Didn’t have time to attend our recent webinar on managing chronic conditions? Don’t worry – we’ve got you covered with a recap!
According to the most recent health expenditure data, the U.S. spent $3.8 trillion on health care in 2019.1 Patients with chronic diseases, such as heart disease, diabetes, cancer and arthritis, disproportionately drive health care spending, accounting for an astonishing 90% of the health care expenditures.2
Unfortunately, despite these very high costs, plans are seeing suboptimal outcomes, including low rates of adherence for medications used to treat chronic conditions. With high costs and poor outcomes, it’s no wonder chronic conditions have become a major area of focus for plan sponsors.
During a recent webinar, Laura Jester, PharmD, CSP, Nicholas Skalitzky, and Amanda Lee, PharmD, discussed solutions that drive real change for chronic condition populations, including how to:
Unfortunately, the strategy behind drug coverage and management often differs between the pharmacy and medical benefit, creating a significant barrier for plans. Plans might be implementing specialty drugs on the pharmacy side, but not the medical side, resulting in misalignment of drug management for chronic conditions.
These tips and tools can help bridge the gap between pharmacy and medical benefits, thereby reducing costs and improving the quality of care.
Despite the massive spending on health care and innovative new technologies hitting the market, significant health challenges still exist for members with chronic conditions. To provide you with a little more insight, these alarming statistics on adherence demonstrate an opportunity for clinical intervention.
With the goal of reducing health care spending, while simultaneously improving member health, clinicians must take advantage of every opportunity with a member to assess their personal barriers to adherence. Within programs such as Medication Therapy Management (MTM), a member's understanding of their medications, and the best way to monitor their efficacy can be checked. It's also an opportunity to identify side effect concerns that may be prompting the member to reduce their dose.
TIP: Most Medicare Part D plans include MTM programs, but MTM services can be provided to any patient population that would benefit from personalized member-level support, specifically patients with multiple chronic conditions and an extensive medication regimen.
Chronic conditions continue to be drivers of health care spend, while at the same time, optimal treatment outcomes are frequently not met. Consider how your PBM can help you better manage specialty drug spend for chronic conditions, increase medication adherence, close gaps in care and improve health outcomes.
Want to learn more? Watch the webinar on-demand today for more tips and tools to help you lower costs and improve the quality of care for chronic populations.