Sharon Butler is our leader of people strategies at Magellan Rx Management and is an integral part of our thriving culture. She inspires our teams to use their strengths to overcome challenges and deliver a pharmacy experience unlike any other. We sat down with Sharon to talk about her love of human resources, the current state of the industry, how the pandemic has affected HR professionals and how people make the difference in any organization.

What’s your background, and how did you get into Human Resources?

I love sharing this story because it’s the last place I thought I would be. I grew up in a poor neighborhood in Albany, NY in a family that didn’t value education. It wasn’t until I had the opportunity to attend college later in life that I met so many people who were resetting their path and going back to school after finding themselves in a job that didn’t fulfill them. It was then and there I realized my passion for people and believe there is so much more to illuminate a person if they are exactly where they want to be versus where they can be.

This realization led me to study organizations and leadership, dedicating my career to understanding the power of giving people an opportunity to do great things. There’s not an organization out there that’s great because of something other than people. If you think about it, organizations can’t achieve anything without people driving change.

How do you think your life experiences have shaped your work as a Human Resources professional?

I have learned through personal experience that some of the hurdles in your life are the ones you create and put in your own way. You can do anything if you have the passion and power to do it. You can’t just dream it. A dream isn’t a strategy, it’s the motivation that pushes you forward.

I’ve also learned that your career can have a huge impact on your overall wellbeing.

I have now been with Magellan for 14 years, and I’ve seen firsthand that when you tap into someone’s personal strengths, you unleash an incredible amount of potential within not only yourself, but your team as well. As a leader or manager, placing people in the right seat creates a highway for growth and development.

Our data tells us that we’ve had 455 internal promotions over the last 12 months and that we continue to focus on supporting effective career conversations and encourage every employee to start a conversation. I’ve seen a correlation between employee driven career discussions and success of achieving aspirational goals.

We can’t impact what we don’t measure. We are focused on pulsing engagement and investing in what makes our employees feel valued. Our pulse surveys provide us with data for leaders to use to ensure they are having the impact intended. This is one tool that should be used with a variety of tools to ensure we continue to understand each other regardless of role. These surveys allow us to have impactful conversations to gauge overall organizational wellbeing. Now that we are far more virtual than ever before, we must continue to create connectedness, check in with each other in a variety of ways and respond to the ever-changing climate of our work.

How has the pandemic impacted Human Resources professionals?

HR professionals have really had to stretch outside their comfort zones, beyond the predictable outcomes they are used to. What we’ve all seen happen over the last few years in our communities with regulations, politics, human behaviors and attitudes changing is also happening within organizations. We can’t build a policy to navigate it, we must lean in and care about it.

We have had to consider every perspective to make the right decisions for us as an employer, and to make the right recommendations for employees as one size does not fit all. While some organizations have used this as an opportunity to be defined by their policies, we’ve found that we’re too complex and dynamic to pick one side or another on many points related to the pandemic. The passionate people at Magellan Rx are navigating through every circumstance in the most caring way possible.

These last few years have impacted everyone. Leaders, managers and employees are recognizing the need to practice self-care first before care for others. I’ve been starting my day with MAGIC Mornings, which I’ve recoined for myself ‘Miracle Mornings,’ this practice affords me a margin of time to focus on myself and set my day through exercise, meditative prayer, affirmational writings, gratitude journaling and intention or goal setting. I’ve been doing this for four months now and have noticed a complete shift in how I approach and move throughout my day. I encourage teams and individuals to rethink how they start their days and prioritize their wellbeing to avoid burnout.

What’s your perspective on the Great Resignation?

My observation of what the data suggests is that people are reacting to what adds value to their lives. The notion of an employee leaving their job, and possibly their career, is changing attitudes and expectations. Employees have more of a voice than ever before in what they are willing to do, and not do, for a paycheck. We need to listen.

Do you think organizational culture plays a role in the Great Resignation?

