Some Foods And Drugs Don’t Mix December 29, 2009
Posted by George Van Antwerp in Books / Articles, Healthcare, PBM / Pharmacy, Value Propositions.add a comment
Without getting into all the clinical rules, I’ve always looked for a cut-to-the-chase consumer list of when to avoid what specific foods if you take certain medications.
Finally, in Real Simple magazine (pg. 74, Jan 2010), I found one. Here it is:
- Avoid grapefruit [including juice] if you’re taking a cholesterol lowering drug or a prescription sleep aid.
- Avoid chocolate if your using an MAO-inhibiting antidepressant.
- Avoid black licorice if you’re on heart medication.
I’m not sure of the science here, but I’m assuming that it’s real. I’ve heard the grapefruit advice before, but never the others. Do physicians and/or pharmacists tell you this?
The story also goes on to recommend a few foods:
- Shiitake Mushrooms – help boost the immune system and prevent the growth of cancer cells
- Brazil Nuts – may ward off colon, lung, and prostate cancer
- Horseradish – increase the liver’s ability to fight carcinogens and suppress growth of cancerous tumors…and may help avoid urinary tract infections.
- Walnuts – help reduce cholesterol and inflamation that may lead to high blood pressure and heart disease
- Black rasperries – may retard the growth of precancerous cells
So…watch what you eat!
Why Didn’t I Know There Was A Generic Version December 28, 2009
Posted by George Van Antwerp in Consumerism, Healthcare, Managed Care, Marketing / Communications, PBM / Pharmacy, Value Propositions.add a comment
I got this question e-mailed to me today. The patient has been using the same drug for years and it lost it’s patent about 6 months ago. They just found out that they could have saved a lot of money and wondered who should have told them. Here’s my thoughts.
- It’s the member’s responsibility ultimately to search for ways to save money and ask for generics.
- A lot of managed care companies and PBMs won’t reach out when patents expire because 90% of the time the drug is switched to the generic within 90-days by the pharmacy.
- The key players who would communicate are aligned – the pharmacy / PBM makes more money when generics are used and the managed care plan saves more money.
- BUT, sometimes managed care plans or individual employers (groups) will opt-out or never sign up for communication programs so their members don’t hear about ways to save money.
- BUT, sometimes consumers opt-out of communications from the PBM or managed care company and therefore miss out on opportunities.
- BUT, sometimes physicians won’t allow the prescription to be switched to the generic drug (even when chemically equivalent) and will write the prescription DAW (Dispense As Written) or say no substitution allowed.
- BUT, there have been a few instances when due to exclusivity on the generic that it actually costs more than the brand during the initial 6-months and people don’t move to the generic.
So, with lots of nuances, my reply was that no one had a legal obligation to tell her, but they all had good incentives to do it. I suggest talking to the physician and/or the pharmacist.
Brand Drugs That Might Lose Patent In 2010 December 28, 2009
Posted by George Van Antwerp in PBM / Pharmacy, Research.add a comment
Here’s a short list of the big drugs that might lose patent protection (i.e., have a chemically equivalent generic become available) in 2010. This is always subject to change and is based on data from PBMI which is summarized from presentations at the AMCP.
| 2010 | Aricept® | donepezil | Alzheimer’s disease |
| Cozaar® | losartan | High blood pressure | |
| Effexor XR® | venlafaxine | Depression, panic disorder | |
| Flomax® | tamsulosin | Benign prostatic hypertropy | |
| Hyzaar® | hydrochlorothiazide and losartan | High blood pressure |
FDA “Listed” Drugs – A New Hassle December 28, 2009
Posted by George Van Antwerp in Healthcare, Managed Care, PBM / Pharmacy.add a comment
As of 1/1/2010, Medicare beneficiares will face a new hassle at the pharmacy. How big of a deal will this be? I honestly don’t know.
But, from their site:
Starting January 1, 2010, if your pharmacy tries to sell you a version of a drug that isn’tlisted with the FDA, your Medicare drug plan might not pay for it. This means you mightgo to the pharmacy where you regularly get your Medicare-covered prescriptions filled, andif the pharmacy stocks only a version of the drug that isn’t listed (and, therefore, your planwon’t cover), the pharmacy may not be able to fill your prescription that day.
