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New Respiratory Program Designed to Manage Costs of Asthma and COPD The new proprietary Walgreens Health Initiatives Healthful Living™ Respiratory Care Management Program was developed to help plan members with asthma and chronic obstructive pulmonary disease (COPD) to optimize their health, quality of life, and

productivity while also curbing clients’ healthcare costs. Asthma, a chronic inflammation of the bronchial airways, affects nearly 20 million Americans at an estimated annual economic cost of $16.1 billion, consisting of $11.5 billion in direct healthcare costs and $4.6 billion in indirect costs, such as lost productivity. COPD, a condi-

tion in which the airways are partially blocked, is the fourth-ranking cause of death in the United States, affecting more than 12 million people diagnosed with COPD and another 12 million who have the condition but have not been diagnosed, according to the National Heart, Lung, and Blood Institute.

In This Issue:

Client Survey Results ...........2

Medication Adherence .......3

Holiday Hours .......................4

OptionCare ...........................4

Rx Drug Update ...................4

Clients Recognized ..............5

New Rx Indications ..............5

Mark Your Calendar ............5

Medication Matters ...........6

November-December 2007

Volume 11, Number 6

©2007 Walgreens Health Initiatives, Inc., a wholly owned subsidiary of Walgreen Co. All rights reserved.

Rx Matters

Certified By

A newsletter created for Walgreens Health Initiatives clients,

delivering a mix of news and trends in healthcare, and up-to-date

information about our products and services

continued on p. 2

Our Healthful Living Respiratory

Program helps manage two costly and prevalent chronic conditions

through varying levels of member intervention, based

on risk stratification

®

Rated No. 1 in overall member satisfaction by:

The Healthful Living Respiratory Program helps manage these two costly and prevalent chronic conditions through varying levels of member intervention, based on risk stratification.

The Care Management team analyzes clinical indicators to stratify participating members into low, moderate, or high levels of intervention corresponding to their current level of risk. Our program pro-vides patient education materials, telephone counseling with specially trained pharmacists, face-to-face counseling in designated markets, and pharmacist-physician collaboration which includes updating physicians on the latest clinical treatment guidelines for the targeted conditions. After completing the first counseling session, telephonic or face-to-face in specified areas, participants in the asthma program receive an asthma tool kit designed to provide the necessary devices to monitor symptom control and get the most out of their metered-dose-inhaler.

This multifaceted approach is designed to help members develop the skills they need to effectively manage their condition, prevent related complications, and promote the cost-effective utilization of healthcare resources.

In addition to our Healthful Living Respiratory Program, we also offer Healthful Living programs for diabetes care management, weight management, tobacco cessation, and flu prevention. Contact your account executive today to find out how these programs might increase member care and decrease your plan costs.

92 Percent of Clients Rate Walgreens Health Initiatives Good to Excellent Clients gave us high marks in our annual PBM client survey conducted in August, with 92.5 percent rating Walgreens Health Initiatives good to excellent in overall satisfaction. Some key categories that were rated good to excellent overall include: • 97.4percent—Advantage90®, our 90-day retail program • 96.6percent—MedMonitor®, our retrospective drug utilization review program• 93.3percent—website,MyWHI.com• 92.9percent—specialtypharmacy• 92.5percent—cost-controlability• 92.4percent—mailservice

A summary of all the results for both the client and the member survey will be available soon. Annual surveys are part of our ongoing efforts to help ensure that Walgreens Health Initiatives services continue to meet our clients’ needs.


Rx MattersNew Respiratory Program ... (continued from p. 1)

Medication Adherence Saves Thousands in Diabetes Costs Diabetes is a condition estimated to affect nearly 21 million people in the United States. Promoting medication adherence is the key to managing this chronic condition and preventing complications such as cardiovascular disease, kidney problems, vision loss, and limb amputations.

