Verispan Reports: Proton Pump Inhibitors Most Impacted by Third-Tier Status.Business Editors & Health/Medical Writers NEWTOWN, Pa.--(BUSINESS WIRE)--Sept. 23, 2002 Proton pump inhibitors Proton Pump Inhibitors Definition The proton pump inhibitors are a group of drugs that reduce the secretion of gastric (stomach) acid. They act by binding with the enzyme H+, K(+)-ATPase, hydrogen/potassium adenosine triphosphatase top the list of therapeutic classes most likely to be affected by cost-control measures known as three-tier co-pays, according to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. HMO HMO health maintenance organization. HMO n. A corporation that is financed by insurance premiums and has member physicians and professional staff who provide curative and preventive medicine within certain financial, pharmacy pharmacy, art of compounding and dispensing drugs and medication. The term is also applied to an establishment used for such purposes. Until modern times medication was prepared and dispensed by the physician himself. In the 18th cent. executives participating in Verispan's Benefit Design: Keeping Score for 2002 and Beyond. Verispan's Rx Co-Pay Report notes the average co-pay for third-tier drugs in this class is $32.55. HMO pharmacy executives who were part of the second annual Benefit Design study were asked to name the therapeutic classes that they perceive to be most affected by three-tier co-pays.
Therapeutic Classes Most Impacted by Three-Tier Co-Pays
Based on Panelists' Perceptions
-------------------------- --------- --------- ------------------
Class Name # of HMOs % of HMOs Average Third-Tier
Co-Pay
-------------------------- --------- --------- ------------------
Proton pump inhibitors 79 81% $32.55
-------------------------- --------- --------- ------------------
Cholesterol reducers 68 70% $29.10
-------------------------- --------- --------- ------------------
ACE inhibitors 50 52% $30.06
-------------------------- --------- --------- ------------------
Nonsedating antihistamines 50 52% $33.55
-------------------------- --------- --------- ------------------
HMOs felt these classes were most impacted by three-tier co-pays because of the availability of therapeutic equivalents and generic alternatives. Use of these classes of drugs in treating chronic conditions was another reason cited by several panelists. A benefit design with three or more tiers is used by about 80% of HMOs and affects approximately 59% of HMO members. Under this system, users generally pay the smallest co-pay for generic drugs generic drug, a drug sold or prescribed under the nonproprietary name of its active ingredients or under a generally descriptive name rather than under a brand or trade name. , a higher co-pay for preferred or formulary formulary /for·mu·lary/ (for´mu-lar?e) a collection of recipes, formulas, and prescriptions. National Formulary see under N. for·mu·lar·y n. brand-name drugs Noun 1. brand-name drug - a drug that has a trade name and is protected by a patent (can be produced and sold only by the company holding the patent) proprietary drug drug - a substance that is used as a medicine or narcotic , and the highest co-pay for brands not on a plan's formulary. The Benefit Design study integrates primary research conducted with HMO and PBM PBM - play by mail. See play by electronic mail. pharmacy executives with results from Scott-Levin's Managed Care Formulary Drug Audit. It is a comprehensive study of current and future HMO and PBM pharmacy benefits and formulary designs. The study also explores the relationships between PBMs, HMOs, PPOs and employer groups employer group Association of employers Managed care An entity with a current group benefits agreement in effect with a health plan to provide covered health care services to its employee-subscribers and eligible dependents. , and investigates the measures HMOs and PBMs are taking to combat rising pharmaceutical costs. The Rx Co-Pay Report examines how the tiered co-pay structure affects almost 1,000 drugs across 43 therapeutic classes. The report is arranged by therapeutic class and shows, for individual products in each class. the percentage of plans covering a drug at each tier level, the percentage of lives impacted at each tier, and the average weighted co-pay.
Brands with the Highest Third-Tier Status
HMO Lives
--------- --------------------------- ---------------- --------------
Drug Name Class % of HMO Average Co-Pay
Three-Tier Lives
--------- --------------------------- ---------------- --------------
Teczem Cardiovascular combinations 55.7% $32.80
--------- --------------------------- ---------------- --------------
Lexxel Cardiovascular combinations 55.1% $32.71
--------- --------------------------- ---------------- --------------
Dynabac Macrolide antibiotics 55.0% $32.78
--------- --------------------------- ---------------- --------------
Vaseretic Cardiovascular combinations 54.9% $32.63
--------- --------------------------- ---------------- --------------
Zagam Quinolone antibiotics 54.7% $32.85
--------- --------------------------- ---------------- --------------
More than any other brand-name medication tracked in Verispan's Rx Co-Pay Report, the third-tier status of Teczem affected the largest percentage of HMO members with a drug plan, 55.7%. The average weighted third-tier co-pay for Teczem was $32.80. In comparison, for the 35% of drug-plan-eligible HMO enrollees who had Teczem covered at a second tier, the average co-pay was only $17.54. Verispan's Benefit Design: Keeping Score for 2002 and Beyond and Rx Co-Pay Report will both be available in late September. Verispan: The True Measure of Healthcare Verispan, a health care informatics Health care informatics has been defined as:
Quintiles was founded in 1982 by Dennis Gillings and as of 2007 it has 18,000 employees. Transnational Corp. (Nasdaq:QTRN) and McKesson Corp., is the nation's leading provider of patient-level, longitudinal lon·gi·tu·di·nal adj. Running in the direction of the long axis of the body or any of its parts. data, with de-identified data from approximately 1.7 billion U.S. pharmacy transactions and 275 million electronic medical transactions annually. Verispan includes three of the top names in the U.S. health care information market: Scott-Levin and SMG SMG - Screen Management Guidelines. A VMS package of run-time library routines providing windows on DEC VT100 terminals. Marketing Group from Quintiles and Kelly/Waldron from McKesson. Verispan is headquartered in Newtown. The company's Web site is www.verispan.com. |
|
||||||||||||
Printer friendly
Cite/link
Email
Feedback
Reader Opinion