Since there are multiple manufacturers of a generic medication, multiple forms (capsule, tablet), and sometimes repackagers, this could complicate things for patients simply trying to fill their medications. I’m not sure I understand what’s being addressed here.
You Know You’ve Had A Good Workout When December 23, 2009
Posted by George Van Antwerp in General Thoughts, exercise.add a comment
Every once in a while you have that great workout. As we get ready for the 60% surge in gym memberships that occur with 1/1, I started thinking about what criteria I use to know this.
- An inability to walk up stairs without pain. I even had one workout years ago (kickboxing plus spinning) where I had to crawl up my stairs at home for day.
- You have to take Advil before you workout again since you’re still sore.
- You have to use IcyHot before you workout again to try to relax your muscles.
- An inability to lift light objects (such as kids) since your arms are too sore.
- An ability to wring the sweat from your clothes as if you had just jumped in a pool.
- Throwing up from a workout. (I have to trust this. I’ve come close, but my body seems to stop before I get there.)
- Totally physical collapse. (I also have to trust this. You often see this with marathoners or people doing the IronMan, but my body seems to stop before I get to this point.)
Of course, you can’t do this everyday or you can’t recover (and you probably aren’t very comfortable). But, I often find that the best way to get this is to try a new routine or new workout. I’ve done this new core workout a few times at the Lifetime Fitness in Chesterfield, MO which seems pretty easy but is really hard. I have trouble with certain movements the next day for sure.
Because People Are Different December 22, 2009
Posted by George Van Antwerp in General Thoughts, Healthcare, Marketing / Communications, Silverlink, Value Propositions.add a comment
I’ll borrow our tagline from Silverlink Communications - Because People Are Different – to follow-up on my post on direct mail from yesterday. The first commentor makes a good point. Certainly e-mail doesn’t work for everyone. Nor does the phone (although it is generally ubiquitous today).
The reality is that different segments require different modes of communication. The question is how to figure that out.
- Do you ask people for their preferences…realizing that many times people don’t know what they want or need?
- Do you look at historical behavior to predict what will work best for people like them…realizing that healthcare is intensely personal and while predictive may not be indicative…and people’s healthcare behaviors change over time?
- Do you pursue a cluster approach – i.e., send multiple modes simultaneously…realizing that this isn’t very cost effective?
- Do you pursue a strategy of sequencing – i.e., call then e-mail then letter – and which pattern works best…and what spacing between modes works best? (This will vary by message, objective, and audience.)
And, the question that I surprisingly don’t hear many people ask is why is there so much direct mail when we as a culture are generally more interested in being environmentally aware than ever (although we still have a long way to go). Why kill a tree when other modes are more effective, less expensive, and offer better consumer insights?
Why Does Direct Mail Exist In Healthcare December 21, 2009
Posted by George Van Antwerp in Healthcare, Marketing / Communications, Silverlink, Technology.2 comments
Given all the progress we’ve made in the past 15 years around communications, I wonder why direct mail is still a primary component of communications. Obviously, there are some times when compliance requires a written notification, but considering you can’t tell if someone opened the mail and most companies don’t process return mail, you really have no visibility or ability to audit.
Written communications are also so static unlike a website or an automated call where a response can alter the next step in the communication.
Additionally, there is a time lag on written communications that you don’t have with e-mail or with an automated call.
I’ll break it out more in the table below, but in the end, direct mail costs the most yet gives you the least data, the worst customer experience, and is the least time sensitive. Seems like a problem to me.
| Channel |
Automated Call |
Direct Mail |
|
| Cost |
Low – Medium |
High |
Low |
| Ability to Personalize |
High |
Medium |
High |
| Dynamic Content |
Yes |
No |
No |
| Know if received by consumer |
Yes |
No |
Yes |
| Know how long consumer interacted |
Yes |
No |
No |
| Time from event to consumer |
Minutes |
Days |
Minutes |
| Response Rate |
High |
Low |
Low |
Now, don’t get me wrong, there is a place for direct mail.
