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Value of Pharmaceuticals in Managed Care Pharmacy PowerPoint Presentation

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Description : This presentation on Value of Pharmaceuticals in Managed Care Pharmacy was created by the School of Pharmacy Relations Committee for AMCP.

Tags : Managed Care Pharmacy, healthcare, Academy of Managed Care Pharmacy, pharmacists, Managed Care Organizations, Student Pharmacist, Medication Therapy Management, Part D, Prescription Drug, Biosimilars, Specialty Pharmacy, specialty pharmaceuticals

Published on : Jul 01, 2020 | Views : 1934 | Downloads : 1

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Slide 1-

Value of Pharmaceuticals in Managed Care Pharmacy Created by the School of Pharmacy Relations Committee for AMCP Updated: March 2020
Slide 2-

Managed care pharmacy focuses on: Developing and applying evidence-based medication use strategies that enhance patient and population health outcomes while optimizing the use of available healthcare resources A structured approach to financing and delivering covered healthcare benefits designed to provide affordable access to improve the quality of care in a cost-effective manner What is Managed Care Pharmacy?
Slide 3-

The Value Equation for Pharmaceuticals If benefit increases, and cost decreases, value of the pharmaceutical is increased substantially If benefit remains constant, and cost increases, the value decreases If benefit increases, and cost remains constant, the value increases VALUE = Benefit Cost Evidence-based treatments that increase the likelihood of achieving desired health outcomes Usually defined as drug cost, and as applicable administration and adverse effect costs
Slide 4-

Pharmaceuticals in the Total Healthcare Process The value of pharmaceuticals is also taken into consideration in context of the total healthcare delivery process Lifestyle changes Pharmaceuticals Surgical/Invasive interventions Three options for treatment of disease Least invasive, usually considered first, when appropriate Considering a choice between a pharmaceutical regimen or surgical/invasive procedure, most will choose a pharmaceutical regimen if appropriate
Slide 5-

The Importance of Innovation Pharmaceuticals help people to manage their illnesses and live longer and/or more productive lives Pharmaceuticals may reduce costs by preventing expensive hospital treatments and other therapies Today’s medicines fund research and development for tomorrow’s prescription drug innovations From 2010 through 2019, the FDA averaged about 37 novel drug approvals per year [range of 21-59 approvals per year] Managed care entities review clinical and economic data supporting each innovative drug approved by the FDA to assess its value and manage patient access accordingly
Slide 6-

Increasing Life Expectancy Studies have shown that pharmaceutical innovation was a significant contributor to the increased life expectancy observed worldwide between 1986-2009
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Decreasing Mortality: Cancer Source: 1WHO Mortality Database (accessed January 2017); 2American Cancer Society Cancer Statistics Center; 3Sun et al., 2008, “The determinants of recent gains cancer survival: an analysis of the surveillance, epidemiology, and end results (SEER) database,” Journal of Clinical Oncology.
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Decreasing Mortality: Chronic Diseases Note: The four main types of chronic diseases defined by WHO are cardiovascular diseases (e.g. heart attacks and stroke), cancers, chronic respiratory diseases (e.g. chronic obstructed pulmonary disease and asthma) and diabetes. Source: 1US Food and Drug Administration; 2WHO Mortality Database (accessed February 2016); 3Kremer, 2008, “COMET’s path, and the new biologicals in rheumatoid arthritis,” Lancet.
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Curing Deadly Diseases: Hepatitis C Source: 1WHO Mortality Database (accessed January 2017); 2American Cancer Society Cancer Statistics Center; 3Sun et al., 2008, “The determinants of recent gains cancer survival: an analysis of the surveillance, epidemiology, and end results (SEER) database,” Journal of Clinical Oncology.
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Reducing Hospitalizations and Other Costs *Countries include Australia, Austria, Belgium, Canada, Czech Republic, Finland, France, Germany, Hungary, Italy, Japan, Korea, New Zealand, Norway, Poland, Slovak Republic, Spain, Switzerland, Turkey, UK and US. Source: 1Preaud, 2014, “Annual public health and economic benefits of seasonal influenza vaccination,” BMC Public Health; 2Lichtenberg, 2009, “Have newer CV drugs reduced hospitalizations in 20 OECD countries? Evidence from longitudinal country-level data on 20 OECD countries, 1995-2003,” Health Economics.
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Minimizing Workplace Productivity Loss Note: Conventional therapy refers to conventional disease-modifying anti-rheumatic drugs. Presenteeism is the act of attending work while sick. Source: 1Victoria Institute of Strategic Economic Studies, 2014, Impact of health on worker attendance and productivity in APEC region; 2Halpern et al., 2009, “Impact of adalimumab on work participation in rheumatoid arthritis: comparison of an open-label extension study and a registry-based control group,” Annals of the Rheumatic Diseases.
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Medicines Are Part of the Solution Note: Each product is counted exactly once, regardless of the number of indications pursued. Source: Adis R&D Insight Database.
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References AMCP. Managed Care Glossary. https://www.amcp.org/about/managed-care-pharmacy-101/managed-care-glossary#M%20-%20R. Accessed March 8, 2020. Trygstad T. The Changing Value Equation in Pharmacy. Pharmacy Times. December 2015. https://www.pharmacytimes.com/publications/Directions-in-Pharmacy/2015/December2015/The-Changing-Value-Equation-in-Pharmacy. Accessed March 8, 2020. FDA. Advancing Health Through Innovation: New Drug Therapy Approvals 2019. January 2020. https://www.fda.gov/media/134493/download. Accessed March 8, 2020. Lichtenberg F. The Impact of New Drug Launches on Longevity: Evidence From Longitudinal, Disease-level Data From 52 Countries, 1982–2001. Int J Health Care Finance Econ. 2005;5(1):47-73. Available at: https://www0.gsb.columbia.edu/mygsb/faculty/research/pubfiles/1315/LICHTENBERG%20IJHCFE.pdf. Accessed March 8, 2020. Lichtenberg F. Pharmaceutical Innovation and Longevity Growth in 30 Developing and High-income Countries, 2000–2009. Health Policy and Technology. 2014;3(1):36-58. Available at: https://www.nber.org/papers/w18235.pdf. Accessed March 8, 2020. PhRMA. Prescription Medicines: International Costs in Context. March 2017. http://phrma-docs.phrma.org/files/dmfile/PhRMA-International-Costs-in-Context-2017-03-011.pdf. Accessed March 8, 2020.
Slide 14-

Thank you to AMCP members Maher Abdel-Sattar and Jorge Farias for updating this presentation for 2020.
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To improve patient health by ensuring access to high-quality, cost-effective medications and other therapies. Mission & Vision

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