2003 - Spring by Arkansas Blue Cross and Blue Shield

Spring 2003

Brand Name or Generic?

What you don’t know can cost you

from the n e w s

s t o r i e s

HEALTH f r o m

Generic drug use reaches all-time high in 2002 The Washington Post recently reported that generic drug usage in the United States reached an “all-time high” in 2002. Express Scripts, a pharmacy benefits manager based in St. Louis, found that 45.2 percent of prescriptions filled were from generic drugs, an increase of 5 percent from the previous year. The shift toward greater generic drug usage was fueled by generic versions of popular brand-name drugs entering the market, as well as the health insurance industry’s efforts to control rising health care costs, according to The Washington Post. The Post cited that the biggest reason for the jump was because patients now were able to purchase generic versions of three popular medications: Pr ozac (anti-depr essant), Glucophage (for treatment of diabetes) and Zestric (for high blood pressure).

Need help finding the best deals on prescription drugs? According to a recent article in The Wall Street Journal, the National Council on Aging has launched a new service to help senior citizens search for programs that provide the best bang for their buck when it comes to prescription drugs. The new service, which can be accessed at www.benefitscheckup.org, is designed to reach millions of seniors in the United States who may be eligible for public or private assistance, but who are not receiving it at this time. Seniors with Medicare, who do not have prescription drug benefits and have an income under $28,000 for one person or $38,000 as a couple, will be able to find programs to save them money.

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According to The Wall Street Journal, the Web site also is designed to help younger people and, in come cases, Americans with higher incomes, through searches of 116 patient-assistance programs sponsored by pharmaceutical companies.

FDA drug application review time increased in 2002 According to an article in The Wall Street Journal, the Food and Drug Administration’s (FDA) approval time for drug applications increased slightly last year, a trend that represents a contrast from previous years. In 2002, the median approval time for standard drug applications was 15.3 months, an increase from 14 months in 2001 and 12 months in 2000, according to the newspaper. The increased approval time is an effort by the FDA to investigate new drugs more thoroughly.

Survey shows patients often get requested drugs Preliminary results of a new survey show that most of the time when patients request a medication, physicians write prescriptions for that drug, according to news reports. The Food and Drug Administration (FDA) survey also showed that half the time in those situations, patients requested a drug after seeing it advertised, The Washington Post reported. USA Today reported that 40 percent of doctors said pharmaceutical companies’ direct-to-consumer (DTC) advertising has a somewhat or very positive effect on their practices; 32 percent said the effect was somewhat or very negative; and 28 percent said the DTC ads had no effect at all.

Customer Service Numbers Little Rock Toll-free Number (501) Number

Category

State/Public School Employees 378-2437 1-800-482-8416 e-mail: publicschoolemployees@arkbluecross.com stateemployees@arkbluecross.com Medi-Pak (Medicare supplement)

378-3062 1-800-338-2312

Medicare (for beneficiaries only): Part A (hospital benefits) Part B (physician benefits)

378-3151 1-877-356-2368 378-2320 1-800-482-5525

UniqueCare, UniqueCare Blue, Blue Select®, BlueCare PPO & PPO Plus (individual products) 378-2010 1-800-238-8379 Group Services

378-2070

BlueCard®

378-2127 1-800-880-0918

Federal Employee Program (FEP)

378-2531 1-800-482-6655

Health Advantage

221-3733 1-800-843-1329

BlueAdvantage Administrators

378-3600 1-800-522-9878

Pharmacy Customer Service (AdvancePCS): Arkansas Blue Cross and Blue Shield Health Advantage BlueAdvantage Administrators Specialty Rx

1-800-421-1112

1-800-863-5561 1-800-863-5567 1-888-293-3748 1-866-295-2779

For information about obtaining coverage, call: Category

Little Rock Toll-free Number (501) Number

Medi-Pak (Medicare supplement)

378-2937 1-800-392-2583

BasicBlue®, BlueCare PPO & PPO Plus (individual products) 378-2937 1-800-392-2583

Regional Office locations are: Central, Little Rock; Northeast, Jonesboro; Northwest, Fayetteville; South Central, Hot Springs; Southeast, Pine Bluff; Southwest, Texarkana; and West Central, Fort Smith. Customers who live in these regions may contact the regional offices or call the appropriate toll-free telephone numbers above.

Web sites:

www.ArkansasBlueCross.com, www.HealthAdvantage-hmo.com, www.BlueAdvantageArkansas.com, www.BlueAndYouFoundationArkansas.org www.BlueAnnEwe-ark.com

is published four times a year by Arkansas Blue Cross and Blue Shield for the company’s members, health care professionals and other persons interested in health care and wellness.

INSIDE THIS ISSUE

~Spring 2003~

From the Health files ................................... 2 High standards for generic drugs ................. 4 Q & A on generic drugs ................................ 5 The cost of new drugs ................................. 6 New generic drugs on the way ..................... 7 On-line resources for health & drug info ..... 7 The rising cost of prescription drugs ........... 8 Helping to control drug costs ...................... 9 Storing and handling your medications ....... 9 Generic drugs for many illnesses .......... 10-11 Over-the-counter painkillers ...................... 12 New pharmacy Web site ............................. 13 How to use My Blueprint ....................... 14-15 Protection of your health information .. 16-18 The pharmacist is in .................................. 19 A leader in Web site performance .............. 19 Fayetteville office sponsors seminars ....... 20 Joining with Cardiovascular Task Force .... 21 Health Advantage pleases doctors ............ 21 Readership/Internet survey results ............ 22 “Wellness” contest winners announced .... 22 High School Heroes .................................... 23 Blue & Your Community ............................. 24

Vice President of Advertising and Communications: Patrick O’Sullivan Editor: Kelly Whitehorn — BNYou-Ed@arkbluecross.com Designer: Gio Bruno Contributors: Tammi Bradley, Janice Drennan, Damona Fisher and Kathy Luzietti

Generic drugs must meet HIGH standards A

ccording to the Congressional Budget Office, generic drugs save consumers an estimated $8 to $10 billion per year when compared with the price of brand-name products. Equally as important as the cost-effectiveness of generic drugs is that they are reviewed by the U.S. Food and Drug Administration (FDA) to ensure that they provide the same level of benefit to patients as their brand-name counterparts. The FDA has approved approximately 7,000 generic drugs for various treatments. The basic requirements for approval of generic and brand-name drugs are the same. The only difference is that generic drug makers do not have to repeat the safety and efficacy studies conducted by the developer of the original product. In approving a generic drug, the FDA relies on its previous finding that the original drug is safe and effective. The generic version must have the same dosage form, safety, strength, route of administration, and conditions of use as the brand-name product. The generic drug’s manufacturer also must show that the active ingredient of the generic drug is absorbed at a rate and extent similar to its brand-name counterpart. With the exception of language protected by patents or exclusivity, the labeling of the generic drug, including directions for use, must be virtually the same as that of the brand-name product. Both generic and brand-name drug makers must submit information to show the approved products are being manufactured to the FDA’s specifications. The FDA regularly assesses the quality of generic medications and reports on their performance. A recent FDA review found that the average difference between the bioequivalence of more than 270 generic drugs approved in 1997 and their brandname counterparts was 3.5 percent. This is

about the same as the differences found between separate batches of brand-name products. The Drug Price Competition and Patent Term Restoration Act of 1984 encourages the production of generic medicines while protecting the rights of brand-name manufacturers. The law builds in certain protections for the original drug developer in terms of patents and market exclusivities, but it also allows sponsors of identical products to apply for their approval by the FDA without repeating the original developer’s clinical trials. In addition, the law rewards exclusivity for a first generic version of a brand-name drug, thereby encouraging generic firms to challenge innovator patents. — Source: U.S. Food and Drug Administration

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generic version must have the same dosage form, safety, strength, route of administration, and conditions of use as the brand-name product.

