Program Can Help Employers And Plan Sponsors Control Impact Of Migraines On Members And Employees. With the financial impact of migraines reaching upwards of *$17.2 billion in lost wages and decreased productivity each year, the cost of care for those afflicted with the often debilitating headaches is giving many health plan sponsors pains of their own.
Recognizing the physical, emotional and financial toll of migraines, Prescription Solutions, a leading pharmacy benefit management (PBM) firm, has launched a Migraine Management program. Pharmacists at the PBM believe it is a comprehensive program designed to increase awareness of therapies and ways to prevent migraines for both physicians and health plan members.
With fewer than half of migraine sufferers ever receiving a diagnosis and more than 35 million Americans afflicted with one or more migraine each year, the program educates physicians on how to diagnose, prevent and effectively treat migraines. The program also educates the health plan members on how to prevent and manage migraine.
In addition to providing information to physicians, the program will also help them identify patients who are taking chronic or acute medications for the treatment of migraine. The information is initially being sent to more than 3,500 physicians in California, Colorado and Washington with plans to expand based on customer demand.
“We took a close look at the financial and physical impact of migraines and carefully researched the most effective options available today,” said David Berenbeim, M.D., medical director for Prescription Solutions. “What we discovered is that there are many good, cost-effective therapies on the market, as well as proven medications to prevent migraines. We also found that physicians needed additional information in order to properly identify and prescribe therapies for their patients with migraines.”
Migraines are characterized by a unilateral, bilateral, or pulsing pain, variable onset (from minutes to hours), and variable duration (4 to 24 hours). Nausea, vomiting, and sensitivity to bright lights and sound frequently accompany attacks. More than 85 percent of migraine sufferers report some disability.
The most common way to treat migraines is with over-the-counter (OTC) medications. However, with aggressive marketing aimed directly at consumers from pharmaceutical manufacturers, the use of high-cost prescriptions to treat migraines is increasing. It’s estimated that the cost to treat migraines over a 30-day period using an OTC product such as Excedrinâ Migraine versus the newest prescription medication is $10 per month for Excedrin versus $175 per month for one of the newest prescription migraine products. However, recent independent studies have shown that often OTC medications can work as well, if not better, than prescription medications for many patients. For those patients with severe migraines, prescription beta-blockers, calcium channel blockers and NSAIDS (non-steroidal anti-inflammatory drugs) can lessen, and in some instances, prevent attacks. The cost for these therapies ranges from $10 to $35 a month.
“Employers depend on PBMs to help them control pharmacy costs,” said Berenbeim. “With such tremendous variations in cost, we thought it was important to help physicians and patients understand the cost of medications and the value that other, lower-cost therapies would offer.”
In addition to recommendations on therapies, the program provides migraine sufferers with educational materials that highlight the value of managing stress, keeping a notebook to identify when migraines occur and their triggers, as well as the role of diet and exercise in migraine management.
“We want to help people take control of their health,” said Berenbeim. “With our Migraine Management program and the help of a physician armed with the right information, we think we can help reduce the discomfort that migraines cause so many of our health plan members while we help plan sponsors control costs.”
Prescription Solutions estimates that the average midsize employer (between 5,000 - 10,000 employees) could reduce overall migraine medication use by 25% with a comprehensive migraine management program.
Prescription Solutions, one of the nation’s leading managed care pharmacy benefit companies, manages the prescription drug benefit of employers, unions, commercial and governmental health plans representing five million members nationwide and $1.5 billion in pharmaceutical purchases. A wholly owned subsidiary of PacifiCare Health Systems, Inc. (NASDAQ: PHSY), one of the nation’s largest health care services companies, Prescription Solutions now serves members through two state-of-the-art mail service pharmacies in San Diego County, as well as through a network of 51,000 community pharmacies. Online information can be found at www.rxsolutions.com.
