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Study Finds Letter to Health Care Providers Results in Reduction of Potentially Unsafe Concurrent Use of Plavix and Proton Pump Inhibitors

ST. PAUL, Minn., April 18, 2011 /PRNewswire/ -- A letter sent by a commercial insurer to health care providers notifying them of potentially unsafe drug use when combining anti-clotting drug clopidogrel (Plavix®) with a proton pump inhibitor (PPI), showed a significant reduction in the number of members combining the drugs, according to a new study by pharmacy benefit management thought leader Prime Therapeutics (Prime). Details of the study will be presented on April 29th at the Academy of Managed Care Pharmacy's 23rd Annual Meeting in Minneapolis, Minn.

Recent data has shown the use of some PPIs, commonly prescribed to reduce gastric acid production, in combination with clopidogrel, an antiplatelet medication used to prevent stroke and heart attack, can increase a person's risk for clopidogrel failure and a subsequent cardiac event. Current guidelines suggest providers re-evaluate the need for PPI therapy in patients taking clopidogrel and consider recommending another type of heartburn medication as an alternative treatment.

Researchers from Prime and one of its Blue Cross and Blue Shield clients used a retrospective drug utilization review to analyze claims data from a 1.3 million member commercial insurer. From this, researchers determined 1,316 members were actively combining clopidogrel with a PPI. A letter was then sent to health care providers alerting them of the potentially unsafe drug use and requesting the provider re-evaluate the need for PPI therapy in their patients. The study also tracked a control group of 2,740 patients who met intervention criteria but whose providers did not receive a letter.

At 180 days post-letter, actively enrolled members in both groups were assessed for the presence of a PPI, clopidogrel, or both. This analysis showed a significant absolute 7.5 percentage point reduction in the number of members who were combining PPIs and clopidogrel when they received the letter, compared to the control group.

"When patients or physicians are unaware of how drugs can react with one another they are potentially putting themselves at risk for greater harm and health complications," said Patrick Gleason, PharmD, Director of Clinical Outcomes Assessment for Prime. "This study shows that insurers, in partnership with pharmacy benefit managers, can increase member safety using simple and cost-effective tactics to significantly reduce the incidence of concurrent clopidogrel and PPI therapy and ensure patients continue to receive safe, high-quality care."

The published study abstract can be found in the Journal of Managed Care Pharmacy 2011;17(3):254-255 at

Prime Therapeutics is a pharmacy benefit management company dedicated to providing innovative, clinically-based, cost-effective pharmacy solutions for clients and members. Providing pharmacy benefit services nationwide to nearly 17 million covered lives, its client base includes Blue Cross and Blue Shield Plans, employer and union groups, and third-party administrators. Headquartered in St. Paul, Minnesota, Prime Therapeutics is collectively owned by 12 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those Plans. Learn more at

SOURCE Prime Therapeutics
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