Questions onandgeneric Answers drugs

Q. Are generic drugs really the same as brand-name drugs, or are they inferior imitations? A. All drug makers must adhere to strict manufacturing requirements from the U.S. Food and Drug Administration (FDA) to earn approval to sell their products. FDA regulations require that generic medications be made with the same standards of purity, stability, strength and quality as their brand-name equivalent. A generic drug must demonstrate the same bioequivalence as its brand-name counterpart. Q. What are the differences between generic and brand-name drugs? A. There are two main differences between generic and brand-name drugs. The first difference is the name. The brand name is the name under which the product is sold and is protected by a patent for up to 20 years. For example, the company that developed acetaminophen gave it the brand name, Tylenol. When the patent expired, other companies began producing the same product and selling it under its generic name, acetaminophen. In many cases, the same company that manufactures the brand also produces a generic version. The other difference between generic and brand-name drugs is that generic drugs are not advertised. The lack of advertising helps keep costs down — think of generic drugs as the unadvertised brands. Q. What is a “patent” and how does it work? A. A patent protects and establishes a company’s right to produce and control a product exclusively. The patent prevents other companies from making and selling the product during the patent period. Drug patents can last up to 20 years. The patent is given because the original manufacturer has spent time and money researching and developing the drug.

Q. If both generic and brand-name drugs have the same ingredients, why do they look different from each other? A. Generic drug makers are required by law to make their drugs look different from the brand-name products so consumers can tell them apart. This means the generic usually is a different shape and color than the brand-name drug. Q. Why do generic drugs cost less than brand-name drugs? A. Generic drugs cost less because the generic drug makers did not incur the same research, development, sales and marketing costs as the brand-name drug manufacturer. These savings are reflected in lower prices, which are passed on to the consumer. Q. Why should I care what a drug costs? I have health insurance. A. Everyone pays for higher drug costs in the form of increasing copayments or health insurance premiums. The choices that you make today will impact your premiums in the future. By asking for the generic version when you get your prescription, it will save you money directly. Many times generic drugs have a lower copayment or coinsurance cost than brand-name drugs. When you ask for a generic drug, you save money without sacrificing quality. Q. Does every brand-name drug have a generic alternative? A. No. If a drug still is protected by a patent, it can only be supplied as a brand-name product by one company. When the patent expires, other companies may apply to the FDA to produce a generic version of the drug. Additionally, the original manufacturer usually will continue to make the brand-name product and a generic version, often using the same or side-by-side assembly lines. Q. Why doesn’t my doctor automatically prescribe generic drugs? A. In some cases, generics are overlooked because of direct-to-consumer drug advertising, which promotes brand-name drugs and makes them the first choice for many physicians. Generic drugs are not advertised so people don’t know how to ask for them by name. Another reason your doctor may prescribe a brand-name drug is that there may not be a generic equivalent available. Depending on certain circumstances, the brand-name medication may be the most appropriate medication for you. It’s important to talk to your doctor about generics if you currently are using brand-name drugs.

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Pill-packaging and advertising:

ewer medications cost more than the drugs they are replacing. While many of these new drugs may be life-saving medications, critics of the pharmaceutical industry say that most brand-name products are not breakthrough drugs. In fact, most drugs approved by the U.S. Food and Drug Administration (FDA) are variations of products already on the market. During the 1990s, brand-name drug makers introduced more than 300 new products to the market, and the FDA approved them quickly. However, faster isn’t always better. Several new drugs had to be pulled off the market after causing serious, and in some cases deadly, problems, and the FDA now appears more cautious about approving new drugs for consumers. Drugs approved more recently may be more likely to have unrecognized adverse reactions than established drugs, according to a 2002 study published in the Journal of the American Medical Association. Thirty-five million Americans — 1 in 8 — are age 65 or older, according to the Census Bureau. The number of elderly people is expected to swell to 82 million — 1 in 5 — by 2050. Today’s senior population includes 1.6 million people who are age 90 or older. As consumers age, they begin to encounter more serious health conditions (such as arthritis, high blood pressure and diabetes) that require medication. They also begin to look to drugs to address such issues as hair loss and impotence. Drug manufacturers go to great lengths to generate demand for their drugs, especially the best sellers, which are usually the most expensive medications in their categories. Drug companies send their sales representatives to doctors’ offices with samples, gifts, catered lunches and more. In recent years, they also have increased their “direct-toconsumer” advertising with print ad and television commercials. These ads encourage consumers to “ask their doctor” if a certain drug is right for them. Drug companies spent $2.5

understanding the cost of new drugs billion on direct-to-consumer ads in 2000, and more than 30 times what they spent on mass media ads in 1991, according to the National Institute for Health Care Management. The ad spending exploded, according to the Institute, because drug companies realized it increased sales. One of the most heavily advertised drugs is Vioxx, the best-selling anti-arthritic pain reliever. The manufacturer of Vioxx spent $160 million on direct-to-consumer ads in 2000, exceeding ad budgets for Pepsi ($125 million) and Nike ($78 million). According to the Employee Benefit Research Institute, drug spending has jumped 92 percent nationally in the past five years. Just think how much a gallon of milk or a new car would cost if the price rose 92 percent in five years! In the past, most prescription drug costs have been paid by health insurance companies and employers. But, as the costs continue to escalate, employers are expecting employees to carry some of the burden. As a result, more employees are paying more of the cost of these drugs through higher deductibles and copayments. For years, insurance companies charged a flat copayment for each prescription filled. Now, many plans offer a three-tier formulary copayment plan. The Arkansas Blue Cross and Blue Shield Three-Tier Medications Formulary is a list of FDA-approved medications selected by a committee of practicing physicians and pharmacists. Formularies have been used in hospitals for many years to help ensure that drugs are dispensed in a cost-effective and proper manner. Exclusions will vary depending upon your group benefits. The formularies are revised periodically to reflect changing drug therapies. (See related formulary article on page 9.) After all is said and done, there’s no drug available without a price in both dollars and side effects. If you maintain healthy skepticism about drug ads, and ask your doctor good questions, you’ll do well in this world of direct-to-consumer advertising.

New generic drugs on the way ?

ome significant brand-name drugs lost (or are scheduled to lose) their patents in 2002 and 2003. This will open the door for generic drug launches of the same medications. Drugs with significant potential to see their first generic equivalents hit the market are: Ortho-Novum 7/7/7* (birth control) Ortho Tri-Clyclen* (birth control) Accupril (blood pressure) Nolvadex (breast cancer) Topamax (anti-convulsant) Glucophage XR (diabetes) Monopril (blood pressure) Remeron (anti-depressant) Alphagan (glaucoma) Serzone (anti-depressant) Glucovance (diabetes) Glucotrol XL (diabetes) Wellbutrin SR (anti-depressant) Zyban (smoking cessation) Neurontin (anti-convulsant)

Tiazac (blood pressure) Cipro* (antibiotic)

* Indicates approval, but has not been marketed as a generic drug as patent issues remain. Special Note: This list is a good-faith effort to provide useful information on innovative drug products that face potential competition from a generic equivalent. Many of the drugs listed are associated with active patents that have been challenged. Resolution of these patent challenges in favor of the generic drug maker likely will determine if a generic can be approved in the year noted. For this reason, some of the drugs listed likely will not face generic competition as shown. The expiration of the pediatric exclusivity has been considered for some of the listed drugs. The list is not static and is constantly updated.

