Prescription Care Management

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.

Unsubscribe Forward

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.

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.

Unsubscribe Forward

Call us at 800.281.7050

Email us at sales@pcmsavings.com

4790 Caughlin Parkway, #396, Reno, NV 89519