Outcome Evaluation of a Pharmacy Benefit Management-Based Asthma Management Program

Abstract

Asthma is a highly prevalent, economically burdensome chronic condition. Pharmacy benefit managers (PBMs) have an opportunity to minimize costs and increase guideline-based prescribing by using prescription claims data to develop and evaluate educational interventions for at-risk members and their prescribers. The objective of this outcome evaluation project was to determine if a nurse-led PBM asthma management program of mailed educational interventions were effective in improving members’ asthma medication ratios. A purposive sample of PBM members who submitted six or more claims for short-acting beta-agonists (SABAs) and had a suboptimal asthma medication ratio (AMR) of less than 0.5 over a 1-year period of time was identified. Members and their prescribers received mailed information about asthma control at baseline; members received a second intervention at 6 months. Data were analyzed at 12 months post-intervention to identify changes in AMR and use of prescription claims. Repeated measures analysis of variance (RM-ANOVA) with a Bonferroni correction were calculated to determine mean differences. Significant improvement in AMR and reduction in SABA claims at 12 months were demonstrated in the intervention group. A mailed, educational intervention can result in a significant improvement in members’ AMR and a reduction in SABA use.