Pharmacists Announce HERO Score Results, Challenging the Healthcare Industry to Deliver Measurable Improvements in Patient Outcomes and Superior Value

OptiMed's breakthrough algorithm radically changes the way employers evaluate the quality and value of their specialty pharmaceutical spending.

OptiMed Health Partners

OptiMed Specialty Pharmacy announced the release of a case study demonstrating the Health Economics Return & Outcomes (HERO) Score for an inflammatory bowel disease (IBD) patient on a high-cost specialty medication.  Their breakthrough algorithm changes the way employers critically evaluate the quality and value of their specialty pharmaceutical spending. 

"The calculation of the HERO Score provides valuable insight about a patient's health outcomes and the value their specialty medication provides," says Chad Henry, PharmD, CSP, a senior clinical pharmacist from OptiMed Specialty Pharmacy who led the research with fellow colleague, Lucas Dominick, PharmD. "This could change the way employers benchmark and deliver measurable improvements in patient outcomes and healthcare spending."

Chad Henry, PharmD, CSP

Senior Clinical Executive

OptiMed assists employers in evaluating the return on healthcare dollars invested from specialty pharmaceuticals, which are a major force driving pharmacy benefit costs.

Despite being utilized by only 2% of the population, these high-cost medications account for approximately 45% of the total drug spend. 1. When including drug spending under the medical benefit, this number increases to 60% of the total drug spend. 2. The correlation between the high cost of specialty drugs and the value these medications provide to employees and employers has been difficult to estimate. The HERO Score provides an understanding of outcomes that can be viewed in aggregate to empower health plans and employers to choose their healthcare investments wisely and with confidence. 

In this highlighted case study, the HERO Score demonstrates how costs and outcome variables, such as drug price, site of infusion care, patient management, patient disease control, healthcare utilization, and quality of life, impact the value obtained from the use of a specialty medication in an inflammatory bowel disease (IBD) patient. Results indicated marked improvement in the patient outcomes and quality of life over the course of a year, once transitioned to OptiMed Specialty Pharmacy.  The value obtained from the patient’s medication therapy was far superior due to better disease control, improved quality of life, reduced healthcare utilization and enhanced productivity. This emphasizes the importance of a value assessment that incorporates all the cost variables and outcomes of any given regimen. To read the case study, click here to download the findings.

About OptiMed:  OptiMed Health Partners, headquartered in Kalamazoo, Michigan, is an independently owned and operated national health care organization. With over 25 years of experience, OptiMed leverages personalized attention to detail to deliver customized solutions that optimize patient outcomes while partnering with other health care organizations to usher in a new standard of excellence. To learn more about OptiMed’s innovative and personalized care, visit www.optimedhealthpartners.com or email connect@optimedhealthpartners.com.

About Harmonize.Healthcare:  To learn more about the Health Economics Return & Outcomes (HERO) Score, click here to download the paper or visit HARMONIZE.HEALTHCARE (H2) to learn about applying novel care strategies to positively impact your organization and truly revolutionize employee health and productivity.

Sources: (1) Express Scripts 2018 Drug Trend Report. Published Feb 2019. Available at: https://my.express scripts.com/rs/809VGG836/images/Express%20Scripts%202018%20Drug%20Trend%20Report.pdf. Accessed 8 August 2019. (2) Shah, P. Today’s Specialty Landscape. CVS Health Insights/Specialty. Available at: https://payorsolutions.cvshealth.com/insights/todays-specialty-landscape. Accessed 8 October 2019.

Source: OptiMed Health Partners


Categories: Healthcare Insurance

Tags: healthcare, national infusion provider, patient care, pharmacy benefits, price transparency, specialty medications, specialty pharmacy


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