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DEERFIELD, Ill. — Dr. David Lorber, vice president of clinical affairs at Walgreen Co., discussed key trends in specialty pharmacy at the Pinsonault Associates Managed Markets Summit in Miami.
Walgreens said that the Tuesday session, "Employer Issues in Specialty Pharmacy," examined the impact for payers, including the role of adherence in cost management and containment, benefit and coverage decisions, formulary and medical policy, pipeline management, provider network and member satisfaction and disruption.
"Specialty pharmacy is one of the most rapidly growing segments of total drug spending, which brings both concern as well as opportunity for enhanced efficiencies," according to Lorber. "As more people rely on specialty pharmacy medications, the health care industry needs to place an emphasis on cost control, appropriateness of care, adherence and waste management."
Specialty medications include complex treatment regimens and drugs that require special delivery, storage and handling, Walgreens noted. Depending on the condition and prescribed therapy, the medications may be taken orally, intravenously or self-injected. There is also enhanced clinical management to monitor medication adherence, side effects and dosage changes.
Specialty prescriptions typically cost about $2,000 for a 30-day supply, which is 28 times the traditional retail prescription, the drug store chain reported, adding that 3% to 5% of the population takes a specialty medication — a percentage that’s rising.
Citing a case study, Lorber noted that consistent patient adherence can result in savings. Walgreens multiple sclerosis patients adherent to medications, when compared to less-adherent patients, resulted in savings of about $1.1 million for a large national insurance payer for the 801 patients over a two-year period. The same case study also indicated higher adherence reduced costs related to multiple sclerosis emergency-room visits, inpatient stays and use of durable medical equipment, he added.
"Improving the health and well-being of patients can be accomplished by providing convenient access to drugs and ensuring there is a consistent and coordinated care management programs," Lorber explained. "Patient counseling and education by trained pharmacists and nurses, like those at Walgreens and Take Care Health Systems, translates into fewer office visits as a result of improved adherence. Proactive patient monitoring also drives early recognition of, and response to, adverse drug reactions and side effects, resulting in improved outcomes."
Walgreens said its specialty pharmacy offers patient assistance coordination, multiple distribution channels, strong manufacturer relationships, advanced clinical programs, cost management programs and access to limited distribution drugs.
Lorber joined Walgreens as the vice president of clinical affairs in November 2010 and is responsible for clinical oversight and consistency of Walgreens clinical programs. Previously, he was vice president of medical affairs at CVS Caremark.