Health plans realize that the additional prescription medication costs associated with better adherence are outweighed by savings on hospital and other medical expenses when costly diabetes-related complications are avoided. But, how much of a cost difference can medication adherence make? And, how long does it take to see the savings? A recent two-year study conducted by Walgreens

Health Initiatives on the medication adherence patterns of members with diabetes shows that the adherent group decreased clients’ medical costs by approximately $6,000 and total healthcare spend by $1,000. An initial increase in total healthcare spend due to the increased pharmacy spend was then eclipsed by medical spend savings. Members who were adherent with their medication therapy incurred lower medical costs and lower overall healthcare costs (see chart). Members in the adherent groupincurredapproximately$10,000inmedicalcostsand$17,000inoverallhealthcarecostsduringthe time period studied compared with $16,000 in medical costs and $18,000 in overall healthcare costs for the nonadherent group.

This study underscores the importance of promoting medication adherence to help clients realize significant savings while optimizing patient care. Walgreens Health Initiatives offers an array of clinical programs that can improve your members’ adherence, help them stay healthier, and reduce your healthcare costs. Contact your account executive to sign up or for more information on this study.


Rx Matters

A recent two-year study on the medication adherence patterns of members with diabetes shows

that the adherent group decreased clients’ medical costs by approxi-

mately $6,000 and total healthcare spend by $1,000

Medical, Prescription, and Overall Healthcare Cost Comparisons

Medication Cost

Medical Cost

$0

$5,000

$10,000

$15,000

$20,000

nonadherent adherent

WCCC, Clinical Care Center Holiday Hours Throughout the holidays, the Walgreens Customer Care Center (WCCC) will stay open to serve members and clients 24 hours every day. And our Clinical Care Center hours are 8:00 a.m. – 8:00 p.m. every day of the year.

OptionCare Acquisition Makes Walgreens Largest Home Infusion Provider Walgreen Co.’s recent acquisition of OptionCare, the Buffalo Grove, Ill.-based national home infu-sion and specialty pharmacy provider, makes Walgreens the nation’s largest provider of home infusion services, in addition to the fourth-largest provider of specialty pharmacy services as reported in our September-Octoberissue.OptionCare,withmorethan100locationsin35states,isaproviderofhome infusion and specialty pharmacy services to patients with acute or chronic conditions that can be treated at home, in a physician’s office, a skilled nursing facility, or at one of their ambulatory treat-ment centers. Our OptionCare acquisition, providing Walgreens with more services, locations, and support across the country, expands our ability to provide our clients’ members the care they need. The OptionCare acquisition is a strategic investment that further demonstrates our commitment to being a provider of a variety of patient-focused healthcare services.

Rx Drug Update The Food and Drug Administration recently approved the following new medications:

Drug Name Company/ Availability

Indication(s) Dose Form(s)

Regimen AWP as of October 2007

Endometrin® (progesterone) vaginal insert

Ferring Currently available

To support in vitro fertilization and assisted reproductive technology

100 mg vaginal insert

One insert two to three times daily

$6.53 per insert

Evamist® (estradiol) transdermal spray

Vivus Fall 2007

Treatment of moderate to severe vasomotor symp-toms due to menopause

Spray bottle One to three sprays to forearm once daily

Unavailable

Selzentry™ (maraviroc) tablets

Pfizer Currently available

Treatment of HIV-infected individuals in combi-nation with other HIV medications

150 mg and 300 mg tablets

150 mg to 600 mg twice daily

$18.13 per tablet

Sanctura® XR (trospium) extended-release capsules

Indevus Fall 2007

Treatment of overactive bladder

60 mg capsules One capsule once daily

Unavailable

Somatuline® Depot (lanreotide) injection

Tercica Fall 2007

Long-term treatment for acromegaly, a disorder resulting from excess growth hormone in the body

60 mg, 90 mg, 120 mg single-use syringes

One injection every four weeks

Unavailable


Rx Matters

Season’s Greetings from the Walgreens Health Initiatives team

Clients Recognized for Plan Performance Walgreens Health Initiatives would like to recognize three of our clients for achieving excellence in the following categories of plan performance:• BestGenericDispensingRate:MaricopaCounty• Best90-DayUtilization:PharmaceuticalStrategiesGroup• BestTrend:SKFUSA,Inc.

We applaud their success in minimizing plan costs while providing members with quality healthcare.

