Gold Medal Research

Study on Drug Coverage Gap Among Medicare COPD Patients Earns Gold Medal for UHCOP, Cigna HealthSpring and GlaxoSmithKline Team

A collaborative project by UH College of Pharmacy, Cigna HealthSpring and GlaxoSmithKline (GSK) researchers to examine the factors contributing to prescription drug coverage among Medicare-enrolled Chronic Obstructive Pulmonary Disease (COPD) patients was recognized with a Gold Medal at the Academy of Managed Care Pharmacy's AMCP & Specialty Pharmacy Annual Meeting April 19-22 in San Francisco.

The UHCOP-led project, which was partially supported by GSK, examined retrospective data to identify patients more likely to fall in the coverage gap – known as the "doughnut hole" – which creates an increased cost-sharing burden on patients.

An abundance of pharmaceutical health outcomes research has shown that medication costs in general is one of the primary barriers to medication adherence. For patients in the Medicare Prescription Drug Plan, medication adherence often falters when patients enter the coverage gap but before catastrophic coverage begins (or a new plan year begins) due to the patient's higher out-of-pocket expenses.

Whereas other poor medication adherence for other disease states may also lead to health complications and hospitalizations/readmissions over a longer term, the negative health impacts of poor medication adherence are more immediate for COPD patients due to the nature of their disease state. As a result, health complications in COPD patients typically are more complex and often require hospitalization.

The goal of the project recognized at AMCP was to identify plan beneficiaries as potential candidates for medication therapy management services, counseling on drug utilization or other quality initiatives.

The project was led by Sujit S. Sansgiry, Ph.D., UHCOP associate professor of Pharmaceutical Health Outcomes and Policy (PHOP), and coauthors Archita Bhansali, M.S. ('13), PHOP Ph.D. candidate; Omar Serna, Pharm.D. ('08), BCACP, Cigna HealthSpring clinical pharmacy manager and UHCOP alumnus; UHCOP faculty members Marc L. Fleming, Ph.D., MPH, R.Ph., assistant professor, and Susan Abughosh, Ph.D., assistant professor; and GSK's Michelle Kamdar, Pharm.D., health outcomes director, National Accounts, and Richard Stanford, Pharm.D., senior director, Customer Engagement Value Evidence and Outcomes.

"This was a truly collaborative effort of a pharmaceutical manufacturer and an insurance provider to identify factors associated with COPD patients who do not have adequate access to medications in government-sponsored programs, such as Medicare," Sansgiry said. "Ultimately, no one wins when COPD patients are not adherent to their medication regiments, so this study provides the data to further consider strategies in which the patients either don't reach the gap or their cost burden can be reduced while they're in the gap."