Navitus Launches Program to Help Members Overcome Challenges Along the Prescription Journey

MADISON, Wis., January 15, 2021 – Navitus Health Solutions, a full pass-through pharmacy benefit manager (PBM), today launched its Clinical Engagement Center designed to improve medication adherence and reduce both member and plan prescription costs, while easing benefit transitions. This three-pronged solution consists of Medication Therapy Management, Academic Detailing and Personalized Member Transitions to help health plans, providers and patients navigate the complex prescription journey.

“Members face a number of crossroads along their healthcare journey,” said Dr. Julie Olson, senior director of population health programs and product development at Navitus. “From receiving a new prescription to experiencing a benefit change, each of these situations present a challenge that can potentially disrupt the member’s health outcome and escalate both pharmacy and medical costs for the plan. With Navitus’ new Clinical Engagement Center, we’re able to deliver personalized clinical support while mitigating ancillary prescription costs.”

Nearly 150 million people in the United States have at least one chronic illness, and as many as half fail to take their medications as prescribed.^1,2 As a result, medication non-adherence leads to 125,000 deaths annually and costs the U.S. health care system up to $289 billion a year.³ In addition:

• 20% of prescriptions are never filled³
• 50% of filled prescriptions are taken incorrectly³
• 28% of all patients fail to refill a prescription on time³

Successfully navigating such healthcare challenges is key to preventing poor health outcomes, medical non-adherence and increased plan costs. Navitus’ Clinical Engagement Center will address these issues by providing a three-pronged approach:

• Medication Therapy Management: Provides personalized clinical consults to members to help them get the most benefit from their medications by addressing barriers to medication adherence, identifying gaps in therapy and screening for medication safety concerns while coordinating care with prescribers.
• Academic Detailing: Analyzes prescribing patterns and educates health care providers about equally effective, lower-cost, formulary alternatives. This individual outreach reduces costs for both the plan sponsor and the member, and it improves care by promoting prescribing that’s consistent with medical evidence.
• Personal Transition Services: Guides new members through a personalized onboarding and transition experience to minimize disruption and help navigate the complex health care system.

Navitus’ Clinical Engagement Center aims to eliminate confusion with benefit transitions. It ensures the member understands how to take the medication correctly, identifies if an individual must switch to a different drug and assists with obtaining prescriptions for the lowest cost drug when needed. Such steps create a smoother process for members and plans and improve member satisfaction.

¹Irving D. Chronic Conditions in America: Price and Prevalence. RAND Corporation. https://www.rand.org/blog/rand-review/2017/07/chronic-conditions-in-america-price-and-prevalence.html. Published July 12, 2017. Accessed October 6, 2020.
²Why You Need to Take Your Medications as Prescribed or Instructed. FDA. https://www.fda.gov/drugs/special-features/why-you-need-take-your-medications-prescribed-or instructed#:~:text=The%20High%20Cost%20of%20Not,per%20year%20in%20this%20country Published February 16, 2016. Accessed October 6, 2020.
Original source active as of publication date. For current and comparable data, please see: Medication Adherence: Taking Your Meds as Directed. www.heart.org. Accessed April 8, 2024. https://www.heart.org/health-topics/consumer-healthcare/medication-information/medication-adherence-taking-your-meds-as-directed
³Brody J. The Cost of Not Taking Your Medicine. The New York Times. https://www.nytimes.com/2017/04/17/well/the-cost-of-not-taking-your-medicine.html#:~:text=This%20lack%20of%20adherence%2C%20the,and%20%24289%20billion%20a%20year. Published April 17, 2017. Accessed October 6, 2020.

MORE ABOUT Julie Olson, DNP, MS, RN, CQIA

As a senior health care professional and doctoral prepared nurse, Julie brings nearly 30 years of diverse health care experience, including public health nursing, health outcomes research, public policy analysis and business development. She has served in a variety of roles at Navitus and was an integral member of the team that developed Lumicera Health Services, Navitus’ wholly-owned specialty pharmacy. Prior to joining Navitus, Julie was Associate Director at the Madison Birth Center and Health Policy Director at the Wisconsin Women’s Health Foundation.