Prime Therapeutics Finds Drug Costs Drive Nearly Entire Cost of Care for Hereditary Angioedema
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The study found HAE specialty drug use occurred in 15 per 1 million commercially insured individuals with a
For the study, Prime analyzed pharmacy and medical claims data for its 15 million commercially insured members and found 226 members who had at least one claim for an HAE drug in the first half of 2016. Prime researchers followed the 226 members for 12 months after their first HAE drug claim to determine drug use patterns, hospital and emergency room visits and total cost of care. The average 12-month total cost of care was
Of the 226 members with an HAE claim, 111 (49 percent) met continuous enrollment criteria. Forty-eight (43 percent) of the 111 members had claims for two or more HAE drugs and 10 (9 percent) of those had more than
"Because HAE drugs are processed on both the medical and pharmacy benefit, it's essential to have integrated medical and pharmacy claims data to clearly understand patterns of use and comprehensively manage these members," said
Prime provides analyses of integrated medical and pharmacy claims data to help clients evaluate and enhance their HAE management programs. Prime deploys utilization management strategies, following set criteria for medical review and pharmacy prior authorization to ensure members are receiving the most appropriate treatment.
Keywords for this news article include: Pharmaceutical Companies, Business, Urticaria, Managed Care, Hypersensitivity, Prime Therapeutics, Angioneurotic Edema, Drugs and Therapies, Health and Medicine, Hereditary Angioedemas, Genetic Diseases and Conditions, Immune System Diseases and Conditions, Vascular Skin Diseases and Conditions.
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