On-line resources for health and prescription drug information • • • • • • • • • • • • •

Centers for Disease Control and Prevention, www.cdc.gov National Institutes of Health, www.nih.gov American Medical Association, www.ama-assn.org American Cancer Society, www.cancer.org American Heart Association, www.amhrt.org American Diabetes Association, www.diabetes.org National Drug Information and Referral, www.health.org National Center for Complementary & Alternative Medicine, www.nccam.nih.gov Asthma and Allergy Foundation of America, www.aafa.org The Blue Cross Blue Shield Association, www.bcbshealthissues.com/cost Blue Cross Blue Shield of Michigan, www.theunadvertisedbrand.com Arkansas Blue Cross and Blue Shield, www.ArkansasBlueCross.com/members/cost_video.asp National Institute for Health Care Management, www.nihcm.org

Drug costs continue to rise; no end in sight

Prescription drug spending increased 90 percent between 1998 and 2002

uring the past five years, spending on prescription drugs by Arkansas Blue Cross and Blue Shield for its members has increased approximately 18 percent each year; thatâ&#x20AC;&#x2122;s a 90 percent increase in spending on prescription drugs. In the next five years, it probably will increase by another 18 percent or more each year. Compare that to the 5.25 percent-per-year increase in spending on medical services for members by Arkansas Blue Cross during the past five years. That amounts to an increase of 26 percent in spending on medical services (including physician fees, outpatient and inpatient costs) during the past five years. Spending on prescription drugs increased at a rate of more than three times when compared to spending on medical services. Is there any way to decrease the spending on prescription drugs? Actually, there is. When consumers are prescribed or request generic drugs, everyone saves money. For example, in Arkansas in 2001, the average cost of a brand-name drug was $66 while the average cost of a generic drug was $18. In 2002, the average cost of a brand-name drug increased to $72 while the average cost of a generic drug actually decreased to $16.50. Below are the brand-name drugs with a generic equivalent that were often prescribed (and were the most costly) for Arkansas Blue Cross and Health Advantage members during 2002. Note the difference in cost when the generic is compared to its brand-name counterpart. All costs listed below for prescription drugs are the actual cost for Arkansas Blue Cross and Health Advantage; however, members pay the copayment as specified by their benefit plans. Brand name Prilosec Prozac Zestril Vicodin ES Zantac Minocin Darvon â&#x20AC;&#x201C;100 Zovirax Vasotec

Average cost $109 $125 $35 $38 $60 $65 $46 $92 $60

Other high-cost drugs often prescribed for members include Prevacid for gastritis/esophagitis with an average cost of $99; Celebrex, a pain reliever with an average cost of $67; Zocor, a cholesterol-lowering drug with an average cost of $75; and Vioxx, a pain reliever with an average cost of $52. These three drugs are all on the third tier of the Arkansas Blue Cross Medications Formulary, meaning they have the highest copayment for our members, and there is no generic equivalent for the drugs at this time. However, itâ&#x20AC;&#x2122;s possible there may be a drug on the second tier of the formulary that offers the same effectiveness. The second-tier drugs are brandname-preferred drugs that offer a mid-level copayment. If you are using a third-tier drug, you may want to discuss with your physician other prescription options for your treatment. Here are some second-tier formulary drugs without a generic equivalent at this time (mid-level copayment prescriptions). Lipitor, a cholesterol-lowering drug with an average cost of $58; Zoloft, an anti-depressant with an average cost of $55; Protonix, a drug used for gastritis/ esophagitis with an average cost of $75; Paxil, an antidepressant with an average cost of $58; and Effexor XR, an anti-depressant with an average cost of $66. These drugs often are prescribed for our members. In some instances, there are no generics available for brand-name prescription medications. However, you should always discuss with your physician the best course of action to take in your situation, whether there is a generic drug available, or if there is a lower-cost drug available that is suitable for you as a treatment option.

Used to treat Gastritis, esophagitis Depression High blood pressure Pain Gastritis, esophagitis Infection (antibiotic) Pain Virus (antiviral) High blood pressure

Generic equivalent

Average cost

Omeprazole In transition Fluoxetine $20 Lisinopril $16 Hydrocodone $14 Ranitidine $19 Minocycline $22 Prepoxiphane napsalyte $20 Acyclovir $28 Endapril $22

What are we doing to help control drug costs? A

rkansas Blue Cross and Blue Shield works to control escalating drug costs through its Pharmacy and Therapeutics Committee, whose decisions form the basis of the Three-Tier Medications Formulary. The committee, the majority of whose members are doctors and pharmacists from outside the organization, makes recommendations regarding preferred and non-preferred medications. Members can save the most money by using generic drugs, which are always on the first tier of the formulary, requiring the lowest copayment. Using brand-name preferred drugs (selected for their effectiveness, safety, uniqueness and cost-efficiency) also saves members money because preferred drugs are on the second tier and require a midlevel copayment. Non-preferred drugs (those considered by the committee to fall short of other drugs in the same

The Three-Tier Formulary

therapeutic class in regard to effectiveness, safety, uniqueness or cost-efficiency) comprise the third tier and require the highest copayment.

How you can help control drug costs 1. Ask if the medicine is available in a generic — you could save as much as 75 percent. 2. Ask if there’s a lower-priced alternative that will work just as well. 3. Understand how your prescription drug benefit works. 4. For a new prescription, ask your physician for a starter sample so you won’t be stuck with a costly drug that may not work for you. 5. Call around for the lowest price. Pharmacy prices vary. If you find it cheaper somewhere else, ask your regular pharmacist if he or she can match the price. 6. Ask for discounts that may be offered for seniors, infants, children and students. 7. Buy store-brand or discount-brand over-the-counter products. Ask your pharmacist for recommendations.

Tips on storing and handling your prescribed medications B

y storing your medications properly, you can ensure their effectiveness and reduce potential side effects. Although many people usually store their drugs in the bathroom, that’s probably not the best place. Most drugs are sensitive to heat and moisture. Others may be sensitive to light. Exposure to either may alter or damage your drugs. Store your medications in a cool dry place out of direct sunlight and out of the reach of children and pets. Keep the cap on the bottle, and if you notice any changes to your

drugs (cracking or changes in color), contact your pharmacist. Throw away expired drugs. Do not keep expired drugs “just in case” or because they were expensive. Some drugs lose their effectiveness, and some may actually increase in strength, posing an overdose risk. In some cases, you actually may forget what the drug was prescribed for in the first place. It’s always better to just throw expired drugs away. When you are prescribed a drug by your doctor, take the drug exactly as prescribed. If your doctor or pharmacist tells you to take all of the medicine, don’t stop when the bottle is half empty just because you feel better. Never take someone else’s drugs, and if you are unsure about how to take a prescribed drug, contact your doctor or pharmacist for more detailed instructions.

Be smart:

rom high blood pressure to depression, there are generic drugs to treat many illnesses. By using generic equivalents of brand-name drugs, everybody saves money. Many of our members use the generic equivalents to treat the following illnesses.

High Blood Pressure Brand-name drugs: Zestril ($35) and Vasotec ($60)* Generic drugs: Lisinopril ($16) and Endapril ($22)* You may have high blood pressure and not know it. Approximately 50 million Americans age 6 and older have high blood pressure. The American Heart Association states that more than 31 percent of people with high blood pressure don’t know they have it, and that 26.2 percent of people with high blood pressure take medication but do not have their high blood pressure under control. According to an article in the Journal of the American Heart Association, a recent analysis predicts that current middle-aged Americans face a 90 percent chance of developing high blood pressure during their lives. It also stated that blood pressure control and cardiovascular disease rates are improving among minority ethnic groups in this country. However, rates are not improving as much in majority populations. Blood pressure is defined by two numbers. The first number is called systolic pressure, and it measures the pressure in your arteries while your heart beats. The second number is called diastolic pressure, and it measures the pressure while your heart rests between beats. The two numbers should fall under 140/90 if you have normal blood pressure. But, according to an article in the Journal of the American Heart Association, current blood pressure goals aren’t low enough for people with diabetes. The current goal is 140/90, and it is suggested that the goal be

generic drugs available

130/85 for people with diabetes. You may not even know the cause of your high blood pressure. In 90 to 95 percent of high blood pressure cases, the cause is unknown. What can you do about high blood pressure? • Maintain a normal, healthy weight. • Decrease salt intake. • Take medications as prescribed by your physician. • Do not start smoking, and if you are a smoker, quit. If you are experiencing symptoms of high blood pressure, please visit your physician for diagnosis and treatment.

