Prescription Care Management

All Things Pharmacy

January 16, 2019

Brought to you by PCM

Focus: News

Be in the Know

Breaking combo drugs down into their ingredients can save thousands.
The price of specialty drugs is not the only concern for patients.
Glaucoma drug recalled.
With cannabis edibles legal doesn't mean safe

Focus: Cost Containment

Who determines drug prices?

Along with fireworks, champagne, and resolutions, we rang in 2020 with hundreds of drug price increases. New year, same challenge. However, even amid increasing prices, you can build a comprehensive cost containment strategy. Foundational to developing meaningful methods to cut spend is understanding the origin of these annual price increases; you must know where, and to whom, your pharmacy dollars are going.

Who determines drug prices?

The process of setting drug prices is complex. Pharmaceutical companies grab the headlines each January, but there are other major parties involved in setting medication price points. Below we look at the four major players: manufacturers, distributors, pharmacies and PBMs. Read More

Focus: Analytics

Combo drugs

The price tags of combo drugs are comparable to those of new, cutting-edge therapies, but are simply convenient combinations of two or more common, often inexpensive, medications.

Dr. David Merritt, PCM Chief Pharmacist explains, "Drug companies are taking drugs that are proven safe and effective alone, putting them together, without any new research, and charging substantially more. They offer discount cards so patients never see the actual cost of the combo drug, but employers and insurers end up paying thousands on the back end."

Breaking combo drugs down into their parts can save thousands of dollars. Learn how to identify combo drugs with PCM Analytics here.

Focus: Health

Cervical health starts with testing

January is Cervical Health Awareness Month. There is a lot you can do to prevent cervical cancer. Each year, more than 11,000 women in the United States get cervical cancer. HPV (human papillomavirus) is a very common infection that spreads through sexual activity, and it causes almost all cases of cervical cancer. About 79 million Americans currently have HPV, but many people with HPV don't know they are infected.

The good news?

The HPV vaccine can prevent HPV.
Cervical cancer can often be prevented with regular screening tests and follow-up care.

Women should start getting regular cervical cancer screenings at age 21, and parents should make sure their pre-teens get the HPV vaccine at age 11 or 12. Teens and young adults also need to get the HPV vaccine if they didn't get it as pre-teens. Women up to age 26 and men up to age 21 can still get the vaccine.

Thanks to the health care reform law, you and your family may be able to get these services at no cost to you. Check with your insurance company to learn more. To get more information about Cervical Awareness month and HPV prevention, click here.

For over 10 years, Prescription Care Management has been solving complex pharmacy problems with a client-centric approach. Simply put, we help self-insured organizations see where their pharmacy dollars are going and cut spend where it counts.

Call us at 800.281.7050

Email us at sales@pcmsavings.com

4790 Caughlin Parkway, #396, Reno, NV 89519

All Things Pharmacy

December 18, 2019

Brought to you by PCM

In this month's issue I wanted to share a letter from our CFO recapping our year in pharmacy. I have enjoyed sharing our newsletter with you and look forward to 2020.

Wishing you a happy holiday!

Linda Brokaski

2019 was quite the year. For our clients it started with the frustration of rising drug prices but ended with some much-needed pharmacy cheer. The implementation of our new pharmacy analytics tool has put many of our clients in control of their pharmacy spend. From school districts to health systems our partners have a greater understanding of their claims, spend, and participants to make more informed benefit decisions. We couldn’t be more grateful to work alongside such forward-thinking, industrious partners.

This year has been one of growth not only for our clients and team but for the entire industry. Increased focus has been directed at lowering costs to make prescription drugs more accessible for patients and pharmacy benefits more economical for organizations. Conversations by industry leaders have resulted in the development of innovative, out-of-the-box solutions that are affecting real change.

This holiday season we are honored to be a part of a pharmacy community dedicated to answering difficult questions, creating pioneering solutions, and focusing on improved outcomes. We are humbled to continue our tireless work providing the highest level of care, service, and savings for our clients, partners, and friends into the New Year.

Many blessings and good health to you and yours this season.

Garret D’Antoni, CFO

Prescription Care Management

Focus: News

Be in the Know

FDA announces new investigation into NDMA in ranitadine
Prescription drug prices drop for the first time in 45 years
Cost of providing health benefits expected to rise 5% next year
Popular flu medication to be released over the counter

Focus: Reader favorites

2019 Top Blogs

Focus: Health

Fighting the winter blues

The holiday season inevitably brings family and friends together around delicious treats. This season also bring seasonal affective disorder (SAD), a type of depression caused by the changing seasons. Symptoms of SAD usually peak during the winter months, but there are ways to use all of that holiday food to help ease SAD.

1. Eat more lean protein to help battle fatigue

2. Incorporate omega-3 fatty acids to boost your mood

3. Battle stress by eating berries

4. Limit sugar to balance your emotions

5. Add folic acid to fight the blues

6. Fit in B-12 to increase energy

7. Up Vitamin D to absorb sunshine (literally)

8. Snack on dark chocolate to feel happier

9. Prepare turkey to relax

10. Grab a banana to reduce anxiety

For more information on altering your diet to battle SAD this winter season, click here.

Call us at 800.281.7050

Email us at sales@pcmsavings.com

4790 Caughlin Parkway, #396, Reno, NV 89519

All Things Pharmacy

November 19, 2019

Brought to you by PCM

Focus: News

Be in the Know

In the last three years there has been a 60% increase in "super spender" patients.
A voluntary recall of blood thinner prasugrel cites failure to meet dissolution requirements.
The CDC reports finding a strong link in vaping illnesses.
Flu season in the United States has officially started.
Some common drugs create a false positive on drug tests.

