BEST/TOP ANALYSIS

Top Programs That are Designed to Improve Patient Adherence to Treatments

Cigna’s Coach Rx program, Aetna’s Rx Healthy Outcomes program, and Humana’s Medication Therapy Management program are some examples of programs that are designed to improve patient adherence to treatments. Cigna’s Coach Rx program is designed for the customers of Cigna Home Delivery Pharmacy as well as beneficiaries who are at risk for nonadherence. Aetna’s Rx Healthy Outcomes program, on the other hand, is designed for patients who have experienced a heart attack while Humana’s Medication Therapy Management program is designed for patients who have chronic diseases. More details regarding these three programs are outlined below.

Cigna’s CoachRx Program

Aetna’s Rx Healthy Outcomes Program

  • Aetna is a leading health care company that offers health insurance and other plans to individuals, families, or employers. It is a subsidiary company of CVS Health Corporation.
  • Aetna’s Rx Healthy Outcomes program increases medication adherence by combining pharmacist outreach with value-based insurance design. This program is designed for patients who have experienced a heart attack.
  • In this program, a pharmacist would call a patient within a week of discharge to explain the medications or reconcile new medicines with the patient’s previous regimen. The call is also intended to answer questions from the patient or to connect the patient with care providers.
  • This program also aims to eliminate or reduce copays for targeted prescription drugs as well as increase personalized support for Aetna members. Through this, Aetna seeks to help members who had a heart attack in the past to effectively take the medications that will improve their health and will lower their chances of experiencing another attack.
  • According to Lonny Reisman, Aetna’s chief medical officer, “As a cardiologist, I know that optimal clinical outcomes depend on patients following recommended treatments. Today’s cardiac medications are well-established in greatly reducing a patient’s chances of having a second heart attack and living longer. Still, only about 40 percent of patients follow the medication regimen after having a heart attack. Armed with new and growing evidence about patient behavior, we can help high-risk members address their personal barriers to adherence.”
  • Through Aena’s Rx Healthy Outcomes program, drug adherence rates have been increased by 6.2 percentage points for statins and 4.4 percentage points for beta-blockers. This is in comparison to other adherence programs that do not involve pharmacist outreach. Patients who participated in the Rx Healthy Outcomes program also experienced a lower rate of stroke.

Humana’s Medication Therapy Management Program

  • Humana is a Kentucky-based health insurance company. Humana’s Medication Therapy Management (MTM) program aims to optimize therapeutic outcomes by focusing on and promoting adherence, effectiveness, safety, and lower-cost alternatives. Through this program, Humana desires to ensure that patients are getting the best possible result from their medications.
  • This program improves adherence by promoting collaboration among patients, pharmacists, and prescribers to optimize effective and safe medication use.
  • This program is for those who have a Humana-covered Medicare Advantage prescription drug plan (MAPD) as well as for prescription drug plan (PDP) patients who have at least three of these chronic diseases: chronic heart failure, diabetes, asthma, dyslipidemia, and rheumatoid arthritis.
  • According to William Fleming, Humana Vice President for Pharmacy and Clinical Integration, “MTM affords pharmacists the opportunity to play an even greater role in enhancing patient care and optimizing outcomes.”
  • According to a survey conducted by MTM services, 85% of patients are having medication therapy problems. But during the course of the MTM program, 55% of patients who participated in the program improved in reaching certain clinical goals. Also, 93.3% of respondents agreed that there has been an improvement in their overall health and well-being because of the MTM program.
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