The Official Medtipster Blog

have your healthcare and afford it, too

Archive for September, 2011

Don’t stop taking your medication!

September 28, 2011 By: PharmaSueAnn Category: Medtipster

An annual survey conducted by the Consumer Reports National Research Center found that 48% of adults admitted skipping or delaying medication or other health care services to save money, up from 39% in 2010.

Visit to stretch your healthcare dollars.

The Three Behavioral Factors Driving Rx Spend Waste

September 27, 2011 By: Nadia Category: HealthCare, Medtipster, Prescription News, Prescription Savings Source: Express Scripts 9.27.11

“We have long used financial incentive to eliminate waste. Now we’re finding that tools that build upon the insights of behavioral economics and psychology can have powerful, positive effects.”
- Alan Garber, MD, PhD, Professor of Health Economics, Stanford University

The above quote is from Dr. Alan Garber, one of the most respected healthcare economists in the country. Dr. Garber recognizes that Plan Sponsors have a critical need for a “new toolbox” to help eliminate healthcare spend waste and drive better behavior.

Plan Sponsors will certainly agree with the statement “behavior is important”, but they are also acutely concerned with dollars. They will want to know specifically – in hard dollars – how behavior is impacting their costs.

What stands between the doctor and optimal health outcomes is consumer behavior. Wasteful pharmacy-related behavior costs the healthcare system a staggering $403 billion a year:

Drug Mix: $51 billion – People using a brand drug when a generic drug would be just as effective

Channel Choice: $6 billion – People choosing to continue to get their maintenance medication at a retail pharmacy instead of using home delivery

Non Adherence: $106 billion – People not taking their medications appropriately

Clearly, consumer behavior is a factor that you cannot leave out of the equation when trying to get the most out of your pharmacy benefit. So what can we do to motivate people to change? To improve Rx spend effectiveness?

Most PBMs offer two options to increase the effectiveness of the plans performance – passive education programs and mandatory programs. Mandatory programs are effective, but because of the potential for noise, many Plan Sponsors have not wanted to use them. Passive programs solve the noise issue, but don’t achieve the effectiveness that most plans need today. So how do we move from where we are today to maximizing plan performance without putting mandatory programs in place?

We can close a great deal of this gap by applying the behavioral sciences to healthcare. This allows Plan Sponsors to achieve greater effectiveness without the member disruption.

Five Largest PBMs

September 26, 2011 By: Nadia Category: HealthCare, Medtipster, Prescription News Source: Mallory Gillikin, 9/20/2011,

Business Insurance released its ranking of the nation’s largest pharmacy benefit managers. 

  1. Medco - Franklin Lakes, N.J.-based firm reported $66 billion in unbundled PBM revenues in 2010, a 10.4% increase from 2009
  2. CVS Caremark Corp.  – Woonsocket, R.I.-based firm retained the No. 2 position in the 2011 ranking, reporting $47.8 billion in unbundled PBM revenues in 2010, a 6.4% decrease from 2009.
  3. Express Scripts Inc. – Reporting nearly $45 billion in unbundled PBM revenues in 2010, St. Louis-based  firm remained in the No. 3 position in this year’s Business Insurance ranking. Express Scripts, which acquired WellPoint Inc.’s NextRx subsidiaries in December 2009, reported an 81.7% increase in unbundled PBM revenues in 2010.
  4.  Prescription Solutions Inc. - Irvine, Calif.-based firm and
  5. Catalyst Rx - Rockville, M.D.-based firm rounded out the top five largest PBMs.

To view the full ranking or to purchase copies of the 2011 Directory of Largest Pharmacy Benefit Managers, go to

Recall of several varieties of birth control pills

September 21, 2011 By: PharmaSueAnn Category: Medtipster

Qualitest Pharmaceuticals, an oral contraceptive manufacturer, has announced a recall of several varieties of birth control pills due to a packaging error. The card used to track dosage is misaligned and may result in women taking the hormone-free “filler” pills on days when they should be taking active pills. If you are taking Cyclafem 777, Cyclafem 1/35, Emoquette, Gildess FE 1.5/30, Gildess 1/20, Orsythia, Previfem or Tri-Previfem – contact your pharmacy.

Atorvastatin – generic for Lipitor

September 14, 2011 By: PharmaSueAnn Category: Medtipster

Atorvastatin – generic for Lipitor is scheduled to be released on November 30, 2011. Although it will be quite a while before we see atorvastatin on a $4 list, it’s availability will allow many of us to see a reduction in prescription drug co-payments.

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