Physicians receive a significant amount of ongoing education about prescription drug therapy from pharmaceutical companies. The manufacturers’ promotion of brand-name drugs is influential. It often results in the physician prescribing higher cost branded medications when lower cost generic or therapeutically equivalent brand drugs are available for their patients. Drug benefit payers must counter balance pharmaceutical company promotion by effectively communicating with physicians about the efficacy and savings potential of low cost alternatives to brand-name drugs.

Objectives

The Office of Group Benefits (OGB), State of Louisiana and Catalyst Rx sought to provide prescribing data, cost data, and clinical information that would convince physicians to prescribe generics or low-cost brand drugs when medically appropriate. The objective was to achieve patient and OGB cost savings by promoting clinically-sound and cost-effective prescribing.

Target Audience

The top prescribing physicians for the Office of Group Benefits (OGB), State of Louisiana are the target audience for a Prescriber Education and Intervention (PEI) program implemented by Catalyst Rx for OGB. The targeted prescribers represent approximately $25 million annually in OGB drug spend.

Solution

The ongoing PEI program, implemented in 2004, is localized and individualized. Catalyst Rx clinical pharmacists dedicated to OGB meet one-to-one with high prescribing physicians at their practice sites. Using a partnership approach, the pharmacist reviews a summary of the physician’s prescribing history, comparative prescribing trends, and opportunities for cost savings through the use of generic equivalents, lower cost therapeutically equivalent brands, and over-the-counter (OTC) products. The modeling to identify these savings uses plan-specific data, not aggregated national data. This ensures real, “bottom-line” savings for OGB and its members.

In addition to the face-to-face meetings, the PEI program regularly provides physicians with up-to-date clinical drug information through its education and physician appreciation components. Communication vehicles used to educate and influence, include:

• Lunch and dinner presentations to share OGB formulary and plan design changes, updated clinical guidelines, generic and OTC drug launch information, and AWP drug cost comparisons
• Quarterly Catalyst Rx New and Generic Drug Pipeline Report
• Rx Update, a news alert notifying physicians of generics new-to-market and/or coming soon
• Formulary drug lists including generics and plan-preferred brand drugs, formatted in both pocket and poster sizes
• Sampling programs for OTC medications
• Appreciation letters to physicians recognizing their cooperation and participation in achieving generic drug savings for their patients and OGB

Results

The PEI program is a key contributor to OGB’s generic substitution rate increasing by 5% and generic utilization increasing by 7.2%. This equates to about $28 million in savings over the first three years of the program. It is important to note that these plan savings are not due to other factors such as increased member copay or change in benefits.

The program significantly changed the prescribing habits of many physicians. The following examples illustrate the impact of the program on individual physicians.

Catalyst Rx deploys the PEI program on a local or regional basis for drug benefit plan sponsors throughout the country. It is a proven program, resulting in cost savings and improved physician relationships.