New Rx Indications The following medications have been approved by the Food and Drug Administration for new or expanded indications:

Drug Name Original Indication New Indication

Reclast® (zoledronic acid) injection

Treatment of Paget’s disease Treatment of postmenopausal osteoporosis

Risperdal® (risperidone) tablets

Treatment of schizophrenia in adults, short-term treat-ment of acute manic or mixed episodes associated with bipolar disorder in adults, and the treatment of irritability associated with autistic disorder in children and adolescents 5 to 16 years of age

Treatment of schizophrenia and short-term treatment of bipolar mania in children and adolescents

FluMist® (influenza virus vaccine, live) intranasal spray

Active immunization for the prevention of disease caused by influenza A and B viruses in individuals 5 to 49 years of age

Active immunization for the preven-tion of disease caused by influenza A and B viruses in individuals 2 to 49 years of age

Evista® (raloxifene) tablets

Treatment and prevention of osteoporosis in postmenopausal women

To reduce the risk of invasive breast cancer in postmenopausal women with osteoporosis and in postmeno-pausal women at high risk for invasive breast cancer

Mark Your Calendar Stop by the Walgreens Health Initiatives booth at the following show to learn more about our innovative solutions to pharmacy benefit management:

17th Annual National Health Benefits Conference & Expo (HBCE)

January 17-18, 2008 Tampa Waterfront Convention Center

Tampa Bay, Fla. www.HBCE.com


Rx Matters

continued on p. 6

National ObservancesSome upcoming health-related observances are listed below to help you plan health fairs and other activities. For more information, log on to the sponsoring organization’s web site. For a complete listing of this year’s national observances, visit the National Health Information Center’s web site at www.healthfinder.gov/library/nho.

Observance Date Sponsor, Web Site

Great American Smokeout November 15 American Cancer Societywww.cancer.org

American Diabetes Month November American Diabetes Associationwww.diabetes.org

Lung Cancer Awareness Month November Lung Cancer Alliancewww.lungcanceralliance.org

Pulmonary Hypertension Awareness Month

November Pulmonary Hypertension Associationwww.phassociation.org

World AIDS Day December 1 Joint United Nations Programme on HIV/AIDSwww.unaids.org

National Handwashing Awareness Week December 2 - 8 Henry the Hand Foundationwww.henrythehand.com

Medication Matters The following article, written for your members, can help raise awareness of how to read and understand labels on medications.

Understanding Labels Is Essential When Taking MedicationsIt is important for patients to read labels whether they are taking prescription medications or

over-the-counter (OTC) medications. This sounds simple, but studies have shown that this isn’t as easy as it seems, due to factors such as unclear directions on the labels or patients’ poor eyesight.

Labels are usually short, so many assume they are simple and easy to understand. But they often

are unclear and confusing. Patients also may be confused by warning labels on medications, such as those instructing them to take the medication with food or not to take it with a certain other medication. Some patients, especially the elderly, may find the type size on labels is too small to read. Some pharmacies offer larger print on labels upon request, but not all have this option.

Patients can confuse tablespoons with teaspoons and not know the right number of tablets to take in one day when they see the instructions, “Take two tablets by mouth twice daily.” Some might think that means a total of two tablets, while others might interpret it as four tablets. Instructions reading, “Take two tablets in the morning and two tablets at night” would be easier to understand.


Rx MattersMark Your Calendar ... (continued from p. 5)

If patients talk to their doctors or pharmacists about how to take

medications, they will be more likely to take their medications correctly

continued on p. 7

Patients also may not understand instructions like, “Take with plenty of water,” which may make patients wonder, “How much water is that?” The labels need to be written clearly so the directions are not open to interpretation.

Tips for Reading LabelsIt is important for doctors to talk to patients to explain the label instructions and how to take the medication before the patients leave the office. Doctors should not assume that patients will know what to do.

However, it also is a good idea for patients to ask questions about their medica-tions, if there is something they do not understand. They can ask questions at the doctor’s office or at the pharmacy when they pick up a prescription. It is a patient’s right to be counseled on medications by a pharmacist, but the patient must agree to it. If patients talk to their doctors or pharmacists about how to take medications, they will be more likely to take their medications correctly.

OTC medications may be available without a prescription, but they are still med-ications, so patients should take them seriously and read the labels each time they take them. For example, a patient may pick up an OTC medication he or she has taken several times and take the medication without reading the label. The person will then not be aware that the medication has gone through a product change so the per-pill dosage has changed and is now higher. Patients should remember to always inform their doctor of any OTC medications that they are taking because of how they may interact.

