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WASHINGTON — Pharmacy Advisor, CVS Caremark Corp.’s integrated pharmacy-based program for diabetes and other chronic diseases, has demonstrably increased medication adherence rates and physician initiation of prescriptions for concomitant medications to improve patient health.
At a recent Health Affairs forum, CVS Caremark chief health care strategy and marketing officer Helena Foulkes presented findings from a new study that reviewed how Pharmacy Advisor, through targeted outreach and patient counseling, provided an innovative way to improve plan member health outcomes while working to reduce health care costs.
“This study highlights the central role pharmacists play in improving the health of their patients and how our programs leverage that expertise as we reinvent pharmacy care,” Foulkes said. “The program featured counseling by pharmacists at retail stores and a dedicated pharmacist call center for those identified as having diabetes.
“The pharmacist interventions resulted in increased patient adherence and encouraged higher initiation rates of medications needed to best treat diabetes,” she pointed out. “The results show we are helping people on their path to better health.”
Presentations at the event discussed studies published in the January issue of Health Affairs that focused on treatment and health care programs for people with diabetes. The issue included findings from the CVS Caremark study, which analyzed the pharmacy claims data of benefit members at a large Midwestern manufacturing company that focused on interventions with diabetes patients between October 2009 and April 2010.
The study followed medication behavior of an intervention group of 5,123 people with diabetes who were proactively counseled by retail and call center pharmacists and a control group of 24,124 patients with the disease who did not receive specialized counseling. The researchers measured gains in patient adherence and medication initiation rates — of concomitant therapies for diabetes, such as statins, ACE inhibitors and ARBs (angiotensin receptor blockers).
Researchers from CVS Caremark, assisted by experts from Harvard University and Brigham and Women’s Hospital, illustrated that contacts by pharmacists with the patients and their doctors increased therapy initiation rates by as much as 39% for the full sample and an even higher 68% for the group counseled at retail stores, and increased medication adherence rates by 2.1%. The researchers noted that face-to-face interventions by store pharmacists increased adherence rates by 3.9%.
The integrated pharmacy-based program featured counseling by pharmacists at 12 stores near the manufacturer’s headquarters and counseling through a dedicated pharmacist call center for those identified as having diabetes.
CVS Caremark launched Pharmacy Advisor for diabetes in 2009 because the cost and prevalence of the disease continues to rise. The American Diabetes Association estimated diabetes’ cost to the United States economy in 2007 at $174 billion.
The study estimated that the employer saved more than $600,000 through health care cost avoidance with the intervention group, while expenditures for the counseling totaled $200,000, a return on investment of $3 for every $1 spent on additional counseling.
“In a health care system eagerly seeking programs that can reduce costs and improve care, such simple, pharmacist-based counseling programs to improve adherence to existing medication regimens and initiate missing therapies should be of great value,” the researchers concluded.
Study lead author Dr. Troy Brennan, executive vice president and chief medical officer at CVS Caremark, said, “Ensuring adherence and appropriate treatment has long been the domain of primary care providers. However, as demands on the time of these providers increase, interventions carried out by pharmacists can complement primary care. Indeed, pharmacists are in the unique position to monitor patient adherence and effectively intervene when indicated.”
Brennan said the study also added insight into the problem of time-limited health care interventions. “This study showed that patients stay on their medications while they are actively counseled, but once those pharmacist-patient conversations ended, adherence fell quickly. We need to continue these kinds of interventions to make sure patients benefit from the full beneficial impact of their medications.”
