Diving deep into the drug trends driven by COVID-19 provides insight on the impact shelter-in-place may have on the future of healthcare. It also provides a correlation between prescription drug utilization and economic impact.
Ensuring members have access to medications and support is a focus during these unprecedented times. Knowing when there is a medication shortage and what policy changes are taking place is a key component of being prepared and informed. Current policy changes include:
- Refill Too Soon
- Prior Authorization 90-Day
- 90-Day Specialty Fill
- Utilization Management rules
As we look at COVID-19 and the impact on our world, it is also important that we look at history to guide the decisions we make today. In 1919, the world was experiencing the Spanish Flu, a worldwide pandemic. This was the first insight into the concept of social distancing and shelter-in-place policies to mitigate death count and hospital overwhelm. Both social distancing and shelter-in-place policies proved to be effective, yet cities that opened too soon or relaxed their policies early, saw spikes in Spanish Flu cases. This is much like what Arizona has experienced today – opening too soon and consequently an upward trend of COVID-19 cases.
Confidio clinicians have seen an increase in the number of claims for drugs used to treat COVID-19 in clinical trials – Albuterol Sulfate Inhaler, Azithromycin, and Hydroxychloroquine. However, these are not the only drugs that have seen an increase in utilization. There has been a steady increase of drug claims for medications in the anxiety and sleep aid mediation categories, thus creating a nationwide shortage.
In response to both medication demand and policy changes, PBM’s implemented changes to allow for:
- Relaxing the Refill Too Soon requirements
- Encouraging the transition from 30-day to 90-day maintenance medications
- Extension of 90-day prior authorizations
As we look to the future, it seems inevitable that deaths from cancer and other comorbidities will increase due to the lack of health services available to patients. Another challenges that may arise is nonalcoholic steatohepatitis (NASH), liver inflammation and damage caused by buildup of fat on the liver. The impact of COVID-19 on specific populations such as those with obesity, diabetes and fatty liver disease is yet to be known but research is showing these populations are at higher risk. Actionable advice and optimal care will be needed to care for these populations as treatments become available.