• Premera Announces Notable Results From Prescription Drug Safety Program

    Polypharmacy Analysis Indicates Reduced ER Visits, Fewer Hospitalizations, and Lower Healthcare Costs

    MOUNTLAKE TERRACE, WA – (April 28, 2009) – Emergency room visits and hospitalizations fell among patients who received medication safety education, according to an analysis of Premera Blue Cross’s nationally recognized Polypharmacy Program.

    In a recent two-year assessment of nearly 13,000 Premera members, Seattle-based health services researchers observed a 1.2 percentage point decrease in persons having ER visits and a 1 percentage point decrease in persons having hospitalizations after members were mailed a simple brown bag with a set of instructions.


    Patients were asked to fill the brown bag with all their prescriptions, over-the-counter medications, and supplements and to take the bag to their next doctor’s appointment for review. Premera had found many of its members not only were receiving multiple medications but also had multiple doctors. By putting all the drugs in one place, a provider could assess the appropriateness of the medications and change dosages if necessary.

    The new analysis, whose key findings are now being released, noted that pharmacy utilization did increase after the program materials were mailed. A reduction in total healthcare costs was also observed by Premera based on a review of relevant claims data.

    However, Ed Wong, Premera’s vice president of Pharmacy Services, points out that the Polypharmacy Program was never intended to save money on drug costs. “The goal of this program has always been patient safety,” says Wong. “Our intention with this brown bag review is for patients to get a better assortment of drugs and suffer fewer adverse reactions.”

    Premera has mailed out approximately 150,000 bags since the program began in 2001. The bags are sent to members in Washington, Oregon and Alaska who are 19 and older and who are taking five or more drugs daily over a three-month period for chronic conditions, such as diabetes, hypertension or high cholesterol.


    In one of the key observations, the researchers found that 22.8 percent of the patients had gone to the emergency room in the year before they had received their brown bags, while 21.6 percent went during the year after they had taken part in the program. Meanwhile, 12.9 percent had been hospitalized the year prior to the program, compared to 11.9 percent the year after.

    The program has drawn national media coverage and has been highlighted in an advertising campaign by the Blue Cross Blue Shield Association. In annual surveys, an average 51 percent of respondents since 2001 have reported undergoing a medication review, while 51 percent said they found the informational brochures in the bags to be somewhat to very valuable.

    “This is very helpful. I know somebody cares. Also, my doctor is more on the ball because of this,” said one member.

    Another said, “Thanks for caring about my medications. Taking them correctly makes me feel great! My doctors are in touch with each other and all agree that my medications are fine and do not react poorly with other conditions. They have taught me what times of the day each medication should be taken and what foods to avoid or take with each one.”

    And, “It was definitely helpful. I knew I needed a list but hadn’t made one. It gave me the incentive to do so, and I actually needed to use it several times right after that. Thank you!”


    Premera officials emphasized that it is up to the individual member to decide whether to take the brown bag to his or her provider. The health carrier does not get in the way of the patient-doctor relationship; it only enables the conversation, officials noted.

    The recent results are yet another indication that the brown bag approach to polypharmacy is working.

    As researchers at Harvard Medical School wrote a few years ago, “By bringing intervention to the most effective point in the healthcare system – conversations between patients and their physicians – the program helps prevent errors with prescription drugs as well as over-the-counter medications and herbal supplements. Premera’s plan emphasizes a review of all types of medication, which is significant because patients often do not discuss non-prescription drugs and supplements with their doctors. This is a simple, yet effective program.”

    Premera’s Polypharmacy Program is endorsed by the Washington State Medical Association (WSMA) and the Washington State Department of Health (WSDOH), and by the Oregon Medical Association (OMA) and Alaska State Medical Association (ASMA) in their states.

    About Premera Blue Cross

    Our mission is to provide peace of mind to our members about their healthcare coverage. We provide health insurance and related services to more than 1.5 million people. Premera Blue Cross has operated in Washington since 1933, and Alaska since 1957. Premera Blue Cross is an independent licensee of the Blue Cross Blue Shield Association. Premera Blue Cross is a member of a family of companies based in Mountlake Terrace, Washington, that provide health, life, vision, dental, and long-term care insurance, and other related services.