Faxes Led to Improved Statin Use, Prime Study Shows

by Lauren Flynn Kelly

A prescriber fax program alerting physicians when their diabetic patients have not had a statin claim demonstrated a statistically significant boost in statin use and could be a valuable addition to Medicare Advantage Prescription Drug (MA-PD) plans' efforts to improve both medication adherence and star ratings, according to a new study from Prime Therapeutics LLC.

Cholesterol-lowering statin drugs began to play a bigger role in the CMS star ratings in 2019, when the Pharmacy Quality Alliance-developed Statin Use in Persons with Diabetes (SUPD) measure was added to the Part D calculations and when the NCQA-developed Statin Therapy for Patients with Cardiovascular Disease measure was added to the Part C ratings.

With the launch of a prescriber fax program in 2019, Prime Therapeutics began identifying diabetic members who did not have a statin pharmacy benefit claim and sending faxes to the member's prescriber recommending statin therapy. To assess the effectiveness of such a program, Prime researchers monitored the claims of two member groups comprising individuals who had one paid claim for a statin during 2018 and 2019 and were continuously enrolled with one of Prime's owner/client Blue Cross Blue Shield Medicare plans.

From 2018 to 2019, there was a statistically significant 3.7 percentage-point increase in diabetic members having at least one paid claim for a statin among those exposed to the fax program and a separate pharmacist outreach program offered by Prime, according to the study, which was presented at the Pharmacy Quality Alliance 2021 Online Annual Meeting.

Put another way, researchers found that "78.5% of eligible diabetes members utilized at least one statin in the pre-period for contracts that participated in both the pharmacist outreach and SUPD fax program and 82.2% of eligible diabetes members utilized at least one statin in the post-period for contracts that participated in both the pharmacist outreach and SUPD fax program," explains Steven Champaloux, principal data scientist and a study co-author.

The SUPD fax program was also associated with a star measure improvement, says Champaloux. "Due to the narrow cutoffs within the SUPD star ratings, a small boost can easily move members into a higher star rating," he suggests. "Higher health plan star ratings mean better rates for members. Prime is focused on better outcomes and lower costs, so improving this metric is a great way to achieve both."

From RADAR on Medicare Advantage