Transcript A&M Care 2012 – 2013 Prescription Drug Program A G C T C G G G A T C T C T A G A T C G C A 1 0 011 1 1 0 0 1 000101 0T C G C T 0

A&M Care
2012 – 2013 Prescription Drug Program
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Today’s Agenda
Your Medco prescription drug plan
Benefit description
Specialized care
Tools to help manage the prescription benefit
> Online Gaps in Care Alerts
> My Rx Choices®
> Mobile Tools
> Caregiver Coordination
> Other available resources
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Your Medco Prescription Drug Plan
•
Medco administers your prescription
drug plans on behalf of the A&M
Care plan.
•
Benefit includes both a retail and
mail component
•
Medco has its own mail-order
pharmacy – Medco Pharmacy –
where specialist pharmacist focus on
compliance and lower cost options
for the patient, and the automated
filling system ensures the
prescription is filled accurately.*
• Medco’s mail-order pharmacies fill about 2 million prescriptions per week through a highly automated process that is
99.9997% accurate and is 23 times more accurate than a retail pharmacy
“Dispensing Error Rate in a Highly Automated Mail-Service Pharmacy Practice”; Nov. 2007, Pharmacology, a peer-reviewed
journal of the American College of Clinical Pharmacy
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Prescription Drug Benefits
Annual Deductible
$50 per person per year / $150 per family per year
(Deductible does not apply to medical plan deductible)
Access Options
Generic Drug
Copayment
Retail – 30 Day Supply:
Refills allowed as prescribed. (Good
option for new prescriptions)
Retail – 90 Day Supply:
Refills allowed as prescribed
Medco By Mail Pharmacy:
Up to a 90-day supply*. Refills allowed
as prescribed
(Best option for maintenance
medication)
Preferred Drug
Copayment
Non-Preferred
Drug
Copayment
$10
$35
$60
$30
$105
$180
$20
$70
$120
* If you obtain a brand-name drug when a generic equivalent is available, you are responsible for the generic copayment plus
the cost difference between the brand-name drug and the generic drug. Chart illustrates benefits when network pharmacies
are used. Non-network benefits are also available; see Enrollment Guide for more information.
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The right care at the right time
Specialization and member engagement are critical components to
controlling health care costs and driving quality clinical outcomes:
 Specialist pharmacists
 Accredo Health Group
 Closing gaps in care
 My Rx Choices®
 Digital and Mobile Tools
 Caregiver Coordination
 Worry Free Fills
 Other available resources
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Patient Stratification: Patient’s needs vary…
Patient Care Needs
Well
Wrinkles, Baldness,
Impotence, Contraception,
Vitamins
Acute
Chronic
Complex
Colds & Flu, Strep Throat, Ear
Infection, Headache, Sprains
Heart Disease, Diabetes,
Arthritis, High Blood Pressure,
High Cholesterol,
Dementia, Back Pain
Multiple Chronic Conditions
such as Heart Failure &
Diabetes, Cancer, AIDS,
Multiple Sclerosis, Metabolic
Syndrome
Medco’s specialist pharmacists create a patient experience which improves
the quality of member care and increases savings for our clients
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Medco’s Therapeutic Resource Centers
Specialized pharmacies for people with chronic & complex conditions
Rare &
Specialty*
Oncology
HIV/
Immunology
Diabetes
Cardiovascular
Pulmonary
Neuroscience
Women’s Health and Family Medicine
* Specialty conditions, including: Rheumatoid Arthritis, Multiple Sclerosis, Immune Disorders, Pulmonary Hypertension, Hemophilia,
and Hepatitis C. Does not include Accredo-only patients and drug spend.
** Does not include Liberty-only patients and drug/supply spend.
Source: Medco Book of Business Data 12 months ending 12/30/11.
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Medco’s Specialist Pharmacists are an integral part of
the healthcare continuum
• Specialist Pharmacists are specially
trained to counsel patients about their
conditions, and connect with
physicians and healthcare coaches
97% of
patients
Extremely Satisfied/Very
Satisfied with overall
counseling experience
– Calls are monitored and recorded for
training
“We strive to have our pharmacists
deliver the level of patient care that any
of us would want for our families.”
