Mercer's New Pharmacy Benefit Design Improves Compliance

Mercer's new Dx-Rx Pairing™ is an advanced pharmacy benefit design that encourages patients to follow pharmacy treatment plans proven most effective for certain high-cost chronic conditions by addressing common barriers to compliance. Dx-Rx Pairing is unique because it addresses three major flaws in current pharmacy design and delivery. First, the plan design minimizes financial barriers to compliance by reducing or eliminating member cost sharing for designated diagnosis/drug pairs. Second, proactive communication to prescribing physicians optimizes first-time prescribing. Third, members whose utilization patterns indicate reduced or minimal compliance are contacted to encourage them to adhere to the preferred therapy. These three levers address financial, clinical and personal barriers to compliance. Dx-Rx Pairing is unique among evidence-based pharmacy benefit designs since it targets only those combinations of diagnoses and drug therapies that have been medically proven to improve health status while lowering overall health care costs. Mercer developed the program in conjunction with a number of national experts, notably Niteesh Choudhry, MD, PhD, a leading researcher at Harvard Medical School. Clinical evidence shows that linking a specific diagnosis (Dx) with a specific regimen of prescribed drugs (Rx) results in a health status improvement that avoids or reduces other medical costs. Yet traditional health plan designs often discourage the use of these pairings by requiring higher co-payments, even where the pairings have a proven and measurable impact in reducing other medical costs and improving employee productivity and quality of life. Dx-Rx Pairing encourages patients to use the most appropriate medication for specific conditions by reducing drug copayments for certain diagnosis/drug pairings and increasing educational outreach to participants and providers. Most important, Mercer's unique approach fully integrates the efforts of disease management and pharmacy benefit management vendors, integration that is essential to eliminating the barriers to patient compliance. "Today's pharmacy benefit plans typically are designed to reduce drug cost only. They provide little to no monitoring of compliance and miss significant opportunities to improve health,” said David Dross, national leader of Mercer's managed pharmacy consulting group. "Dx-Rx Pairing promotes the use of evidence-based drug therapies that improve enrollee health and reduce total health care spending. This approach can reduce an employer's total health care spending by an estimated 1-2 percentage points.” Examples of Dx-Rx Pairing include the use of ACE inhibitors for enrollees with diabetes and statins and other drugs following a heart attack. Since this approach results in improved outcomes and proper adherence, it is particularly effective for employers with a stable workforce and those with poor drug compliance rates for chronic diseases (such as asthma, heart disease, diabetes and hypertension). "What makes this program so innovative is that it moves beyond a cost containment initiative to address not only the efficiency of employers' prescription benefit spending but also the effectiveness of medications in achieving better health outcomes for employees,” Mr. Dross noted. About Mercer Mercer is a leading global provider of consulting, outsourcing and investment services. Mercer works with clients to solve their most complex benefit and human capital issues, designing and helping manage health, retirement and other benefits. It is a leader in benefit outsourcing. Mercer's investment services include investment consulting and multi-manager investment management. Mercer's 17,000 employees are based in more than 40 countries. The company is a wholly owned subsidiary of Marsh & McLennan Companies, Inc., which lists its stock (ticker symbol: MMC) on the New York, Chicago and London stock exchanges. For more information, visit www.mercer.com.