Depression Brand-name drug: Prozac ($125)* Generic drug: Fluoxetine ($20)* No one knows what triggers depression. No one knows for sure why the brain chemistry becomes imbalanced. One factor is an imbalance in the chemical messengers in the brain. Age, sex, upbringing and major life stresses, including chronic illnesses, also can tip the balance. Anti-depressant drugs work to restore this balance. Women Women suffer depression more frequently than men. Typical symptoms include crying, withdrawal, inability to experience pleasure, loss of energy and perhaps even feeling they would be better off dead. Women have to cope with the mood-altering hormonal effects of the menstrual cycle, pregnancy and childbirth, and menopause, which produce special problems. New mothers expect to feel joy and exhilaration after giving birth. But because of the enormous hormonal changes and the challenges of dealing with an infant, some women will feel short-lived sadness, often recovering from this on their own. Others may progress to a fullblown postpartum depression that requires medical evaluation and intervention for recovery.

* Costs represent the average cost of the prescription medication.

for many illnesses Men Some men exhibit the same symptoms of typical depression as women, but many depressed men exhibit atypical symptoms. Some depressed men have what has been called hidden depression. They may manifest depression by becoming irritable, pessimistic or critical of others, having difficulty getting along at work, becoming aggressive or abusing alcohol. Elderly Depression is not a normal part of aging. It may be a reaction to the loss of physical and mental vitality; the loss of important others, such as friends, spouse and family; or having to give up a career. Unexplained crying and persistent sadness are often clues, as are multiple vague physical symptoms, such as persistent fatigue, headaches, loss of appetite, chest pain or upset stomach. If medical illness has been ruled out, depression is often the correct diagnosis. Illness It’s normal to feel blue when you’ve been diagnosed with any chronic illness. Any chronic condition can trigger depression, but risk increases in direct proportion with the severity of the illness and the life disruption it causes. But it’s not normal to stay depressed. Depression is one of the most common and potentially dangerous complications of every chronic illness. It is particularly common in those with recent heart attacks, hospitalized cancer patients, recent stroke survivors and those who have multiple sclerosis, Parkinson’s disease and diabetes. Today we know the link between depression and chronic illness is a two-way street. Chronic illness is depressing. And the depression often exacerbates the illness. Treating depression often improves the outcomes in those with other chronic illnesses. Children Depression in children often is not recognized. Emotional and physical abuse, personal loss or having a

depressed parent increase the risk of a child developing depression. Children often do not show the typical symptoms of depression. They may show their depression behaviorally. They may become irritable, aggressive, have difficulty in school, withdraw from friends, or lose their usual playfulness. Teens Adolescence is a very difficult time in life. Major hormonal changes are experienced at this time with higher highs and lower lows. Family ties are being loosened, but the teen has not yet established himself or herself as an individual. Look for problems at school, difficulty in bouncing back from life’s disappointments or any other sudden change in mood or behavior that is out of the ordinary. Sometimes depressed teens turn to drugs or alcohol to feel better, which ultimately makes matters worse. Good News There is good news about depression. Once major depression is recognized, it can be treated successfully with medication or psychotherapy or both. Not everyone responds to the same therapy, but if a person doesn’t respond to the first treatment used, he or she is likely to respond to another approach. Medication compliance is important to the successful treatment of depression. The goal of treatment is complete symptom remission, not just symptom improvement. All patients prescribed medication should remain on the treatment through symptom resolution and then continued treatment for some additional months. All patients on medication should have follow-up visits with their physician in the initial diagnosis and treatment phase.

Gastritis Brand-name drug: Zantac ($60)* Generic drug: Ranitidine $19)* Gastritis is not a single disease, but it means an inflammation of the stomach lining. Gastritis can be caused by drinking too much alcohol, prolonged use of

* Costs represent the average cost of the prescription medication.

(Illnesses, continued on Page 12)

No pain with over-the-counter painkil ers

orting through massive amounts of painkillers on the market today is enough to give you a headache. Advertising adds to the confusion. However, here’s help for the achy — almost all over-the-counter (OTC) pain relievers fit into one of four categories.

• Acetaminophen (Tylenol): For fever and pain, but not for swelling. Doctors often tell people who face bleeding (from dental work or ulcers) to use this pain reliever because it’s the only one of the four basic types that doesn’t prolong bleeding. • Aspirin (Bayer, Anacin): Helps relieve fever, and minor aches and pains caused by arthritis or swollen muscles. Aspirin is known to decrease the tendency for the blood to clot, so some people take this inexpensive drug daily to ward off heart attacks. Before taking that step, contact your doctor. • Ibuprofen (Advil, Motrin): Helps relieve pain, swelling and fever. Common uses for ibuprofen include relief from menstrual cramps and arthritis. • Naproxen sodium (Aleve): Used for fever, swelling, arthritis, minor aches and menstrual cramps. Usually lasts longer than other pain relievers on the market.

Did you know . . .

1. Aspirin, naproxen sodium and ibup rofen work by suppressing chemicals that send pain signals to the brain. Acetaminophen works in the brai n to dull the sensation of pain. 2. All the pain relievers are available in less-expensive generic forms. 3. Tablets, caplets, buffered or gel-coa ted variations usually cost more, but are easier on the stomach. 4. Read all the warning labels. For exa mple, children and people with asthma shouldn’t take asp irin, people with kidney problems should skip the acetaminophen, and those with high blood pressure sho uldn’t take ibuprofen. 5. Signs of overdose on the pain relie ving medication include ringing in the ears, cramps, stom ach pain and vomiting. With the exception of acetam inophen, all these drugs can harm your digestive systems. 6. OTC pain relievers and alcohol do not go together. Regular use can cause stomach bleeding or liver damage.

(Illnesses, continued from Page 11)

nonsteroidal anti-inflammatory drugs (NSAIDs), or infection with bacteria such as Helicobacter pylori. Sometimes gastritis develops after major surgery, traumatic injury, burns or severe infections. Certain diseases, such as pernicious anemia, autoimmune disorders, and chronic bile reflux, can cause gastritis as well. The most common symptoms are abdominal upset or pain. Other symptoms include belching, abdominal bloating, nausea, vomiting or a feeling of fullness/ burning in the upper abdomen. Blood in your vomit or black stools may be a sign of bleeding in the stomach, which may indicate a serious problem requiring immediate medical attention. Gastritis is diagnosed through one or more medical tests: • Upper gastrointestinal endoscopy. • Blood test. • Stool test.

Treatment usually involves taking drugs to reduce stomach acid and thereby help relieve symptoms and promote healing. (Stomach acid irritates the inflamed tissue in the stomach.) Avoidance of certain foods, beverages or medicines also may be recommended. If your gastritis is caused by an infection, that problem may be treated as well. For example, the doctor might prescribe antibiotics to clear up an H. pylori infection. Once the underlying problem disappears, the gastritis usually does, too. Talk to your doctor before stopping any medicine or starting any gastritis treatment on your own. — Sources: National Digestive Diseases Information Clearinghouse, National Institute of Mental Health and the American Heart Association

New pharmacy Web site for members: COMING

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ave you ever been curious to know if the prescription you are taking for your blood pressure could have an interaction with the medication you’ve just been prescribed for your skin rash? Well, soon you’ll wonder no more. In addition to asking their doctor or pharmacist about drug interactions, Arkansas Blue Cross and Blue Shield members (and Health Advantage or BlueAdvantage Administrators of Arkansas members who have their prescription benefits provided by Arkansas Blue Cross) will soon be able to go on-line to look up drug interaction information as well as find a wealth of general — and personal — information about prescription medications. Beginning this spring, members covered by the drug benefits provided by the Arkansas Blue Cross family of companies will be able to visit their plan’s Web site and connect to the AdvanceRx.com link for free access to valuable information on pharmacies and pharmaceuticals. The AdvanceRx.com link will be located within the ArkansasBlueCross.com, HealthAdvantage-hmo.com and the BlueAdvantageArkansas.com Web sites. The new feature will allow members to: • Look up their specific drug coverage (formulary information and pricing) • Locate a pharmacy • Access a drug dictionary • Check the drug-to-drug interaction checker • Refill prescriptions and check order status (if mail orders apply in coverage) • Check personal prescription history

