DIEGO, April 4, 2013 /PRNewswire/ -- Prime Therapeutics (Prime), a leading pharmacy benefit manager, will be presenting three new studies at the Academy of Managed Care Pharmacy (AMCP)'s 25th Annual meeting & Expo in San Diego today. Studies concluded that UM programs may increase the quality of health care for patients taking specialty medications. Furthermore, 30-versus 90-day retail supply claims reduce specialty medication waste.

Effect of PA programs on MS patient outcomes
In the first study, Prime evaluated utilization patterns using integrated medical and pharmacy claims for natalizumab (Tysabri®), a drug FDA approved for Crohn's disease and relapsing forms of multiple sclerosis (MS), among 8.1 million commercially insured members. All members using natalizumab had an MS diagnosis. Natalizumab is generally recommended for patients who have had an inadequate response or are unable to tolerate an alternative MS therapy, due to the risk of developing progressive multifocal leukoencephalopathy, a rare viral disease that damages the brain and is often fatal. Researchers found that during the six-month analysis period, 50.7 percent of natalizumab new initiators did not have a history of having tried analternate MS medication. The percent of members with no alternate MS agent decreased to 39.0 percent and 26.3 percent for 24 and 60 months look back, respectively.

"Health insurers and payers are increasingly using PA programs to help ensure patients receive the safest and most effective treatment," said Patrick Gleason , PharmD, FCCP, BCPS, director of health outcomes at Prime. "This study finds about one in four patients hadn't tried another MS treatment prior to natalizumab. Thissuggests a PA
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SOURCE Prime Therapeutics LLC
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