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United Physicians Incentive Program Reduces Pharmacy Costs

BINGHAM FARMS, Mich., April 17 /PRNewswire/ -- United Physicians reduced pharmacy costs by 6.8% through a pharmacy incentive program. The incentive program began in March 2002, when United Physicians Internists, Family Practitioners, and Gastroenterologists who participate in HMO plans were invited to participate in an incentive program that would encourage management of certain pharmaceutical costs. The results of this program show pharmacy costs decreased across all of the HMO plans for United Physicians participating doctors.

The program was designed to reduce costs in two pharmacy categories of Proton Pump Inhibitors (PPI), which are generally used for the treatment of acid reflux disease, and Selective Serotonin Re-uptake Inhibitors (SSRI), which are generally used for the treatment of anxiety and depression. A significant percentage of pharmacy costs can be attributed to drugs in these categories. They are among the most expensive and most frequently prescribed drugs. United Physicians' Medical Management staff evaluated drugs in these two categories based on cost and efficacy and made recommendations based on the results. Additionally, use of generic drugs, when appropriate, and judicious use of antibiotics, was recommended to the participating physicians.

A baseline measurement of the average prescription costs was determined using pharmacy claims data from the HMO plans. This baseline data was compared to pharmacy data from the period of the incentive program. During the monitoring process, 73% of United Physicians doctors participating in the program decreased their average costs in each of the two drug categories. Prizes were awarded to physicians who maintained the lowest average drug cost for the PPI and SSRI drug categories, and for those physicians who decreased their average drug cost by the greatest percentage overall.

"Our pharmacy incentive program was successful because of our effort to approach pharmacy savings in an unique way," said Dana Norris, B.S., R.N., C.C.M., medical resource manager at United Physicians. "We targeted two specific drug classifications and the specialists who were most likely to prescribe these types of medications. In addition, our program was for a short duration, which allowed us to keep it fresh in the minds of our physicians."

"The basic theory of the program can be summed up this way; when all things are equal, try the recommended drugs first," said Harry Doerr, M.D., medical director at United Physicians. "We felt other approaches to lowering pharmacy costs involved mostly punitive measures. Our approach was to offer an incentive to reduce costs and it seems to have worked."

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