The new AdvanceRx.com link will provide members with current, accurate information regarding their medication needs and empower them to make informed decisions about their drug benefits that should help improve their health and lower health care costs. “The AdvanceRx.com link will give our members a more efficient channel for multiple transactions,” said Alicia Berkemeyer, manager of the Managed Pharmacy Division of Arkansas Blue Cross. “To date, we have been able to provide a limited amount of prescription-related information for our members on our Web sites, but the new link will give members access to so much more. And because AdvanceRx.com is hosted by AdvancePCS, the company that manages pharmacy benefits for the Arkansas Blue Cross companies, information will be updated automatically, so members can be assured they are receiving timely and accurate information. The new link will eliminate the need to manually update formularies and other data. Plus, members will have access to great information 24 hours a day, seven days a week.” When the prescription history component is added, only members (those whose names are on the health plan contract or “policyholders”) will be able to view their personal prescription information. Later this year, family viewing will be implemented. Also planned for later in 2003, members will have access to their benefit summaries in case they have any questions about what is covered under their plan. To access AdvanceRx.com, members will log on to the ArkansasBlueCross.com, HealthAdvantage-hmo.com or BlueAdvantageArkansas.com Web site, and click on the link to the Prescription Drug

(AdvanceRX.com, continued on Page 18)

How To Use My Blueprint:

What is My Blueprint?

My Blueprint is an on-line, self-service center for members of Arkansas Blue Cross and Blue Shield, Health Advantage and BlueAdvantage Administrators of Arkansas. The Arkansas Blue Cross family of companies strives to meet customer expectations by providing members with this convenient self-help access to their health plan information 24 hours a day, seven days a week.

What can I do by using My Blueprint? • Check member eligibility (policyholder, spouse and dependents); • Check status of claims and claims history; • Check primary care physician (PCP) history (for those plans that require a PCP); • Order a replacement ID card; • Update My Blueprint registration information.

Where is My Blueprint? The self-service center is available now on www.ArkansasBlueCross.com, www.HealthAdvantagehmo.com and www.BlueAdvantageArkansas.com. To access My Blueprint, click on its button on the home page of the appropriate site. The button takes you to the log-in page. If you haven’t registered, click on the First-Time User link.

Why must I register to use My Blueprint? You must register on-line and receive a password by U.S. Mail before you can enter My Blueprint. This level of security is necessary to protect your personal information and meet federal privacy regulations.

Who can register to use My Blueprint? Only the policyholder (subscriber or contractholder) can register, but the policyholder can see information for a covered spouse or dependent. The policyholder must enter some basic information from his or her ID card to complete the registration form: • Member ID number • First and last name and middle name or initial • Date of birth The information entered should match the ID card information exactly. The only other information the form requires is selection of two secret questions and answers to be used if you forget your password. Entering your e-mail address is optional.

Personal Benefits and Claims Tracker What do I need to log in? A log-in ID and password are needed to log in. When you register on-line, you receive a log-in ID. You should print your registration confirmation page, which shows your log-in ID, and save it for future reference. You will receive your password by U.S. Mail in five to seven business days following successful registration. After you receive your password by mail, you can return to the site and log in. The account must be activated using the computer-generated ID and password. After the initial log-in, you may change the password to something easier to remember but cannot change the log-in ID. Please remember to keep your log-in ID and password private. If you log in on the wrong site, you will be directed to the site of the company that manages your health plan. More than 2,700 members had registered by midJanuary to use the on-line service. My Blueprint will add additional self-help features as they are developed. One recent enhancement allows Health Advantage members to view a copy of their explanation of benefits statement (EOB) for a completed claim. The EOB shows the total charge, allowed charge, payment to the provider and amount the policyholder owes.

Registe to win r !

Register Arkansas for My Blueprint o BlueCross n .com, HealthAd vantage-h mo.com o BlueAdva r ntageArk a nsas.com April 15, by and you c ould win Wal-Mart a $50 gift card. A total of members 10 â&#x20AC;&#x2122; na random fr mes will be drawn om at tered by th those who have regisat date. L o My Bluep rint butto ok for the n on the page of th home ea click on F ppropriate site. Th irst-Time User to re en Check yo gister. u r health p if youâ&#x20AC;&#x2122;re n la n ID card ot sure w hic manages your healt h company h plan. Yo need you u r ID card to comple â&#x20AC;&#x2122;ll registratio te the n form.

How is my health information protected? How can I be sure?

y April 14, 2003, Arkansas Blue Cross and Blue Shield and Health Advantage will have completed implementation of requirements of the Privacy Rule of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Compliance is mandated, but that’s not the only reason the Privacy Rule will be in place. Arkansas Blue Cross believes it is the right thing to do for our members, who expect confidentiality and privacy regarding their medical information and history. “A fundamental component of the overall service commitment we make to our customers is the strict maintenance of their personal information relative to both privacy and confidentiality,” said Robert L. Shoptaw, chief executive officer of Arkansas Blue Cross. “This is ‘job No. 1’ for each of us in every area of enterprise operations.” The Privacy Rule creates national standards to protect individuals’ protected health information and

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gives individuals increased access to their medical records. It is the responsibility of those who create, maintain, or distribute protected health information (providers, insurance companies and clearinghouses) to safeguard this information. As the consumer, the new law gives you certain rights and access to your information. These rights, and how to exercise them, are provided in the Notice of Privacy Practices (Privacy Notice) following this article. Paper copies of the Privacy Notice and the forms associated with making requests will be available by April 14 through our Web sites or by calling your customer service representative. Members of self-funded group health plans served by BlueAdvantage Administrators of Arkansas or USAble Administrators, please note: the following Privacy Notice does not apply to you as your plan will issue its own separate privacy notice.

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THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. By law, Arkansas Blue Cross and Blue Shield and its affiliated company (referred to for convenience as a group as “Arkansas Blue Cross”) is required to protect the privacy of your protected health information. We also must give you this notice to tell you how we may use and give out (“disclose”) your protected health information held by us. Throughout this notice we will use the name “Arkansas Blue Cross” as a short-hand reference for not only Arkansas Blue Cross and Blue Shield, but also for its affiliated company, HMO Partners, Inc., d/b/a Health Advantage. Please note that although we are combining this privacy notice in this way for convenient, short-hand reference, and to make it more efficient to inform you about your privacy rights, these companies remain separate companies, each with their own operations, management and compliance responsibilities. Arkansas Blue Cross must use and give out your protected health information to provide information: • To you or someone who has the legal right to act for you (your personal representative); • To the Secretary of the Department of Health and

Human Services, if necessary to make sure your privacy is protected, and; • Where required by law. Arkansas Blue Cross has the right to use and give out your protected health information to pay for your health care and to perform business operations. For example: • We can use your protected health information to pay or deny your claims, to collect your premiums or to share your benefit payment with other insurer(s). • We can use your protected health information for regular health care operations. Members of our staff may use information in your health record to assess our efficiency and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of benefits and services we provide. • We may disclose protected health information to your employer if your employer arranges for your insurance. If your employer meets the requirements outlined by the privacy law, we can disclose protected health information to the appropriate areas so they can modify benefits, work to control overall plan costs,

and improve service levels. This information may be in the form of routine reporting or special requests. • We may disclose to others who are contracted to provide services on our behalf. Some services are provided in our organization through contracts with others. Examples include pharmacy management programs, dental benefits and a copy service we use when making copies of your health record. Our contracts require these business associates to appropriately protect your information. • Our health professionals and customer service representatives, using their best judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care. An example would be your spouse calling to verify a claim was paid, or the amount paid on a claim. Arkansas Blue Cross may use or give out your protected health information for the following purposes, under limited circumstances: • To state and other federal agencies that have the legal right to receive Arkansas Blue Cross data (such as to make sure we are making proper payments). • For public health activities (such as reporting disease outbreaks). • For government health care oversight activities (such as fraud and abuse investigations). • For judicial and administrative proceedings (such as in response to a subpoena or other court order). • For law enforcement purposes (such as providing limited information to locate a missing person). • For research studies that meet all privacy law requirements (such as research related to the prevention of disease or disability). • To avoid a serious and imminent threat to health or safety. • To contact you regarding new or changed health plan benefits. By law, Arkansas Blue Cross must have your written permission (an “authorization”) to use or give out your protected health information for any purpose other than payment or health care operations or other limited exceptions outlined here or in the Privacy regulation. You may take back (“revoke”) your written permission at any time, except if we already have acted based on your permission.

