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

,730 calcineurin claims. Members were then tracked for 365 days to determine if they switched drugs and if waste occurred. Researchers found average days of waste per claim were 44 days wasted among patients receiving a 90-day retail supply, 16 days waste for those receiving a 30-day retail supply, and three days wasted for those receiving a 90-day supply by mail. Although claims associated with waste were rare, when waste was found it was 10 times more likely to be a retail 90-day supply claim then a retail 30-day supply or mail 90-day supply claim (p<0.01).

"Medication waste is a continued concern of ours, especially in regard to specialty drugs requiring frequent drug switches and supplies beyond the traditional 30 days," said Gleason. "Often, treatment will stabilize for patients after one year, so moving to mail order could potentially reduce the chance of waste and may improve adherence."

About Prime Therapeutics
Prime Therapeutics LLC (Prime) helps people get the medicine they need to feel better and live well. Prime manages pharmacy benefits for health plans, employers, and government programs including Medicare and Medicaid. The company processes claims and delivers medicine to members, offering clinical services for people with complex medical conditions. Headquartered in St. Paul, Minn., Prime serves nearly 20 million people. It is collectively owned by 13 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans. Prime has been recognized as one of the fastest-growing private companies in the nation.


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