It must be a record!

Twice each year, several thousand pharmacists and health care professionals from across the country convene at an Academy of Managed Care Pharmacy (AMCP) conference to continue their educations and network. One major component of each of these conferences is the poster presentations where researchers and professionals from all corners of health care can share their insights and outcomes of advanced managed care practice.

In a strong showing, Prime’s health outcomes team presented seven research posters at the conference in late October. “We are very appreciative to be recognized by AMCP with poster awards for the majority of our submissions this fall,” says Patrick Gleason, PharmD, assistant vice president, health outcomes team at Prime Therapeutics and AMCP board member. “The rigor of AMCP’s peer review process reinforces the integrity of our study methodology. Acceptance shows that the Academy sees the topics as relevant to the industry. And the awards give us better opportunities at the conference to talk to our peers about the research.”

Prime’s ability to draw insights from medical and pharmacy claims data is a key differentiator. The research demonstrates Prime’s unique total drug management approach and access to real-world evidence that allows for meaningful results.

Prime shows Drug Super Spender research during a poster session at AMCP

Picture (left to right): David Eckwright, health outcomes research principal; Steven Champaloux, data scientist principal; James Burke, health outcomes research principal.

Prime’s presented research

Platinum Award winner – podium presentation

Osimertinib (Tagrisso) First Line Approval in Epidermal Growth Factor Receptor (EGFR) Mutation Positive Metastatic Non-Small Cell Lung Cancer (NSCLC) Impact on Utilization and Total Cost of Care among 15 Million Commercially Insured Members

Major finding: The study shows a ten-fold increase in the use of osimertinib (Tagrisso®) – an epidermal growth factor receptor inhibitor (EGFR-i) – since it became a guideline recommended first-line cancer therapy option in late 2017. These real-world findings of members with non-small cell lung cancer (NSCLC) treated with an EGFR-i show those taking Tagrisso® had a 50% higher total cost of care than those using competitor EGFR-i products, resulting in an additional $4 million in drug costs for payers over two years’ time.

Gold Award winners

Proactive Pharmacist Call Program: Assessing the Impact of a Predictive Model-Driven Medicare Member Outreach on Adherence and Star Ratings

Major finding: In the pharmacist call program, Medicare members’ adherence to their medicines improved following proactive phone calls from pharmacists informed by a predictive model. The program focused on members with diabetes, hypertension and high cholesterol.

Medicaid Missed Refill Letter Intervention Impact on Refill Rate versus Randomized Controls

Major finding: A Medicaid Missed Refill Program found that reminder letters drove a 14-18% higher rate of refilled prescriptions in three chronic drug therapy categories (depression, diabetes and asthma) over a randomized group of members who didn’t receive a letter.

Silver Award winner

Drug Super Spenders: 2016 to 2018 Growth in Number of Members and Total Pharmacy Plus Medical Benefit Drug Cost for Members with Extremely High Annual Drug Cost in a 17 Million Member Commercially Insured Population

Major finding: The study shows a sharp jump in the number of drug super spenders – members with pharmacy and medical drug therapy claims totaling $250,000 or more annually. With pharmaceutical manufacturers bringing more ultra-expensive treatments to market, Prime is using predictive analytics to identify the very small, but fast-growing group of drug super spenders to uncover savings opportunities and create optimal care strategies to better meet members’ and insurers (e.g., self-insured employers) needs and help control costs.

Additional research

Real World Botulinum Toxin Utilization and Treatment Cost for Cervical Dystonia and Limb Spasticity among 15 Million Commercially Insured Members

Major finding: Prime researchers analyzed real-world use of the botulinum toxin (BT) Botox® (Onabotulinumtoxin A) and three other BTs approved to treat several movement disorders and found shifting treatments from Botox® to the equally effective, lower cost BT therapies would save an estimated $6.3 million annually.

Calcitonin Gene-related Peptides (CGRPs) Uptake and Acute Migraine Medication Use among 15 Million Commercially Insured Members

Major finding: The study shows a rapid, increased use of three new medicines to prevent chronic migraines. However, each of these new calcitonin gene-related peptide (CGRP) receptor blockers carries a wholesale cost of approximately $600 per month, and CGRP drug costs are expected to reach $15 million per month by the end of 2020 – triple the cost seen in July 2019. One positive, this real-world study also showed a statistically significant decrease (5%) in the number of members with an opioid claim in the six months after starting CGRP therapy.

Short Acting Opioid Duration Edit Substantially Reduces Large Days Supply for Opioid Naive Members

Major finding: Alerts sent to pharmacies notifying them that insurance would cover no more than a 7-day supply for patients who were newly starting opioid therapy resulted in a decrease in patients receiving too much of the opioid drug.

For more of Prime’s research, go to Prime Insights research page.