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Your Rights Regarding Medical Information About You By law, you have the right to: • See and get a copy of your protected health information that is contained in a designated record

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set that was used to make decisions about you. Have your protected health information amended if you believe that it is wrong, or if information is missing, and Arkansas Blue Cross agrees. If Arkansas Blue Cross disagrees, you may have a statement of your disagreement added to your protected health information. Receive a listing of those getting your protected health information from Arkansas Blue Cross. The listing will not cover your protected health information that was given out to you or your personal representative, that was given out for payment or health care operations, that was given out based on an authorization signed by you, or that was given out for law enforcement purposes. Ask Arkansas Blue Cross to communicate with you in a different manner or at a different place (for example, by sending your correspondence to a P.O. Box instead of your home address) if you are in danger of personal harm if the information is not kept confidential. Ask Arkansas Blue Cross to limit how your protected health information is used and given out to pay your claims and perform health care operations. Please note that Arkansas Blue Cross may not be able to agree to your request. Get a separate paper copy of this notice.

To Exercise Your Rights If you would like to contact Arkansas Blue Cross or Health Advantage for further information regarding this notice or exercise any of the rights described in this notice, you may do so by contacting Customer Service at the following telephone numbers: Little Rock Toll Free Arkansas Blue Cross (501) 378-2010 1-800-238-8379 Health Advantage (501) 221-3733 1-800-843-1329 You also may get complete instructions and request forms from the Arkansas Blue Cross or Health Advantage Web sites at: www.ArkansasBlueCross.com www.HealthAdvantage-hmo.com Changes to this Notice We are required by law to abide by the terms of this notice. We reserve the right to change this notice and make the revised or changed notice effective for medical information we already have about you as well as any future information we receive. When we make changes, we will notify you by sending a revised notice to the last known address we have for you. We also will post a copy (Privacy, continued on Page 18)

(Privacy, continued from Page 17)

of the current notice on the Arkansas Blue Cross and Health Advantage Web sites.

Complaints If you believe your privacy rights have been violated, you may file a complaint with Arkansas Blue Cross or one of its affiliated companies, or with the Secretary of the U.S. Department of Health and Human Services. You may file a complaint with Arkansas Blue Cross or one of its affiliated companies by writing to the following address: Privacy Office ATTN: Privacy Officer P.O. Box 3216 Little Rock, AR 72201

We will not penalize or in any other way retaliate against you for filing a complaint with the Secretary or with us. You also may file a complaint with the Secretary of the U.S. Department of Health and Human Services. Complaints filed directly with the Secretary must: (1) be in writing; (2) contain the name of the entity against which the complaint is lodged; (3) describe the relevant problems; and (4) be filed within 180 days of the time you became or should have become aware of the problem. Effective Date The provisions of this Notice become effective April 14, 2003.

(AdvanceRX.com, continued from Page 13)

Information section. Members will be required to register to gain access to their personal information. Personal health information will be strictly confidential and accessed by members through a log-in ID and password. Just some of the information members will have access to through the AdvanceRx.com link includes: Drug Coverage — Throughout a member’s on-line search in AdvanceRx.com, information is available for generic/preferred/formulary indicators and a link to coverage and pricing. Members may search for information about drugs either by drug name or therapeutic class. They also may look up therapeutic alternatives and get real-time pricing for those medications. Since the data requests are driven by the member’s benefits composition, all information will be accurate according to the member’s health plan. The member will know coverage and savings information, and remaining deductible and benefit cost information, as well as per-day cost, annual cost if a maintenance medication, and home delivery vs. retail cost. Personal Prescription History — Soon, members will be able to access their prescription claims information, which will give them a full picture of all of the prescription medications they are taking or have taken.

Pharmacy Locator — The Pharmacy Locator helps members find a convenient retail pharmacy. Drug Dictionary — A comprehensive drug dictionary allows members to look up the name of their medication and find out what all of the “-tens,” “-cins,” “-prils” and “-zenes” mean. Drug-to-Drug Interaction Checker — By typing in the names of their prescription medications, members can find out if they are likely to experience any side effects or interactions with the drug-to-drug interaction checker. Refill Prescriptions & Check Order Status — If their benefits allow members to receive prescriptions by mail order, information is just a click away on how to refill “scripts” and check on orders placed. “We believe the AdvanceRx.com link will provide better knowledge of health issues and benefit details and can encourage appropriate drug use,” said Berkemeyer. “This is another example of how Arkansas Blue Cross is connecting our members to leading edge health care services.”

The Phar macist is in Do you have any questions? Pharmacists frequently get questions about the

effectiveness of a generic medication when compared to its brand-name counterpart. Here are some facts that help provide the answers to these questions. • The term “generic” has been misused and abused over the years due to association with alternate foods, clothes or devices that may have exhibited inferior qualities when compared to the “original.” Generic medications are alternate choices to a formerly patented drug and are less expensive because multiple manufacturers are competing in the same marketplace. • The U.S. Food and Drug Administration (FDA) is charged with evaluating all medications in regard to their safety for human use and their effectiveness for the treatment of designated medical conditions. After a drug patent expires, other manufacturers must submit data to the FDA that ensures their drug is both pharmaceutically equivalent and bioequivalent to the pioneer or innovator drug before they are allowed to market these drugs. The following criteria are applied by the FDA to verify drug equivalence before issuing approval for human use: 1. Pharmaceutical Equivalence The FDA must assure that equivalent drugs, whether generic or brand name, contain the same active ingredi-

ents, same dosage form, are identical in strength, have the same route of administration, and meet the same standards of quality and purity. Equivalent medications may differ in physical characteristics such as color, shape, scoring, flavor and preservative if used. 2. Pharmaceutical Bioequivalence This is a measurement of the rate and extent to which the active ingredient of a drug becomes available at its site of action. Bioequivalence of different formulations of the same drug from multiple manufacturers is determined by the rate of absorption and the comparison of blood level concentrations of those drugs in healthy adults. These comparisons must meet the standards established by the FDA. Fair and reasonable prices of any product in a free marketplace are heavily dependent upon competition. The discovery of any new invention is accorded some marketplace protection through patent security to allow the inventor some prosperity. This protection encourages the invention process to continue and grow by rewarding future inventors and providing new and better products for purchasers. The competitive marketplace, after patents expire, must thrive so that affordable prices will remain available.

Arkansas Blue Cross recognized as leader in Web site performance rkansas Blue Cross and Blue Shield’s Web site, A www.ArkansasBlueCross.com, recently received recognition on two fronts. The site ranked in the “top 16” for on-line services among 97 Blue Cross and Blue Shield Plans and other commercial payors in a recent study conducted by Cap Gemini Ernst & Young Group, one of the largest management and information technology consulting organizations in the world. The site also was ranked as the state’s “Best Insurance Site” in the 2002 Arkansas Business Best of Arkansas Web Awards.

