Pharmacy Outcome Improvement Programs
Supporting your patient care efforts
Providing you with information about your patient's pharmaceutical treatment patterns and options can help you improve outcomes and avoid unintended drug consequences. Our pharmacy outreach programs support you and your patients who have both Cigna HealthCare medical and pharmacy benefits.
If you have patients who are Cigna HealthCare members and who meet the criteria for a pharmacy outreach program, we'll send you a notification letter with the patient's clinical history. A pharmacist from Cigna Pharmacy Management may call you to discuss the patient's information. Learn about three of our pharmacy outcome improvement programs:
- Cholesterol treatment to goal-People who reduce their LDL cholesterol levels may also lower their risk of heart attack. We use medical, pharmacy and laboratory claims data to help identify members who are taking lipotropic medications, but who may not be reaching their National Cholesterol Education Program (NCEP) LDL cholesterol targets.
This program showed promising results.
- 75% of program members who remained eligible and had repeat LDL lab values available reduced their LDL cholesterol within six months; and
- 43% of met their target LDL cholesterol goal within six months.
You can help. When you talk to your patients, stress the importance of taking medications as prescribed, as well as the importance of regular cholesterol testing through labs that participate in the Cigna HealthCare network.
- Asthma Management-The National Heart, Lung, and Blood Institute asthma care guidelines recommend controller therapy for most people diagnosed with asthma. Studies show that those who rely on reliever therapy (beta-agonist inhalers) without concomitant controller therapy are seven times more likely to be hospitalized.*
To help prevent asthma complications, we help identify members who have frequently filled prescriptions for short-acting beta-agonist inhalers, but have not filled prescriptions for controller therapy. We also provide you with patient information for an enhanced treatment picture. Our approach has had positive results.
- 50% of program members added controller therapy within six months of outreach.
- After controller therapy was added, asthma-related hospitalizations and emergency room visits were reduced by 50% for program participants.
- Use of rescue therapy dropped 36%.
You can help. Talk with your patients about helping to control their asthma by adding controller therapy to short-acting, beta-agonist inhalers when indicated.
*See, for example, Donahue JG et al. JAMA 1997; 277:887-891.
- Depression Management-This improvement opportunity integrates data from medical, behavioral and pharmaceutical services to help identify opportunities to improve member adherence to prescribed treatment. The data identifies opportunities for improvements measured by diagnosis, length of therapy and medication waste.
In 2004, more than a million member-specific anti-depressant compliance scores were measured and shared with physicians, and 73,000 mailings were sent to prescribers.
Our approach promises positive results.
- 30% improvement in completing prescribed treatment for program members.
- 48% fewer ER visits among program members
- 18% lower medical and behavioral health costs among program members
You can help. Talk with your patients about the importance of adhering to their prescribed course of treatment.
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