Optum Study Documents Pivotal Role Specialty Pharmacy Plays in Improving Health Care Outcomes, Lowering Costs

  Optum Study Documents Pivotal Role Specialty Pharmacy Plays in Improving
  Health Care Outcomes, Lowering Costs

 One-year program results in 30 percent lower post-transplant-related medical
             costs and 13 percent lower overall health care costs

Business Wire

IRVINE, Calif. -- June 27, 2013

A study published in the Journal of Managed Care Pharmacy measures how
clinical management and adherence programs at a specialty pharmacy add value
beyond what patients experience acquiring medications at conventional retail

The study, which followed for one year two groups of people enrolled in
employer-sponsored benefit plans and who had kidney transplants, found that
the specialty pharmacy program group showed consistently lower costs and
higher therapy adherence compared with those using retail pharmacies,
including a 30 percent reduction in transplant-related medical costs and a 13
percent reduction in overall health care costs.

“This research should be of great interest to stakeholders in health care who
want to improve health outcomes and lower overall costs,” said Kevin Host,
Pharm.D, senior vice president for Specialty Pharmacy, OptumRx. “It
underscores the value of ensuring that patients have a positive experience and
receive outstanding support to help ensure adherence.”

“We’ve seen similar outcomes in improving medication adherence and clinical
results and lowering medical service costs through our specialty pharmacy
programs in oral oncology, rheumatoid arthritis and multiple sclerosis,” said
Suzanne Tschida, Pharm.D, BCPS, lead author for the study and vice president,
Specialty Benefit & Outcomes Strategy, OptumRx. “We have found that, by
delivering a simpler, more personalized and convenient member experience, we
empower members to manage their medications and take ownership of their

The study authors noted that medication adherence or compliance – defined as
the extent to which patients take their medications as instructed by a
physician – is a well-recognized problem in transplant medicine, and concrete
solutions are hard to find. Based on available literature on the topic, the
study authors found between 20 percent and 70 percent of patients who have
received an organ transplant do not adhere to therapy – the rate varying with
definitions of adherence measures and study populations. Moreover, the rate of
nonadherence is highest at one to three years post-transplant, but it may
happen at any point during lifelong therapy.

Study Design
The study matched one group of 519 people enrolled in an employer-sponsored
benefit plan who filled at least 80 percent of their renal transplant
immunosuppressant medication prescriptions at the specialty pharmacy in its
specialty program, with another group of 519 plan participants who filled at
least 80 percent at retail pharmacies.

The study was a one-year retrospective claims analysis after the
implementation of a transplant specialty pharmacy program that, in addition to
medication dispensing, includes adherence and clinical management programs,
member education, and counseling services provided by specialty pharmacists
trained in transplant pharmacology.

Primary outcomes included pharmacy medication costs, medical inpatient and
outpatient costs and overall health care costs. Patient adherence to
transplant medication therapy and health care resource utilization was also
evaluated. One-year outcomes post-specialty pharmacy program implementation
were compared between the two groups with t-tests for continuous variables and
chi-square tests for nominal variables. Results included:

  *13 percent lower total mean cost during the first follow-up year – $24,315
    vs. $27,891 (P=0.03)
  *30 percent lower transplant-related medical costs – $5,960 vs. $8,486
  *More transplant-related prescriptions dispensed – 18.67 vs. 17.90 (P<0.05)
  *A higher weighted medication possession ratio – 0.87 vs. 0.83 (P=< 0.001).

About OptumRx
OptumRx is part of Optum, a leading information and technology-enabled health
services company dedicated to making the health system work better for
everyone. OptumRx is an innovative pharmacy benefit management business
managing the prescription drug benefits of commercial, Medicare and other
governmental health plans, as well as those of employers and unions through a
national network of 66,000 community pharmacies and state-of-the-art mail
service pharmacies in California and Kansas, both of which have earned the
prestigious Verified Internet Pharmacy Practice Sites™ (VIPPS®) accreditation
by the National Association of Boards of Pharmacy®. Visit www.optum.com for
more information.

About Optum
Optum (www.optum.com) is a leading information and technology-enabled health
services business dedicated to helping make the health system work better for
everyone. Optum comprises three companies – OptumHealth, OptumInsight and
OptumRx – representing more than 35,000 employees worldwide who collaborate to
deliver integrated, intelligent solutions that work to modernize the health
system and improve overall population health.

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David Himmel, 949-988-6000
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