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Patented Process for Beneficially Managing Mental Health (Psychotropic) Drug Usage by Plan Members HR Specialty Products & Services Catalogue Executive Summary A No Frills Distillation of Vendor’s Marketing Collateral Thomas A Ference President & CEO Human Resources Mining & Distribution Co Locating, Validating and Accelerating HR Innovation Office: 219-662-0201 Cell: 630-240-2583 Fax: 219-661-0236 e-mail: tference@hrmdco.comtference@hrmdco.com Website: www.hrmdco.comwww.hrmdco.com
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Typically 15% to 20% of healthcare plan members are being prescribed mind altering drugs by non-specialized / regular physicians (not psychiatrists) No scientific assessment of either the initial diagnoses or the propriety for continued usage as symptoms change Among the top 5 therapeutic classes of drugs, psychotropics are the: -third largest representing 21% of the total spend -largest overall in terms of number of written scripts Employers’ indirect costs include unnecessary claims in healthcare, disability and workers comp plus lost productivity and outweigh direct Rx costs. Patented Process for Beneficially Managing Mental Health (Psychotropic) Drug Usage
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Rx consultancy deploys a comprehensive and patented process that also incorporates mental-health-coach- supported and telephonically-delivered Hospital Anxiety / Depression (HAD) screenings. The HAD screenings are used for both initial and ongoing diagnoses in close coordination with the members’ prescribing physician on clinical outcomes. A free upfront analytic for employers assesses the scope of problem and establishes the requisite and at-risk-for- success pepm. In one case, savings in the targeted psychotropic drug spend was reduced by 30% with a similar reduction in percent of indirect savings in healthcare spend.
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The Research Only 12.7% of individuals seeking mental health treatment in the general medical setting received minimally adequate care compared to 43.9% of patients treated in the specialty mental health sector Of 74 (short-term) studies on antidepressants registered with the FDA, 38 reported a positive outcome and 36 reported a negative outcome (Which do you think were published for peer review?) 38% of the patients properly enrolled in the largest trial ever remitted during one of the four stages of drug treatment. Only 3% of the patients remitted and then stayed well throughout the 12-month follow up (108 of 4,041.) The remaining patients either failed to remit, relapsed during the follow up or dropped out.
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Implementation Plan and Metrics: Establish a secure two-way data feed with the PBM Filter on drug data to identify potential candidates Coordinate a targeted member outreach Decide - “stick” or “carrot” benefit plan design approach Manage Concurrent Authorization process with the PBM Provide telephonic evaluations, screenings and coaching Provide clinical outcomes to prescribing physician Coordinate with EAP for free psychotherapy and other resources Monitor side effects and drug adherence Provide education and feedback to participants and physicians
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Case Study - Arizona-Based Hospital System’s Health Plan 96 percent higher medication compliance for EBT participants at 1 year 96% 200 percent average increase in EAP engagement over 4 years 200% 30 percent reduction in the EBT target drug spend within 15 months 30% 29.4 percent overall average reduction in total medical claims costs for the EBT participants in the year after enrolling in the EBT compared to prior year 29.4 % 60 percent of the EBT participants scored reduced symptoms based on multiple standardized screenings 60% 6
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Next Steps This product/service is contained in the HR Specialty Products & Services Catalogue™ Operational level details about this particular service provider can be obtained in conference with the vendor The HR Mining &Distribution Co. is an independent and contracted representative of the vendor Upon your request, we will arrange for an introduction that can range from a simple, quick conference call to a services overview / system demo Tom Ference 219-662-0201 (Chicagoland area) or tference@hrmdco.com Thank you for your potential interest in this fresh thinking
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