Magellan Rx Management is hosting its annual Specialty Summit from August 28-30, 2017 in New York City. This premier event provides insights, innovations and solutions for some of the pharmaceutical industry’s hottest topics.

DO YOU HAVE A STORY TO TELL?

If you have compelling research or new ways to drive innovative thinking that can help solve complex specialty pharmacy challenges, we want to hear from you! Magellan Rx Management is accepting proposals now through March 13.

Click here to submit your story, and learn more about the Specialty Summit here. 

Heart disease is the leading cause of death for both men and women, but you can make healthy changes to lower your risk of developing heart disease. Controlling and preventing risk factors is also important for people who already have heart disease. According to the U.S. Office of Disease Prevention and Health Promotion, ways to lower your risk include:

• Watching your weight.
• Quitting smoking and stay away from secondhand smoke.
• Controlling your cholesterol and blood pressure.
• If you drink alcohol, drink only in moderation.
• Getting active and eat healthy.

February is great time to take control of your health and know your health numbers.

According to the Kim Foundation, one out of four Americans experiences behavioral health issues. Of those, 60 percent are not receiving treatment.

Why are so many people not receiving treatment?

What does this mean for providers?

What more can be done to increase access to behavioral healthcare?

Learn more about this issue by downloading Magellan’s new infographic, “Mind the Gap: Increasing Access to Behavioral Healthcare.”

Millions of people are challenged by drug and/or alcohol use, which may result in physical and emotional health concerns. Many individuals feel like they have lost control and struggle with depressive signs and symptoms, in addition to substance use – and only a fraction of these individuals receive care, according to a report on addiction released in November by the U.S. Surgeon General.

At Magellan Health, our clinical methodology for the management of substance use incorporates leading principles of care, involving appropriate assessment, evidence-based interventions, as well as close collaboration with other healthcare providers who are vital to the delivery of effective care. At the core of Magellan’s interventions for substance use is our suite of computerized cognitive behavioral therapy (CCBT) programs powered by Cobalt Therapeutics, as well as screening software, and optional wraparound telephonic support.

Magellan’s Cobalt platform includes online, well-studied programs proven to help individuals who are coping with various behavioral health conditions. Among our Cobalt CCBT programs is SHADE – a 10 session mobile and web-based program for individuals living with alcohol, and/or drug use and co-morbid depression. SHADE provides skills-building exercises, which include mood monitoring, problem brainstorming, pros and cons analysis, planning for change, identifying problematic thought patterns and developing effective drug refusal skills. SHADE helps participants control their substance use, alcohol use and low mood by promoting long-lasting skill-based changes in behavior and thinking.

Published in the journal Addiction, SHADE has been proven in randomized, controlled trials to:

• Be comparable in efficacy to face-to-face therapy.
• Reduce hazardous drug and alcohol use by 44-58 percent after 6 months.
• Reduce hazardous use by 72 percent after 12 months.
• Significantly reduced binge drinking.

SHADE was listed favorably among the technology assisted interventions highlighted by the surgeon general’s report as a tool designed to “(1) increase access to care in underserved areas and settings; (2) free up time so that service providers can care for more clients; (3) provide alternative care options for individuals hesitant to seek in-person treatment; (4) increase the chances that interventions will be delivered as they were designed and intended to be delivered; and (5) decrease costs” (see https://addiction.surgeongeneral.gov/ for more information).

You can learn more about Magellan’s Cobalt CCBT capabilities here:

Magellan’s self-guided Computerized Cognitive Behavioral Therapy from Magellan Health on Vimeo.

Ransomware, malware, distributed denial of service attacks, Mirai – bad actors in a scary sci-fi thriller targeting your personal computer (PC), tablet or gaming device? Cyber attacks look for vulnerabilities in any system, not just your PC. Many sectors including credit cards, banking, government, retail and social media are objects of cyber attacks. The healthcare ecosphere, particularly medical devices, are a prime target of cyber bugs. In fact, healthcare is the number one industry when it comes to breach of data and generally lacks specialized security controls. Moreover, personal health information is 50 times more valuable on the black market than a credit card.

Ransomware, which block access to a computer or network until money is paid, are on the rise with 88 percent of attacks occurring in healthcare. Earlier this year, a California hospital paid $17,000 to cyber intruders to regain control of its electronic health network. Just last year, Anthem’s database of about 80 million people was also hacked.

Internet-connected medical devices, hospital networks, and other devices fall in the realm of Internet of Things (loT). Like computers, these connected devices can be hacked, potentially affecting the safety and effectiveness of the device and compromising patient privacy and safety.

