July 5, 2011

Medco's Specialty Pharmacy Improves Hepatitis C Patient Outcomes, Drives Down Costs by an Average $13,000 Per Patient

Accredo Health Group poised to aid patients with new treatments

HCV patient compliance remains high for complex medication regimen

FRANKLIN LAKES, N.J., July 5, 2011 /PRNewswire/ -- Accredo Health Group Inc., the specialty pharmacy of Medco Health Solutions, Inc. (NYSE: MHS), has developed a unique ability to manage the costs of treating hepatitis C (HCV), while keeping patients adherent to a complex medication regimen for a sometimes lethal disease that can lead to liver cirrhosis and certain cancers. The introduction of two new HCV medications that hold tremendous promise but also add even a greater degree of complexity to treatment will require this "high touch" approach to help increase patient adherence.

Patients must be at least 80-85 percent adherent to therapy for the HCV treatment to be effective, and Accredo has results demonstrating that patients who receive therapy from Accredo's nurses and specialist pharmacists are nearly 10 percent more adherent than those who get their therapy from another provider. Accredo has also been successful in using genotype information to identify patients who may need only 24 weeks of therapy, resulting in drug cost savings up to $13,000.

Accredo's high-touch care model helps educate patients about their treatment and the necessity to adhere to it. This includes patient instruction about using their medications, communicating with doctors about treatment programs and assisting patients to manage side effects. This, in turn, helps to improve patient outcomes and reduce costly hospitalizations or the wastage of expensive medications that are not being properly taken.

As Accredo has improved care for HCV patients, boceprevir and teleprevir will likely improve patients' odds for beating the condition that affects 3.2 million Americans, sparing thousands of patients from liver failure, potential transplants or cancer.

"These new drugs will likely be game-changers for HCV patients, but patients are going to need help adhering to treatment," said Richard Faris, vice president and national practice leader for Medco's Rare and SpecialtyTherapeuticsResourceCenter. "Medco's enhanced clinical oversight and expertise in gene-based medicine enables us to help patients get the right treatment and stay on therapy."

The U.S. Food and Drug Administration (FDA) approved the medications in May to supplement treatments of pegylated interferon and ribavirin in patients with HCV genotype 1, the most common type of the virus. The new treatments improve efficacy to approximately 75 percent from 50 percent when pegylated interferon and ribavirin, the standard of care for HCV since 2001, are used together for 48 weeks. At the same time, the new drugs can shorten the duration of treatment to 24 weeks in most patients. Despite being oral drugs, the new treatments that prevent HCV from replicating add a layer of complexity to an already complex treatment program.

The Accredo Model

The Hepatitis C Therapeutic Resource Center at Accredo has been successful in helping patients, physicians and payers with this difficult therapeutic regimen. Accredo's approach is to maximize clinical effectiveness for patients and benefits plan sponsors by reducing the potential for waste. Failure to properly monitor the therapy, genotype and viral load can cost up to $64,000 in unnecessary drug costs for treating an HCV patient. Pegylated interferons are dosed in precise increments based on a patient's weight.

Patient adherence to these therapies is crucial to achieving a successful course of therapy, but made difficult given their significant side effects and intensive drug regimen. Accredo's Hepatitis C Therapeutic Resource Center services include patient training, preventing drug waste, coordination of care, genetic screening, and patient monitoring and counseling to overcome barriers to treatment adherence.

Hepatitis C and its costs

HCV – and subsequent liver cirrhosis – is the leading cause of liver transplant and it is estimated that 30 percent of the 17,000 people on the liver transplant list are infected with HCV. The initial cost for a liver transplant is $315,000 with follow-up care costing $22,000 annually. HCV is also a leading cause of liver cancer. HCV patients also can have significant co-morbidities that require complex care from specialty pharmacy. For example, in the United States up to 8 percent of those with chronic HCV may be HIV co-infected. Overall, an estimated 6,200 persons with bleeding disorders are affected by HCV, representing 44 percent of all persons with hemophilia and 5 percent of all persons with von Willebrand disease. Persons above the age of 21 have the highest rates of infection, since they were most likely to get human blood products as treatment.

About Medco

Medco Health Solutions, Inc. (NYSE: MHS) is pioneering the world's most advanced pharmacy® and its clinical research and innovations are part of Medco making medicine smarter™ for more than 65 million members.

With more than 24,000 employees worldwide dedicated to improving patient health and reducing costs for a wide range of public and private sector clients, and 2010 revenues of $66 billion, Medco ranks 34th on the 2011 Fortune 500 list and is named among the world's most innovative, most admired and most trustworthy companies. Accredo Health Group, Inc., is a wholly-owned subsidiary of Medco.

For more information, go to http://www.medcohealth.com/.

This press release contains "forward-looking statements" as that term is defined in the Private Securities Litigation Reform Act of 1995. These statements involve risks and uncertainties that may cause results to differ materially from those set forth in the statements. No forward-looking statement can be guaranteed, and actual results may differ materially from those projected. We undertake no obligation to publicly update any forward-looking statement, whether as a result of new information, future events or otherwise. Forward-looking statements are not historical facts, but rather are based on current expectations, estimates, assumptions and projections about the business and future financial results of the pharmacy benefit management ("PBM") and specialty pharmacy industries, and other legal, regulatory and economic developments.

SOURCE Medco Health Solutions, Inc.

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