Rx Matters - Walgreens...Rx Matters continued on p. 3 pressure) are evaluated or self-reported at the worksite screening. Together, these components help assess modiﬁ able health

59.5 Percent Generic Utilization Rate Achieved In the pharmacy benefi t management industry, one of our key differentiators is our success at increasing generic utilization for our clients. Walgreens Health Initiatives achieved an excellent generic utilization rate of 59.5 percent during the third quarter

of 2006. To put this fi gure into perspec-tive: one large pharmacy benefi t man-ager recently described their lower rate of 58.3 percent during the

same quarter as “industry leading.” The fact that every 1 percent increase in generic utilization produces 1 percent in prescription drug plan savings illustrates the signifi cant impact of our high generic utilization rate on our clients’ prescription medication expenditures.

In This Issue:

Blueprint for Wellness™ Scores High ......................2

Member Survey Results ............................... 3

FDA Puts Generics on the Fast Track .................. 3

Medication Management .................. 3

Rx Drug Update ................. 4

New Rx Indications ............ 5

Plan Ahead .......................... 5

Corner Healthcare ............. 6

Medication Matters ...........7

January-February 2007

Volume 11, Number 1

Increasing generic utilization is one of our key strategies for meeting the

challenges that plan sponsors face

©2007 Walgreens Health Initiatives, Inc., a wholly owned subsidiary of Walgreen Co. All rights reserved. Page 1

Rx Matters

A newsletter created for Walgreens Health Initiatives

clients, delivering a mix of news and trends in healthcare,

and up-to-date information about our products and services

Certified By

Blueprint for Wellness™ Scores High with MembersWhen participants speak of their experience with Blueprint for Wellness™, the Walgreens Health Initiatives Health Evaluation Program, administered in collaboration with Quest Diagnostics®, it’s often expressed in dramatic terms. This is because our program is frequently the catalyst for a life-altering, even life-saving experience. For some, the test results inspire them to make the behavioral changes necessary for averting serious and costly chronic conditions; others are inspired to renew their commitment to a healthy lifestyle and disease prevention. Below are some typical comments illustrating that our program is “member-tested and approved”: • Thank God employees’ spouses are allowed to participate! My husband’s [blood glucose] levels were literally off the charts. He’s now on medication and a strict diet for his diabetes, and we have it under control.• This is one of the best benefi ts I have ever received from an employer. The fi rst year it was offered, the results terrifi ed me into taking my health seriously so my kids would not be left without a mom! The next time the results were so much improved, I was walking on air! The report inspired me to take control over my health, and reminded me that I am the only one that can make the difference. Thanks for this wonderful tool.• Words can’t even touch what I feel right now. There was a major health concern that took the life of my sister, which my doctor did not think I needed to be concerned about yet because I was young. Now, here I am with this information that I wish my sister had fi ve years ago. I am thankful for this wonderful testing program.• To my surprise, my cholesterol level was insanely high. This has led me to start a diet and exercise program. If it weren’t for this program, I probably wouldn’t have found out about my cholesterol for several years, since I’m young and don’t worry about these things.• I never knew that my sugar was high. Without this knowledge, I could have ended up on insulin. Thank goodness that I found out early enough to do something about it.• From last year’s results I made a lot of changes to my eating habits. I was so pleased to see that my efforts paid off. My blood pressure and my cholesterol were lower.• Getting my results was like getting a great report card. It explained every test and how it affected my health. If I had known I was in such good shape, I would have taken better care and tried for perfect. It has made me more aware of my health. I now own my good health, and will be a better partner with my doctor in taking care of me.

This program offers employers three options for improving and maintaining employee health and wellness and better managing healthcare expenditures. • Blueprint for Wellness Comprehensive provides a comprehensive health risk assessment (HRA) questionnaire designed to collect medical history and assess preventive healthcare needs, health risks related to lifestyle, and readiness to change. Blood testing, used in more than 30 laboratory-based diagnostic tests, is used to assess risks for cardiovascular disease; diabetes, thyroid, kidney, and liver function; and salt and water balance. In addition, biometric measures (height, weight, and blood


Rx Matters

continued on p. 3

pressure) are evaluated or self-reported at the worksite screening. Together, these components help assess modifi able health risks with the greatest impact on health and healthcare costs. • Blueprint for Wellness Express includes the HRA questionnaire and blood screenings that measure cholesterol levels and glucose to assess risks for cardiovascular disease and diabetes.• Blueprint for Wellness Express Health Risk Assessment is a value-driven, economical choice for employers that provides only the HRA questionnaire to participating employees.

In addition to helping members assess and manage their health through HRAs and health screenings, the Blueprint for Wellness program offers employers valuable aggregate data that can help them anticipate and control healthcare costs.

For more information, please contact your account manager.

