Life Sciences

Physicians lack pharmacogenomic training

Medicare & Reimbursement Advisor Weekly, October 30, 2009

Although 98% of physicians agree that knowing a patient’s genetic profile may help them better prescribe medications, only 10% believe they have adequate training and education to use pharmacogenomic tests. That’s according to a national benchmark survey of more than 10,000 physicians on their acceptance, use, and knowledge of pharmacogenomic testing from Medco Health Solutions and the AMA. Only 26% of physicians have had any type of education in pharmacogenomics. The survey also found that 13% of physicians had ordered or recommended pharmacogenomic testing for their patients in the preceding six months, and more than 26% planned to do so within the next six months. Among total respondents, 10% reported that pharmacogenomic tests had benefited their patients by improving drug effectiveness, and another 10% said their patients benefited from reduced drug toxicity due to testing.

UHC gives free drug compendium access to network doctors

UnitedHealthcare (UHC) is offering in-network physicians and their staff members free access to the National Comprehensive Cancer Network (NCCN) Drugs and Biologics Compendium. In January 2008, UHC began basing its benefit coverage for chemotherapy drugs used in outpatient settings on the NCCN Drugs and Biologics Compendium. At this time, UHC is the only health insurer that provides an online NCCN Compendium subscription for in-network physicians. “[We’re] constantly looking for ways to enhance the quality of oncology care for our health plan customers, and this is another important step in doing so,” said Lee Newcomer, MD, UHC’s senior vice president, oncology.

Home health: Outcomes and oral medications

Editor’s note: As home health becomes an emerging managed market, occasionally I will address pharmacy issues that might be worth exploring with your payer customers or internally.

There is a Home Health Compare Web site that posts information about two different types of patient outcomes: (1)End-result outcomes, which report a change in the patient’s status between start or resumption of care and discharge. These outcomes include improvement in ambulation, bathing, transferring, dyspnea, oral medication management, pain interfering with activity, urinary incontinence, and surgical wound status. (2) Utilization outcomes report the rates for utilization of healthcare, captured through transfer or discharge assessments.These outcomes include acute care hospitalization, emergent care, emergent care for wound infection or deteriorating wound status, and discharge to the community. An audio conference on home health and evidence-based care was held earlier this fall. For a complimentary copy and to discuss this market, e-mail me at your convenience. My publisher’s home health division, Beacon Health®, conducted the conference (find details at http://www.beaconhealth.org/cgi-bin/ccp51/cp-app.cgi?pg=prod&ref=J091709A). Beacon Health provides pharmaceutical companies and managed care organizations access to its 10,000 home health companies for education, marketing, consulting and research.

Reminder: P&T presentation restrictions

The Idaho Medicaid P&T Committee appreciates scientific data provided by pharmaceutical companies and their scientists. Per new public testimony guidelines adopted by Idaho Medicaid, scientific data to be presented by pharmaceutical companies or their scientists is limited to new information not already available to P&T Committee members through Provider Synergies, LLC, OHSU’s DERP, and/or other standard drug information sources. Those wishing to submit scientific data for consideration must review data already available to the committee. Material submitted for review needs to be limited to what will be presented. Product monographs and dossiers, P&T Committee briefs, extensive bibliographies, or similar inclusions will cause submissions to be rejected and returned.

Massachusetts may restrict site of care access

Massachusetts’ plan to shake up how providers are paid could have a hidden price for patients: Controlling the state’s soaring medical costs, many healthcare leaders believe, may require residents to give up their freedom to go to any hospital and specialist they want. A growing number of hospital officials and physician leaders warn that the new payment system proposed by a state commission would not work without restrictions on where patients receive care. For the full story, visit http://www.boston.com/news/health/articles/2009/ 10/11/massachusetts_plan_could_limit_patients_hospital_choices/.