BLOOMFIELD, Conn., Oct. 6, 2004 -- CIGNA Pharmacy Management (CPM) today announced the expansion of a program to reduce health care costs for employees suffering from depression. The program, a collaboration between CIGNA's pharmacy and behavioral organizations, is designed to help improve the health of members while decreasing the costs associated with depression, which is the leading cause of health-related lost work and productivity.
In this second phase of the program, CPM sends physicians a report listing their patients who are CIGNA HealthCare members who have been prescribed antidepressants, but are not taking their medications consistently. CPM also provides tools to help physicians educate their patients about the importance of appropriate medication therapy for depression.
"These reports are the most useful of their kind that I have seen from a managed care organization," said Dr. Jerry Penso, associate medical director for SHARP Mission Park Medical Group in Ocean Side, California. "This program is a good example of the promise of managed care facilitating not just routine care, but optimal care."
According to the American Psychiatric Association, an employee suffering from untreated depression will miss between 30 and 50 days of work per year and will incur from $2000 to $3000 in additional direct medical costs. Further, when depression is treated appropriately, it is conservatively estimated that absenteeism can be reduced by 50 percent and incremental medical costs can be reduced by 40 percent.
Dr. Ronald Zent, medical director at Memorial Healthcare IPA in Signal Hill and Seal Beach, California agreed, saying, "This type of program means that the bottom line for both CIGNA and the physician is taking care of patients." Both physicians encouraged their colleagues to take advantage of this program and other CPM Outcome Improvement Programs designed to help patients with depression, asthma and high cholesterol achieve better outcomes.
Medication Compliance is Critical:
"People with depression are three times more likely to stop taking their medications before they have had a chance to take effect which can lead to significant increases in the risk of a relapse," said Jon Maesner, PharmD, vice president for CPM. "The good news is that studies have shown that in a majority of cases, depression can be treated successfully, provided patients continue their prescribed treatment." In the first phase of the program, CIGNA saw a decrease in members filling antidepressant prescriptions only once or who were filling their antidepressant medications inconsistently.
Medication compliance is especially important for people with depression as the risk of recurrence is significant: 50 percent after one episode, 70 percent after two episodes, and 90 percent after three episodes(1). Therefore, according to the National Institute of Mental Health (NIMH), it is important to continue taking antidepressant medications for four to nine months to make sure the feelings of depression do not return. According to a study reported in 1998 in the Journal of Family Practice there is a $750 net health care savings per patient completing the appropriate length of therapy.
About depression:
According to the NIMH, 9.5 percent of the population, or about 18.8 million American adults will suffer from depression in any given one-year period. A study reported in the Journal of Clinical Psychiatry in December 2003 estimated that the treatment cost for depression in 2000 was $83 billion. Of that amount, $51.5 billion was attributed to hidden workplace costs such as absenteeism and performance impairment due to underlying symptoms such as reduced concentration, moodiness, fatigue, and the inability to become motivated to accomplish even routine tasks.
According to Dr. David Whitehouse, CIGNA Behavioral Health medical director, depression is increasingly treated in an outpatient setting, rather than in a hospital environment, placing a greater emphasis on care provided by primary care physicians and prescription drugs. A study reported in the Journal of Clinical Psychiatry in December 2003(2) indicated that fewer than 25 percent of all sufferers received adequate care. That is because current analysis focuses on the costs of the disease itself rather than on all the related and seemingly unrelated manifestations of depression.
According to Maesner, that is why the integration of services between CIGNA Behavioral Health, CIGNA HealthCare and CIGNA Pharmacy Management is so important.
"We continue to find that individuals who suffer from depression are also at greater risk for chronic diseases, and vice versa," said Dr. Whitehouse. "Our ability to look at the whole person and support their physician's development of a comprehensive course of treatment for both the mental and physical conditions improves outcomes for both."
Some of CIGNA's comprehensive services include member education through the award winning disease management program Well Aware for Better Health(R), support services through a nurse case manager, covered therapy sessions through the behavioral health benefit, or medication compliance to help achieve the best possible outcomes for CIGNA HealthCare members.
"CIGNA Pharmacy Management" refers to various operating subsidiaries of CIGNA Corporation (NYSE: CI). Products and services are provided by these subsidiaries and not by CIGNA Corporation. These subsidiaries include Connecticut General Life Insurance Company, Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., and HMO or service company subsidiaries of CIGNA Health Corporation.
(1) Agency for Health Care Policy and Research, Depression Guidelines Panel. Depression in Primary Care. Vol. 2: Treatment of Major Depression, Clinical Practice Guidelines. (AHCPR pub. No. 93-0551) Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, 1993b).
(2) Greenberg, PE. J.Clin.Psychiatry 64.12, December 2003
SOURCE: CIGNA Pharmacy Management
Contact: Lindsay Shearer, CIGNA, +1-603-268-7721, lindsay.shearer@cigna.com
Web site: http://www.cigna.com/
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