Member Survey Results Results of a recent survey, conducted by an independent organization, show that Walgreens Health Initiatives continues to exceed the needs of plan members who expressed a high degree of satisfac-tion with us overall, as well as our Advantage90® program. This program allows members to get a 90-day supply of their maintenance medication at select retail pharmacies in addition to mail service. Ninety percent of members rated their overall satisfaction with Walgreens Health Initiatives and their overall satisfaction with Advantage90® as good to excellent.

FDA Puts Generics on the Fast TrackThe FDA intends to speed up its reviews of some fi rst-eligible generic medications to get them on the market faster, according to a recent AHIP Solutions SmartBrief. The director of the Center for Drug AHIP Solutions SmartBrief. The director of the Center for Drug AHIP Solutions SmartBriefEvaluation and Research stated that drugmaker applications that would receive priority consideration are those that are the fi rst to propose a generic version of a branded drug losing patent or market exclusivity protection, or if a drug is needed in the event of a public health emergency or shortage. This is good news for plan sponsors for whom every 1 percent increase in generic utilization produces 1 percent in prescription drug plan savings.

Medication Management Below are the latest enhancements to the Walgreens Health Initiatives Medication Management Programs—clinical prior authorization (CPA) and step care therapy—which provide patient-centric programs that promote clinically appropriate, cost-effective drug utilization:


Rx Matters

continued on p. 4

Blueprint for Wellness (continued from p. 2)

Ranexa® CPA Developed The new Ranexa® CPA has been designed to promote the safe and appropriate use of Ranexa (ranola-zine) for the treatment of chronic angina (chest pain). This program’s clinical criteria help ensure that this agent is prescribed in accordance with Food and Drug Administration-approved labeling, which states that Ranexa should be used in combination with amlodipine, beta-blockers, or long-acting nitrates. In addition, due to signifi cant potential drug interactions and adverse effects associated with Ranexa, this medication should be reserved for patients who have not achieved an adequate response with other antianginal drugs. This CPA program also sets appropriate quantity limitations, based on maximum approved dosage. The Ranexa CPA program is the latest manifestation of our commitment to providing quality care to members while enhancing plan savings. If you have any questions or would like to implement this program, please contact your account manager.

Rx Drug Update The Food and Drug Administration recently approved the following new medications:

Drug Name Company/Availability

Indication(s) Dose Form(s)

Regimen AWP as of January 2007

Januvia™(sitagliptinphosphate)tablets

Merck & Co., Inc.

Early 2007

Treatment of type 2 diabetes as monotherapy or adjunct therapy in patients taking other oral diabetes medications, including metformin and thiozolidinediones

25 mg, 50 mg, and 100 mg tablets

100 mg daily, with or without food

$6.00 per25 mg tablet



Omnaris™(ciclesonide)nasal spray

Altana

Early 2007

Treatment of nasalsymptoms associated with seasonal and perennial allergic rhinitis in patients age 12 and older

200 mcg/spray One spray daily Not available

Tyzeka™(telbivudine)tablets

Novartisand IndenixPharmaceuticals, Inc.

Unknown

Treatment of chronic hepatitis Bvirus in adults

600 mg tablet One tablet daily Not available

NitroMist™(nitroglycerin)lingual aerosol

NovaDelPharma, Inc.

Unknown

Treatment and prophylaxis of acute angina due to coronary artery diease

400 mcg/spray Onset of an attack – one to two sprays on or under the tounge. May be repeated every five minutes if needed.

The maximum dose is threesprays in 15 minutes.

Prevention of an attack – Prevention of an attack – Prevention of an attack one to two sprays five to 10 minutes before engaging in an activity that may cause an attack.

Not available


Rx MattersMedication Management (continued from p. 3)

New Rx Indications The following medications have been approved by the Food and Drug Administration for new or expanded indications:

Drug Name Original Indication New or Expanded Indication

Aricept® (donepezil HCl) tablets Aricept was FDA approved in 1996 for the treatment of mild to moderate Alzheimer’s disease (AD).

Treatment of severe AD; Aricept is the first and only agent approved for all symptoms of AD (mild, moderate, and severe)

Seroquel® (quetiapine fumarate) tablets

Seroquel is already approved for the treatment of acute and manic episodes associated with bipolar I disorder and acute manic episodes associated with bipolar disease.

Treatment of patients with depressive episodes associated with bipolar disorder

Risperdal® (risperidone) tablets Risperdal was originally FDA approved in 1993 to treat acute manic or mixed episodes of bipolar I disorder and schizophrenia in adults.

Treatment of irritability associated with autistic disorder, including symptoms of aggression, deliberate self-injury, temper tantrums, and mood swings in children ages 5 to 16 years. This is the first time that the FDA has approved a medication for autism.