In October 2016, J&J reported the potential for hackers to exploit a security susceptibility in the Animas® One Touch Ping® insulin pump. This could force the pump to deliver unauthorized insulin injections, leading to a possible insulin overdose, which can be life threatening. In August 2016, there were denied allegations about a possible dangerous cyber bug with one manufacturer’s cardiac devices. Last year, the FDA issued a few warnings about potential cyber bugs with Hospira’s (now Pfizer) infusion pumps. Despite these reports, the FDA is not aware of any cases where hackers have exploited cyber vulnerabilities to harm a patient.

In January 2016, the FDA made medical device cybersecurity a priority by issuing draft guidance for manufacturers. It provides direction to monitor, identify, and address cybersecurity vulnerabilities throughout the medical device lifecycle. This is largely a voluntary framework to aid manufacturers in building a scaffolded approach to minimize and mitigate risk.

Cyber attacks on medical devices are expected to grow and become more sophisticated as hackers continue to hone their craft. Threatened connected devices range from security cameras to coffee makers and from the federal government to medical devices such as MRIs, infusion and insulin pumps, and the list goes on. There is a proliferation of wearables and medical devices with software and programmable logic. When factoring in the evolution of electronic medical records and telehealth, regulators, medical device manufacturers, and health networks need to get savvier in order to provide solid security against this new reality.

Consumerization of products continues to drive new innovations across the marketplace. For example, you can use your smartphone as a GPS device, to request a car service directly to your house and to shop for a new car online, seeing the prices other people paid in real time. In banking, we’ve seen the transition from teller to the ATM to online banking, smartphone banking and now, using your smartphone as a smart pay device. Underscoring all of these innovations is the desire to make whatever experience the consumer is engaging in easier, simpler and more personalized.

Healthcare is no different. Across the healthcare continuum, companies like ours are finding new and innovative ways to enhance member engagement and participation in the healthcare journey, particularly through computerized or mobile devices. Think about how healthcare has changed over the past 50 years – house calls from doctors to office visits to telephone triage and now, computerized therapy and text therapy.

At Magellan, we’ve invested in a unique type of computerized therapy – Computerized Cognitive Behavioral Therapy (CCBT) – to help individuals seek the therapy they need, in the comfort, convenience and privacy of their own home. Our CCBT programs were originally developed more than 20 years ago, for stand-alone personal computer use, but have since been developed for use on the internet and mobile devices, in both English and Spanish.

 The following five conditions make up more than 90 percent of behavioral health complaints in adults, and are present in more than 25 percent of adults:

• Insomnia
• Depression
• Anxiety
• Substance Abuse
• Obsessive Compulsive Disorder

Within each condition, studies have shown CCBT to be effective at reducing symptoms and severity. Importantly, our CCBT programs have undergone clinical trials involving more than 1,000 patients and have received endorsements and recognition from the American Academy of Sleep Medicine, the United Kingdom’s National Institute of Clinical Excellence, Accreditation Canada and the Substance Abuse and Mental Health Administration’s National Registry. Underscoring all of the studies and reviews, what can members expect? Sixty-nine percent of users show meaningful improvement within 30 days.

But CCBT isn’t just for members. We’ve found that providers can use a tool called Smart Screening to help screen individuals and triage them to the most appropriate levels of care on the CCBT platform, and in person, for the most serious cases. Various levels of screening can help direct individuals to CCBT, directly to an in-person counselor or a mix of both. Through this triage system, 90 percent of engaged participants rate this program as helpful and useful, and 75 percent of individuals actually prefer a non-medication care option when asked.

The most important thing about innovation in any industry – healthcare, banking or electronics – is refusing to rest on your laurels. There are new start-ups launched everyday whose mission it is to disrupt the status quo and provide new ways of doing things. As healthcare evolves, we plan to do the same.

Opioid addiction kills thousands of people every year. In 2014, for example:

• There were 18,893 overdose deaths related to prescription painkillers
• There were 10,574 overdose deaths related to heroin

Despite these shocking numbers, the problem continues to grow. (It quadrupled in the first decade of this century and continues to explode). In the past twelve months, the Drug Enforcement Administration (DEA) has been forced to issue new warnings on drugs such as fentanyl, a potent opioid more than 100 times more powerful than morphine and 30-50 times stronger than heroin. While fentanyl has killed thousands of people over the past few years, many only heard of it recently, when it was attributed to the death of the musician Prince.

Close to Home: Opioid Addiction from Prescription Sources

Given the dangerous nature of some of the most common prescription painkillers—not just from concerns about addiction but from accidental and intentional overdose (the leading cause of accidental death)—it may be surprising to find out just how common it is to find opioid medications in the home.

In 2012, the Centers for Disease Control (CDC) calculated that healthcare providers wrote 259 million prescriptions for opioid painkillers. That is enough for every American adult to receive a bottle of pills.

While there have been efforts to reduce the number of prescriptions written, the number of prescriptions remains very high and the volume of opioid medications already distributed is also alarming.

