Wayne Pharmacy Student Presentation Final to Post

Embed Size (px)

DESCRIPTION

Study guide for pharmacy

Citation preview

  • DCF-13-2666B

    OneTouch Makes Testing Accessible for All Patients.

    LifeScan Confidential Do Not Distribute

  • DCF-13-2666B

    Sharon Ditata MT(ASCP) Customer Development Representative

  • AW 3102280A

    Diabetes affects

    1 in 12 People today

    Source: CDC, National Diabetes Fact Sheet, 2011

  • AW 3102280A

    Diabetes will affect

    1 in 3 people by the year 2050

    Source: Boyle PP et al. CDC Population Health Metrics 2010, 8:29

  • AW 3102280A

    Source: TRx Share, Retail Sept YTD 2012. Data Source - IMS Xponent TRx Share. *Some health plans may have more than one test strip covered at the lowest co-pay.

    Test Strip Share by Manufacturer*

    New Product Innovations

    Lowest Co-pay on the Most Health

    Plans*

    Sales Force Strength

    Leading Share of Voice in

    Advertising

    OneTouch Ultra Family of Products

    #1 Recommended Brand by

    Endocrinologists

    Partner with the category leader.

    Total Rx POS (%)

    LifeScan Abbot Roche Bayer PrivateLabel

    OtherMfg

    40.5%

    19.2% 18.9% 14.4%

    5.7% 1.3%

    Abbott

  • AW 3102280A

    Source: TRx Share, Retail Sept YTD 2012. Data Source - IMS Xponent TRx Share. *Some health plans may have more than one test strip covered at the lowest co-pay.

    Test Strip Share by Manufacturer*

    New Product Innovations

    Lowest Co-pay on the Most Health

    Plans*

    Sales Force Strength

    Leading Share of Voice in

    Advertising

    OneTouch Ultra Family of Products

    #1 Recommended Brand by

    Endocrinologists

    Partner with the category leader.

    Total Rx POS (%)

    LifeScan Abbot Roche Bayer PrivateLabel

    OtherMfg

    40.5%

    19.2% 18.9% 14.4%

    5.7% 1.3%

    Abbott

  • DCF-13-2666B

  • DCF-13-2666B

    Diabetes Category Opportunity

    More shoppers

    Repeat traffic

    Higher basket ring (front & back

    of store).

    Long-term opportunity drive shopper loyalty among high value shoppers.

    Annual retail spend : diabetes patient - up to $6,875*

    *The Full value of a Diabetes Patient. Smart Retailing Rx 2013

    Rate of diabetes diagnosis is increasing

    Chronic disease

    Co-morbid nature of disease drives additional needs

    8

  • AW3070996B

    Coverage Confusion

    9

    Commercial Coverage Medicare

    Cost is a leading reason why patients

    stop testing

    Confused about their co-pays

    Move to mail order due to perceived

    benefits

    Confused about their options

    Partner with OneTouch to keep your patients at retail

  • DCF-13-2666B

    37% Retail

    35% Mail Order

    28% Non-Retail

    SMBG Category Overview Payer Mix

    Cash

    Retail 11% Cash 27% Government 62% Commercial

    Mail Order 59% Government 41% Commercial

    Data Source IMS DDD, 12 months ending June 12, Category size, mix, and share based on total test strip volume.

    LifeScan Confidential Do Not Distribute 10

  • DCF-13-2666B LifeScan Confidential Do Not Distribute 11

    OneTouch Commercial Coverage.

  • DCF-13-2666B

    Commercial Coverage Challenges Confusion with misconceptions and clutter

    LifeScan Confidential Do Not Distribute

    Co-pay card usage:

  • DCF-13-2666B LifeScan Confidential Do Not Distribute 13

    2012 Typical Average Co-Pays in 3-Tier Benefit Design

    Patients could be saving up to:

    $42/month

    Data Source: Health Strategies Group: Health Plan Pharmacy Management Trends March 2013 data from 2012

    OneTouch Commercial Rx Access Unmatched patient savings

  • DCF-13-2666B

    Scenario

    Patient chooses a Tier 3 product (such as Abbott, Freestyle, Bayer Contour, or Store Brand) that is currently listed in Tier 3 and fills at retail twice. On the third fill, the following will occur:

    1. Tier 3 product is no longer covered at retail patient pays full price 2. Patient is asked to switch to a preferred product from Tier 1 (currently either

    OneTouch or Accu-Chek) 30-day fill at retail: average co-pay $10 90-day fill at PBM Mail: average co-pay $25

    3. Patient stays with non preferred product but must switch to pharmacy mail (Medco), pay corresponding Tier 3

    30-day fill at retail: average co-pay $50

    NOTE: Not all members with a pharmacy benefit participate in this program.

    *This is a case study of the United Healthcare Select Designated Pharmacy Program. This program is excluded in the following states: NY, NJ, CT, LA, AR, and MD.

