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Optum Study Documents Pivotal Role Specialty Pharmacy Plays In Improving Health Care Outcomes, Lowering Costs

A study published in the Journal of Managed Care Pharmacy measures how clinical management and adherence programs at a specialty pharmacy add value beyond what patients experience acquiring medications at conventional retail pharmacies.

The study, which followed for one year two groups of people enrolled in employer-sponsored benefit plans and who had kidney transplants, found that the specialty pharmacy program group showed consistently lower costs and higher therapy adherence compared with those using retail pharmacies, including a 30 percent reduction in transplant-related medical costs and a 13 percent reduction in overall health care costs.

“This research should be of great interest to stakeholders in health care who want to improve health outcomes and lower overall costs,” said Kevin Host, Pharm.D, senior vice president for Specialty Pharmacy, OptumRx. “It underscores the value of ensuring that patients have a positive experience and receive outstanding support to help ensure adherence.”

“We’ve seen similar outcomes in improving medication adherence and clinical results and lowering medical service costs through our specialty pharmacy programs in oral oncology, rheumatoid arthritis and multiple sclerosis,” said Suzanne Tschida, Pharm.D, BCPS, lead author for the study and vice president, Specialty Benefit & Outcomes Strategy, OptumRx. “We have found that, by delivering a simpler, more personalized and convenient member experience, we empower members to manage their medications and take ownership of their conditions.”

The study authors noted that medication adherence or compliance – defined as the extent to which patients take their medications as instructed by a physician – is a well-recognized problem in transplant medicine, and concrete solutions are hard to find. Based on available literature on the topic, the study authors found between 20 percent and 70 percent of patients who have received an organ transplant do not adhere to therapy – the rate varying with definitions of adherence measures and study populations. Moreover, the rate of nonadherence is highest at one to three years post-transplant, but it may happen at any point during lifelong therapy.

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