The Myth Busters team at MedCallRx is back again to debunk another common misperception of backup pharmacy. This month we tackle the myth that antibiotics and opioid analgesics are the top utilized backup pharmacy drugs.
Surprisingly, while antibiotics are sometimes sent to backup pharmacy, they don’t rank in the top 10 list of medications, and opioid analgesics used to manage pain, only ranks ninth by overall prescription count.
So, what are the most common medications sent to backup pharmacy partners? In this article, we’ll examine the therapeutic classes that comprise the largest share of total prescriptions by count and cost.
Across the MedCallRx book of business, the top therapeutic classes by prescription count are:
| Rank | Therapeutic Class | % total by Prescription Count |
|---|---|---|
| 1 | Antidepressants | 6.77% |
| 2 | Anticonvulsants | 6.11% |
| 3 | Antidiabetics | 5.64% |
| 4 | Antiasthmatic and Bronchodilator Agents | 4.43% |
| 5 | Antihypertensives | 4.34% |
| 6 | Antipsychotics/Antimanic Agents | 4.30% |
| 7 | Antihyperlipidemics | 3.70% |
| 8 | Antianxiety Agents | 3.47% |
| 9 | Analgesics – Opioids | 3.47% |
| 10 | Dermatologicals | 3.03% |
While antidepressants command the largest share of prescriptions by volume, they represent just 2.5% of total costs as many generic formulations are available at a low cost per prescription, and their average day supply is only 13 days. Similarly, despite being the second most common by count of prescriptions, anticonvulsants only represent 3% of total costs. Antidiabetics, on the other hand, is the only class of drugs that ranks in the top three for both total prescription count and prescription cost.
Interestingly, when we examine backup pharmacy utilization by share of cost, three therapeutic classes account for over one-quarter of the total cost (37%), as follows:
| Rank | Therapeutic Class | % Cost |
|---|---|---|
| 1 | Antidiabetics | 15.01% |
| 2 | Antiasthmatic and Bronchodilator Agents | 13.13% |
| 3 | Antiviral Agents | 8.40% |
For each of these classes, unit of use or package size may play a factor in driving costs with the entire therapy having to be dispensed instead of a limited day supply, which frequently occurs in other drug classes.
For instance, the average day supply for antidiabetics is 18 days due to insulin formulations necessitating dispensing vials or pre-filled syringes for injections whereas the average day supply for analgesics (tablets) is just 7 days. Also, while lower in prescription volume, antivirals have a higher cost per prescription, making this class of drugs one of the most expensive on a per prescription basis.
The following three therapeutic classes represent nearly 15% of total costs:
| Rank | Therapeutic Class | % Cost |
|---|---|---|
| 4 | Antipsychotics/Antimanic Agents | 6.21% |
| 5 | Antineoplastics and Adjunctive Therapies | 4.69% |
| 6 | Miscellaneous Therapeutic Classes | 3.97% |
Outside the top six classes, every other therapeutic class (individually) has less than 4% share of costs.
To maximize pharmacy profitability, it’s important to routinely review drug spend reports and analyze backup pharmacy utilization.
At a minimum, your backup pharmacy partner should provide real-time visibility into the following:
- Facility utilization (with reasons for use)
- Orders by hour, by day of week
- Top medications by volume and cost
- Frequently used pharmacies
At MedCallRx, one of the many benefits of TracRx is that it allows you to easily analyze backup utilization and compare/contrast performance by facility. Our dynamic reports can be customized by date range or other filters.
In addition, every order placed in TracRx requires the pharmacist to select the reason for using backup pharmacy from a drop-down menu. This information is invaluable for understanding why backup pharmacy is being used and making adjustments to improve pharmacy profitability. These reports can prompt changes in inventory, changes to facility e-kits, or trigger refresher training for pharmacists.
Understanding backup pharmacy utilization should be an important component of your program and your backup pharmacy partner should provide the necessary reports and analysis to help you run your business!
For more information about TracRx, or to request a demo or complimentary consultation, contact us.
