Point-of-Sale Electronic Safety Check May Reduce Heart Attack Risk for Diabetic Patients

ST. PAUL, Minn., April 12, 2011 /PRNewswire/ -- According to a new pharmacy benefit study, a point-of-sale automated electronic safety edit, designed to require provider prior authorization (PA) for members who have a rosiglitazone claim with concurrent use of insulin or nitrate (CIN), potentially decreased members' risk for myocardial ischemia. The study will be presented at the Academy of Managed Care Pharmacy's 23rd Annual Meeting in Minneapolis, Minn. by Prime Therapeutics (Prime), a thought leader in pharmacy benefit management.

Rosiglitazone, also known under its brand name Avandia®, is an antidiabetic drug therapy (ADT) designed to help control blood sugar in patients with Type 2 diabetes mellitus. Studies suggest rosiglitazone and CIN can put patients at an increased risk for myocardial ischemia, a condition where the arteries in the heart become blocked, thus increasing a person's risk for heart attack.

To prevent use of rosiglitazone and CIN, one of Prime's Blue Cross and Blue Shield (BCBS) clients implemented an automated electronic safety edit that included 1.2 million members. The edit required a PA for rosiglitazone if a CIN drug supply already existed.

During the six-month study period (Jan-Jun 2009), 168 members had their rosiglitazone claim denied at the point-of-sale. Researchers conducted an observational cohort study to assess ADT utilization in the 168 members in which a rosiglitazone claim was denied. Researchers also assessed a control group of 222 members for whom the safety edit was inactive. Claims for both groups were periodically observed post-denial, or post-initial paid rosiglitazone claim among control group, to determine whether members continued with rosiglitazone, switched to a safer alternative or abandoned therapy altogether.

After 180 days, 78.6 percent of the 168 members with an initial safety edit claim denial were using a different ADT other than rosiglitazone, versus only 25.6 percent of control group. The safety edit did not result in increased ADT abandonment. Only 13 percent of affected members abandoned an ADT drug altogether, compared with 15 percent in the control group.

"This study shows insurers can successfully implement safeguards to protect members from potentially harmful drug interactions," said Patrick Gleason, PharmD, Prime's Director of Clinical Outcomes Assessment. "Through the use of this safety edit, many patients were able to avoid potential heart complications that would require further medical treatment and unnecessary medical costs."

The published study abstract can be found in the Journal of Managed Care Pharmacy 2011;17(3):255. http://www.amcp.org/amcp.ark?c=jmcp&sc=articles&year=2011&volume=17&issue=3

Prime Therapeutics is a pharmacy benefit management company dedicated to providing innovative, clinically-based, cost-effective pharmacy solutions for clients and members. Providing pharmacy benefit services nationwide to nearly 17 million covered lives, its client base includes Blue Cross and Blue Shield Plans, employer and union groups, and third-party administrators. Headquartered in St. Paul, Minnesota, Prime Therapeutics is collectively owned by 12 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those Plans. Learn more at www.primetherapeutics.com.

SOURCE Prime Therapeutics