SOURCE: Pharmacy Benefit Management Institute (PBMI)

Pharmacy Benefit Management Institute (PBMI)

March 01, 2016 13:00 ET

PBMI Announces Six Organizations as Winners of Its Inaugural Excellence Award

PLANO, TX--(Marketwired - Mar 1, 2016) - The Pharmacy Benefit Management Institute (PBMI) announced the winners of its Excellence Award at the 21St Annual Drug Benefit Conference today. Six organizations were recognized for exceptional contributions across the pharmacy management continuum in the areas of care management strategies, cost containment, and quality improvement.

"PBMI is dedicated to awarding organizations for their contributions in promoting innovative and best-in-class strategies that address cost challenges of prescription drug management, improve the quality of healthcare, and provide clinically appropriate care for members and their families," says Jane Lutz, Executive Director of PBMI. "With a record number of submissions this year, we are honored to be able to recognize six organizations across the industry."

Winners by category include:

Care Management Strategies Category

  • Duke University and Health System: Duke University and Health System is recognized for its program to meet the challenges of a dynamic health care environment where costs are rising, regulations flourish, and it is more important than ever to ensure the right clinical decisions are made for prescription drug benefits. Working with their PBM, they hired a dedicated, full-time clinical pharmacist to work closely with their Benefits office. The clinical pharmacist developed relationships with prescribers to increase awareness of opportunities for cost-effective prescribing and help them navigate formulary changes saving the plan $7.72 million. Additionally, the clinical pharmacist worked with the PBM to develop and implement programs to reduce out of pocket costs for patients and improved medication adherence.
  • Manatee "YourChoice" Health Plan: Manatee "YourChoice" Health Plan is an employer-sponsored self-insured plan for Manatee County, Florida Government employees, and is recognized for its in-house Specialty Medication Management Program. A Pharmacy Advocate, staffed by a clinical pharmacist, provides one-on-one pharmacy case management for members using specialty medications. The Pharmacy Advocate plays an integral role in managing the logistics of meeting both prescriber and the patients' specialty medication needs including managing prior authorization, identifying possible opportunities for dose titration or less expensive therapeutics options, and providing patient education, and counseling. This program has contributed to a 27% avoidance in specialty drug costs.

Cost Containment Category

  • Truveris: Truveris is recognized for OneRx®, a free, consumer-friendly, prescription benefits and savings application. This comprehensive consumer prescription tool provides information on drug coverage at the point of care, current out-of-pocket drug prices based on location, and allows consumers to take advantage of savings from discounts and coupons that are available. Truveris has found that members who use the OneRx app make positive changes in their medication purchasing behaviors, choosing lower cost pharmacies and increasing adherence to important medications. Savings of 8% to 25% have been achieved, depending on plan design.
  • Express Scripts: Express Scripts is recognized for its Hepatitis Cure Value Program®, which not only ensured access to a cure for Hepatitis C patients but also produced savings for plan sponsors served by Express Scripts. Additionally, Express Scripts helped to elevate the discussion around fair drug pricing for a high cost, specialty chronic disease nationally, resulting in an estimated health care savings across the nation of $4 billion in 2015.

Quality Improvement

  • Inland Empire Health Plan (IEHP): IEHP, a non-profit health plan located in southern California, is recognized for its Pharmacy Pay for Performance (P4P) Program. The P4P program leverages retail pharmacists to lower costs and improve the quality of care for IEHP members. Using prescription-based quality measures aligned with medication adherence and patient safety to measure network pharmacy performance, overall improvement from 2013 baseline measures have been achieved. The P4P program is also credited with improvement in pharmacy provider engagement and overall commitment to quality improvement initiatives.
  • OptumRx: OptumRx is recognized for its BriovaLive™ Specialty Pharmacy Video Consultation Program. BriovaLive enables patients to schedule private appointments with a BriovaRx specialty pharmacist via webcam, on any type of device, from the comfort of the patient's home. Patients who participated in the BriovaLive support program were significantly more likely to be adherent to their medications than those who did not participate. Ninety-six percent of participating patients reported that they better understood how to use their medications because of the program.

About PBMI
The Pharmacy Benefit Management Institute is dedicated to unraveling the complexities of pharmacy benefit management by providing research, continuing education, and Web resources that help organizations work effectively with their pharmacy benefit managers to improve the overall management of drug benefit programs. Learn more at www.pbmi.com.

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