Identifying and managing diabetes and weight loss therapies earns AMCP platinum award
EAGAN, Minn., Oct. 16, 2023 /PRNewswire/ -- Prime Therapeutics LLC/Magellan Rx Management (Prime/MRx) will present three research studies at the 2023 Academy of Managed Care Pharmacy (AMCP) Nexus event, October 16-19 in Orlando, Fla.
Health outcomes teams from the organization used integrated medical and pharmacy claims data to evaluate real-world drug utilization, managed care pharmacy programs, and associated costs of care for a range of conditions, including diabetes, lymphoma, and hemophilia.
"Our aim is to improve health outcomes and reduce health care costs, which is why it's particularly important for our teams to research these conditions associated with high costs of care," said Pat Gleason, PharmD, assistant vice president for health outcomes at Prime.
The following studies will be featured at this year's event:
As a recipient of an AMCP platinum award, this study looks at members taking duplicate glucagon-like peptide-1 agonists (GLP-1a), duplicate dipeptidyl peptidase-4 inhibitors (DPP4) or a combination of both drugs that work through the same incretin pathway to lower blood sugar. This study shows that when members switch from duplicate incretin treatments to a single drug therapy through the HighTouchRx®, Prime's clinical program, $3.5 million in validated savings can be delivered, at an average $7,578 saved per case.
Duplicate incretin therapy has not been shown to result in improved diabetes clinical outcomes, however, it can increase costs and may increase adverse drug effects. What's more, GLP-1a drugs have become an increasingly popular weight loss therapy, exacerbating drug shortages and increasing costs.
Eliminating duplicate incretin therapy is especially important due to the increasing costs of both GLP-1a and DPP4 drugs. Among the 12 million commercially insured members studied, the per patient per month (PMPM) expenditure for GLP-1a and DPP4 drugs increased by 59% from August 2022 ($13.45 PMPM) to July 2023 ($21.38 PMPM).
This study looks at the effectiveness of HighTouchRx to curb duplicate therapies. One in 59 commercially insured members had an incretin drug therapy claim during the term of the study, and one in 20 of those appear to be using duplicate incretin therapies. When a managed care pharmacist-to-prescriber outreach was performed requesting a change to a single incretin drug therapy, the success rate for switching users to one therapy was 66%.
Prime also recently announced a real-world analysis of individuals using GLP-1a drugs for weight loss, which found low adherence and an increased cost of care in the first year.
"GLP-1a drugs continue to be a dynamic trend in health care, and we will remain focused on this class of drugs to continue providing data and insights that support the most informed heath care decisions," Gleason said.
For more on this study, watch a video recap of the research here.
Chimeric antigen receptor (CAR) T-cell therapy is engineered from patients' own immune cells, where T-cells are removed and genetically modified to produce CARs to treat cancer. This has revolutionized the treatment of large B-cell lymphoma (LBCL) and non-Hodgkin lymphoma (NHL).
This study finds that four in 10 members with LBCL fail to achieve positive CAR T-cell therapy outcomes.
This study also looks at real-world integrated medical and pharmacy claims data to better understand clinical outcomes following CAR T-cell infusion outside the clinical trial setting, particularly cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), which are common CAR T-cell associated toxicities within six months after CAR T-cell infusion.
Of the individuals identified in the study, 44.6% have one or more claim for CRS or ICANS during follow-up, and 6.9% initiated subsequent systemic treatment prior to disenrollment or end of follow-up, including chemotherapy (26.2%) and radiation (10.8%).
With 40% of members with LBCL failing to achieve positive CAR T-cell therapy outcomes, this study suggests that pharmaceutical manufacturers should be offering value-based purchase agreements.
Hemophilia is a rare, inherited bleeding disorder caused by missing or defective clotting factors. Treatment options include factor products, bypassing agents, and gene therapy. This study illustrates the impact of comprehensive hemophilia care and managed care strategies which led to more than $3.7 million in cost avoidance. And overall, implementation of a comprehensive hemophilia management program resulted in decreased utilization of high-cost products, prevented unnecessary spend, improved quarterly post-program bleed rates, and enhanced the quality of documentation for reporting.
Annualized bleed rate (ABR) is one way to assess the clinical benefits of treatment, and decreased ABR can lead to long-term health benefits and reduction in total cost of care by preventing negative effects from uncontrolled bleeding. After implementing MRx's Hemophilia Management Program among impacted members, overall utilization of high-cost hemophilia agents decreased by 12.5%, which equates to more than $3.7 million in cost avoidance for those with managed treatment ($0.12 PMPM cost avoidance). ABR also decreased during the term of the study from an average of 0.55 to 0.24 bleeding events per individual.
Prime researchers also will present several sessions during AMCP Nexus. More information about these presentations can be found on Prime Therapeutics' events page or the AMCP Nexus website.
And for further insights on the studies noted above, visit Prime Therapeutics' newsroom.
About Prime Therapeutics + Magellan Rx
Prime Therapeutics LLC (Prime) is a diversified pharmacy solutions organization serving health plans, employers and government programs. Prime is collectively owned by 19 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans. Magellan Rx Management LLC, a Prime Therapeutics LLC Company, is a pioneer in specialty and medical drug management and a leader in serving public sector state government programs. Together Prime and Magellan Rx provide a wide range of clients with solutions that bridge the distance between medical and pharmacy management. For more information visit primetherapeutics.com and magellanrx.com or follow us on X (Twitter) at @Prime_PBM and @Magellan_Rx.
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SOURCE Prime Therapeutics LLC