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BCBS Plans Implement Programs Encouraging Appropriate Use of Prescription Drugs
A report released today by the Blue Cross and Blue Shield Association (BCBSA) examines the issue in detail. The report was commissioned as part of BCBSA's multi-year initiative to champion healthcare affordability in the United States. Prescription drug costs continue to be one of the top drivers of healthcare costs. In 2002, the annual growth rate for prescription drugs was 11.8 percent, according to IMS Health, a prescription tracking service.
Blue Cross and Blue Shield Plans around the country have developed innovative programs to encourage appropriate drug use:
- Excellus BlueCross BlueShield in New York is working closely with physicians using nationally recognized approaches such as a team of pharmacy services consultants who visit physicians in their offices to provide up-to-date, accurate information on drugs. Excellus also operates a toll-free drug information line and the Rx Facts newsletter that provides objective drug information on a monthly basis to physicians and pharmacists and provides compliance assistance on selected medications. Counter-detailing efforts to physicians dovetail with member education and outreach and employer information services. Excellus’ saved its members and the health plan more than $8 million in direct costs in 2002, plus demonstrated improvement in compliance and outcomes in targeted disease categories.
- Highmark, Inc. in Pennsylvania has partnered with its pharmacy benefits manager on a first-of-its-kind nationwide generic drug sampling initiative. The Western Pennsylvania Generics First program provides physicians with generic prescription drug education materials and access to free generic medication samples in four frequently prescribed, expensive drug categories with generic equivalents – anti-hypertensives, anti-depressants, gastrointestinal agents and non-steroidal anti-inflammatory medications. Through the two-year-old program, more than 600 physicians in Western Pennsylvania have ordered more than 100,000 generic drug samples, equaling nearly 600,000 days of drug therapy.
- Blue Cross Blue Shield of Minnesota has an eight year old program that sends registered pharmacists to physician offices, targeting the top 20 percent that write 80 percent of all prescriptions. The pharmacists walk the physicians through evidence-based information showing the appropriate populations for drugs and explaining the effectiveness and value of generics. Physicians receive reports on their prescribing patterns compared to their peers. The program has documented an increase in generic use and an increase in appropriate prescriptions overall. This is positive because many important drugs, like beta blockers, are underprescribed. Allan Korn, M.D., BCBSA Chief Medical Officer, said the Blue Plan initiatives are part of a national effort to provide better information to increase consumer access to generic drugs and improve drug safety.
"We also are actively supporting the Food and Drug Administration's public service campaign to raise awareness of the safety and effectiveness of generic drugs," Dr. Korn said. "Blue Plans are stepping up to collectively provide prescribing data to the FDA as part of a nationwide collaboration to enhance the quality of drug safety information the FDA provides to physicians and pharmacists.”
The BCBSA report -- "Getting Doctors to Say 'Yes' to Drugs: the Cost and Quality Impact of Drug Company Marketing to Physicians" -- examines the extent to which pharmaceutical companies' promotional efforts contribute to both the appropriate and inappropriate use of medications and their impact on the quality and cost of patient care.
“One need not go to extremes of argument – e.g., banning all contact between physicians and pharma representatives – to conclude that substantial changes in current marketing practices are needed to protect the public,” concludes the report. “These practices have victims – some Americans will lose their health insurance entirely while others will see their benefits reduced because of rising costs that could have been avoided.”
The report notes that the “pharmaceutical industry suggests that any assessment of the cost of pharmaceuticals must include the value of what the money is buying in terms of lowering costs elsewhere. However, a balanced assessment of the 'value of medicines' cannot consist of an equation with only one side to it."
It continues: "Some pharmaceutical firms pour more than $1 billion each into their sales forces every year. By comparison, President Bush proposed spending a total of $940 million for grants to state and local health departments to meet threats ranging from SARS to bioterrorism."
"In addition to influencing physicians to prescribe unnecessary medications, industry promotional activities can lead to the prescription of expensive new drugs when less expensive ones are at least equally effective."
Source: Blue Cross and Blue Shield Association