    Case Study: UnitedHealthcare Programs Partnering with retail to meet formulary & cost objectives

    14

  • DCF-13-2666B

    OneTouch Verio and Ultra Test Strips are the only test strips covered on the

    Express Scripts National Preferred Formulary

    Patients on all other brands will have to switch as of

    January 1, 2014 or pay list price.

    OneTouch Verio and Ultra Test Strips are preferred1 on the CVS Caremark

    National Formulary

    As of January 1, 2014, Abbott FreeStyle and Bayer CONTOUR Test Strips are no longer reimbursed by

    many CVS Caremark plans.2

    1 Preferred: For most plans, products that are usually covered at the lowest co-payment or co-insurance. 2 Plans that opt-in to the CVS Caremark 2014 Formulary Exclusion List. The information provided is not a guarantee of coverage or payment. Actual benefits are determined by each plan in accordance with its respective policies and procedures. All trademarks are the property of their respective owners.

    OneTouch: Sole Source Carefirst BCBS as of 7/1/13 Express Scripts as of 1/1/14 RegenceRx as of 1/1/14 Illinois Medicaid as of 7/13/13 .and many other OneTouch Regional Contract wins

    Opportunity to convert

    non-formulary patients to OneTouch.

    OneTouch Commercial Access Expanding OneTouch Commercial Coverage in 2014

    15

  • DCF-13-2666B

    Drive Loyalty Among BGM Patients by delighting Patients at the Pharmacy

    Patient presents script to

    Pharmacist/Tech

    Prescription is adjudicated and

    processed

    Patient receives test strip

    Patient presents script to Pharmacist/Tech

    Insurance coverage is checked to determine

    lowest copay

    Prescription is adjudicated and

    processed

    Patient receives test strip

    Quick extra step could save patients up to $42 per box

    Current Process

    Future Process

    16

  • DCF-13-2666B

    OneTouch Commercial Access Meter Offerings Available

    Universal Meter Voucher Give patients the right meter with a single ID no-charge meter voucher.

    Patient Starter Kits with Meter Card at HCP Offices Meter adjudicated at Pharmacy with branded prescription.

    17

  • DCF-13-2666B LifeScan Confidential Do Not Distribute 18

    OneTouch Medicare Coverage.

  • DCF-13-2666B

    Coverage Confusion

    19

    Commercial Coverage Medicare

    Cost is a leading reason why patients

    stop testing

    Confused about their co-pays

    Move to mail order due to perceived

    benefits

    Confused about their options

    Partner with OneTouch to keep your patients at retail

  • DCF-13-2666B

    Medicare Coverage Clarity

    LifeScan Confidential Do Not Distribute

    Supplemental (MediGap)

    With Medicare Part B and most supplemental insurance plans,

    patients will have

    $0 out-of-pocket expense for OneTouch

    Products1

    Medicare DME: Durable Medical Equipment

    80%

    20%

    1 Not a guarantee of coverage and payment. Coverage and payment may be subject to co-insurance, deductible and patient eligibility requirements 20

  • DCF-13-2666B

    Medicare Challenges Coverage changes causing confusion and shift to mail order

    LifeScan Confidential Do Not Distribute

    Perceived benefits of mail order: More cost effective More convenient Automatic refills and reminders

    Do I have to go to mail order?

    Data Source: Roper Patient Data 2010

    Medicare reimbursement changes have caused confusion among pharmacists and patients

    What is covered?

    Where can I get my favorite brand?

    Coverage Confusion Shift to Mail Order

    21

    *Not a guarantee of coverage and payment. Coverage and payment may be subject to co-insurance, deductible and patient eligibility requirements.

  • DCF-13-2666B

    Multiple OneTouch Meters

    are available for your Medicare patients at no charge*. Also get access to offers on ancillary products.

    OneTouch also offers rebates on OneTouch Brand Test Strips1

    OneTouch Medicare Access Medicare and Medicaid Assignment Program (MAP): How does it work?

    LifeScan Confidential Do Not Distribute 22

    No special Medicare SKUs means less hassle

    Completely automatic program for faster payment

    1Applicable if customer is signed up for existing MAP program. *Some limitations may apply

    Slide Number 1Slide Number 2Slide Number 3Slide Number 4Partner with the category leader.Partner with the category leader.Slide Number 7Diabetes Category Opportunity Coverage ConfusionSlide Number 10Slide Number 11Commercial Coverage Challenges Confusion with misconceptions and clutterSlide Number 13Slide Number 14Slide Number 15Drive Loyalty Among BGM Patientsby delighting Patients at the PharmacyOneTouch Commercial AccessMeter Offerings AvailableSlide Number 18Coverage ConfusionMedicare Coverage ClarityMedicare Challenges Coverage changes causing confusion and shift to mail order OneTouch Medicare AccessMedicare and Medicaid Assignment Program (MAP): How does it work?