Absolutely. For a long time, organizations have been trying to define an attractive culture with policies and programs like education reimbursement, wellness credits and unlimited PTO. What we are seeing during this Great Resignation is a shift in focusing on employee’s wellbeing and how they are treated. Cultures are formed by how leaders behave and employees feeling truly valued. It isn’t about a program; it’s about behavior.

What we’ve noticed at Magellan is that while our turnover rate has inched up, it isn’t at the national average, and we are still able to attract talent to our positions. We believe that this is a direct reflection of our strong culture of caring people who are leveraging their strengths in their everyday work and modeling positive behaviors.

What do you think is needed to create a thriving culture? 

First and foremost, authenticity and accountability from leaders. Then, you must focus on people because people make the difference. You do this by unlocking their strengths and unleashing their potential. Mix that with a little fun, and you’ve got a solid foundation to build a thriving culture.

Our secret sauce at Magellan Rx is that we don’t have a one size fits all strategy for any person. We start by focusing on an individual’s core strengths, which allows leaders and employees to deploy very tailored career development, growth performance and learning opportunities.

How do you think teams have remained resilient these last few years while some haven’t?

I think there is a lot of masked resiliencies happening right now – pushing through versus truly evolving through the challenges – which can be very dangerous because it means we are closer to burnout than we know.

You can tell resiliency is occurring when you are faced with the next challenge, and it energizes you because you learned from the last challenge and are able to use your learnings to evolve through the next obstacle.

For those that haven’t, do you have any advice?

There is no time like the present to pause and take inventory of all the things that you have pushed through, map those things to what you have learned, and really understand the impact of your work. When you are focused solely on what’s ahead and what’s not done, you deprive yourself the opportunity to pause and learn. Look back at the path you’ve laid and the wake you’ve made.

What should organizations do to invest in their people?
Create safe spaces and support systems for employees to stretch, learn and grow in their careers.

Think about their world, their environment and what they are trying to transform. Don’t forget to ask their opinion on what great looks like and listen, because at the end of the day it’s the people who make the difference in any organization.

Haita Makanji, vice president, clinical strategy and innovation supporting the specialty division of Magellan Rx Management, has worked for MRx for nearly 10 years, where she has focused on helping to support payers as they navigate the pharmacy space. Makanji, who is based out of Massachusetts, leads a team of highly trained pharmacists and experts in development and implementation of clinical solutions for customers in various high-cost specialty conditions across both the medical and pharmacy benefits including but not limited to cancer, hemophilia, and rare diseases. Her team focuses on utilization management, dose optimization, care management and technology-based programs for commercial, Medicare and Medicaid patients across the country. Continue reading to learn more about the innovative projects Makanji and her team are working on in the pharmacy space:

What sort of projects are you currently working on?

I’m passionate about working closely with payers and supporting them as they navigate the evolving landscape of new, expensive treatments, while also helping to deliver the highest quality of care to patients. For exceedingly high-cost specialty conditions, our emphasis is always on value through delivering clinical solutions that offer the most appropriate treatment to patients while combating the rising spend payers are facing.

For example, a recent project centers on a one-of-a-kind solution for payers focused on precision medicine in the oncology space, which is the highest-spend category for specialty drugs on the medical benefit for over 10 years. This is an exciting, next-generation pharmacy initiative where we will be combining genomic testing with drug selection for providers who treat cancer patients and meeting a critical need for payers who are looking for more complete solutions on both the medical and pharmacy benefit.

In 2021, we launched a comprehensive high-cost therapy program to provide enhanced utilization management strategies and case management referral for ultra-rare diseases. Payers often struggle to identify specialized experts, either internally or within their network, so our ability to leverage our MRx Expert Clinical Network of more than 175 key opinion leaders who practice various specialties, combined with our team of experts, offers a unique opportunity to support treatment decisions that leads to better health outcomes.

Why is Magellan the best place for these projects?