- People who don’t respond to automated calls or e-mail.
- People who request more information.
- Communications which require detailed information to make a decision.
But, why is it that so many companies begin their communications to consumers with direct mail. Is it that people are simply stuck in a rut of what they’re used to and can’t embrace decade old technology? Or is it that people don’t believe the facts in front of them?
How will PBMs be affected by current trends? December 17, 2009
Posted by George Van Antwerp in PBM / Pharmacy.add a comment
You can certainly see the piece of the PBM world that I’m wrapped up in right now, but these seem to be important trends.
What are the most likely developments/trends that could affect pharmacy benefit executives in the year ahead? Why?
While healthcare reform or market consolidation could impact the industry, we don’t see either as having a material impact in 2010. We expect several trends. There will continue to be a focus on mail order utilization, specialty pharmacy market share, and generic fill rate, and the sophistication of those programs will continue to evolve. PBMs will look at how to predict responses by patients to offers such as retail-to-mail and subsequently segment the market using variables such as condition, age, and plan design. PBMs will continue to develop strategies to address programs like $4 generics, 90-day retail, and pharmacy to employer direct contracting. We have also seen a huge focus on adherence which will take several forms – automated refill programs, physician focused programs, and pharma-funded programs. Additionally, there will continue to be efforts to create a single view of the member in a longitudinal view of their claims and intervention history. PBMs will begin to think and act more like consumer companies employing techniques like motivational interviewing and behavioral economics.
How might pharmacy benefit executives most effectively prepare for these important trends?
Executives should be developing processes with an inside-out perspective that focuses on how the consumer experiences the PBM not how the PBM optimizes their process. They should be looking at how they blend claims data, lab data, communications data, and event data (e.g., website visits) to have a holistic view of the patient. Additionally, PBMs need to have a rapid testing strategy for how they evaluate consumer hypotheses and rapidly improve programs while capturing insights about their population.
What are the biggest challenges facing pharmacy benefit executives in 2010? December 17, 2009
Posted by George Van Antwerp in PBM / Pharmacy.add a comment
Another question from the recent Drug Benefit News where I was interviewed with several other experts on the industry. My answer…
- How to continue to grow (top line, bottom line, marketshare, functionality, internationally)?
- How to avoid commoditization within specialty and how to scale specialty operations with a lower FTE to Rx ratio without impacting outcomes?
- How to prevent “churn” from mail whether due to non-adherence or movement to $4 generic type programs?
- How to simplify consumer messaging and drive health outcomes?
- How to develop restrictive benefits that drive behavior with minimal disruption?
- How to structure client and pharma financial relationships that reward them for better outcomes?
Other thoughts?
Will there be more PBM acquisitions in 2010? December 17, 2009
Posted by George Van Antwerp in PBM / Pharmacy.add a comment
My response to this question…
The Express Scripts acquisition of Wellpoint’s NextRx certainly put several captive PBMs in play, but that appears to have died down. There may be small acquisitions, but the big 3 appear focused on expansion into more health services and internationally more than buying new lives.
Other opinions?
Should Rx Data Be Used By Pharma? December 16, 2009
Posted by George Van Antwerp in General Thoughts, Healthcare, Marketing / Communications, PBM / Pharmacy, Politics, Value Propositions.add a comment
This is a great question as posed by numerous people (see WSJ blog). Now, the one reality that most people don’t realize is that the data is only directionally correct. Not everyone sells their data to the aggregators so depending on pharmacy (or PBM) marketshare the data could be close to significantly off.
Perhaps, that’s not the issue. The question is whether pharma should have a right to see prescription data by physician to understand their behavior. It’s not patient specific data so that alleviates what I think should be the big issue.
Between patients visiting healthcare sites, registering for coupons, buying disease specific publications or supplies, the individual data is probably a lot easier to get and use…and probably more accurate (at least at the household level).
