News and Insights

Value-added Service: Asthma Management

November 5, 2024

Asthma is a serious yet manageable chronic condition characterized by inflammation of the airways, leading to symptoms like wheezing, coughing, and shortness of breath.1 While commonly associated with children, asthma affects individuals of all ages, with both its prevalence and impact continuing to grow globally.2 In fact, asthma affects over 350 million people worldwide, and the economic burden is significant—costing the U.S. alone $81.9 billion annually due to direct health care expenses, missed workdays, and loss of productivity.2,3

Despite ongoing efforts to improve asthma care, asthma control remains suboptimal, particularly in pediatric populations and low-income communities. Even in high-income countries like the U.S., patients still face barriers in accessing appropriate medications due to affordability and lack of evidence-based treatments.1,2 Additionally, social determinants of health (SDOH), such as economic and cultural factors, further complicate asthma management.1

The Role of Pharmacists in Asthma Management

Pharmacists play an integral role in the care of asthma patients. As medication experts, pharmacists can assist healthcare providers by ensuring that treatment plans align with the latest clinical guidelines, addressing issues like low health literacy and patient understanding of their condition. Pharmacists can also help patients navigate their treatment options, improving adherence to controller medications and empowering them to better manage their asthma.

Pharmacy Benefit Managers (PBMs) like PerformRx add another layer of support by utilizing a comprehensive view of a patient’s overall care, including pharmacy and medical claims data. With this holistic perspective, PBMs can implement specialized programs that target asthma management and improve outcomes.4

PerformRx's Asthma Drug Therapy Management (DTM) Program

At PerformRx, we are committed to improving asthma care through our innovative Asthma Drug Therapy Management (DTM) program. This program is designed to collaborate with health plans and address the unique needs of asthma patients, particularly those who are non-adherent to controller medications or have a history of emergency room visits and hospitalizations.

The goals of the PerformRx Asthma DTM program include:

  • Optimizing medication regimens by closing gaps in evidence-based care, addressing safety concerns, and improving adherence to controller medications.
  • Improving patient outcomes by reducing emergency room visits, enhancing lung function, and increasing overall quality of life.
  • Reducing overall costs by offsetting higher pharmacy costs with savings from reduced medical interventions and hospitalizations.

Each patient enrolled in the Asthma DTM program receives a comprehensive medication review from a pharmacist. This review includes an evaluation of the patient’s pharmacy and medical claims, consultation insights, and demographic data. The pharmacist identifies and addresses medication-related issues, collaborates with prescribers, and ensures that patients receive the best care possible.

Partnering for Better Health

Collaboration is key to the success of the PerformRx DTM program. We work closely with our health plan partners to offer a two-way referral process that addresses both medical and social determinants of health. This holistic approach helps resolve SDOH-related issues quickly and effectively, leading to better health outcomes and greater health equity.

Measurable Results

The PerformRx Asthma DTM program has demonstrated measurable success. For one Medicaid line of business, a full cost and utilization analysis showed that medical utilization and costs decreased following program enrollment and pharmacist intervention. Additionally, provider acceptance of the program’s recommendations remains strong, with a 41% acceptance rate for interventions.

As a PBM dedicated to improving patient care, PerformRx’s Asthma DTM program continues to advance asthma management by optimizing medication use, reducing healthcare costs, and ultimately enhancing the quality of life for asthma patients.

Learn More About How PerformRx Can Help

Are you looking for a way to improve asthma management for your health plan and its members? Contact PerformRx today to learn more about how our Asthma DTM program can enhance care, reduce costs, and deliver better health outcomes for your population. Our team is ready to partner with you to create tailored solutions that meet the unique needs of your members.

Get in touch with us at info@performrx.com to explore how PerformRx can support your asthma management goals.

This blog post is a summary of an article from the Summer 2023 edition of PerformRx Review. If you enjoyed it, sign up to receive new editions and discover more content like this.

References:

  1. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2022. Available from: www.ginasthma.org.
  2. Asthma trends and burden. American Lung Association, 2018. Available from: https://www.lung.org/research/trends-in-lung-disease/asthma-trends-brief/trends-and-burden.
  3. Garcia-Marcos L, et al. Asthma management and control in children, adolescents, and adults in 25 countries: a Global Asthma Network Phase I cross-sectional study. Lancet Glob Health 2023;11:e218-228.
  4. “Healthy People 2030”, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved September 2, 2022, from https://health.gov/healthypeople/objectives-and-data/social-determinants-health

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