Plan Ahead—Mark Your Calendar Stop by the Walgreens Health Initiatives booth at the following shows:

Health Benefits Conference & Expo (HBCE) January 25-26, 2007Tampa Waterfront Convention CenterTampa, Fla.www.HBCE.com

2007 Pharmacy Benefit Management Institute Conference February 21-23, 2007Pointe Hilton Tapatio Cliffs ResortPhoenix, Ariz.www.pbmi.com


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continued on p. 6

National ObservancesSome upcoming health-related observances are listed below to help you plan health fairs and other activities. For more information, log on to the sponsoring organization’s web site. For a complete listing of this year’s national observances, visit the National Health Information Center’s web site at www.healthfi nder.gov/library/nho.

Observance Date Sponsor, Web Site

National Blood Donor Month January AABB (formerly the American Association of Blood Banks)www.aabb.org

National Birth Defects Prevention Month January March of Dimes Birth Defects Foundationwww.marchofdimes.com

National Wear Red Day 2007 February 2 National Heart, Lung, and Blood Institute Health Information Centerwww.nhlbi.nih.gov/health/hearttruth

National Women’s Heart Day February 16 Sister to Sister: Everyone Has A Heart Foundation, Inc.www.womansheartday.org

American Heart Month February American Heart Association,www.americanheart.org

National Wise Health Consumer Month February American Institute for Preventive Medicine,www.healthylife.com

Healthcare Right at the Corner In-store Walgreens Health Corner Clinics™ , with services provided by licensed medical vendors, are a recent new benefi t to Walgreens customers. Designed to provide convenience for patients and cost-savings for patients, employers and managed care organizations, the fi rst of these clinics opened in the Kansas City, Mo. and St. Louis, Mo. markets last summer. Clinics have also opened in select Chicago, Atlanta, and Las Vegas stores this fall. Walgreens Health Corner Clinics offer patients diagnosis and treatment for nonemergency medical conditions, diagnostic screenings, and vaccinations—all performed by certifi ed nurse practitioners (NPs) who follow protocols based on guidelines established by the medical community. These clinics will be open seven days a week, with no appointment necessary, and can treat patients as young as 18 months for common ailments, such as strep throat, ear and sinus infections, seasonal allergies, and skin conditions.

“The services offered will complement the physician’s treatment of the patient while providing convenient, affordable access,” said Luke Kleyn, vice president, Clinics.

Walgreens Health Corner Clinics and pharmacies fully support the eight principles recommended by the American Medical Association to help ensure that high-quality care is provided at in-store health clinics nationwide. In addition, they follow the guidelines outlined by the American Academy of Family Physicians for clinical quality. They also collaborate with local physician groups or hospital systems that regularly review patient health charts and perform site visits in accordance with state regulations to ensure that patients receive high-quality, professional care.


Rx MattersPlan Ahead—Mark Your Calendar (continued from p. 5)

Medication Matters The following article, written for your members, can help raise awareness of the importance of properly storing medications to prevent deterioration:

Proper Storage Can Help Lead to Safe, Effective Medication Use It is important to properly store your medications and make sure that they haven’t reached their expiration date in order to benefi t from their full potency and not put yourself at risk.

Often, people keep their medications in the bathroom, but this is considered by many healthcare experts to be the worst place to keep medicine. The American Phar-maceutical Association recommends that consumers store their medication in a cool dry cabinet in a room of their home that is out of direct sunlight. Keeping medication away from heat or steam is very important. High levels of humidity can cause medications to break down and lose their effectiveness. Exposure to heat and moisture can cause tablets and capsules to lose their potency. Also, you should not leave the cotton plug in a medi-cine container that has been opened, because it may draw moisture into the container.

In addition to the bathroom, some areas of the kitchen are not a good place to store medicine. It is recommended that you not place medicine near the sink, stove, or any heat-releasing appliance, because dampness and heat can lead to deterioration. You also should not keep medicine for long periods of time in the car where temperatures can vary a great deal.

Other Helpful Storage TipsStoring all of your medications in a designated location in your home also can be helpful. In case of an emergency, someone will be better able to fi nd all of your medication to know what you are taking. Oral medications should be kept separate from other items that are for external use such as creams and ointments.

When you receive a new medication, it is recommended that you ask your doctor or pharmacist about any specifi c storage instructions. It also is important to read the label for storage instructions. For example, some liquid antibiotics must be refrigerated. In other cases, refrigerating certain liquid antibiotics will break down the medication, making them ineffective. In general, do not store medicines in the refrigerator unless directed to do so.

It also is important to keep medicine in the original container, where the label identifi es it and gives directions. You also should save, in addition to the label, any other printed information that comes with the medication.


Rx Matters

continued on p. 8

It is recommended that you not mix different medications together in one container, because this will make it diffi cult for you to identify your medications in an emergency. Also, you should never place medicine near a dangerous substance, which could be taken by mistake.

