#MMCC2012: The ACA as an Opportunity for Pharma Companies to Increase the Proper Use of Medication

Monday at the 20th annual Medicaid Managed Care Congress, Cindy Pigg, SVP of Pharmacy at Magellan Medicaid Administration shared that the ACA is the largest opportunity for the pharmaceutical industry since Medicare Part D. By 2019, there’s expected to be more than 25 billion dollars spent on pharmaceutical drugs. This is a huge increase, especially considering during the recession, a lot less people went to the doctor’s office, and of those, a fair amount got prescriptions but never got them filled. Therefore, as a part of the ACA, pharmaceutical organizations have not only the opportunity to grow, but also to give lifechanging medical access to those who have not had access in years.

However, funding is limited, so pharma companies need to demonstrate the increase in the value of the drug (the trifecta of access, quality and cost). States are increasingly looking for comparative effectiveness studies, although at this point the data is quite limited. It doesn’t matter how your drug may hold up against the placebo, what matters is how it increases the patient’s overall health, including patient adherence. Judi Grupp, CEO of Physicians Pharmacy Alliance, suggested that PCMHs and ACOs are one way to increase the patient’s health, and ensure they’re taking the right amounts of the right prescribed medications.

What are other ways pharmaceutical organizations and MCOs can work together to increase adherence?