Here are some other tips on reading labels to help ensure that patients take medications properly:• Followtheproperdosinginstructions.Forexample,adultmedicationshouldnotbegivento children or infants. • Readtheinformationaboutsideeffects,suchasdrowsiness,thatmaymakeitdangerousto drive or operate machinery. Also watch for warnings about taking alcohol with the medication. • Checkthelabelforpossibleallergyalertsandreadthelistofingredientstoseeifthere’sanything the patient is allergic to in the medication.• Checktheexpirationdateanddonottakethemedicationpastthisdate.• Followwarninglabelsandotherinstructionssuchassafe-storageinstructions like,“Keeprefrigerated”andinstructionsforuse,suchas,“Shakewellbeforeusing.”• Makesurethemedicationdoseisaccurate.Forliquidmedications,dosingcups,spoons, and syringes are available for measuring doses. These devices are more accurate than a standard teaspoon or tablespoon.• Ifpatientsreadthelabelandstillhavequestionsorconcerns,theyshouldnothesitatetocontact a pharmacist, doctor, or another healthcare provider.


Rx MattersMedication Matters ... (continued from p. 6)

References New Respiratory Program• AmericanLungAssociation.AmericanLungAssociationData:2006.www.lungusa.org. AccessedMarch2007.• NationalHeart,Lung,andBloodInstitute.COPDLearnMoreBreatheBetter.www.nhlbi.nih.gov. AccessedMarch2007.

Rx Drug Update and New Rx Indications • FoodandDrugAdministration.www.fda.gov/default.htm.AccessedOctober2007.• AmericanSocietyofHealth-SystemsPharmacists®. www.ashp.com/shortage. AccessedOctober2007.• P&TCommunity.www.ptcommunity.com.AccessedOctober2007.• PharmaceuticalNewsHarvest™.www.internetdrugnews.com.AccessedOctober2007.• Drugs.com™.www.drugs.com.AccessedOctober2007.• PharmacyOneSource®.www.pharmacyonesource.com.AccessedOctober2007.• FactsandComparisonson-line4.0.http://online.factsandcomparisons.com.AccessedOctober2007.

Medication Matters • Medications–theimportanceofreadingthelabel.AmericanAcademyofPediatrics. www.medem.com/medlb/article_detaillb.cfm?article_id=zzzf7lsyq7c&sub_cat=27. AccessedAugust2007.• Butterfield,S.Makingdruglabelssaywhattheymean.AmericanCollegeofPhysicians. www.acponline.org/journals/news/apr07/labels.htm.AccessedAugust2007.• Davis,TC,Wolf,MS,etal.Literacyandmisunderstandingprescriptionanddruglabels. Annals of Internal Medicine. December 19, 2006; vol 145. Issue 12. www.annals.org/cgi/content/ full/0000605-200612190-00144v1.AccessedAugust2007.• Levy,M.Studyfindsmedicationlabelsare‘confusing’.USA Today. www.usatoday.com/news/ health/2006-12-10-medicine-labels_x.htm.AccessedAugust2007.

Rx Matters

©2007 Walgreens Health Initiatives, Inc., a wholly owned subsidiary of Walgreen Co. All rights reserved. PBM7270-1107

For general information about Walgreens Health Initiatives products and services,

call 800-926-6779, e-mail [email protected] , or visit WalgreensHealth.com/pbm.

Editorial Board

Editor Christiane Tiskus Contributing Writer Rhonda Deutsch Consultant Patrick Smith, Pharm.D., B.C.P.S.

Designer Rabel ShamuelBrand names are the property of their respective owners.This publication does not constitute professional advice. Although it is intended to be accurate, neither Walgreen Co., its subsidiaries and affiliates, nor any other party assumes liability for loss or damage due to reliance on this material. If you have a medical question, consult your medical professional.

Articles in Walgreens Health Initiatives Rx Matters may be reprinted only by clients of Walgreens Health Initiatives or respective agents of clients. Please attach the following statement: Reprinted with permission. ©2007 Walgreens Health Initiatives, Inc., a wholly owned subsidiary of Walgreen Co. All rights reserved.

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