San Diego—For the first time in 60 years, prescription drug sales declined in the United States in 2012, falling by 1%. At the same time, the number of prescriptions filled increased only 1.2% last year, according to data from IMS Health, a healthcare analytics company.

Douglas Long, MBA, vice president of industry relations at IMS Health, discussed the reasons behind the trend and shared other industry insights during a Contemporary Issues session at the AMCP meeting titled Emerging Issues and Trends in Healthcare and Managed Care Pharmacy.

San Diego—The Medicaid system includes patients described as complex, who comprise a challenging and transient group of patients. Managing this group of patients in the face of complications including lack of claims data, high rates of nonadherence, frequent hospital admissions, and cultural challenges have led plans to develop new techniques such as integrated pharmacies that work directly with the health plans, providers, case workers, and others to help manage this complex patient population.

San Diego—Patients with nonmetastatic HER2+ breast cancer who were administered trastuzumab in an outpatient hospital setting incurred higher total monthly healthcare costs compared with patients treated in an office clinic, according to information presented during a poster session. They also had a higher incidence of nontrastuzumab-related outpatient hospital and office clinic visits.

San Diego—In the United States, approximately 400,000 people have multiple sclerosis (MS). Each day, there are approximately 200 new diagnoses of the disease, presenting a burden on patients who typically live with MS for 20 to 40 years as well as the healthcare system that has to treat the chronic, costly condition.

San Diego—The Centers for Medicare & Medicaid Services (CMS) Star Ratings program has heightened plan sponsors’ attention for the need to improve medication adherence and other aspects of medication use. As a result, plans will continue to have increased accountability associated with medication use quality measure performance. Pharmacies and pharmacists are well-positioned to be key partners in strategies aimed at improving the quality of medication use.

San Diego—Personalized medicine is promising to revolutionize medical care by tailoring diagnostic and therapeutic approaches to individual patients based on an improved understanding of genetics and molecular biology. For pharmacists and pharmacy groups, this focus on personalized medicine will pose a number of challenges to delivering care. Among these will be issues regarding the economics of personalized medicine, including coding and reimbursement issues, as well as formulary management for high cost, targeted therapies.

San Diego—Engaging patients and improving medication adherence was the aim of a program implemented in a population of dual-eligible special needs Medicare Advantage (MA) beneficiaries. The program involved the cooperation of a MA plan (iCare), a pharmacy benefit manager (MedImpact HealthCare Systems, Inc.), and a mail-order pharmacy (United States Medical Supply [US MED]).

San Diego—The Medicaid patient population is expected to grow under the Patient Protection and Affordable Care Act (ACA), leaving managed care organizations (MCOs) to face increasing challenges as they attempt to limit costs, particularly in the area of medication management. These challenges, current Medicaid trends, and future clinical issues expected to impact Medicaid MCOs were discussed at a Contemporary Issues session during the AMCP meeting.

San Diego—The best time for a physician and patient to decide on an effective, comprehensive, and manageable treatment plan is during the initial prescribing visit. This is, according to a Contemporary Issues session at the AMCP meeting, the medical moment of truth, which can make or break a patient’s pattern of medication adherence and set the tone for the efficacy of his or her treatment.

San Diego—The challenges that come with the launch of the new health insurance marketplaces as 2014 rapidly approaches were topic for discussion in a Contemporary Issues session at the AMCP meeting titled Fostering Healthy Markets: Opportunities and Challenges with Launching Health Insurance Marketplaces. The presenters were Heather Bonome, PharmD, senior clinical account executive, Express Scripts; H.

San Diego—The emerging model for healthcare in the United States is value-driven healthcare, according to speakers at a Contemporary Issues session at the AMCP meeting. The session was titled How Much of the $3 Billion in Star Rating Bonuses Did your MCO Capture? The first speaker, David Nau, RPh, PhD, CPHQ, FAPhA, president, Pharmacy Quality Solutions, opened the session by defining value as the balance of quality and costs, creating an environment in which healthcare providers can “optimize value by improving quality while reducing costs.”

San Diego—Currently, health plans are designing pharmacy benefits to be used in conjunction with the medical benefits for the state health exchanges. Successful health plans will engage pharmacists to improve the design and management of the individual and small group benefits. A panel of health plan pharmacists discussed the key features of pharmacy benefits related to health exchanges during a Contemporary Issues session at the AMCP meeting titled Essential Pharmacy Benefits for Individual and Small Group Insurance.

San Diego—The federal budget sequester struggle, the continuing movement toward the implementation of the Patient Protection and Affordable Care Act (ACA), and issues facing Medicare Part D are among the most significant legislative and regulatory proposals of interest to managed care pharmacy.

San Diego—Compared with other chronic conditions, national trends indicate that adherence to medications to treat overactive bladder (OAB) is relatively poor. Antimuscarinic medications, including oxybutynin, are commonly prescribed for OAB. The updated 2012 Beers List recommends against using oral antimuscarinics in patients ≥65 years of age due to the increased risks of symptoms such as constipation.

San Diego—Existing healthcare decision models may not always address real-world needs of decision makers, according to information presented during a Contemporary Issues session at the AMCP meeting titled Adapting Decision Analytic Models to Meet the Needs of the Health System. The presenters were Steve Duff, MS, president, Veritas Health Economics Consulting; Joe Gricar, MS, president, Apo-MED; and Prakash Navaratnam, RPh, MPH, PhD, senior director, DataMed Solutions LLC.

San Diego—The annual prevalence of major depressive disorder (MDD) in the United States is 7% and the lifetime prevalence rate is 16%. Patients with MDD experience depressed mood, fatigue, lack of interest in activities, insomnia or hypersomnia, and other symptoms that have a negative affect on productivity and quality of life.

San Diego—Healthcare decision makers face challenges in optimizing disease management in patients with type 2 diabetes mellitus (T2DM). Increasing healthcare expenditures can be attributed, in part, to the costs, including medical and pharmaceutical, associated with managing T2DM.

San Diego—With the dominance of specialty drugs driving increasing prescription medication expenditures, pharmacists need to prepare for significant growth in specialty pharmaceuticals and its impact on medication benefit plans.

San Diego—In March 2012, the U.S. Department of Health & Human Services (HHS) issued guidelines for the use of antiretroviral therapy (ART) in patients with HIV that recommend 4 specific preferred ART regimens for ART-naïve patients. In spite of trials of the guideline-preferred regimens showing “optimal and durable virologic efficacy, favorable tolerability and toxicity profiles, and ease of use,” there is real-world evidence suggesting that some healthcare providers prescribe non-preferred ART.

San Diego—As many as 6 million people in the United States are at risk of anaphylaxis, and the prevalence is increasing, especially among people <20 years of age, according to several studies. In August 2012, the FDA approved Auvi-Q^™ (epinephrine injection, USP) as an emergency treatment for type 1 allergic reactions, including anaphylaxis, to stinging and biting insects.