Biotechnology Healthcare - September/October 2008 - (Page 43)

SPECIALTY PHARMACY The Value of Value-Added Services Scott Kober, Contributing Editor T he generally accepted distribution model for traHealthways, a Nashville-based provider of patient care and ditional pharmaceuticals has always been pretty health-support services. “It doesn’t make sense to prescribe clear — walk into your neighborhood pharmacy, three or four extremely high-cost drugs for patients withhand over the written prescription, fork over out also addressing behavior and expect that to be the most your copayment, follow the simple instruction on the cost-effective way of dealing with their conditions over label, and call your physician if any problems arise. It’s a time. You need to promote behavior change — not by policroutine almost everyone follows dozens of times throughing patients and lecturing them on why they need to take out their lives. It works, and it works well. their medications, but by coaching them and But with the emergence of specialty pharreadying them to change their lifestyles. maceuticals, it became obvious that patient “So many of these high-touch services promanagement was not going to be as simple as moting lifestyle change are effective across filling out a form. Because of the complexity multiple conditions and have such a low price of specialty pharmaceuticals — along with compared with the overall cost of a specialty the financial investment they required — the drug. If you bring about change, even a little, rise of value-added services was inevitable. it’s clearly a winning proposition for better As so often happens in new niche induspatient outcomes.” tries, the carnival barkers initially came out in Today’s value-added services cover a wide full force, promising everything to any health Promoting behavior scope. They can be as simple as lifestyle manchange, not policing or plan and employer willing to listen: We’ll lecturing patients, is agement programs that encourage people to promise you 100 percent compliance for your more effective in manparticipate in exercise protocols intended to patients with rheumatoid arthritis on biologic aging conditions over help manage symptoms of RA, or as complex therapies! Naturally, those that could not de- time, believes Dexter as hands-on, day-to-day management of heShurney, MD, MPH. liver on promises were slowly weeded out. patitis C patients so that they take their preWhat has evolved is a complex array of ofscribed dose of antiviral medications. ferings that may be attached to specialty pharmacy on eiAlthough their working mechanisms may be very difther the distribution or service side. It can seem like a conferent, the promise of every proposed value-added service fusing mix of choices; is one-on-one counseling to help is simple: improve patient outcomes and, consequently, individuals quit smoking worth any more or less than a save money. But the primary question surrounding them reneonatal care management program? But those are the mains as complex as ever: Which value-added services kinds of decisions that many employers are faced with. truly add value — and which are merely marketing? “If 80 percent of chronic conditions are lifestyle-related, “Most value-added services are centered around one of then we need to address the root cause of the problem first two concepts — cost or convenience,” says Judi Grupp, to have any chance of success,” says Dexter Shurney, MD, president of ActiveCare Network, a provider of vaccine, inMPH, senior vice president and chief medical officer for jection, and infusion services throughout the United States. “When you have chronic patients you are trying to manage over long periods of time, you want not only patientWhat is a value-added service? reported data, which can be very subjective, but also cliniValue-added services provide employers and cal data that show whether the drug is working like it’s health plans with an array of choices, such as: supposed to. Health plans don’t mind covering a biologic if it does what it is supposed to do, but they need data • Adherence and disease management programs to help make that decision. More and more frequently, • Reimbursement assistance that’s what we’re asked to provide.” • Data products for payers and manufacturers • • • • Infusion therapy Physician education and support Patient education and support Patient lifestyle management DRIVEN BY DATA It’s not surprising that in this data-rich era, providers of value-added services are increasingly being asked for statistical evidence of their effectiveness. As Shurney points SEPTEMBER/OCTOBER 2008 · BIOTECHNOLOGY HEALTHCARE 43

Table of Contents Feed for the Digital Edition of Biotechnology Healthcare - September/October 2008

Biotechnology Healthcare - September/October 2008 Openers Editorial/David B. Nash, MD, MBA Contents At a Glance: Multiple Sclerosis Drug Track Personalized Medicine Healthcare Reform’s Effects on Biologic Access Breast Cancer Status Testing: A Crapshoot With Deadly Odds Trends, Issues, and Perspectives In the Management of MS So High-Tech, Yet So Simple The Evolution of Ascertaining the Value Proposition Specialty Pharmacy Employer to Employer Health Plan Confidential Trends

Biotechnology Healthcare - September/October 2008

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