20160627 Pharmacy Initiatives Part 3

2016 Quorum
Pharmacy Spend
Reduction Initiatives
Part 3
Nicolle Rychlick, PharmD
Director, Clinical Integration and Implementation,
HealthTrust
Scott McGee
Contract Manager, Quorum Purchasing Advantage
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Greetings and
Introductions
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Today’s Presenters
Nicolle Rychlick, PharmD
Director, Clinical Integration and Implementation, HealthTrust
Nicolle Rychlick, is the Director of Clinical Integration and Implementation
at HealthTrust. She has responsibility for multiple clinical initiatives
including biosimilars and multi-modal pain. Nicolle completed her PGY 2 in
Corporate Pharmacy Leadership with HealthTrust and PGY 1 at Mercy
Springfield Hospital, Springfield, Missouri. She completed her PharmD at
Pacific University in Hillsboro, Oregon, MBA and bachelors at Oregon State
University, Corvallis, Oregon.
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Today’s Presenters
Scott McGee
Contract Manager, Quorum Purchasing Advantage
Scott McGee has more than a decade of financial analysis experience,
primarily in the technology and telecommunications sectors. In his current
position, Scott specializes in the collection, analysis and reporting of large
amounts of data related to QPA member hospital purchases, as well as
providing analytic support for both the Supply Operations and Strategic
Service Partners groups.
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Overview of 2016
Pharmacy Spend
Reduction Initiatives
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Goals of 2016 Quorum Pharmacy Initiative
Begin focus and dialogue in
the pharmacy area to drive
cost out while achieving
targeted outcomes.
Utilize every other month
calls to support pharmacy
managers in understanding
and driving the initiatives.
Utilize tracking tools to
communicate on a monthly
basis hospital savings and
opportunities with each
initiative.
Provide conduit for
pharmacy managers to hear
from other Quorum facilities
that have successfully
initiated these programs and
to share tips for success in
implementation.
Educate pharmacy managers
to fully utilize HealthTrust
tools to support efficiencies
in pharmacy and cost
reduction.
Achieve $5 million in savings
in 2016 through the
implementation of these and
future initiatives.
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HealthTrust/QPA
Focus Initiatives
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Daptomycin
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Daptomycin Mitigation
• Appropriate use of Daptomycin
 Persistent, resistant gram-positive bacteremia as second line
therapy
 Type 1 anaphylaxis to vancomycin
 Transition to outpatient therapy
• Goal is to reduce spend by 20%
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Daptomycin – Next Steps
• Review purchase data
• Determine current utilization
 Indications
 Setting
 Prescribers
• Create a plan
 Target one area first
 Review HealthTrust tools
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Where to Find Daptomycin Tools
1
There are additional
resources available on
the MRSA page,
including a FAQ webinar
for Daptomycin
2
3
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Granix
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Granix
• Goal is to increase market share to 70%
• Review HealthTrust educational tools
• Are you currently using a mix of Granix and Neupogen?
 Indications
 Setting
• Has it been taken to P&T?
• Focus on target areas
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Where to Find Granix Tools
1
The Biosimilar page also
houses resources on
naming and
reimbursement
2
3
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Eligard
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Eligard
• Goal is to interchange to Eligard for savings

Pediatric not included
• Determine current utilization
Indications
 Setting
 Prescribers

• Create a plan
Target one area first
 Review HealthTrust tools

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CPO Program
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CPO
• Next measurement period is April 1, 2016 – September 30, 2016
Combined Product Offering (CPO)
Performance *Remicade + Simponi Aria Unit Volume at 90% of Baseline period of (Oct
Requirements 2014 – March 2015). Current System Baseline 7,492 Vials
*Procrit Market Share > 60%
Rebate
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*Xarelto volume > 105% of baseline (Oct 2013 – March 2104).
Current Xarelto Baseline is 34,770 PDOT units
2% on eligible purchases
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CPO – Next Steps
• Determine product use
 Purchased products
 Review market baskets
 Current utilization
• Formulary
 Product formulary status
 Interchanges
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CPO Market Basket
• Xarelto (rivaroxaban)
 Eliquis (apixaban)
 Savaysa (edoxaban)
• Remicade (infliximab)/Simponi Aria
 Remicade100 mg vial; NDC 57894003001
 Simponi Aria 50 mg/4mL; NDC 57894035001
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CPO Market Basket
• Procrit



10,000 units/vial; NDC 59676031001 & 59676031002
20,000 units/vial; NDC 59676032004
40,000 units/vial; NDC 59676034001
• Procrit market basket