Assuming no one says that pharma can’t communicate with physicians, I think the data is relevant. Certainly, they have an agenda – drive marketshare of their drugs. I think we have to assume that physicians aren’t just guppies that hear the pharma rep talk and do whatever they say. Physicians are smart, well-trained professionals that should be able to hear messaging about drug pros and cons; look at the research; talk to their peers; talk to their patients; and appropriately prescribe.
I think the prescription data probably creates a more efficient system. Physicians that use a drug frequently are visited less often by the rep and don’t spend time away from patients. Physicians that don’t prescribe a drug frequently (and prescribe a high volume of competitive drugs) probably get more visits…BUT they have the choice of saying don’t come.
[I'm taking a little extreme of a view here since nothing is black and white, but I'm not sure I see the privacy issue here.]
Lance Armstrong And Diabetes December 15, 2009
Posted by George Van Antwerp in Healthcare, Marketing / Communications, PBM / Pharmacy.add a comment
Lance has decided to focus some of his passion and conviction on diabetes. I think this is great. Certainly, this is a condition which affects a lot of Americans and continues to get worse with the obesity epidemic.
Given the focus on the pharmacies (CVS, Walgreens) and the PBMs (Caremark, Medco, Express Scripts) on management of this condition, I wonder who (if anyone) will get Lance Armstrong to be their sponsor or public face. For the PBMs that traditional don’t have a consumer brand, I would think this is a great opportunity. I compare it to Medco having Amy Tendrich from DiabetesMine promoting Liberty Medical. While Amy might not be a household name, she is certainly a name in the diabetes community.
Phones On The Planes – Please No December 10, 2009
Posted by George Van Antwerp in General Thoughts.add a comment
The fact that there is even a coalition called the Inflight Passenger Communications Coalition which is focused on getting passengers the “right” to use their mobile phones on planes in the US is crazy. I don’t care what they do in other countries. This would drive me insane. As someone who spends a significant amount of time on planes, the last thing I want to hear is some person talking the whole flight. This is great downtime and work time for me.
I completely agree with having Internet access. People can stay connect via SMS (text messaging), e-mail, web chats, or other written modes. Having dozens of people talking out loud in a confined space would be unpleasant for everyone.
Hoarders – Scary Pictures; Big Health Consequences December 3, 2009
Posted by George Van Antwerp in Healthcare.add a comment
Have you seen the show Hoarders? Very scary. It’s amazing that people can live like this. Logically, it would appear that there is some type of additive or compulsive behavior issue here. Go to the website and look at some of the pictures.
I can only imagine the social and health consequences of this on the entire family.
Can Un-Athletic Coaches Be Role Models? December 1, 2009
Posted by George Van Antwerp in General Thoughts, exercise.2 comments
As a parent, I always think about setting examples for my kids. Since I do believe that playing sports is important to teach kids teamwork, coordination, social skills, and competitive skills, I think this is a key question. Sports is an integral part of our society. I see three potential role models for kids around sports: [Also, over time, I think that kids peers can become role models or certainly older kids.]
- Parents
- Coaches
- Professional Athletes
While I think there are some great professional athletes who can serve as role models (e.g., Michael Jordan, Tiger Woods), there are a lot that aren’t due to drugs, violence, unsportsmanlike conduct, gambling, cheating, and financial mismanagement. And, that’s a very hard thing to control. We’re always (IMHO – in my humble opinion) going to pay to see the best even if they’ve used steriods or have control issues.
As parents, we have the most control over ourselves. We can make sure our children see us play sports and exercise. We can stress the importance of this. We can help them learn sports and make sure they take away lessons from their playing – e.g., winning isn’t everything. [One interesting observation that I've had is that athletes make good sales people because they know how to keep trying and get focused even after a loss.]
But, the one I struggle with is coaches. Sometimes you may have control over the coach, but they can be a very powerful influence on your kids. They spend hours with them and provide guidance. There are some things that you obviously don’t want in a coach – too demanding, not demanding enough, someone who encourages winning at any cost. But, what do you do about the coach that is very smart and understands how to play, but isn’t in shape at all? They can’t even run down the field with the kids. What type of image does that give the kids? It seems mixed to me, but maybe I’m wrong.
