Healthcare systems are generally slow to adopt new technologies. For all the talk about leveraging “Big Data,” the industry has been even slower to adopt analytics to make those data actionable. In fact, not one state Medicaid agency currently uses an evidence aggregation platform with post-approval adverse drug events intelligence when creating preferred drug lists, writing prior authorization criteria, negotiating supplemental rebates, educating prescribers and dispensers, or performing prospective, concurrent, or retrospective drug utilization reviews. This is in spite of the fact that millions of patient lives are put at risk and billions of dollars are spent every year from adverse drug events. Yet there is no mandate to use readily available, reliable data to inform making decisions about prescription medicines.
Fortunately there are the outliers - innovators and early adopters that see things differently. They know that they can make a difference by incorporating new ideas and approaches to improve patient outcomes and their own bottom lines.
One such innovator is Memorial Hermann in Houston Texas and their Director of Clinical Pharmacy Services, Dr. Patti Romeril. On September 3rd 2015, H&HN (Hospitals & Health Networks) published an article by Dr. Romeril where she detailed how Memorial Hermann is using data and analytics, contained in an evidence aggregation platform, on prescription drug side effects to reduce readmissions, improve patient safety, and lower the costs of patient care.
Dr. Romeril has been an early and ardent supporter of new approaches to drug safety and she sums up exactly how she is making these data and analytics actionable:
“At Memorial Hermann, the change in our formulary review process unfolded as a three-step process:
We assessed our current formulary review process for incorporating adverse events side effect data beyond clinical trials and FDA alerts. We asked ourselves: Is the process using broad-based, post-approval adverse events data and technical analysis to compare true drug costs per patient across an indication, class or mechanism of action? Does it dig deeper into the data provided by the FAERS database to analyze what the information means? If the analytics reveal compelling results, does the process lead to changes in formulary?
We ascertained strengths and weaknesses of today's system. We asked: Is the hospital leadership able to track and prevent side effects of the most commonly prescribed medications in the hospital setting? Is it coupling its internal review findings with a review of FAERS? Is it taking the time to clean up the FAERS data to remove input errors or errant information?
We reconfigured the process to include sophisticated analytics of post-marketing side effects. This was accomplished by calculating adverse event risks and costs as part of the decision-making process. While off-the-shelf software solutions can be an affordable, fast and efficient solution, we wanted to make sure that the chosen system includes:
— The right data. Does the system include on- and off-label usage of sanitized data from not only FAERS, but also the most recently reported adverse events that have not yet been entered into FAERS? These data can be obtained by employing the Freedom of Information Act and requesting this information from the FDA. However, we were fully aware that the FDA is sometimes six months behind in inputting data about adverse events into FAERS.
— The right analytics. Does the system utilize algorithms and analytics that identify, assess and rank medicines, and that deliver final outputs that are timely and actionable? Analytics are the key to generating a return on investment that will result in better patient safety and reduced readmissions. We aimed to dissect the data critically and reveal the costs related to serious adverse events and outcomes per patient, as well as to identify the specific adverse drug reactions that are driving increased costs.
— The right measurement. Does the system measure progress and success in terms of cost savings per prescription and outcomes?”
Dr. Romeril sums up by saying that “Memorial Hermann is proud to have embraced this methodology early on, and plans to push for continued improvements in formulary analysis. The benefits will be realized in a reduction in adverse event costs, such as hospital readmissions or other serious consequences, as well as improved outcomes among patients.”
Advera Health’s Evidex™ is an evidence aggregation platform that makes evidence collection and generation easy though a simple to use, yet powerful web-based application. To learn more about specific use cases of evidence aggregation platform's like Evidex for pharmaceutical companies, managed care organizations, hospitals, and product liability insurers, download our new White Paper, Use Cases for a Pharmaceutical Evidence Aggregation Platform- Combining Clinical Trial Results with Real World Data.
Jim Davis, EVP Advera Health Analytics