Burman's Specialty Pharmacy - a Diplomat Company - Collaborate in Landmark Study on Coverage of Hepatitis C Medications with Penn Medicine

Burman's Specialty Pharmacy releases a study in collaboration with Penn Medicine revealing coverage differences in positively diagnosed hepatitis patients.

Nov 23, 2015, 16:30 ET from Diplomat

FLINT, Mich., Nov. 23, 2015 /PRNewswire/ -- Burman's Specialty Pharmacy, a Diplomat company (NYSE: DPLO), released a landmark study with Penn Medicine to find differences in medication coverage for the treatment of hepatitis C in patients with proven disease. The results show an overall 86 percent approval rate, with large differences among the populations studied. The results were statistically significant.

According to the study—reported at the American Association for the Study of Liver Diseases 2015 Liver Meeting—it was discovered that nearly 50 percent of Medicaid patients infected with chronic hepatitis C virus (HCV) whose doctors had prescribed newer, life-saving antiviral drugs were denied coverage to the therapies because they were not considered "a medical necessity," among other reasons. In contrast, only 5 percent of Medicare patients and 10 percent of commercial patients were ultimately denied. The data was revealed through a prospective analysis of prescriptions submitted to Burman's Specialty Pharmacy for patients in Pennsylvania, New Jersey, Delaware and Maryland.

"Burman's is a provider of individualized patient care with a primary focus on the challenging condition of hepatitis C," said Phil Hagerman, Diplomat CEO and chairman. "We couldn't be any prouder to be a part of this study with Penn Medicine and look forward to future collaboration to improve patient care."

According to the study, among chronic HCV-infected patients prescribed direct-acting antiviral therapy (DAA), certain specific factors were strong predictors of denial. These include insurance type and lack of cirrhosis.

To determine the number and cause of denials, the team analyzed prescriptions from 2,342 patients between Nov. 1, 2014, and April 20, 2015, submitted to Burman's Specialty Pharmacy branches throughout the four states. Among those patients, 517 were covered by Medicaid, 800 by Medicare and 1,025 by commercial insurers.

"We are glad to collaborate with one of the world's leading academic medical centers to study the early portion of a patient's journey for those diagnosed with hepatitis C," said Paul N. Urick, RPh, an author on the study and the vice president of industry relations and pharmaceutical account management at Diplomat. "While nearly one in two Medicaid patients were denied medication, 90 percent or greater of all commercial and Medicare patients were approved. These results also motivate our focus toward drug adherence, rather than drug denials. The study also provides information for health plans to lower administrative costs, since a vast majority of commercial and Medicare prescriptions for direct-acting antivirals are ultimately approved."

Among the most common reasons for denial by Medicaid were "insufficient information to assess medical need" (48 percent), "lack of medical necessity" (31 percent) and positive alcohol/drug screen (4 percent). It was also found that those who did receive therapy through Medicaid had to wait 10 days longer to have prescriptions filled, compared to privately insured and Medicare patients.

According to the National Medical Association, more than 3 million Americans suffer from chronic hepatitis C. Many of those in the infected population are also on Medicaid. Hepatitis infections can lead to chronic hepatitis, which can become cirrhosis, liver failure and liver cancer. Hepatitis C is also the most common cause for liver transplantation in the U.S.

Co-authors on the abstract include Charitha Gowda, Paul N. Urick, Josh Halladay, Amanda Binkley, Dena M. Carbonari, Kathryn Battista, Cassandra Peleckis, Jody Gilmore, Jason A. Roy, K. Rajender Reddy and Jay R. Kostman.

For access to Penn Medicine's news release, please visit http://www.uphs.upenn.edu/news/News_Releases/2015/11/hcv/.

To learn more about Diplomat, visit www.diplomat.is.

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About Diplomat

Diplomat (NYSE: DPLO) serves patients and physicians in all 50 states. Headquartered in Flint, Michigan, the company focuses on medication management programs for people with complex chronic diseases, including oncology, immunology, hepatitis, multiple sclerosis, HIV, specialized infusion therapy and many other serious or long-term conditions. Diplomat opened its doors in 1975 as a neighborhood pharmacy with one essential tenet: "Take good care of patients, and the rest falls into place." Today, that tradition continues—always focused on improving patient care and clinical adherence. For more information visit www.diplomat.is. Follow us on Twitter and LinkedIn and like us on Facebook.

About Burman's Specialty Pharmacy

Burman's Specialty Pharmacy, a Diplomat company, is a leader in disease-specific treatment programs and has been in business for more than 50 years. Burman's comprehensive services and patient-first approach help patients and physicians navigate the complex waters of a variety of challenging health conditions, all while achieving improved results. Burman's offers individualized pharmaceutical care for a variety of challenging health conditions and complex drug therapies.

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