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Prescriber Education Programs_ An Evidence-Based

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									Prescription Drug Policy
        Update:
 Evidence-Based Prescribing

             Ann L. Woloson,
             Executive Director
             Prescription Policy Choices


             Health Action 2012
             Families USA
             January 21, 2012
Prescription Policy Choices (PPC)

l Nonprofit, nonpartisan 501(c) (3) educational & public
  policy organization providing objective research,
  information and expertise on prescription drug policy to
  ensure access to safe, effective and affordable
  prescription drugs in Maine and the US
l Foundation & Consumer Advocacy Group Funding:
    Nathan Cummings Foundation, Endowment for Health, Maine
    Health Access Foundation, Bingham Program, Consumers
    Union, Community Catalyst-Pew Prescription Project, Sadie and
    Harry Davis Foundation, Maine Community Foundations
l   No Industry Funding
Evidence-based prescribing: Most
effective, safe and cost-effective drugs

    Uses unbiased, objective information (the
    science) about the relative effectiveness,
    safety and cost-effectiveness of Rx drugs
l   Improves health care quality
l   Helps maintain access to health care services by investing
    resources wisely
l   Reduces prescription drug (and health care) costs
l   “Preferred” does not always mean “evidenced-based” or best
    value
Evidenced-based Drugs:
Three Points for Policy Impact

1.       Prescribers
     –   Academic Detailing/prescriber education (counters drug reps in
         prescriber’s offices)

2.       Consumers
     –   Consumer Reports Health Best Buy Drugs™ / Consumer
         component to academic detailing (counters direct-to- consumer
         advertising) –AARP Drug Saving Tool

3.       Payers – Promotes quality, contains costs
     –   Using evidence-based information in preferred drug lists/formulary
         development Drug Effectiveness Review Project (DERP), AHRQ
         Effective Healthcare, etc.
Providers/Prescribers:
Academic Detialing/Provider Education

  –   Educational outreach to prescribers at practice site provided
      by clinicians
  –   Balanced data about medications based on evidenced-
      based, independent, non-commercial sources
  –   -Counters Drug Rep activity in provider practices: provides
      information on entire class of drugs re: what works best and
      is safest – compared to drug reps promoting specific new
      product
  –   -Active Academic Detailing Programs in VT, ME, DC, PA
  –   -Well received by physicians who participate
Consumer engagement

l   80 drug ads every hour, every day on TV
     (Nielsen Co.)

l   30% of people have spoken to their doctors about a
    drug ad; 44% got the prescription they asked about
    (Kaiser Family Foundation)

l   PPC is working with Consumer Reports Health Best
    Buy Drugs™ to promote evidence-based drugs
l   Vision: independent scientific evidence (what works
    best, is safest, and most often, more affordable - not
    branding and marketing - should drive consumers
Consumer Reports Health Best Buy Drugs™
   What works best, is safest and cost-
        effective (tried and true)
www.CRBestBuyDrugs.orgReports


    Drugs to treat high cholesterol: The Statins / Drugs to treat hepatitis C
  Drugs to treat rheumatoid arthritis/ Migraine Headache Drugs – the Triptans
       Drugs to Treat Enlarged Prostate / Osteoarthritis, Pain – the NSAIDs
       Drugs to Treat Muscle Spasms and Spasticity: Muscle Relaxants
      Drugs to Treat Nausea and Vomiting: The Oral 5-HT3 Antagonists
               Drugs for Heartburn, Acid Reflux Disease - the PPIs
     Drugs to Treat Schizophrenia and Bipolar Disorder /Antidepressants
                Attention Deficit Hyperactivity Disorder Drugs
            Angina, High Blood Pressure – Calcium Channel Blockers
             High Blood Pressure, Heart Failure – the ACE Inhibitors
             Heart Disease and High Blood Pressure – Beta-Blockers
                Treating Type 2 Diabetes – the Oral Diabetes Drugs
    Constipation Drugs / Menopause – Hormones/ Sleeping Pills for Insomnia
                       Treating Chronic Pain – the Opioids
  Treating Bipolar Disorder, Nerve Pain and Fibromalagia – the Anticonvulsants
         Treating Heart Disease, Heart Attack, and Stroke – Antiplatelets
        Overactive Bladder / Asthma and Lung Disease – Inhaled Steroids
   Alzheimer’s Disease Drugs/ Allergies, Hay Fever, and Hives – Antihistamines
Consumer Magazines

l   Best Buy Drugs offers a free, independent consumer
    magazine with no industry advertising
    - ConsumerReportsHealth.org/BestBuyDrugs
l   Compare to WebMD Magazine
    –   includes many advertisements mostly for Brand drugs
    –   sponsored sections are not reviewed by the WebMD Editorial
        Department for accuracy, objectivity or balance

    Request Best Buy Drug Magazines by contacting PPC at
     (207) 512-2138 or awoloson@policychoices.org
AARP’s Drug Savings Tool helps patients
get the most value for and learn more
about the prescription drugs they take


•1 Select Drug                                           http://drugsavings.aarp.org/
 Search for a drug you are taking.
•2 Review Options
 Review your drug’s price range and efficacy and compare it to Consumer Reports
 Best Buy Drugs. Print out your options for discussion with your doctor.
•3 Learn More
 View more information about this group of drugs, including safety and effectiveness.
Talk With Your Doctor:
• Is the medication you’re taking is really the best one for your condition?
• Is there a less expensive, but equally effective medication you can use
  instead?
• Or is there a comparable drug with fewer side effects?
Payers: Minnesota Study*
of Public and Private Plans

l Increasing the utilization of evidenced-based
  recommended drugs can yield cost-savings
of more than 50% (for drug categories studied)
l Achieved through formulary/ PDL changes
  that incentivize value-based utilization of
  prescription drugs
*Kjos, AL, et al. A comparison of drug formularies and the potential for cost-savings.
American Health & Drug Benefits, vol 3, No. 5 (September/October 2010): 321-330.
Payers: Avandia Example

l   ME: Avandia was listed as preferred in 2009
Avandia sales peaked at about $3 billion in 2006 - world’s best-
  selling diabetes Type II med. Sales dropped sharply after a
  2007 NE Journal of Medicine report linking it to increased heart
  attack and cardiovascular death risks
l   Metformin, a generic drug, is recommended drug
    alternative (supported by DERP/CRHBBD™)
l   Estimated potential savings for replacing Avandia
    with metformin in 2009: $150,000 (does not include
    potential savings related to improved quality)
                        Payers
Are States working to make sure public and private health
programs are making use of the best, most effective and
safest drugs? Are States using evidence-based information?
lHow are States integrating evidenced-based information into Rx
drug coverage decision-making processes?
lEvidenced-based resources for state policy makers:
        RAPID: Regional Adaptation for Payer Policy Decisions
        PCORI: Patient Centered Outcomes Research Institute
        AHRQ: Agency for Health Research and Quality
               Effective Healthcare Program
       DERP: Drug Effectiveness Review Project
For More Information


    Please visit www.policychoices.org

          Contact information:
              Ann Woloson
        awoloson@policychoices.org
              207-512-2138

								
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