I’m proud to work for an organization that has a deep understanding of medical and pharmacy trends and a history of pioneering industry-first solutions for specialty drug management. With 17 years of experience in managing specialty conditions, we are unique in the marketplace.  Our customers routinely expand their collaborations with us because we continuously elevate our suite of solutions with innovative and forward-thinking approaches. Our mission is to help patients live healthy, vibrant lives and we accomplish this by ensuring that the right patients receive the right therapies at the right time.

What are your thoughts on the culture here at Magellan? How has that culture impacted your work?

We have a family-oriented culture where we collaborate and have a true understanding and trust of each other. Magellan fosters an environment that encourages open, honest feedback in all teams. Magellan also provides employees with the opportunity to challenge themselves and embrace new opportunities. This is imperative as we innovate and bring new programs to the market.

What exciting trends are you noticing in the healthcare industry? In what direction do you see healthcare going and what lessons are there to learn from other industries that can be applied to healthcare?

I’m energized by how quickly our industry is adapting to new technologies and advancements in the delivery of healthcare. Particularly in digital health solutions with the shift towards value-based care strategies and the pivot to personalized medicine.

The market will need to be laser-focused on providing clinically appropriate, personalized care at the lowest cost for both payers and patients.

One lesson we can take from other industries is the ability to be nimble and flexible. Disruptors in every sector of healthcare are bringing new offerings directly to consumers in the hopes that simplicity and transparency will cultivate consumer loyalty. We can take advantage of the availability of data and deployment of new technologies to respond quickly to changing market dynamics and the needs of our customers and their unique patient populations. While we have a proven track record and hundreds of successful case studies across our suite of solutions, it’s important that we never stop innovating!

Meredith Delk, general manager of the government markets division within Magellan Rx Management

What is the government markets division within Magellan Rx?

We are the largest pharmacy benefit administrator across 27 states and Washington D.C. working with Medicaid and public health agencies. We partner with states across the country to ensure that their Medicaid or AIDS Drug Assistance Program (ADAP) enrollees, depending on the state, have access to the drugs they need at the right time and at the right place. Additionally, we process approximately $18 Billion in rebate dollars on behalf of 20 states annually.

How does your work in the government markets division align with Magellan’s mission of leading humanity to healthy vibrant lives?

Our work is focused on people living in poverty across the United States. So, irrespective of the state and specific program, everyone we serve within the government markets division is affected by poverty and our commitment is to provide our customers (government agencies) and the consumers they serve with best-in-class service to access medications, therefore positively impacting their quality of life. We have about 1,000 employees on any given day who are dedicated across 27 states to ensure that the individuals we serve have a role in accessing their drugs and that they understand that their voices matter.

Further, we are deeply committed to our work across the country administering ADAP, thru our ADAP Center of Excellence. This is a federally funded program benefiting those who are affected by HIV and AIDS. As a result, these members are able to receive their life changing and lifesaving medications. In addition, there are wraparound services and other support services for people living with HIV and AIDS who do not have commercial healthcare and are not on Medicaid. The Ryan White program created a solution to ensure that, regardless of your socioeconomic status, if you are affected by HIV or AIDS, you will have access to medications. It is a fantastic program and one we are honored to be a part of here at Magellan.

Given everything that’s happening in healthcare right now with the pandemic, how does Magellan’s mission and improving customer service relate to the work you’re doing?

In many respects, the work we are doing in the government markets division supports the fabric of the safety net for millions of Americans. We know that through this pandemic unemployment has been on the rise, which means Medicaid enrollment has been on the rise, throughout the country. We also know that mental health issues have increased, creating additional challenges related to overall physical health and access to behavioral health services and medications. Within Magellan Rx and the government markets division, we’re on the front lines with our customers.

We partner with public health agencies to provide them real time solutions beyond our core POS work, for example. Right after the COVID vaccine was made available a Governor in a state where we have business announced during a press conference, that Magellan’s call center would be the vaccine hotline for every person in that state, regardless of their type of insurance. Almost overnight, we stood up a call center to support that state in improving their vaccination rates. We’re listening to and keeping a close eye on new and innovative challenges that Governors and Medicaid regulators have experienced during this pandemic.