– Pharmacists spend their time focused
on a single condition
Glen Stettin, M.D., Medco’s Chief Medical Officer
– Average patient call lasts 12 minutes
– Advanced tools let pharmacists see
the “whole patient” along with their
drug regimen across prescribers and
pharmacies
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Specialty Medications
• Medco provides specialty pharmacy services through our wholly
owned subsidiary Accredo Health Group, Inc.
• What are specialty medications?
• High cost infused, injectable, and oral drugs that typically require
added supervision of patient therapy
• With Accredo, at no extra cost, you’ll benefit from:
• Personalized Care
• Safe, prompt delivery
• 24 hour support
• Refill reminders
• Drug safety monitoring
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Types of Gaps in Care Online Alerts
Adherence
Omission
On track
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Close-up: Sample alert message
Information about
the alert and why
it’s important
Video clips
relevant to
each alert
Links to
additional
resources
Ability for patients
to self-close gaps
as appropriate
Printable
information to
take to the doctor
Access to
e-mail Medco
pharmacists
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My Rx Choices®
Your online savings tool
 Lower the cost of prescriptions with My Rx Choices®
> Features include:
– Personal assessment of cost-saving opportunities based on the A&M Care
prescription plan
– Print a kit to help their doctor better understand the economic impact of different
medication alternatives
– Alternative medications are based upon greatest cost savings to you presented
in order, starting with the highest value
– Brand-to-generic and retail-to-mail comparisons are shown
 Simply visit www.medco.com/save. Members will need to take a
moment to register before using this service. They can also call
1-800-367-3636
 Prices can vary at different retail pharmacies, so it is important to shop
the benefit.
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My Rx Choices
Available through Customer Service or on www.medco.com
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Medco’s online tools and mobile apps help connect
patients and their caregivers
Smartphone
Apps
Refill Reminder
Widget and
Worry Free Fills®
Helps patients stay
on track with
medications as
prescribed
Remind patients to
refill necessary
medications
Drug Interaction
Screening
Helps patients identify
potential
drug-to-drug interactions
between over the counter
and prescription medications
Gap In Care Alerts
Help members identify
and address potential
safety issues with their
prescriptions
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Omission
Not Using Controller
Medication for Asthma
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Medco recognizes the increasingly critical role
caregivers play in coordinating patient care
Engaging and empowering
caregivers:
www.medco.com/caregiver
• Give caregivers authorized privileges
• Let caregivers manage, monitor, track,
and coordinate a loved one’s care online
• Enable Member Services
Representatives and Pharmacists to
recognize caregivers on inbound calls
and empathize with their needs
• Tailor communications to caregivers and
their distinct needs
• Help caregivers take care of themselves
in addition to the person or people for
whom they are responsible.
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Worry-free Fills™
• Worry-free Fills™ is an automatic refill program
available to A&M Care members who utilize the Medco
Pharmacy.
• Members enroll for the program at the drug level.
• If you choose to enroll a particular medication, a
reminder letter is either mailed or emailed to you
approximately three weeks before the prescription is
filled.
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Express Scripts/Medco Merger
 On July 21, 2011, Express Scripts, Inc. and Medco Health Solutions,
Inc. announced that they have entered into a definitive merger
agreement. The agreement has been unanimously approved by the
boards of directors of both companies. After an extensive FTC review,
the merger was finalized on April 3, 2012.
 Express Scripts and Medco believe the transaction will deliver value to
clients and their members
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Information Resources
• A&M Benefits Web site – www.tamus.edu/benefits/
• Pharmacy Benefit Highlights
• List of participating retail pharmacies
• Download forms
• Medco Member Web site – www.medco.com
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Formulary Information
Locate a Participating Pharmacy
Health and Wellness Information
My Rx Choices® / Price a Medication
Online Ordering
Medco Mobile App
Order Medco Pharmacy Refills
Caregiver Resources
Download forms
Medco widget
• Customer Service Number 1-866-544-6970
• Annual Enrollment Book
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