The real-time monitoring of patients through medically integrated dispensing (MID) programs can reduce costs of care and remove barriers, said Christie Smith, PharmD, MBA, vice president, pharmacy and payer strategy, Cencora.
Medically integrated dispensing (MID) can help reduce cost of care through real-time monitoring of patients to address adverse effects in a timely manner, said Christie Smith, PharmD, MBA, vice president, pharmacy and payer strategy, Cencora.
In her session, Smith discussed innovative care models and MID programs. She was joined by Marci Conlin, vice president, pharmacy network management, Prime Therapeutics/Magellan Rx Management; and Kyle Verley, director, network management, Prime Therapeutics.
Transcript
How are innovative care models, such as MID programs, working to remove barriers to care and address disparities?
We are constantly working to help address SDOH, social determinants of health. Our providers are stretched all over the place, and so we try to support them in helping patients get the right resources to what they need, basic resources. I think that it is challenging. It is challenging. I think we need more nonprofit organizations to help not only physicians but payers. I think the payers need to provide some sort of financial support so that providers and the entire community can afford to help their patients in those ways.
What are innovative care models implementing to reduce costs of care?
So, for example, in the model that we're participating in, what plans have seen is that MID actually is a cheaper cost model than specialty pharmacy. I've worked for a specialty pharmacy in my lifetime. I love specialty pharmacy. But there are certain situations where it would make sense for certain therapies to be considered in this model. Basically, the total cost of care has been reduced under the [MID] model. And I think I sort of alluded to some examples like you can see in real time if a patient will or will not need the medication due to disease progression, side effect management from the cost of that drug.
That side effect management is so critical because this where, if a patient is having severe diarrhea, because that’s a common reaction, and they have to go to the hospital to get treated because of dehydration and all of that, that cost avoidance is huge for a medical plan vs when this script is outside of the practice’s direct authority.
Navigating Sport-Related Neurospine Injuries, Surgery, and Managed Care
February 25th 2025On this episode of Managed Care Cast, we speak with Arthur L. Jenkins III, MD, FACS, CEO of Jenkins NeuroSpine, to explore the intersection of advanced surgical care for sport-related neurospine injuries and managed care systems.
Listen
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
Listen
Understanding Primary and Secondary Nonadherence to Chronic Oral Medication
March 28th 2025Medication nonadherence to oral anticoagulants and oral anti–prostate cancer medication has been scrutinized through new research conducted among patients and health care providers and presented by the American Medical Group Association at its 2025 annual meeting, held March 26-29 in Grapevine, Texas.
Read More