Compounded medicines are increasingly being dispensed for common disorders such as pain management, women’s health, men’s health, and weight loss and are also being prepared as vitamins, supplements and cosmetic treatments.1 The use of compounded medicines raises concerns about quality, cost and patient safety — and the practice is on the rise. Between 2012 and 2013, our customers have seen a 35 percent increase in spend for compounded prescriptions and it is now often a Top 5 trend driver for many clients.2 According to a compounding industry source, some 2,500 U.S. pharmacies added compounding practices between 2009 and 2012, bringing the total number of compounding pharmacies to over 7,500.3
OptumRx recently hosted a webinar for brokers and consultants; Compounding Pharmacies: A Costly Challenge. discussion on the impact of compounding pharmacies and strategies implemented to limit the impact.
UnitedHealthcare and OptumRx both employ strategies to manage compounds - focusing on eliminating concerns of member safety, drug efficacy and potential waste of healthcare resources.
Business Week. America's Shadow Pharmacies. November 14, 2012.
OptumRx recently hosted a webinar for brokers and consultants; Compounding Pharmacies: A Costly Challenge. discussion on the impact of compounding pharmacies and strategies implemented to limit the impact.
UnitedHealthcare and OptumRx both employ strategies to manage compounds - focusing on eliminating concerns of member safety, drug efficacy and potential waste of healthcare resources.
- Identifying bulk chemicals for benefit exclusion as they hit the market
- Requiring a notification/prior authorization for compound medications, that are reviewed and approved by our National Pharmacy &Therapeutic Committee
- Extensive list of non-FDA approved bulk chemicals used in compounds maintained regularly to ensure products are not approved
- Network pharmacies are monitored by the OptumRx Pharmacy Network team to ensure pharmacies abide by state federal law, must be credentialed, accredited and licensed to practice – in addition, OptumRx has a network audit team tracks and investigates high-dollar compounds
- Targeted outreach to high prescribers of compounds through peer-to-peer and written communications
Business Week. America's Shadow Pharmacies. November 14, 2012.
- UnitedHealthcare carve-in book of business, twelve-month period between 2012 and 2013.
- International Academy of Compounding Pharmacies.
1 comment:
This is a very important presentation; in and of itself, an important quantitative public health safety signal.
It was very challenging to obtain guarantees that bulk chemical ingredients (active and inactive) were not adulterated and had the specifications required for the dosage forms I was asked to make, including spinal and respiratory drugs, now over 20 years ago--I am not sure if this has improved as many chemicals for compounding are advertised in a "use at your own risk" or "for research and development" manner. Insurers may not be aware of the status of product liability coverage for drugs made from chemical powders, on the basis of formulas that may also come with disclaimers on safety and effectiveness. Pharmacies and/or their business partners advertise and market the products, sometimes making claims the products are safe and effective based on preliminary, un-scruitinized studies (demand generation). But because pharmacists are not learned intermediaries, liability associated with marketing and sale of non-FDA approved products can sometimes be extended to other parties in the drug access chain--this may also implicate payers that cover the drugs in their formularies, if pharmacies do not obtain product liability insurance for the products they market and promote?
The multifaceted interventions developed by OptumRx will help protect the drug supply without compromising access to compounded drugs, where necessary.
Post a Comment