Horizon and Aetion Partner to Optimize Treatment Pathways and Cut Healthcare Costs

Aetion, a company that delivers real-world evidence for healthcare decision making, recently partnered with Horizon Healthcare Services, Inc’s to analyze its type 2 diabetes (T2D) population to evaluate the cost-effectiveness of treatment with sodium-glucose cotransporter-2 (SGLT2) inhibitors. The analysis showed that this therapy class was more expensive than other second-line drug classes at first, but using SGLT2 inhibitors could lead to better health outcomes; thus, the newer class offered a more cost-effective option, according to a statement from Aetion. Horizon estimated the intervention would create an annual savings of $5 million.

Aetion partnered with Horizon in an effort to optimize treatment pathways throughout 9 therapeutic areas. Aetion provides a technology platform to deliver real-world evidence that allows biopharmaceutical companies and payers to participate in value-based care agreements.

The companies are leveraging near real-time data analytics to identify high-risk members and apply targeted formulary and drug adherence interventions to improve health outcomes and, ultimately, cut costs. Horizon has implemented an initial intervention program targeting 1500 of its members with T2D.

“This partnership has already produced insights that simultaneously improve outcomes and upend conventional wisdom around which interventions work best for which patients,” said Carolyn Magill, chief executive officer of Aetion. “This gets at the essence of value-based care, illustrating the power of real-world evidence to transform how we think about treatment pathways.”

In a 2018 study, Aetion analyzed patient data and developed a predictive model to identify members most likely to use more healthcare during the next year. Aetion then analyzed medical and pharmacy claims data together and applied machine learning, a branch of artificial intelligence, to determine the optimal treatment pathway for the cohort of high-risk members.

Adherence programs and conversion to SGLT2 inhibitors as a second-line therapy were the recommended interventions and proved to be the most effective treatment for the cohort. Although the SGLT2 drug class was initially more expensive, it was found to be the most cost-effective option over time. Horizon is currently applying pharmacy case management interventions and working with pharmaceutical companies to structure value-based agreements for their high-risk members living with T2D.

“Aetion’s rapid turn-around time is critical, as is the fact that these analyses are based on our membership,” said Saira Jan, MS, PharmD, director of pharmacy strategy and clinical integration at Horizon and a professor at Rutgers University’s Ernest Mario School of Pharmacy. “This enables us to quickly engage with providers and health systems to improve outcomes for our specific patient populations.”

Aetion and Horizon have planned to delve into other therapeutic areas, such as inflammatory bowel disease, immunologic diseases, chronic obstructive pulmonary disease, and asthma over the next 2 years.

“Horizon is dedicated to innovative partnerships that tap into the power of our data to help our members achieve their best health,” said William D. Georges, senior vice president and chief strategy officer at Horizon. “We started with a diabetes treatment pathway identified by Aetion and the success of that initiative has laid the groundwork to expand our partnership to new solutions that will improve care for even more patients.”