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Prime Therapeutics, Health Care Service Corp. remind Medicaid members to take critical meds

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EAGAN, Minn.— Prime Therapeutics’ (Prime) Medicaid Missed Refill Program is designed to increase prescription refill rates in depression, diabetes and asthma drug categories by reminding select members via a letter to refill their medications. An analysis specifically assessing the program impact among Health Care Services Corporation (HCSC) Medicaid members found the letters drove a 14-18% higher rate of refilled prescriptions in all three chronic drug therapy categories over a randomized group of Medicaid members who didn’t receive a letter. Letters were mailed to members if seven or more days had lapsed since their prescription supply ended.

As part of Prime’s GuidedHealth comprehensive care management suite, the Missed Refill Program letter educated members on the importance of taking their medication as prescribed and provided resources to help overcome barriers that may be contributing to missing refills. The program was a success when comparing refill rates between members who received a letter and members in the control group who did not. In the group receiving a letter, Prime saw:

  • 18% higher refill rate among members taking depression medicines
  • 14% higher refill rate among members taking diabetes medicines
  • 15% higher refill rate among members taking asthma medicines

“We are extremely encouraged by these results because we believe that when members refill their medicines, they stay healthier and avoid other costlier health care services,” said Steven Champaloux, principal data scientist, Prime Therapeutics. “We also know from previous research that adherence to depression medicine increases the likelihood that someone is adherent to their other medicines. This result is extremely encouraging for the holistic health of Medicaid members.”

“We work hard, in collaboration with physicians, to educate our members about the importance of medication adherence, which can lead to better health outcomes and healthier lives,” said Jay Gandhi, vice president, Enterprise Pharmacy Government Programs, HCSC. “The Medicaid Missed Refill Program is one component of our broader outreach efforts to provide information that helps guide our members in their health care journey.”

A common concern about mailing letters to the Medicaid population is the lack of an accurate address resulting in wasted effort and costs. In this program, only 0.5% of mailings were returned to sender, signifying a reliable database of addresses for the population.

“Health plan-administered clinical programs to Medicaid recipients are understudied and, to our knowledge, this is the first study of its kind assessing the impact of a refill reminder letter from a health insurer to Medicaid members,” added Champaloux. “Based on the positive results, we highly encourage health plans to consider similar campaigns to increase refill rates of medicines for chronic condition among this population.”


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