Dr Jeremy Whalen Cites Patient Safety, Total Cost of Care as Key Policy Goals for Prime Therapeutics

Patient safety is paramount when deciding how to roll out a new program or even if a program should be developed or not. After that, the consideration would be what impact the program will have on total cost of care for that member, said Jeremy Whalen, PharmD, BCOP, specialty clinical program director for oncology at Prime Therapeutics.

Transcript

How has cost-effectiveness impacted medication prescriptions as healthcare transitions to a more value-based model?

Costs will still be a driver within a value-based care model, and I think it’ll become a bigger component of it. As providers are more engaged within what the cost of care is, and they're having those conversations with the patients up front—that now is becoming a part of the decision on what care is being delivered. When we have equally efficacious or similarly efficacious medications or regimens to treat the patient, cost will now be kind of a driving factor in a value-based model on what therapies patients receive.

What are the various benchmarks that decision makers consider when deciding whether to implement or test certain strategies or policies?

Patient Safety is kind of paramount when we're deciding how to roll out a new program or even if a program should be developed or not. After that, it [would] really be also what impact the program will have on total cost of care for that member—will it increase it? Will it decrease it? Then, also I kind of say tongue-in-cheek is will this program get us on the Wall Street Journal? Will that be a positive thing or a negative thing on that front page?

As we look at oncology and the cost within that system, the total cost of care is really becoming paramount. One thing that we're really striving and are successful with at Prime Therapeutics is doing integration of health and benefits. So, both on the medical and pharmacy side, to really look at what that impact is on the patient and that total cost so then we can help make better decisions and support our patients.