|Pharmacy Industry P4P Program Being Adopted
Add the pharmaceutical industry to the growing list of health-related industries recognizing the importance of P4P programs.
The Pharmacy Benefit Management Institute (PBMI) awarded
four 2010 Rx Benefit Innovation Awards to the 1199 Service Employees
International Union (SEIU) Benefit Funds, Blue Cross and Blue Shield of
North Carolina, Manatee County (Florida) Government Employee Health
Benefits, and Unity Health Plans Insurance Corporation with the
Wisconsin Pharmacy Quality Collaborative.
The 1199 SEIU Benefit Funds are being recognized for a
cost containment program offering members the most clinically effective
medications at no out-of-pocket cost, while achieving a -1 percent drug
trend. Blue Cross and Blue Shield of North Carolina (BCBSNC) is being
recognized for a program that increased medication adherence in its
chronic disease population by minimizing barriers to adherence.
In an era of increased cost-shifting to participants,
the 1199 SEIU Benefit Funds provide 420,000 members with access to a
range of generic and brand-name drugs at no cost, provided members
follow the plan. The Funds’ aggressive management strategies
include mandatory generics, mandatory mail-order for maintenance drugs,
and a preferred list. If members make choices outside these parameters,
they pay out-of-pocket. The approach has engaged members in using their
benefits wisely and saved more than $200 million in drug costs since
BCBSNC implemented member and provider strategies to
increase medication adherence in a 100,000-member population with
hypertension, high cholesterol, diabetes or congestive heart failure.
The plan offered free generics and reduced copayments for certain
brand-name drugs. Members received refill reminders and physicians
received ePrescribe messages about patient adherence.
Address: Pharmacy Benefit Management Institute, 8679
East San Alberto Dr., Suite 101, Scottsdale, AZ 85258-4368; (480)