Cap Gemini Survey of “Payor” Web Sites The Cap Gemini study evaluated Web site

performance based on the following attributes of Web sites typically expected by customers: • Secure — Leading Web sites use passwords and/or encryption to restrict access to sensitive information. • Extensive — Leading Web sites offer a variety of online services that are valuable to their customers. • Accessible — Leading Web sites offer customer services, provider directories and log-ins for secure member/provider information directly to users on the home page. • Connected — Leading Web sites have links to other sites that offer health information. (Web, continued on Page 20)

office sponsors Fayetteville educational seminars

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s part of a continuing customer education camA paign on escalating health care costs, Ray Bredfeldt, M.D., regional medical director, of Arkansas Blue Cross and Blue Shield’s Northwest Regional Office in Fayetteville, recently presented “Facing the Challenge of Higher Health Care Costs” during a series of local Business Leadership Forums. Claudia Gardner, the region’s medical affairs manager, said the message was timely because many companies are weighing the heavy decision of Bredfeldt whether to offer future health care speaks at benefits. “Our primary goal was to Business develop a presentation for the Leadership chief executive officer/decision Forum. maker audience that would arm them with the latest trends in health care and give them a glimpse into the future of employee health care costs,” she said. “Additionally, we wanted to provide the participants with information regarding our new benefit options — ® ® MyChoice Blue, BlueFlex PPO, Group BasicBlue ,

MSA Blue , Open Access Point of Service and our Consumer-Driven Health Plan,” said Gardner. Regional Executive Mel Blackwood, who facilitated a Ray Bredfeldt, M.D. portion of the forum, said much of the audience lacked key information on the reality of future health care costs. “From their questions and feedback, we identified commonalties, as well as specific concerns,” he said. “We are working to tailor our proposals to meet their needs with consumer-driven health care products.” More than 120 business leaders attended the forums, which were held in Siloam Springs, Harrison, Mountain Home, Bentonville and Fayetteville from Oct. 28 through Nov. 15, 2002. Several network hospitals, including Siloam Springs Memorial Hospital, North Arkansas Regional Medical Center, Baxter County Regional Medical Center, St. Mary’s Hospital and Washington Regional Medical Center co-sponsored the events. ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○

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• Customized — Leading Web sites have tailored their design and offerings to address members’ individual needs. Sixteen Web sites were able to meet two or more of the above criteria. In addition to Arkansas Blue Cross, Montana Blue Cross and Blue Shield, New Jersey Blue Cross and Blue Shield (Horizon), South Carolina Blue Cross and Blue Shield, and North Carolina Blue Cross and Blue Shield also were included in the top 16. The information for the evaluation was gathered between September and October 2002.

Best of Arkansas Web Awards “Dynamic … easy to use … functional” is what Arkansas Business, the state’s weekly business journal, looked for when it set out to find the state’s best Internet sites. “The Web site for the state’s largest health insurance company does a great job of conveying its myriad of information in an organized manner,” the judges said. “A personal benefits and claims tracker, along with sections providing rate quotes and legislative updates, keeps the site user-focused. And BlueAnn’s

Wild and Woolly Web Site offers games, music videos, a weekly poll and other interactive tools for younger viewers.” Farm Bureau of Arkansas was first runner-up with its www.arfb.com site. Judges included Steve Asmussen, information technology director, BAPTIST HEALTH; J. Edward Horton, marketing and alliances leader, Acxiom Corp.; Tom Allen, president, Avow Technology Solutions; Russell Shain, dean of the College of Communications, Arkansas State University; Wayne Chapman, associate professor of theater arts and member of CyberCollege IT faculty, University of Arkansas at Little Rock; Pamela Schmidt, associate director, Information Technology Research Center, University of Arkansas; Dan Delaughter, director of management of information systems, Arkansas Department of Arkansas Parks and Tourism; Michael Preble, associate director-education, Arkansas Arts Center; David Snyder, general manager-interactive division, Crain’s Chicago Business; and Jeff Ireland, president, virtuallythere.net, Fort Worth, Texas.

Arkansas Blue Cross and Blue Shield joins Arkansas Cardiovascular Task Force Cardiovascular disease (CVD) is the No. 1 cause of death in Arkansas. High blood pressure affects almost one-third of adult Arkansans. The stroke rate in Arkansas is the second highest in the United States. The Arkansas Department of Health is in its second year of funding from the Centers for Disease Control and Prevention to develop a state plan to reduce CVD in Arkansas. Arkansas Blue Cross and Blue Shield is one of the more than 60 partners from the private sector, government and non-government organizations throughout the state who have joined the Arkansas Cardiovascular Task Force to assist in developing the state plan. The overall goals of the plan include: taking action to delay the onset of CVD and postpone death due to CVD; making Arkansans aware of the risk factors and what each person can do to affect their risk; promoting environmental changes to improve access; and establishing policies that support and encourage healthy lifestyles. The Task Force has been organized into five workgroups to develop goals, objectives and action steps for the state plan. The groups are Health Care, Physical Activity, Nutrition, Tobacco Use and Advocacy. The Task Force has compiled a Cardiovascular Health Resource Directory. It includes descriptions of members’

on-going programs related to CVD and an inventory of state and federal laws and regulations. According to Linda Faulkner, Cardiovascular Health Program leader, among the Directory’s programs listed are those that address increasing physical activity, eating a healthy diet, smoking cessation, diabetes, hypertension and high cholesterol. “Commitment of partner resources, hard work and creative thinking are required to develop a state cardiovascular health plan that will make a difference in the health of Arkansans.” Some of Arkansas Blue Cross programs which met the criteria and are profiled in the directory include: Blue & Youth health programs, which is aimed at improving the health of young Arkansans, Don’t Start, which focuses on teaching elementary students the dangers of smoking, and the Enterprise Health Education Programs, which provide health information and resources to members regarding cardiovascular disease, diabetes and healthy lifestyles. The Cardiovascular Health Program also partnered with the Arkansas Wellness Coalition to provide cardiovascular disease principles, chart tools and patient tracking tools to more than 3,600 physicians last year. Arkansas Blue Cross is a member of this organization and assisted in the development of these tools, which were based on the American Heart Association guidelines for CVD.

Physicians express satisfaction with Health Advantage I n September 2002, a survey was conducted to

measure how satisfied the statewide network of primary care physicians (PCPs) are with Health Advantage services as they relate to state and public school employees in Arkansas. According to the survey, the majority of physicians surveyed were satisfied with the services received from Health Advantage. Each question scored a mean of at least “4” on a 5-point scale with “1” being not satisfied and “5” being very satisfied. Results: • Overall experience with Health Advantage — 96 percent of respondents gave Health Advantage a rating of 3 or higher. • Claims were handled accurately by Health Advan-

tage — 94 percent of respondents gave Health Advantage a rating of 3 or higher. • Claims were handled timely by Health Advantage — 94 percent of respondents gave Health Advantage a rating of 3 or higher. • Answers provided by Health Advantage Customer Service were accurate — 95 percent of respondents gave Health Advantage a rating of 3 or higher. • Inquiries provided by Health Advantage Customer Service were handled promptly — 94 percent of respondents gave Health Advantage a rating of 3 or higher. Every PCP in the Health Advantage network received the survey, including 787 individuals and PCP clinics. Of the 787 surveyed, 365 responded (46.4 percent).

The results are in!

Readership survey

Thanks to plenty of healthand-wellness and health insurance information, Blue & You readers told Arkansas Blue Cross and Blue Shield loud and clear that it is something they appreciate and find helpful. The Autumn 2002 issue had a readership survey (an annual process) enclosed for members to return with comments, and customers gave Blue & You an average of 4.54 on a five-point scale (with 5 being the highest rating). The survey respondents gave Blue & You a mean satisfaction rate of 4.63 in the category of Design; a 4.74 in the category of Easy to Read; and a 4.61 in the category of Content. Compared to results from the 2001 readership survey, respondents gave Blue & You higher marks in every category.

