Implementing and Monitoring Pharmacotherapy Benefit

1
Implementing and Monitoring Pharmacotherapy
Benefit

• Rebecca Ruiz-McGill
• Arizona Smokers Helpline a service funded by the
  AZ Department of Health Services, a part of the
  AZ College of Public Health.

2
Arizona Cessation History

• Arizona Smokers Helpline began operations in
  1995 and became a service funded by the Arizona
  Department of Health Services (ADHS) in 1996.
• Community based group cessation classes funded by
  the state in 1997.
• Various discounts for medications provided by
  county and/or project. No standardization among
  funded programs.

3
Arizona Cessation History

• ADHS standardized and centralized pharmacotherapy
  benefit for community based group programs FY
  03-04.
• December 2003, AZ Smokers Helpline allowed to
  provide benefit to telephone-based clients.

4
The Benefit

• 50 discount on
• Zyban (with prescription), 30 tabs-150 mg
• Patch 14-day supply 7,14, or 21mg dose
• Gum 48 or 50 pieces of 2m or 4mg dose
• Lozenge 72 pieces of 2mg or 4mg dose.

5
The Benefit

• Three to six vouchers redeemable each week or
  every two weeks (depending on product selected)
  from date of issue.
• Valid for up to 6 months.
• Client allowed to enroll for benefit once every 6
  months.

6
Managing the Benefit

• ADHS contracts with US Script to manage the
  pharmacy benefit.
• US Script contracts with any pharmacy within
  state to accept discount on medications as
  outlined under plan.
• Enrollment tracked by name of client enrolled
  through quit line or community based cessation
  programs.

7
Managing the Benefit

• Need to screen for contraindications
• Need to monitor use
• Need to minimize abuse
• Need to track product distribution
• Need to verify 18 and older through valid state
  ID

8
Managing the Benefit

• Client is enrolled onto US Script system.
• US Script tracks enrollees name, contact info,
  birth date, vouchers redeemed, and product
  distributed.
• Quit line developed ID verification process,
  contraindication screening and internal
  monitoring process to minimize abuse.

9
Process Development

• Developed medication screener to ensure
  contraindications were addressed.
• Doctors written approval needed for pregnant
  women, those under 18 and those with
  contraindications as listed by product.

10
Process Development

• Developed an ID verification process using
  community-based programs offices and quit line
  office as verification sites.
• Minimized abuse by training staff to verify
  client has not been enrolled in the program
  during last 6 months through US Script database.

11
Promoting the Benefit

• Mass mail out using database which captures data
  to track healthcare providers who refer clients
  or request materials.
• Benefit promoted through on-going trainings for
  healthcare providers.
• Added worksite promotion 05.

12
Results
13
Results
14
What have we learned

• Direct link with US Script data to client intake
  data/enrollment to assess impact on quit status
  and minimize abuse.
• Product compliance an issue.
• Identification process a barrier.

15
Contact Information

• Rebecca Ruiz-McGill
• rrmcgill_at_u.arizona.edu
• www.tepp.org
• www.ashline.org