Procrit
o
2,000 units/vial; NDC 59676030201
o
3,000 units/vial; NDC 59676030301
o
4,000 units/vial; NDC 59676030401
o
10,000 units/multi-dose vial; NDC 59676031204
Aranesp (darbepoetin alfa)
Epogen (epoetin alfa)
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QPA Pharmacy Reporting
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HealthTrust inSight Rx
• QPA purchased a license in Q1 2016 in order to facilitate
the Pharmacy Initiative
• Receives periodic feeds from all major pharmaceutical
distributors
• Provides dashboards as well as standard and custom
reporting capabilities
• Will serve as the primary source of information for the
QPA Pharmacy Initiative Dashboard
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HealthTrust inSight Rx
In addition to utilizing the inSight Rx portal for a data
source, QPA can also run facility-specific reports upon
request. Possible reports include:
• Custom Trending Report
• Change Factor Detail Report
• Savings Opportunity by NDC
• Generic Conversion Opportunity Report
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HealthTrust inSight Rx – Custom Trending Report
• The custom trending report allows members to extract
total Rx spend from multiple wholesalers
Purchased
Generic Name
NDC
55513019001 PEGFILGRASTIM
57894003001 INFLIXIMAB
55513073001
67919001101
66733095823
00469650189
68817013450
55513095601
50242008527
00078064881
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Drug Strength
6MG/0.6ML
100 MG
120 MG/1.7 ML
DENOSUMAB
(70 MG/ML)
DAPTOMYCIN
500 MG
CETUXIMAB
200 MG/100 ML
REGADENOSON
0.4 MG/5ML
PACLITAXEL PROTEIN-BOUND 100 MG
400 MG/20 ML
PANITUMUMAB
(20 MG/ML)
ALTEPLASE
100 MG
OCTREOTIDE ACETATE,MI30 MG
SPHERES
Contract
Rebate
Quarter Purchase
Number
Quantity Total Spend Amount
SYRINGE
2343 Q1 2016
62 $259,182.84
$0.00
VIAL
2319 Q1 2016
198 $194,756.58
$0.00
Form
VIAL
Q1 2016
VIAL
VIAL
SYRINGE
VIAL
Q1 2016
Q1 2016
Q1 2016
Q1 2016
5694
83 $155,832.58
$0.00
322 $135,169.92
$0.00
84 $86,408.90
$0.00
399 $78,503.67 $2,355.11
73 $76,580.05
$0.00
VIAL
Q1 2016
18
$73,065.68
$0.00
VIAL
Q1 2016
9
$71,838.73
$0.00
VIAL
Q1 2016
13
$60,156.18
$0.00
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HealthTrust inSight Rx – Change Factor Detail Report
• The Change Factor Detail Report allows users to identify the root
cause of spend fluctuations by NDC. This report performs
calculations to show if spend changes are due to quantity or price
change.
NDC
61953000404
55513095601
57894035001
63020004901
00003218710
63323041510
49281019020
55513054610
59676031001
63459039008
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Brand Name
FLEBOGAMMA DIF
VECTIBIX
SIMPONI ARIA
VELCADE
ORENCIA
NEOSTIGMINE
METHYLSULFATE
IMOGAM RABIES-HT
NEUPOGEN
PROCRIT
TREANDA
Manufacturer
Grifols
Amgen
Janssen Biotech
Millennium Phar
Bms Primarycare
App Pharmaceuti
Sanofi-pasteur
Amgen
Janssen Product
Cephalon,inc.-t
Comparison
Current
Period Spend Period Spend
$7,002.40
$65,239.50
$15,838.71
$73,065.68
$20,100.31
$49,551.47
$43,470.00
$61,256.00
$6,935.43
$24,009.50
$13,330.89
$2,627.00
$13,365.43
$11,606.71
$6,625.06
$29,772.62
$17,762.99
$26,716.04
$21,382.86
$16,399.29
Spend
Spend
Change
Variance
$58,237.10
832%
$57,226.97
361%
$29,451.16
147%
$17,786.00
41%
$17,074.07
246%
$16,441.73
$15,135.99
$13,350.61
$9,776.15
$9,774.23
123%
576%
100%
84%
148%
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HealthTrust inSight Rx – Savings Opportunity by NDC
• This report displays purchased products compared to the optimal
products and the potential lost savings for a user specified period
of time.
Purchased
NDC
Purchased Description
00009069801 SOLU-MEDROL 1 GM VIAL
OXYCODONE HCL 5 MG
00406055262 TABLET
IPRATROPIUM BR 0.02%
00487980101 SOLN
AGGRENOX 25 MG-200 MG
00597000160 CAPSULE
LANOXIN 125 MCG
24987024256 TABLET
59148000813 ABILIFY 10 MG TABLET
IRINOTECAN HCL 100
63323019355 MG/5 ML VL
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Purchased
Contract # Optimal NDC
Optimal Non-Optimized Purchase Optimal Lost
Lost
Optimal Description
Contract Net Purchases Quantity Spend Savings Savings %
METHYLPREDNISOLONE
SS 1 GM VL
4531
$233.90
10 $114.43 $119.47
51.08%
OXYCODONE HCL 5 MG
TABLET
4558
$282.34
10 $215.40 $66.93
23.71%
IPRATROPIUM BR 0.02%
SOLN
4605
$551.06
118 $390.88 $160.18
29.07%
ASPIRIN-DIPYRIDAM ER
25-200 MG
4590
$428.84
1 $245.29 $183.55
42.80%
4576
63323026530
4563
00904644461
4568
00591379860
3692
00093304006
4531
42292000320 DIGITEK 125 MCG TABLET
ARIPIPRAZOLE 10 MG
60505267403 TABLET
IRINOTECAN HCL 100
59923070205 MG/5 ML VL
4591
$678.02
1 $108.47 $569.55
84.00%
4989
$839.97
1 $291.00 $548.97
65.36%
7094
$199.86
6
58.42%
$83.10 $116.76
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HealthTrust inSight Rx – Generic Conversion Opportunity Report