Child safety is important when it comes to placement of your medications. You should keep all medi-cine out of children’s reach, use child-resistant caps, and never leave containers uncapped. Also place your medicine where your pets cannot accidentally get into them.

Be Aware of Expiration Dates You should properly dispose of medicine if the label date indicates it has expired. Expired medications lose their potency and may become less effective, totally ineffective, or even dangerous.

If there is no expiration date on a prescription, you should consider it expired if you received it more than a year ago. When the label shows only a month and a year, the implied expiration date is the last day of that month.

The U.S. Food and Drug Administration has required pharmaceutical manufacturers to provide expiration dates on all their products since 1979. For the majority of medications sold in the United States, the dates range from 12 months to 60 months from the date they are manufactured.

The expiration date assures that the medication meets applicable standards of strength, quality, and purity at the time of use. Pharmaceutical manufacturers determine a medication’s expiration date after testing it to see how fast the drug degrades. This ensures that the potency and integrity are intact over a specifi c amount of time. Factors infl uencing the expiration date include the type of active ingredients, storage conditions, preservatives, and the type of storage container.

The shelf life of medications varies based on the dosage and form. For example, pediatric liquid antibiotics, insulin, and certain injectables will expire more quickly than medications in other forms such as tablets.

Regardless of the expiration date, you should not use a medication that has changed color, consistency, or odor. If aspirin or another type of medicine looks sticky or crumbled, throw it away or bring it back to your pharmacy. You also should dispose of or return capsules or tablets that stick together, are harder or softer than normal, cracked or chipped.

Some pharmacists recommend going through your medicine cabinet once a year and discarding expired medications as well as those that your doctor has told you to discontinue using. At that time, it also is important to make sure that any discarded medicine is out of the reach of children.

Rx Matters


Expired medications lose their potency, and

may become less effective, totally ineffective, or

even dangerous

continued on p. 9

Medication Matters (continued from p. 7)

Safe Disposal To discard expired or unusable medications in a safe and environ-mentally friendly manner, do not throw them in the trash where children or pets might discover them. Instead it’s usually best to simply remove the expired medications from their contain-ers and fl ush them. However, some medications require special care. Contact your local pharmacist or local health department and Environmental Protection Agency (EPA) offi ce for specifi c requirements for disposing of unusable or expired medications in

your area. You can fi nd your local health department at http://www.apha.org/public_health/state.htm. You can fi nd your EPA regional offi ce at http://www.epa.gov/epahome/whereyoulive.htm#regiontext.

ReferencesRx Drug Update and New Rx Indications• Red Book & Updates. 111th ed. Montevale, N.J.: Thomson Healthcare, Inc.; 2007.

• www.ashp.com. Accessed December 2006.

• www.drugs.com. Accessed December 2006.

• www.fda.gov. Accessed December 2006.

• www.internetdrugnews.com. Accessed December 2006.

• www.pharmacyonesource.com. Accessed December 2006.

• www.ptcommunity.com. Accessed December 2006.

Medication Matters• Mayo Clinic. www.mayoclinic.com. Accessed August 2006.

• U.S. Department of Health & Human Services. www.healthfinder.gov. Accessed August 2006.

• U.S. Food and Drug Administration. www.fda.gov. Accessed August 2006.

• Walgreen Co. Walgreens Health Library. www.walgreens.com/library. Accessed August 2006.

Rx MattersMedication Matters (continued from p. 8)

©2007 Walgreens Health Initiatives, Inc., a wholly owned subsidiary of Walgreen Co. All rights reserved. PBM5486-0107 Page 9

For general information about Walgreens Health Initiatives products and services, call 800-926-6779,

e-mail [email protected] , or visit mywhi.com.

Editorial Board

Editor Christiane Tiskus Contributing Writer Rhonda Deutsch Consultant Carissa Mancuso, Pharm.D.,

Patrick Smith, Pharm.D., B.C.P.S. Designer Rabel ShamuelBrand names are the property of their respective owners.This publication does not constitute professional advice. Although it is intended to be accurate, neither Walgreen Co., its subsidiaries and affiliates, nor any other party assumes liability for loss or damage due to reliance on this material. If you have a medical question, consult your medical professional.

Articles in Walgreens Health Initiatives Rx Matters may be reprinted only by clients of Walgreens Health Initiatives or respective agents of Rx Matters may be reprinted only by clients of Walgreens Health Initiatives or respective agents of Rx Mattersclients. Please attach the following statement: Reprinted with permission. ©2007 Walgreens Health Initiatives, Inc., a wholly owned subsidiary of Walgreen Co. All rights reserved.

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Rx Matters - Walgreens...Rx Matters continued on p. 3 pressure) are evaluated or self-reported at the worksite screening. Together, these components help assess modiﬁ able health