Guidelines for Collaboration Among Physicians, Pharmacists, and Managed Care Organizations to Improve Asthma Outcomes
Published Online: February 19, 2014
Gary C. Steven, MD, PhD; Don A. Bukstein, MD; and Allan Luskin, MD
Optimum asthma control in the future will rely on managed care organization pharmacy benefit managers working with primary care physicians using new technology to strengthen patient/physician/pharmacist relationships, maximize the group practice model, and improve asthma diagnosis, treatment, and monitoring in accordance with current National Asthma Education and Prevention Program (NAEPP) guidelines.1
Gary C. Steven, MD, PhD
President Allergy, Asthma & Sinus Center
Don A. Bukstein, MD
Clinical Professor, Family Practice
University of Wisconsin
Madison, WI Allergist
Allergy, Asthma & Sinus Center
Allan Luskin, MD
Clinical Associate Professor
University of Wisconsin
Center for Respiratory Health
Dean Medical Center
Sun Prairie, WI
This activity is supported by an educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.
Release date: February 18, 2014
Expiration date: February 18, 2016
Estimated time to complete activity: 1.0 hour
The intended audience for this activity consists of medical directors, pharmacy directors, pharmacy benefit managers, and other managed care professionals who are involved with the treatment of patients with asthma.
After completing this article, participants should be able to:
• Discuss the current management of asthma, including guideline recommendations and emerging treatments
• Explore current asthma control rates and the importance of monitoring asthma severity and control
• Examine managed care implications of asthma treatment, including medical costs and resource utilization
• Identify disease management opportunities to improve the clinical and economic outcomes of asthma
• Describe how medicine and pharmacy can collaborate to improve healthcare delivery and asthma treatment
Type of Activity: Knowledge
Fee: There is no fee for this activity.
How to Obtain Credit
To receive credit, all participants must read the CE lesson in its entirety and complete the posttest and evaluation form online. Each participant achieving a passing grade of 70% or better will receive a statement of credit giving the number of CE credits earned. If you do not achieve a score of 70% or better on the online posttest, you will have the opportunity to take the posttest one more time at no cost.
Please visit www.pharmacytimes.org, where you will be provided with a link to the online lesson, posttest, and evaluation form. You will have the opportunity to print the posttest questions and evaluation and manually complete them ahead of time and then submit answers online at your convenience.
Please retain a copy of the certificate for your records. For questions, please e-mail firstname.lastname@example.org.
Pharmacy Times Office of Continuing Professional Education is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hour (0.10 CEU) under the ACPE universal activity number 0290-0000-14-009-H01-P. The activity is available for CE credit through February 18, 2016.
Gary C. Steven, MD, PhD, has no relevant financial relationships with commercial interests to disclose related to this activity.
Don A. Bukstein, MD, received honoraria/lecture fees from AstraZeneca, Genentech Inc, Merck, Novartis, and Teva Pharmaceuticals.
Allan Luskin, MD, received honoraria/lecture fees from Genentech and Merck. He also acts as a consultant and board member for Genentech and Mylan.
American Journal of Pharmacy Benefits
Planning staff – Jeff D. Prescott, PharmD, RPh, and Ida Delmendo, have no relevant financial relationships with commercial interests to disclose related to this activity.
Pharmacy Times Office of Continuing Professional Education
Planning staff – Dave Heckard, Maryjo Dixon, RPh, Steve Lin, PharmD, RPh, and Donna Fausak, have no relevant financial relationships with commercial interests to disclose related to this activity.
The overall prevalence of asthma in adults and children in the United States has increased from 20.3 million people in 2001 to 25.7 million in 2010.2 Asthma prevalence increased among all subgroups, with significant increases occurring among black and Hispanic populations from 2001 to 2010 (from 3.2% to 11.9% and 3.2% to 7.2%, respectively).2 Underserved populations also had a significant increase in the prevalence of asthma at a rate of 11.2% among persons with family income below 100% of the federal poverty level.2
One recent study found that an estimated 5% to 10% of Americans with asthma experience severe disease, half of whom have severe disease that remains uncontrolled.3 Much of the incurred costs of asthma care in the United States are derived from patients with severe and uncontrolled disease (these patients are characterized by frequent exacerbations, emergency department [ED] and hospital visits, and reliance on multiple medications). Patients with severe uncontrolled asthma represent 2.5% to 5% of all patients with asthma, yet patients with severe uncontrolled asthma account for $21 billion, or 37.5%, of the $56 billion of total asthma-related direct costs.3
Retrospective claims research indicates that approximately half of asthma-related direct costs are incurred by patients with severe asthma. The estimated annual per patient direct costs of severe, uncontrolled asthma are $16,154 to $32,308.3
Three common obstacles to optimal control of asthma in relationship to pharmacy benefit managers (PBMs) and the point of access to medications are:
• Failure to use evidence-based guidelines to direct therapy
• Inadequate use of controller therapy due to cost, low health literacy, and lack of an understandable asthma action plan
• Lack of understanding of the seriousness and level of control of the disease
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