[Note: I was originally going to call this "Fat Coaches", but I think there are plently of overweight people who are athletic. But, I'm not so sure about this guy above or some other coaches I've seen.]
RoadID for your athlete December 1, 2009
Posted by George Van Antwerp in General Thoughts, Technology, Value Propositions, exercise.2 comments
Here’s a simple, yet valuable gift for your athletic spouse, friend, co-worker – RoadID.
This is something you can wear or put on your shoes so that if you get into an accident while you’re working out (i.e., road running, biking, hiking) people can contact someone for you. I think it’s great. I was skeptical of the need for it for a while, but I realize that accidents do happen.
They’ve now come out with RoadID interactive. I have mixed impressions. It’s great in that you can log information into an online profile – addresses, contacts, physicians, medical information, insurance coverage, etc. If you’re in a horrible accident, all of that would be good to have. And, the reality is that you control how much is there. But, I’m still a generally paranoid person so I would worry about someone stealing my shoes and all of a sudden having access to my information.
[Too bad you couldn't make it so that it was only enabled if some of your vitals signs were off and transmitted via a sensor to the site to unlock the information. That would be cool!]
Band-Aid To Monitor Your Heart November 29, 2009
Posted by George Van Antwerp in Books / Articles, Healthcare, Innovation, Technology, Value Propositions, exercise.add a comment
Let’s stick with today’s examples that can be extrapolated to the future. [Good Sunday am thinking]
I was reading in Fast Company [Dec 09 / Jan 10] about Corventis’ PiiX monitor.
It’s a “wireless, water-resistant sensor that sticks to a patient’s chest like a large Band-Aid and monitors heart rate, respiratory rate, bodily fluids, and overall activity.”
Interesting! I see an immediate use for this in team sports like the Tour de France where it can be monitored by a team manager and used to push fluids or encourage a change in pattern. But, as the company talks about, imagine the power of using predictive algorithms here to know when someone may be in danger of a heart attack or some other medical issue.
As devices like this become standard and are used to monitor our key bodily statistics and used, will we become healthier? Again, will companies be able to use these to help guide our decisions through incentives – lower health care costs, lower life insurance costs?
I think as the data from these get transmitted electronically and populate PHRs and EMRs and get used by clinicians it will be very interesting to see how they change outcomes.
Why Keep Covering PPIs? November 26, 2009
Posted by George Van Antwerp in Healthcare, Managed Care, PBM / Pharmacy.add a comment
I’m not a clinician so I’m sure there are some clinical exceptions to this general comment. [For example, look at Aetna's PPI Medicare information.]
But, with Prilosec available OTC (Over The Counter) both as a brand product and as a generic (omeprazole) and now Prevacid will also be available OTC, I wonder why PBMs and plan sponsors don’t stop covering this class of drugs. [See here for CVS Caremark's overview on this.]
BTW – PPIs (or Proton Pump Inhibitors) are generally used for acid reflux and some people can simply use other OTCs such as H2 Antagonists (e.g., Tagamet, Pepcid, Zantac). [Consumers might also read Consumer Reports Best Buy Drugs report on PPIs.]
Traditionally, PPIs represented one of the higher cost drug categories (and also one of the most highly rebated). In CVS Caremark’s BOB (book-of-business), it represented 7.3% of their spend according to their TrendsRx 2009 publication.
Plans have stopped covering NSA (non-sedating antihistamines) once Claritin went OTC. This seems like the next natural category with perhaps some formulary override option for certain medical exceptions.
Happy Thanksgiving!…just remember November 26, 2009
Posted by George Van Antwerp in Events, exercise.add a comment
Samples In The Age Of H1N1 November 19, 2009
Posted by George Van Antwerp in General Thoughts.add a comment
One of my first jobs was at Krogers. That changed my view of sampling food forever. I’ll never forget watching a woman sample the spinach dip at the deli. She dipped her fingers in; licked them; and then dipped them back in to get more. (Discusting!)
