Building resiliency in the time of a pandemic is an ongoing process. It also serves as a reminder that there are other events that can impact our safety, health and well being. These can include drug shortages, drug recalls and the impact of high cost prescription medications on our ability to adhere to prescribed treatment regimens.
In April of this year, the FDA announced an immediate market withdrawal of ranitidine drugs, more commonly known as Zantac, due to reported carcinogen contamination. This was following months of voluntary recalls after traces of the carcinogen were first reported in 2019.* This year, the FDA finally clamped down. This recall has affected millions who take the OTC drug, along with 15 million people on prescription-strength Zantac. And then, to add insult to injury, we quickly learned how one recall can also affect a shortage in another drug. In this case it was Pepcid, as people switched over from Zantac.
Health plan members with access to a drug comparison or therapeutic interchange tool can log online from any device and look for therapeutic options for Zantac or Pepcid. Armed with new information, this tool supports members in talking to their prescribers about both prescription and OTC alternatives, which could include nizatidine (Axid) and cimetidine (Tagamet).
Therapeutic Interchange offers options
In the current social distancing environment, minimizing trips to retail stores, like pharmacies, is desirable. When looking for an OTC product, such as Zantac, members can log on to a therapeutic interchange tool instead, identify medication options, order the drug online and pick it up through a pharmacy drive thru or have it shipped directly to their home.
Therapeutic interchange goes beyond replacing high-cost brand prescription medications with generic equivalents. Therapeutic interchange may also include brand, generic and OTC products that help reduce costs, increase medication adherence, improve outcomes and alleviate possible fears about drug shortages. The ultimate goal is to get therapeutic interchange in the hands of the prescriber, so lower cost medication options start there and flow from the point of prescribing all the way through to the member.
With many benefits, therapeutic interchange is an opportunity to build resiliency in uncertain times.
Impact of high cost drugs on medication adherence
Data shows that the cost of medications is the biggest barrier to medication adherence. As studies have shown time and again, when drugs cost less, members are more apt to follow their prescribed treatments. Medication adherence leads to better health outcomes.
According to a 2019 Kaiser Family Foundation report, 23 percent of seniors say it’s difficult to afford their prescription drugs. Nearly 30 percent report not taking their medicines as prescribed due to cost and eight percent say their condition worsened due to not taking their medication as prescribed.
Unfulfilled prescriptions can also lead to an increased risk of patients going to the ER, along with the chance of costly hospital readmissions.
More options at the point of prescribing
When prescribers can see costs and different medication options at the time of writing a prescription, health plans members are often pleased to have this additional information before they get to a pharmacy. A prescriber can also gain much broader knowledge into available options when they can see all aspects of a drug. This can include not just costs, but also potential side effects, other drugs that may be on the plan’s formulary and any formulary restrictions such as Prior Authorizations (PA) or quantity restrictions. With this information, prescribers can make better health and financial decisions for their patients and members.
Improving Medicare star ratings
Health plans can also build resiliency by improving performance as demonstrated by their Medicare star ratings, which are key measures of health plan quality. Ratings consider a number of key clinical quality measures that ultimately demonstrate how well a health plan takes care of its members. There are eight (out of 48) measures that specifically pertain to medication management.** Health plans that make it easier for beneficiaries to access and take their medications could see higher member engagement.
Proactive Outreach Campaigns
Health plans can proactively connect with members regarding their high cost drugs and suggest they speak with their prescriber about lower cost alternatives. Members can discuss switching or decide to stay with their current prescription. This type of outreach is data driven, supported by a tool that all stakeholders can use to get drug information. Empowering members to talk to their prescribers about options can open up lines of communication so important to building health plan resiliency.
ConnectureDRX and Therapeutic Interchange
ConnectureDRX has a long history in pricing prescription drug products and offers a robust therapeutic interchange solution. Janie Kim, Clinical Director of ConnectureDRX says, “We are working to enhance the therapeutic interchange process by changing the way prescriptions and healthcare costs are managed today.”
Kim adds, “Building resiliency means empowering health plans, pharmacies and prescribers with technology that supports current prescribing trends. This means using carrier data, real-time pricing and ensuring clinical content and drug databases include the most current medication options available at all times.”
ConnectureDRX’s therapeutic interchange product is for both commercial and Medicare insurance products. This repository of prescription drug options, along with the pricing tool, can be integrated with electronic health record (EHR) systems and enables the prescriber to look up member cost and drug options when writing prescriptions.
“Providing the best fit drug for each member, cost savings and improving outcomes matter more today than ever before,” says Kim. “Having a therapeutic interchange database is certainly a valuable tool in today’s uncertain times and an extraordinary opportunity to support drug conservation strategies.”
Medication adherence, lower drug costs and improving outcomes are essential to managing health and increasing well being. Empowering health plans, pharmacies, prescribers and members alike with the right therapeutic interchange tool (one backed by extensive clinical expertise and experience) will help build much needed resiliency today and always.
*Zantac Recall, Drug Watch
FDA Updates and Press Announcements on NDMA in Zantac
May 2020 – famotidine shortages reported due to recalls in this class of drugs
KFF Health Tracking Poll – February 2019: Prescription Drugs
**Medication Adherence: The Lever to Improve Medicare Advantage Star Ratings