More members visit Web sites, find information useful The results of the 2002 Internet Survey showed that Arkansas Blue Cross, Health Advantage and BlueAdvantage Administrators of Arkansas members have increasing access to the Internet and an increasing awareness of the companies’ Web sites. A survey card was enclosed in the Autumn 2002 issue of Blue & You. The 2002 survey had fewer returns than the 2001 survey — 520 compared to 2,363. Those who responded found the most useful sections of the sites to be “Health Plans and Services,” “Prescription Drug Information” and “Provider Directory.” When asked to rate self-service features they would most like to see on the site, the top three were:

Blue & You readers pleased with magazine, Internet services 1. Review benefits. 2. View physicians’ backgrounds. 3. View health and wellness information. This question addressed features not currently on the sites but under consideration for development in the near future. Several of the features listed in the 2001 survey already have been added to the sites, so those were removed from the 2002 survey. One example is “check claims status,” which is now available on the Arkansas Blue Cross, Health Advantage and BlueAdvantage sites. The number of respondents who have Internet access increased from 70 percent in 2001 to 79 percent in 2002. The number who have visited the Web sites jumped from 28 percent in 2001 to 44 percent in 2002. Sixty-three percent of those responding rated the value of the site at 4 or 5 on a five-point scale, with 5 being the highest.

Gift certificate winners! From the Blue & You satisfaction survey, we randomly selected three winners who each received a $50 gift certificate to Wal-Mart. The winners were Pat Harrison of Mena, Charlotte Wigley of Hamburg and Erwin Hall of Little Rock. From the Web site satisfaction survey respondents, we also randomly selected three winners who each received a $50 gift certificate from Best Buy. The winners were Lois Evans of Russellville, Helen Holt of Murfreesboro and Steve Martin of Yellville.

“WELLNESS” CONTEST WINNERS ANNOUNCED I

n the Autumn 2002 issue of Blue & You, Arkansas Blue Cross and Blue Shield sponsored a “Discount Wellness Program” contest for members. Members had a chance to win one of four $50 gift certificates. To win, members simply had to take a look at the discount listings on any of our four Web sites and correctly answer a few simple questions. The four winners have all

received their gift certificates. They could select from Wal-Mart, Target, Sharper Image and Simon Properties (mall certificate). The winners were Jerry Reinhart of Paragould, Charlotte Wicks of West Memphis, Vinie Holt of Hope, and Christy Rothgery of Jonesboro.

Super Heroes Hang Out in High Schools G

ood news, Spider-Man and Powerpuff Girls, there’s a group of Arkansas heroes that is prepared to kick “butts” and put out fires with you. In fact, these heroes have been doing a lot of “stomping,” all in an effort to stem the tide of tobacco use in “the natural state.” Who are these champions of clear lungs, these defenders of adolescents? They are the High School Heroes — a group of high school pupils currently 2,073-strong who are on a mission to share with younger students that smoking is not cool and tobacco is one ugly substance. Capeless and clad in blue jeans, white T-shirts and sneakers, the High School Heroes are an inconspicuous, although elite, group of students who may not have achieved super hero status yet, but certainly are elevated in the eyes of elementary school students who look up to them as role models. Arkansas Blue Cross and Blue Shield has sponsored the High School Heroes program since its inception. Developed by the American Lung Association of Arkansas, High School Heroes is a unique, student-to-student teaching program with a strong anti-smoking message. Through High School Heroes, specially-trained high school students present an anti-smoking program targeted to fourth-, fifth- and sixth-graders in their school district. High School Heroes serve as role models for the kids, pledging to remain smoke-free and delivering a strong testimony about the dangers of smoking and the appeals of tobacco advertising. Using brainstorming, role-play, discussion and question-and-answer, Heroes present their message with the goal of reaching kids at an age when peer pressure and advertising might entice them to start smoking. The discussion includes information about the effects of smoking on the body as well as the deceptive appeals of tobacco advertising. As part of their presentation to students, the High School Heroes teach the “BlueAnn Stomp,” a rapdance created by the North Little Rock High School “Stars” with music composed by Hans Stiritz of Russellville. BlueAnn Ewe, Arkansas Blue Cross’ health

23 Oak Grove High School Heroes “stomp” with BlueAnn.

ambassador, is on hand to perform with the Heroes as often as possible. The “BlueAnn Stomp” ties in the High School Heroes anti-smoking message and BlueAnn’s wellness message, which is taken statewide as well. And the message needs to be shared. Every day, an average of 3,000 kids start smoking in America. The average age for kids to first start experimenting with smoking and tobacco use is 11 — and the trends show that age is getting younger. Most smokers start smoking before the age of 20 — few start after age 18. In Arkansas, more students in grades 9-12 smoke than in 39 other states, and more than 250,000 people suffer with incurable lung diseases caused by smoking. Almost 27 percent of Arkansans smoke, putting our state among the top tobacco-using states (only seven other states have more smokers). Since its introduction in April 1996, the High School Heroes program has grown from being offered in three counties to now being offered in 41 counties. In almost seven years, more than 7,281 Heroes have been trained to teach the program and more than 104,810 elementary school students have been reached with the message. Supporting the Heroes on campus are the more than 80 counselors and advisers who annually help schedule presentations and get the Heroes ready to roll — they are heroes as well. The High School Heroes program definitely has the ingredients to spell success with students, and Arkansas Blue Cross is committed to helping the future generation of health care users to be their healthy best. Watch for more information about the High School Heroes program in future issues of Blue & You. And if you are interested in more information about the program or how it can come to your school district, call the American Lung Association of Arkansas at 501-224-5864, or toll-free at 1-800-586-4872.

rkansas Blue Cross and Blue Shield strives to be a good corporate citizen. Our employees raise money and spend many hours helping those causes near and dear to the hearts of Arkansans. Making Memories and Friends Staff members of the Northwest Regional office laced up their sneakers to join the Alzheimer’s Association for its Memory Walk in Fayetteville. More than 300 people participated in the first annual event held at the Northwest Arkansas Mall to raise awareness of the disease and money to support Alzheimer’s patients and their families. BlueAnn was BlueAnn makes friends at the Memory Walk 2002. there to greet walkers and have fun with the participants. The walk raised about $16,000 for the cause. “Don’t Start” 2003 Gets Started Arkansas Blue Cross is once again joining the American Lung Association and the Arkansas Department of Education to encourage kids to not start smoking. Media partners KASN-TV/UPN Channel 38 and KLRT-TV/FOX Channel 16 are joining the effort as well. The “Don’t Start” Smoking Storyboard Contest 2003 runs through March 28, and is an effort to give kids in kindergarten through fifth grade an opportunity to write a story about why it’s important to never begin this dangerous habit. Kids can “draw their way” to some great prizes and an opportunity to have their story transformed into a television Public Service Announcement (PSA) to be broadcast in Arkansas in the summer and fall of 2003. This is the second year for Arkansas Blue Cross to sponsor the program. In 2002, almost 10,000 students participated in the contest! David Clarke, a then fifthgrader at Pulaski Heights Elementary School in Little Rock, was the grand-prize winner of the contest. The other 17 finalists came from all four corners of the state. Storyboard Contest sheets and educational videos have been distributed to all public and private schools

through the Department of Education and are being mailed to home-school programs. In addition, Storyboard Contest sheets can be picked up at any Arkansas Blue Cross location, at the American Lung Association of Arkansas, and at Clear Channel Communications in Little Rock, or by calling toll-free, 1-800-586-4872, ext. 118. For more information, visit BlueAnn’s Web site at www.BlueAnnEwe-ark.com. The “Don’t Start” Smoking Storyboard Contest will help your kids draw a healthy message today, as well as a good breath, for life. Students from Martin Luther King Elementary in Little Rock promote “Don’t Start” on KATV-TV, Channel 7.

GREAT NEWS! Coming Soon — Arkansas Blue Cross and Blue Shield will be introducing a dental product just for individuals (under age 65) and families. If you’d like to learn more, please give us a call at 1-800-392-2583. Arkansas Blue Cross and Blue Shield P.O. Box 2181 Little Rock, AR 72203-2181

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