November 5, 2004
Contact: Teresa Storm
Prime Therapeutics
651.286.4191
tstorm@primetherapeutics.com
Jan Hennings, APR
Blue Cross and Blue Shield of
Minnesota
651-662-6139
Pager: 612-648-2517
janice_heninngs@bluecrossmn.com
Prime Therapeutics Proves Integrating Pharmacy and Medical Data
Results in Improved Patient Care and Significant ROI
ST. PAUL - Blue Cross and Blue Shield of Minnesota (Blue Cross) reduced
inappropriate prescriptions of metformin by 84 percent and achieved a projected
annualized return on investment (ROI) of 4.26:1. Blue Cross utilized a retrospective drug
utilization review program initiated by Prime Therapeutics, Inc. (Prime), Blue Cross’
pharmacy benefits solutions company. The program used integrated medical and
pharmacy data to identify members who received metformin, a Type 2 diabetes
medication, and had a labeled contraindication (certain conditions where metformin
poses a risk that outweighs the benefit, such as congestive heart failure, renal
insufficiency and metabolic acidosis).
Prime identified all Blue Cross patients who had been prescribed metformin from
January 1 to May 31, 2002. After reviewing the patients’ medical data, Prime identified
566 patients who had been diagnosed with a condition that posed a medical
contraindication with metformin. The program included an actionable targeted warning
letter sent to physicians who had prescribed metformin to a patient with a medical
contraindication. Included with the letter was the patient’s medical contraindication per
medical claims records and metformin prescription history.
Analysis of the program was conducted nine months following the letter mailing.
The decrease in metformin prescribing for the at-risk patients was associated with an
estimated medical cost avoidance of more than $18,000 per patient per year. “These
results provide evidence that the ability to view the entire healthcare picture and
intervene appropriately is extremely important to medical outcomes,” said Kyle VanceBryan, Prime’s vice president and chief pharmacy officer.
“This is a serious issue,” said Alan Heaton, Pharm. D., Blue Cross pharmacy
director. “Many patients who develop metformin induced lactic acidosis are admitted to
the hospital and nearly 50 percent die from the condition. Integrating patient-specific
medical and pharmacy claims resulted in a significant reduction in high-risk metformin
use, potentially preventing serious adverse events. This is the type of real value Blue
Cross aims to achieve for our members.”
Supporting the label contraindications for metformin was a study in the May 15,
2002 issue of the Journal of the American Medical Association (JAMA) describing a
high incidence of inappropriate metformin prescribing for Type-2 diabetics with heart
failure, renal dysfunction or metabolic acidosis.
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About Prime Therapeutics
Prime Therapeutics, Inc. is a pharmacy benefits management company dedicated to
providing innovative, clinically based, cost-effective pharmacy solutions for its clients
and their members. Providing services nationwide to approximately nine million covered
lives, its client base includes several Blue Cross Blue Shield plans, employers, union
groups and third-party administrators. Headquartered in St. Paul, Minnesota, Prime
Therapeutics is collectively owned by several Blue Cross Blue Shield plans, subsidiaries
or affiliates of those plans. Learn more at www.primetherapeutics.com.
About Blue Cross and Blue Shield of Minnesota
Blue Cross and Blue Shield of Minnesota, with headquarters in the St. Paul suburb of
Eagan, was chartered in 1933 as Minnesota’s first health plan and continues to carry out
its charter mission today: to promote a wider, more economical and timely availability of
health services for the people of Minnesota. A not-for-profit, taxable organization, Blue
Cross is the largest health plan based in Minnesota, covering 2.6 million members in
Minnesota and nationally through its health plans or plans administered by its affiliated
companies. Blue Cross and Blue Shield of Minnesota is an independent licensee of the
Blue Cross and Blue Shield Association, headquartered in Chicago.