Now, with all the flu, I’m even hesitant to even eat from a bowl of nuts. Who knows who’s been eating out of the bowl.
“Training” For Disney November 18, 2009
Posted by George Van Antwerp in exercise.add a comment
We’re doing our first family vacation (brother, sister, parents, and kids – 14 in total) at Disney in December. We’ve been to Disney several times with kids, but my family hasn’t been in years. Their travel agent sent out an e-mail telling them that they should be “training” for Disney. She said that you should be able to walk 16 miles.
Are you kidding me? Do you really think that our obese society is paying $70 a day (or whatever it costs) to wait in line and walk 16 miles within the park…especially in the heat of the Florida summer?
Now, my family is all worried about getting ready. I’m pretty sure the millions of young kids that go there every year don’t have the stamina to walk 16 miles a day even hyped up from seeing Mickey and eating lots of junk food.
The Buy-ology Of Healthcare November 17, 2009
Posted by George Van Antwerp in Healthcare.add a comment
Over the past few years, marketing has rapidly evolved with technology, social media, and neurosciences. As consumers are taking a more active role in their healthcare (both willingly and unwillingly), healthcare entities are scrambling to understand how they think, how they make decisions, and how to develop programs that effectively communicate with consumers to drive appropriate and cost-effective behaviors.
“The task of neural science is to explain behavior in terms of the activities of the brain. How does the brain marshal its millions of individual nerve cells to produce behavior, and how are these cells influenced by the environment…?”
To accomplish this, companies are integrating different data sources, leveraging behavior science methodologies like champion / challenger tests, and stepping outside of healthcare for best practices. Financial services (e.g. credit card companies) have been deploying these marketing sciences for years to improve yield, but healthcare companies are just beginning to realize that in order to influence the 50-70% of healthcare costs that are lifestyle related they will need to think differently. This new approach to marketing and healthcare communications blends the qualitative and quantitative aspects of marketing and looks to areas like linguistics and behavioral economics for insights.
“Genetics influence how a person makes a decision based on whether their options are presented to them in a positive or negative way (framing effect) — such as being told there is an 80 percent chance of surviving or a 20 percent chance of dying during an operation.”
One of the leading researchers in this area of neuromarketing is Martin Lindstrom who recently authored a book called “Buy-ology“. In the book, he walks through research where he uses fMRI (functional Magnetic Resonance Imaging) and SST (Steady-State Typography) to study the brain activity during multiple marketing experiments. This analysis reveals a series of insights including things like:
- Cigarette warning labels have the opposite effect on smokers.
- Logos have lost their importance, but branding matters immensely.
-
The reason why people chose Coke over Pepsi is because of their branding not because of taste.
“Our irrational minds, flooded with cultural biases rooted in our tradition, upbringing, and a whole lot of other subconscious factors, assert a powerful but hidden influence over the choices we make.”
Given the challenges that we all face in terms of branding and allocation of marketing dollars, these are important things to understand. We want to make sure that as consumers increasingly control their healthcare decisions that they choose our facilities, buy their health insurance from us, and/or view us as a trusted source of information. To achieve this, we have to get into their heads and understand how they make decisions and what will compel them to act. Since, as Martin Lindstrom points out, almost 90% of our buying behavior is subconscious, we have to better understand our consumers and provide them with value-added content that is tailored to their needs.
Eric Kandel, Principles of Neural Science, fourth edition
Wellcome Trust, news release, May 5, 2009
Martin Lindstrom, Buy-ology: Truth and Lies About Why We Buy (New York: Doubleday, 2008), p. 18
5 Prescription Myths That Cost Consumers Money November 17, 2009
Posted by George Van Antwerp in Healthcare.add a comment
In these difficult economic times, saving money has become a way of life. Unfortunately, Americans have been trimming costs on items vital to their health. A Kaiser Family Foundation study found that 53% of Americans have cut back on healthcare over the past year because of cost concerns, with 21% cutting back by not filling a prescription.
There are ways to save money on prescription drugs without skimping on your health. It’s time to debunk the following prescription drug cost myths.