• This report details generic products that could be purchased based
on the lost generic savings alerts that are currently active. The
alerts stay active for seven days once they are created.
NDC
Brand Name
Manufacturer
Generic NDC
00009032301 GELFOAM
Pharmacia/upjhn
63713001973
00009069801
00065027105
00591387544
00781724055
24987024956
59148000813
Pharmacia/upjhn
Alcon Labs.
Actavis Pharma,
Sandoz
Covis/concordia
Otsuka America
63323026530
64980051705
00904650661
00406901276
42292000220
60505267403
Kremers Urban
00228262011
App Pharmaceuti
00143987510 AMIODARONE HCL
SOLU-MEDROL
PATANOL
MEMANTINE HCL
FENTANYL
LANOXIN
ABILIFY
ISOSORBIDE
62175010701 MONONITRATE
AMIODARONE
63323061603 HCL
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Generic Name
GELATIN
SPONGE,ABSORBABLE
METHYLPREDNISOLONE
SOD SUCC
OLOPATADINE HCL
MEMANTINE HCL
FENTANYL
DIGOXIN
ARIPIPRAZOLE
ISOSORBIDE
MONONITRATE
Generic
Manufacturer
Ethicon
Generic
Lost Savings
Brand Spend Optimal Spend
Amount
$532.10
$507.20
$24.90
$233.90
$222.77
$54.15
$240.82
$1,356.04
$1,679.94
$114.43
$37.98
$34.50
$214.97
$216.94
$523.80
$119.47
$184.79
$19.65
$25.85
$1,139.10
$1,156.14
Actavis Pharma,
$40.25
$9.39
$30.86
West-ward,inc.
$44.77
$37.65
$7.12
App Pharmaceuti
Rising Pharm
Major Pharmaceu
Mallinckrodt Ph
Mylan Instituti
Apotex Corp
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QPA Pharmacy Initiative Dashboard
• Produced quarterly
• Simple-to-use Microsoft Excel workbook
• Contains the current status for each initiative along with
hyperlinks to additional resources
• Is currently still being refined and may have slight
improvements as the quarters progress
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QPA Pharmacy Initiative Dashboard
2016 Pharmacy Intiative Dashboard
Sample Hospital
Q1 2016
Daptomycin Mitigation
Proper Daptomycin utilization is important for a successful Antimicrobial
Stewardship Program as well as optimal patient care. The goal of the
initiative is to reduce total Quorum spend by 20%. Accomplishing this could
potentially save about $1 million annually.
2015 Quarterly
Follow-up
Average*
Q1 2016*
Percent Reduction
Suggested?
$232,481
$208,163
10%
Yes
Reported totals include distributed purchases only and do not include Merck
direct purchases.
HealthTrust Antimicrobial Stewardship Resources
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QPA Pharmacy Reporting
• We will provide the details of available HealthTrust inSight
reports to all pharmacy contacts by e-mail following this call
• The QPA Pharmacy Dashboard report for Q1 2016 will be emailed following this call as well. It will also be posted to the
Resources section of our QPA Supply AdVantage website.
• Going forward, the QPA Pharmacy Dashboard will be
published and distributed quarterly, approximately one
month after the close of the quarter
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Upcoming Programs
Webinars
• Part 4
August 23, 2016 2:00 pm Central Time
• Part 5
October 25, 2016 2:00 pm Central Time
• Part 6
December 13, 2016 2:00 pm Central Time
Register at www.qhrlearninginstitute.com
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Quorum Learning Institute Recordings and Videos: Come Visit Our Library
http://videos.qhr.com/
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Program Evaluation
• Thank you for joining us today. We value your feedback and hope that you will
take a few minutes to evaluate this program so that we may continue to improve
and bring you the quality educational programming you expect.
• As a reminder, you will have two opportunities to complete an evaluation and
receive a completion certificate:

At immediate conclusion of webinar

Post event: within two business days of the webinar, you will receive an email containing
links to the online evaluation and a recording of this webinar
• Upon completing the online evaluation, you will receive an email with a link to
access your completion certificate.
• If you have questions or need assistance, please contact
[email protected].
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Contact Us
Tony Bramer
Vice President
Quorum Purchasing Advantage
[email protected]
615-371-4900
www.QHR.com | (615) 371-7979
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For More
Information
Contact:
[email protected]
(800) 233-1470, ext. 4513
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Creating a Sustainable Futurefor Healthcare Organizations
Intended for internal guidance only, and
not as recommendations for specific
situations. Readers should consult a
qualified attorney for specific legal
guidance.
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