Focus: Analytics

Part 2: What is your pharmacy strategy for 2020?

Last month we gave you two strategies, carefully developed by our pharmacy team, that can help you craft a solid approach to pharmacy benefits. Let’s review:

Strategy 1: Monitor NDC Exclusions. Know what NDCs your plan covers and be on the look-out for significant anomalies in prescription prices to ensure you are covering the most cost-effective drugs.

Strategy 2: Expect PBM accountability. Periodically compare contracted rebates, dispensing fees, and discounts to actual rates paid in claims to ensure your plan guarantees are being met.

With a solid pharmacy strategy, you can make 2020 the year you control pharmacy spend and put your plan on the path to financial sustainability. This month, we are discussing two more strategies that help you dig into your pharmacy data, start conversations, and impact positive change.

Focus: Savings

Engaging physicians to cut spend

Who is writing high-cost prescriptions?

It's not the health plan, the pharmacy, the PBM, or the pharmaceutical company.

It's the physician.

While the process of setting and controlling drug costs is complex, the key to finding measurable, long-term savings is simple. With the right information about true drug costs, cost-effective alternatives, and focus on quality of care, conscientious physicians will make economical prescribing decisions for their patients. Engaging physicians not only combats high drug costs but promotes better health for your participants.

See how PCM is engaging physicians here.

Focus: Health

Diabetes quick facts

Over 30 million people in the United States have diabetes, so it is likely that you know someone living with this disease. In honor of National Diabetes Month, here are some quick facts about the three types of diabetes:

Type 1 Diabetes: When your body does not produce insulin, you have type 1 diabetes. This type affects people of every age, race, shape, and size. Type 1 diabetes is managed with insulin therapy and lifestyle changes.

Type 2 Diabetes: The most common type of diabetes, accounting for 90-95% of diabetes cases, type 2 diabetes occurs when the body does not properly process insulin. It is most commonly managed with diet and fitness changes and oral medication.

Gestational Diabetes: With no symptoms or known causes, a diagnosis of gestational diabetes during pregnancy can be scary, but treatable. Millions of women have healthy pregnancies and babies by carefully following treatment plans including diet, exercise, and medication.

Diabetes is becoming increasing prevalent. In the last 20 years, the number of adults with diabetes has more than doubled. If you or a loved one has increased risk factors, seek testing and work on prevention. With proper management, many people with diabetes live their best lives, doing everything they set out to do.

For more information on diabetes click here.

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Call us at 800.281.7050

Email us at sales@pcmsavings.com

4790 Caughlin Parkway, #396, Reno, NV 89519

All Things Pharmacy

October 23, 2019

Brought to you by PCM

Focus: News

Be in the Know

California is the first state to ban pay-for-delay tactics that slow down generic releases.
Researchers claims drug makers raised prices without clinical support for increase.
New treatment for peanut allergy approved by FDA advisory committee.
Federal agencies issue new guidance on drug coupon rebates for self-insured groups.
FDA recalls popular heartburn drug ranitidine (Zantac).

Focus: Analytics

What is your pharmacy strategy for 2020?

Another year has nearly passed with little change in how the pharmacy industry operates. Pharmaceutical companies are still raising drug prices, PBMs are still receiving clawbacks, and brokers and employers are still searching for the magic formula to save money.

Fortunately, we do know that the variables of that seemingly elusive formula are found in pharmacy claims. Those binders, spreadsheets, and charts you receive every year at renewal contain the details needed to affect positive change for your pharmacy plan – you just have to know where to look. Don’t waste another year doing what you’ve always done and hoping for the best. Start developing a solid pharmacy strategy now to finally control pharmacy spend in 2020.

The foundation of a solid strategy

An effective, cost-savings pharmacy strategy is built on deeper visibility into your pharmacy claims. In order to control spend, you must identify exactly where your money is going. However, with over 50 fields and hundreds, if not millions, of rows in a standard claims file, it can seem all but impossible to productively aggregate your data.

Start by asking questions. Many common pain points are not explicitly included in standard reports, so creating an effective strategy starts by initiating discussions about pharmacy claims with key stakeholders.

Our pharmacy team has developed four strategies that will help you dig into your pharmacy data. Today we’re sharing two of those strategies to help you start conversations and begin building a solid 2020 pharmacy strategy.

Focus: PGx

PGx: Encourage informed medication decisions

Trial-and-error is not a treatment plan. Pharmacogenomics testing (PGx) is a simple oral swab that identifies drug-gene interactions in a patient, helping patients and doctors make informed medication decisions.

Certain drugs are more effective with certain genotypes. By identifying drug-gene interactions, doctors can make more informed medication decisions. PGx is most commonly applied to pain management, psychiatric, neurological, blood thinners, anti-anxiety, opioids, and cardiac therapies.

With PGx testing, people experience better health outcomes and may save money on prescription drugs.

Focus: Health

Identify Breast Cancer Early

October is National Breast Cancer Awareness Month. Breast cancer is one of the most common types of cancer in women. About 1 in 8 women born today in the United States will get breast cancer in their life.

Fortunately, most women can survive breast cancer if it is identified and treated early. If you are a woman age 40 to 49, talk to your with your doctor about when to get a mammogram. If you are a woman age 50 to 74, be sure to get a mammogram every two years.

If you have close family members who have had breast or ovarian cancer or you have multiple risk factors, talk to your doctor about getting a mammogram and setting up a prevention plan.

Learn more about risk factors and treatment here.

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Call us at 800.281.7050

Email us at sales@pcmsavings.com

4790 Caughlin Parkway, #396, Reno, NV 89519