Myth #1: ”My physician would have told me if there was a lower-cost option.”
Physicians are focused on their patients’ health and often don’t have time to study the costs of the more than 10,000 prescription drugs currently on the market, let alone the ins and outs of each patient’s health plan. In one study, over 80% of physicians felt it was the pharmacist’s job to discuss costs with the patients.
What can you do? Talk to your pharmacist about therapeutic alternatives to your prescription drugs.
Myth #2: ”My pharmacist would have told me if there was a lower-cost option.”
There is currently a shortage of pharmacists in the U.S. and while they would like to consult with patients, many don’t have the time to help each person optimize their prescriptions. Also, at retail pharmacies, pharmacists are unlikely to encourage savings opportunities like mail order and may even be hesitant to encourage 90-day retail.
What can you do? Ask your pharmacist about lower-cost options for your drug plan design.
Myth #3: ”Prescription prices are the same everywhere.”
Prices can vary dramatically between pharmacies, especially for generics. In one study, prices varied as much as 1,000% for cash paying customers. Also, getting 90-day prescriptions through the mail or sometimes at your local pharmacy can save you money.
What can you do? Ask your health plan for an online comparison tool and research prescription drug costs in your area.
Myth #4: ”Generics aren’t as effective as brand name drugs.”
Generic drugs have the exact same active ingredients and side effects as brand drugs. They are less expensive than brand drugs because the manufacturers aren’t starting from scratch when it comes to the costs associated with developing and marketing a new drug. In addition, brand drug manufacturers make approximately 50% of the generic drugs themselves under other names.
What can you do? Go to the FDA website and read their educational materials about generic drugs and ask your doctor to prescribe.
Myth #5: ”My adherence to my medication doesn’t affect overall healthcare costs.”
In one study, the annual healthcare costs of a person with diabetes who didn’t take medications were twice that of a diabetic person who adhered to a medication plan. Non-adherence to medication is estimated to cost the healthcare system $290 billion a year. As many as 30% of people never fill their first prescription and more that 50% of people stop taking their long-term medications within 12 months.
What can you do? Research the medications that you are on and understand how other patients have used them and the time it takes for them to work. Never stop taking a medication without discussing it with your physician first.
Tips For A New Runner November 17, 2009
Posted by George Van Antwerp in General Thoughts, Healthcare, exercise.add a comment
I’m sure there are thousands of people more qualified to give these to you, but since I’ve run 3 marathons, I’ll assume that I have a little experience. Here are my basic tips going back to when I started running by run/walking one mile on my treadmill.
- Start small and build up – Start by walking and running short distances to build up some endurance. When you want to add mileage, only add about 10% per week. I made the mistake at one point of adding miles too quickly in my training (35 one week and 50 the next 2 weeks) and spent about a month on the disabled list (DL) due to shin splints.
- Get in a running group – After a few months of running, I was running 12 minute miles which I felt good about. My friends asked me to run with them and within a month, I had dropped my average times down below 10 minute miles. Plus, you feel that extra incentive to get up and meet them in the morning. Some of my friends have a penalty they pay if they don’t show up.
- Vary your routine – Don’t just run the same speed and same route each day. Do sprints. Do intervals. Run hard some days and easy other days.
- Have the right attitude – Find the time when your energy level is high and get in a routine. You have to feel excited about running or exercising and have a positive attitude to succeed. Setting a goal can help (i.e., I want to run a sub-25 minute 5K) or creating an incentive (e.g., I’ll buy myself a new iPod if I lose 10 lbs).
- Buy Glide – A lot of people think you can just walk out the door and start running. I disagree on a few fronts. First, I do think all the wicking clothes do help, but more importantly, I find Glide to be a must have. I won’t run without it. When I first started, no one explained to me about how much chaffing was possible. For months, I would come home looking like I was shot with blood running down my shirt from my bloody nipples. Some people try Vaseline to avoid this. Others use bandaids. Glide is the only thing I’ve found that works and holds up thru weather and distance.