And this is a key contributor to the opioid addiction crisis. According to the CDC, most people who abuse prescription opioids get them for free from a friend or relative. Essentially, people give their old prescribed medications to friends or relatives. Or, alternatively, abusers take old prescription pills from friends and relatives without their knowledge.

Even among the people at the highest risk of overdose (using prescription opioids non-medically 200 or more days a year) a friend or relative’s medicine cabinet is a common source of finding opioid medications. Among that population:

• 27 percent use their own prescriptions;
• 26 percent get them for free from family or friends;
• 23 percent buy them from friends or relatives; and
• 15 percent buy them from drug dealers.

Cleaning Up: Reducing the Availability of Prescription Opioids

Since the early years of the decade, state and federal authorities have made a concerted effort to reduce the regularity by which opioid medications are being prescribed. In particular, there has been a focus on reducing the ability of abusers to use multiple prescribers to issue painkillers.

Several states have achieved various degrees of success. In New York, the number of patients seeing multiple prescribers for painkillers was reduced 75% percent between 2012 and 2013 after prescribers were required to check the state’s prescription drug monitoring program before issuing a prescription.

In the same time-frame, Tennessee saw a 36 percent reduction in the number of patients seeing multiple prescribers for painkillers when it instituted a program similar to New York’s.

Florida saw a 50 percent reduction in oxycodone overdose deaths between 2010 and 2012 after it regulated painkillers and stopped providers from issuing painkillers from their offices.

In addition to programs aimed at healthcare providers, the Federal government has directed resources towards educating consumers about disposing prescription opioids and other medications. The Food and Drug Administration provides information on the safe disposal of painkillers such as Fentanyl patches. The Drug Enforcement Administration is also providing information for the public regarding disposal as well as created a program to authorize and register drug disposal collectors.

A Pioneer in Substance Use Management

Magellan Health is a pioneer in offering integrated, comprehensive opioid risk and substance use management programs. We have an unyielding commitment to ending the current epidemic. And we are uniquely positioned to bring together behavioral, medical and pharmaceutical programs to positively impact overall population health and reduce cost.

Uncertainty is the name of the game for many industries today, including healthcare. With rapidly emerging technologies, regulations and changing consumer demands, companies must manage differently in order to keep up. Jeff Dyer, innovation visionary and co-author of the highly acclaimed, The Innovator’s DNA and its follow-on publication, The Innovator’s DNA: Mastering the Five Skills of Disruptive Innovators highlighted the threat to many companies today – predicting that 50 percent of the S&P 500 will be replaced over the next 10 years.

Human-Centered Innovation

As consumer experiences across nearly every industry become more personalized, on-demand and targeted, he encouraged pushing our thinking beyond meeting functional needs by looking at social and emotional ones as well. By doing so, companies are able to identify unmet needs that can be catalysts for more useful solutions that ultimately win in the market.

The GE Adventure Series Scanner, an MRI scanner designed for children to make scanning a less frightening experience, was a prime example shared of human-centered innovation. While advanced in functional features, what was discovered through observing young patients getting a scan was that the former machine was intimidating – the designer learning that as many as 80 percent of pediatric patients had to be sedated in order to sit still long enough for the scan.  Witnessing this, a new approach was taken, ultimately applying human-centered design methods to redesign the experience as a series of “adventures” for children, delighting and no longer scaring its young users.

The Big Picture in Quality Care

While human-centered innovation can be applied product by product and interaction by interaction, we heard another thought-provoking point from the day’s presentations – that it’s really hard to detect poor quality care through one interaction. The path to a poor outcome most likely includes bouncing from doctor to doctor and breakdowns in coordination and communication between interactions. Often, the big picture reveals the flaws.

The reality today is that many people still get prescriptions from multiple, independent physicians, and many hospital admissions come with undiagnosed behavioral health concerns. The healthcare system has an immense opportunity to come together around the whole patient and to better identify needs at a population level to deliver on value-based care that leads to healthier outcomes.

Physician Collaboration

Our physician panel sparked further ideas in how to collaborate with PCP’s, nurses and other care workers to better meet patients’ needs. Often at the front lines of the patient experience, creativity in finding unidentified needs was discussed as pivotal to creating an effective healthcare experience. While concepts of self-directed, consumer-focused healthcare and increasing consumer participation in healthcare decisions have become popular, the role of physicians is also being transformed. Their responsibility is increasingly to supplement and put into perspective available information, manage expectations, and instill confidence. The discussion thus encouraged leveraging physicians as “natural, trained problems solvers”, bringing them into the ideation for a better patient experience, and empowering them with action-oriented data and decision support along the way.

We thank all of our leaders, clients and partners for joining us in a memorable and energizing event. We look forward to our next gathering in January 2017.