Best Practices In Pharmacy Benefit Management Can Help Reduce 2.3 Million Adverse Drug Reactions That Affect Older Americans Each Year

• Medicines Considered the Fifth Leading Cause of Death for Seniors
  
• Prescription Solutions' Innovative Programs Can Help Employers and Health Plans Manage Costs and Promote Better Health

Costa Mesa, CA - Each year more than 2.3 million older Americans experience adverse reactions to the prescription drugs they take.

According to the Journal of the American Pharmacists Association, adverse drug reactions cost the nation about $177 billion annually. Many of these incidents involve people over the age of 65, who comprise about 12 percent of the population but consume about 30 percent of all prescribed medications.

Also, according to a recent article in BusinessWeek, medicines are considered the fifth-leading cause of death in this age group.

"As people get older, they take more and more medications, and the chances for an adverse reaction increase," said Joseph Addiego, M.D., chief medical officer for Prescription Solutions, a pharmacy benefit management (PBM) company with experience in managing drugs for older adults. "Adverse drug reactions often lead to hospitalization, prolonged illness and even death.

"Seniors and their families aren't the only ones affected by this problem," added Dr. Addiego. "Businesses and organizations of all kinds are affected as well. Many employers provide benefits for their retired workers. Also, as their average lifespan increases, more Americans are working past the age of retirement, and many companies have more older people on their payroll."

Based on their experience managing drug benefits for retirees and for Secure Horizons, one of the nation's largest Medicare Advantage health plans, pharmacists and physicians at Prescription Solutions have identified 10 best practices for safer management of prescription drugs for older adults.

1. Adopt technology linking the retail pharmacy with the pharmacy benefit management company so that the pharmacist is notified in real time if a new prescription might interact with another drug a patient is already taking. With this notification, the pharmacist can immediately take action to prevent a medication error.

2. Offer mail order pharmacy for prescription refills. Mail order pharmacies help monitor safety because they have claims data for a particular patient. Also, by filling a larger supply of refill medications – 90 days vs. 30 days – customers save an average of $400 a year by paying fewer copays. If seniors have questions, pharmacists are available by telephone for consultations. Seniors appreciate the convenience of mail order because they do not have to leave their homes to get their medications and over-the-counter drugs.

3. Implement programs enabling the PBM pharmacist to communicate with a doctor's office within 24 to 48 hours if a prescribed drug might adversely react with another drug or present safety issues for older individuals.

4. Identify patients who are taking multiple drugs so they can be monitored. Communications about potential problems can be sent to them and to their physicians.

5. Adopt management programs for injectables or specialty pharmacy drugs. These high-priced "wonder drugs," which can average $1,000-$1,500 a month or more per patient, are used to treat conditions such as multiple sclerosis, rheumatoid arthritis, cancer and other illnesses that require treatment for life. Specialized care managers can help these patients be compliant with their medication so that they stay as healthy as possible.

6. Require prior authorization for specific drugs that should be checked for the proper dosage, frequency of use and patient education.

7. Use generic drugs that are therapeutically equivalent to branded drugs and are often more affordable.

8. Monitor drugs that may be prescribed outside of recommended guidelines such as sedatives. Excessive use of sedatives and minor tranquilizers may increase the potential for a number of avoidable injuries to occur, such as falls, fractures and motor vehicle accidents, especially among seniors.

9. Monitor the use of drugs that are known to have potentially serious side effects for older adults such as statins. Statin use can result in muscle aches that must be reported to a physician immediately.

10. Educate physicians and patients to be sure that older adults receive medications they need to avoid or prevent chronic conditions from getting worse. For instance, according to the National Osteoporosis Foundation, osteoporosis is a major public health threat for 55 percent of people age 50 and older. Yet people in this age range who have had a fracture often do not receive prescription drugs for strengthening their bones after the break. A second fracture can be more serious and even leave the person bedridden. Proactive patient and physician education can get people on medications that can prevent fractures.

About Prescription Solutions
Prescription Solutions is an innovative pharmacy benefit management company managing the prescription drug benefit of commercial, Medicare and governmental health plans, as well as those of employers and unions representing over $2.6 billion in annual pharmaceutical purchases. A wholly owned subsidiary of PacifiCare Health Systems, Inc. (NYSE: PHS), one of the nation's largest consumer health organizations, Prescription Solutions now serves members through a state-of-the-art mail service pharmacy in Carlsbad, California, as well as through a national network of 53,000 community pharmacies. Online information can be found at www.rxsolutions.com.

About PacifiCare Health Systems
PacifiCare Health Systems is one of the nation's largest consumer health organizations with more than 3 million health plan members and approximately 10 million specialty plan members nationwide. PacifiCare offers individuals, employers and Medicare beneficiaries a variety of consumer-driven health care and life insurance products. Currently, more than 99 percent of PacifiCare's commercial health plan members are enrolled in plans that have received Excellent Accreditation by the National Committee for Quality Assurance (NCQA). PacifiCare's specialty operations include behavioral health, dental and vision, and complete pharmacy benefit management through its wholly owned subsidiary, Prescription Solutions. More information on PacifiCare Health Systems is available at www.pacificare.com.

Source: Prescription Solutions