- Buy the right shoes – This is another very painful memory. When you run, you need shoes that are ½ size larger than you normally wear. If you don’t, you will start finding that your toenails turn black and eventually you lose them. (Not as bad for men as I would expect this would be for a woman who likes to wear open toed shoes.) For my first marathon, I lost five toenails and had to learn to stick needles under my toenails and thru my toenails to pop the blood blisters under them.
- Drink lots of water – This was a beginner’s mistake that I sometimes continue to make. A lot of times, I just like to run without carrying a water bottle. But at different times, I’ve thought I had some type of stomach acid problem because I was so torn up after my runs. It took me a long time to figure out that it was just dehydration.
Unfortunately, I haven’t been as rigorous about my training lately, but running can be a lot more fun and social that you think. I would encourage it for everyone.
PBM Market Share November 17, 2009
Posted by George Van Antwerp in Healthcare, PBM / Pharmacy, Research.add a comment
I was looking for something the other day and stumbled upon this survey from earlier this year. I modified it to add the Wellpoint NextRx lives to the Express Scripts lives, but I wasn’t sure how to reconcile the Walgreens numbers (they are listed twice) and didn’t see any lives for RxAmerica which is now part of CVS Caremark.
| Company |
Rx Covered Lives |
Market Share |
| Express Scripts / CuraScript / Wellpoint NextRx |
90,049,000 |
13.20% |
| CVS/Caremark Rx, Inc. |
82,000,000 |
12.02% |
| Walgreens-OptionCare |
75,000,000 |
10.99% |
| ICORE Healthcare, Inc. |
60,000,000 |
8.79% |
| Medco Health Solutions, Inc. |
60,000,000 |
8.79% |
| NovoLogix (formerly Ancillary Care Management) |
40,000,000 |
5.86% |
| Argus Health Systems, Inc. |
28,600,000 |
4.19% |
| MedImpact Healthcare Systems, Inc. |
27,000,000 |
3.96% |
| HealthTrans |
15,300,000 |
2.24% |
| Prime Therapeutics, LLC |
14,700,000 |
2.15% |
The other thing to note here that we always joke about is how 70% of the market is equal to almost 500M lives (more than the US population). It has to do with people who have mail with one PBM, specialty with another PBM, and claims processing with another PBM (for example).
It is an interesting space right now. Two of the top 10 PBMs are actively looking for a CEO/President – CVS Caremark and Prime Therapeutics. You have seen lots of press releases recently from companies like Express Scripts, Medco, and CVS Caremark on new partnerships and technologies that they are working with. I also think you’ve seen a shift in research from Express Scripts to Medco which has been publishing a lot more recently. And, you’ve also seen several Medco alumni go to CVS Caremark at very senior positions.
72% of People Prefer to Listen W/ Right Ear November 16, 2009
Posted by George Van Antwerp in General Thoughts, Marketing / Communications, Research.add a comment

This is logical since the left side of the brain and right ear specialize in language processing.
But, perhaps the more interesting part of this study by Luca Tommasi and Daniele Marzoli of the University Gabriele d’Annunzio in Italy is that requests spoken into right ears generated more positive responses than those spoken into the left ear. Think about that on your next sales call.
Different Camps – Healthcare Reform November 16, 2009
Posted by George Van Antwerp in Healthcare, Politics.1 comment so far
I think it’s pretty clear that there are a few different camps here. Hearing Rahm Emanual (Obama’s chief of staff) say that the goal is to pass a bill thru Congress not figure out what the ideal bill might look like is certainly one perspective. (NYTimes, 11/11/09, Falling Far Short Of Reform) There are many camps trying to find the ideal solution. Other people are looking at it from a budget perspective. Others from a moral perspective of the need to cover the uninsured. Others from a business perspective.
Can these all be reconciled? No. Not and get anything done.
Everyone agrees the current system is a problem. Can’t someone prioritize the issues and focus us on being successful with one goal at a time and not trying to put pieces that appeal to everyone into one bill that therefore meets the needs of no one. The goal should never be just to pass a bill to meet some artificial deadline set by a candidate to impress the people. The mess after the fact will be too difficult to change.











