- Drug Coverage
- Hypertrophic Cardiomyopathy (HCM)
- Vaccines: 2023 Year in Review
- Eyecare
- Urothelial Carcinoma
- Women's Health
- Hemophilia
- Heart Failure
- Vaccines
- Neonatal Care
- NSCLC
- Type II Inflammation
- Substance Use Disorder
- Gene Therapy
- Lung Cancer
- Spinal Muscular Atrophy
- HIV
- Post-Acute Care
- Liver Disease
- Pulmonary Arterial Hypertension
- Safety & Recalls
- Biologics
- Asthma
- Atrial Fibrillation
- Type I Diabetes
- RSV
- COVID-19
- Cardiovascular Diseases
- Breast Cancer
- Prescription Digital Therapeutics
- Reproductive Health
- The Improving Patient Access Podcast
- Blood Cancer
- Ulcerative Colitis
- Respiratory Conditions
- Multiple Sclerosis
- Digital Health
- Population Health
- Sleep Disorders
- Biosimilars
- Plaque Psoriasis
- Leukemia and Lymphoma
- Oncology
- Pediatrics
- Urology
- Obstetrics-Gynecology & Women's Health
- Opioids
- Solid Tumors
- Autoimmune Diseases
- Dermatology
- Diabetes
- Mental Health
Outcomes From Horizon BCBS of New Jersey Oncology Home Infusion Program | AMCP Nexus 2023
The program yielded savings of $25,000 per patient in its pilot phase but is not expected to produce savings as a routine offering because reimbursement for home infusion was matched to reimbursement at a facility. Horizon executive Timothy O’Shea, Pharm.D., M.S., says cost savings were a “secondary outcome” of the program and noted the high patient satisfaction.
A new Horizon Blue Cross Blue Shield of New Jersey program that allows cancer patients to infusions at home instead of a clinic or doctor’s office cut costs in the early going.
During its pilot phase when 40 Horizon members participated, the savings worked out to about $25,000 per patient, which adds up to $1 million in savings, Timothy O’Shea, Pharm.D., M.S., manager, clinical pharmacy, at Horizon, said in an interview with Managed Healthcare Executive.
But the cost savings were a “secondary outcome,” said O’Shea, who spoke about the program during a session yesterday at the Academy of Managed Care Pharmacy (AMCP) Nexus 2023 meeting in Orlando. Saira A. Jan, Pharm.D., M.S., vice president and chief pharmacy officer at Horizon, was a co-presenter with O’Shea. He discussed the program with MHE in a Zoom interview prior to the meeting.
After the pilot phase was over, O’Shea said Horizon and the provider it worked with, RWJBarnabas Health and the Rutgers Cancer Institute of New Jersey (CINJ) discussed the possibility of an episode of care model that would have involved shared savings. But that fell by the wayside when Horizon and CINJ came to agreement that starting at the beginning of this year the reimbursement for drugs administered in a facility matched the reimbursement for drugs delivered in the home infusion program.
As a result, O’Shea said the program was not expected to yield cost savings for Horizon. O’Shea mentioned, though, that a survey showed high patient satisfaction. "There was a 98% patient satisfaction score. Patients liked it. It was well received," he said.
How Prime Therapeutics Tugged on the Reins of the Galloping GLP-1 Spend | AMCP Nexus 2023
October 20th 2023The Minnesota-based pharmacy benefit manager says a program that resulted in patients switching from two incretin therapy prescriptions to one yielded $7,500 in savings per patient and a total of $3.5 million.
Read More
Race, Income Impact Specialty Drug Use of Autoimmune Condition Treatments | AMCP Nexus 2023
October 20th 2023In a platinum award winning poster presented at the AMCP Nexus 2023 conference in Orlando, “Specialty drug use varies by race and wage among employees with employer-sponsored health insurance,” authors expressed that spending on specialty medications for autoimmune conditions has increased in recent years, raising affordability concerns for employers.
Read More
The Oncology Pipeline Is Delivering Exciting New Treatments — and Sticker Shock | AMCP Nexus 2023
October 19th 2023Research continues to develop new therapies for rare cancers and to provide options that allow for fewer toxicities. At the same, however, more new drugs are launching with high price tags.
Read More
The Benefits of ML, AI Use in Managed Care Pharmacy | AMCP Nexus 2023
October 19th 2023Adopting evolving computer system tools like artificial intelligence and machine learning in managed care pharmacies have resulted in efficiency when addressing the challenges they are faced with, according to Jessica Hatton, PharmD, BCACP, associate vice president of Pharmacy at CareSource and Nick Trego, PharmD, senior vice president of Clinical Analytics and Client Services at HealthPlan Data Solutions, Inc.
Read More
Horizon BCBS of New Jersey Launches Oncology Home Infusion Program | AMCP Nexus 2023
October 19th 2023Just over 160 patients have participated in the insurer's oncology home infusion program since it started in late 2020. Patient satisfaction is high, according to Horizon officials, who are looking to expand the program with other providers in its market and to include more drugs that patients could be treated with at home.
Read More
