Aetna Launching Value-Based Program That Improves Medication Adherence, Cost & Outcomes for Members Who Have Suffered from He...
November 14 2011 - 9:12AM
Business Wire
Aetna (NYSE: AET) announced today an evolution in value-based
insurance design aimed at preventing a leading cause of the
estimated 325,000 recurrent heart attacks that happen each year –
failure to take prescribed medications. The new program, Aetna Rx
Healthy Outcomes, reduces or eliminates copays for targeted
prescription drugs and increases personalized support for members.
These steps will help members who’ve experienced a heart attack
effectively take the medications proven to improve their health and
their chances of avoiding a second heart attack.
The proof is solid
The program was developed based on a prospective, randomized
study conducted by Brigham and Women’s Hospital, Harvard Medical
School and Aetna that looked at the impact of reduced cost-sharing
on medication adherence, on cost and -- for the first time – on
health outcomes for a targeted condition. The results of the
Post-Myocardial Infarction Free Rx Event and Economic Evaluation
Trial were also released today in an article published in the New
England Journal of Medicine. The study, supported by research
grants from Aetna and the Commonwealth Fund, shows that reducing
cost sharing for targeted medications among high-risk members who
have suffered a heart attack is a simple and scalable action that
can substantially improve adherence and health outcomes, with no
added costs.
Remove the barriers, improve the outcomes
“As a cardiologist, I know that optimal clinical outcomes depend
on patients following recommended treatments. Today’s cardiac
medications are well established in greatly reducing a patient’s
chances of having a second heart attack – and living longer. Still,
only about 40 percent of patients follow the medication regimen
after having a heart attack,” says Lonny Reisman, M.D., F.A.C.C.,
Aetna’s chief medical officer. “Armed with new and growing evidence
about patient behavior, we can help high-risk members address their
personal barriers to adherence.”
People stop taking their medications for many reasons including
costs, side effects, access, lack of understanding, and cultural
barriers. As a result, Aetna Rx Healthy Outcomes delivers a
multifaceted approach focused on high-risk members who will benefit
from:
- Early identification that will speed
engagement in the program
- No copay for generic cardiac drugs or
reduced copay for preferred branded cardiac drugs -- as early as
the first prescription
- Personal support from Aetna’s
pharmacists to help members clearly understand what the prescribed
drugs do and how and when to take them; these specialists will also
assist members in managing any side effects
Additionally members may have support from nurses within Aetna’s
Disease Management program. The nurses can also help address any
questions or challenges with the treatment plan including helping
to align plans with the members’ cultural values. Aetna’s clinical
teams will also work closely with members’ doctors to help members
successfully take their prescribed medications and avoid a second
heart attack.
A simple step with significant potential
The program will be available January 2013 to commercial
self-insured, large customers. Members are expected to have reduced
out-of-pocket spending on prescriptions and other health services.
Plan sponsors are not expected to experience increases in overall
health care costs because of an anticipated reduction in
hospitalizations.
“Aetna Rx Healthy Outcomes is a proven program for plan sponsors
that can significantly decrease the risk of recurrent heart attack
and other vascular events and improve the health of their
employees,” Reisman says.
Plan sponsors such as Marriott International and L-3
Communications say they are interested in programs like Aetna Rx
Healthy Outcomes that have proven value in improving adherence and
health outcomes, without adding cost to the system.
“Enhancing our existing value-based program with Aetna Rx
Healthy Outcomes can provide additional, targeted patient support
that more effectively influences behavior and leads to better
health for our employees who have suffered heart attacks. Helping
our employees stay healthy is the best investment,” says Jill
Berger, vice president, Health and Welfare, for Marriott
International.
Helping employees avert serious health events will also result
in fewer disability days, less absenteeism and greater
productivity. Aetna Rx Healthy Outcomes is expected to expand to
include fully insured plans and other health conditions.
About Aetna
Aetna is one of the nation's leading diversified health care
benefits companies, serving approximately 36.3 million people with
information and resources to help them make better informed
decisions about their health care. Aetna offers a broad range of
traditional, voluntary and consumer-directed health insurance
products and related services, including medical, pharmacy, dental,
behavioral health, group life and disability plans, and medical
management capabilities and health care management services for
Medicaid plans. Our customers include employer groups, individuals,
college students, part-time and hourly workers, health plans,
governmental units, government-sponsored plans, labor groups and
expatriates. For more information, see www.aetna.com.
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