Sumit Dutta of OptumRx Discusses COVID Vaccines, How PBM was Affected by the Pandemic

There currently aren't enough vaccines in the United States, and between the Pfizer and Moderna vaccines, the two are very important to get their hands on, according to Sumit Dutta, MD, MBA, of OptumRx.

Dutta, senior vice president and chief medical officer, told MHE during the video interview it's crucial for frontline workers and people most at risk to have access to these FDA approved vaccines, which have been reported to work well.

In this conversation he shares some of the vaccine differences and the responsibilities of OptumRx to educate their members on them.

Q: It's my understanding that the Moderna vaccine doesn't need to be kept at the super cold temperature that the Pfizer vaccine does. It's been shared that for that reason, (Moderna is) more likely to be distributed and administered by pharmacies. Is that correct?

A: The Pfizer biotech vaccine that's available today needs to be stored in a colder fashion. It has refrigeration requirements that are very cold: minus 70 degrees celsius and beyond, versus the Moderna vaccine that will be slightly warmer temperatures.

Q: Does OptumRx have a direct role to play in terms of the vaccine distribution and administration?

A: So today, we have processed claims for the Pfizer vaccine that's available on the market. So that highlights the readiness in terms of claims processing that's required. And in fact, it educates the listeners to all of the work behind the scenes that may seem arcane, that allow actually someone to get a vaccine beyond the physical vaccination.

So let me start with that and move further back and talk about all of the ways that we've monitored: we listen to the FDA comments, we advise our clients about vaccines, we recently had a call with over 650 people on it. We've done that all the way through the pandemic, to make sure that people are aware. We (also) have an important role in making sure our members understand the value of taking the vaccine, which I think is a very important societal role.

Q: Have you used any particular communication channels to talk to your members about vaccines?

Q: We do calls with our clients and the consultant community to educate them, and make sure that they have the information that they need to communicate to their membership. We also have many communications that we put together from our drug intelligence group that then get repurposed for content for our members. We inform our call center representatives, for example, for questions that come in. This is all a part of the work that is behind the scenes to make sure that we're prepared for the inevitable questions that people might have around reactions to the vaccine: How does it get paid for? etc.

I think there's another important thing that we're working on that I'm I'm excited about and proud about, which is using our analytics to make sure that people get that second dose. So as you know, there are two vaccinations that are required approximately a month apart, and using our data to ensure that we're doing everything possible along with the stakeholders, so that our members get that second dose and drive that adherence is another important thing we're working on.

Q: Could you just tell us a little bit about that pivot OptumRx had to make by virtue of healthcare delivery in this case? You know, medication delivery has shifted as a result of the Covid-19 pandemic.

A: I think you rightfully point out that the pandemic has changed all of us. And certainly, we here at OptumRx, in some ways, it has reinforced what we already do. You know, we are really purpose-built for situations like this pandemic. It may be like the behind the scenes piece that I mentioned around making sure that our claims system can adjudicate. It can also be our community behavioral health pharmacies, when there's more vaccines available, may be a part of the solution in administering the vaccination. But it is also this point that you're making around how people see, to get care and have services delivered to them.

As we think back and reflect towards the early days of the pandemic, there were many stay at home orders, a lot of fear and misinformation. That was an opportunity to have people get their medications at home, sort of a renewed understanding that home delivery of medications is a valuable way to get medications. What we found is really interesting: One, we found that member satisfaction improved. During this period getting medications from home, we measured the net promoter score went up 12%.

The second thing is we found our adherence improving. So mail has delivered, improved adherence by getting your medicines at home. It's one less thing you have to think about.