How does your background in social work influence the work you’re doing and your leadership style?

I’m a trained clinical social worker and I also have a PhD in counseling. I have spent quite a bit of time while working on the PhD focused on people living in poverty who were also affected by a mental health issue and more specifically families who had a family member affected by severe mental illness. Additionally, I worked on the streets of Washington DC with people who were homeless and seriously affected by poverty, who also suffered from serious mental health issues. That’s really where I grew up in my 20’s, focused on people living in poverty and their access to mental health care. I worked at a lockdown stabilization unit for people who were suicidal and homicidal. It was a 7 p.m. to 7 a.m. shift on Friday and Saturday nights at the lockdown unit. That’s how I put myself through graduate school. I have seen firsthand the effects that mental illness and poverty combined have on people, families, and communities. In many respects, that is what created the foundation of my career. It helped establish the first pillar of my leadership style which is focus on your people first.

What is your strategy for keeping your team on mission and integrating them into the broader Magellan culture?

Every business leader and CEO rightfully would answer that question by talking about being best-in-class and supporting those we serve. I think the difference between us at Magellan and many other teams is the drive it takes to do that every single day. We are very disciplined about the data and metrics that bring to light how well we are doing on behalf of our associates, customers, and members.

I’m a former Amerigroup executive and Jim Carlson was the CEO when I went to work for them after spending a few years in state government. At AmeriGroup, I was very young and very green. I had the benefit of working under an extraordinary executive team led by Jim. Jim used to say, ‘don’t confuse effort with results.’  This aphorism has defined much of my career. To this end, we focus a great deal on the results we achieve with our customers, associates, and other key stakeholders.

The true measure of how well we are doing includes metrics like winning new business, bringing on new customers and retaining existing customers. In 2020, the government markets division earned a 100% customer satisfaction results. We surveyed all our government customers who are Medicaid regulators, and achieved 100% satisfaction, which is extraordinary and a direct result of the terrific work that our team does day in and day out.

Additionally, we have among the highest associate engagement scores on our internal customer service surveys. There are 28 people on my leadership team who bring 369 years of experience in our fee for service PBA (pharmacy benefit administration) business. On this team, 20 of those individuals have more than 10 years of experience with Magellan and eight of those individuals have more than 20 years. Three people have over 30 years of experience and the longest serving person on the team has 39 years of experience with Magellan. So, when you think about that, you know the turnover among leaders and subject matter experts is very low. This team is fundamentally about the people who come to work every day – they are truly focused on getting good work done, they like one another, they want to be here, they enjoy the work they’re doing and feel respected and valued for it.

What is exciting you about where we’re going, in terms of both Medi-Cal and Magellan Health as a broader company?

It is an exciting time for us in the government markets division. Medi-Cal is an extraordinary project, and it has been a true testament to the commitment and leadership brought by hundreds of people across the company and an exceptional California-based team led by Billy Thomas. They have shown up every day for the last year and a half, even during the pandemic, and are a team that’s so deeply committed to this work, and we will go live with Medi-Cal on January 1, 2022. The Medi-Cal project is transformative for the government markets division.

Additionally, we’re very excited about the work within the ADAP business. We’ve recently piloted our Navigate Whole Health program with our ADAP members. Results so far have shown us that very simple and straightforward clinical interventions with our providers and prescribers can really move the needle on quality and general efficacy of treatment modalities for HIV and AIDS medication. For example, we developed a regimen for one patient who didn’t want to take medications at work. As a result, the patient will be more compliant with the regimen. I believe it’s about adding more value and being a smart and sophisticated partner to these government entities and the people they serve.

Our national footprint allows us to be big thinkers. We can be more thoughtful and add more value because we are in 27 states across the country and every state is a little different. We also have the ability to leverage expertise, technology, infrastructure and innovation across the country.

Are you currently hiring for the Medi-Cal team?

Yes, we are. It’s a truly extraordinary project and an opportunity to be part of a team like no other in the country. There’s no state that has done quite what California has done with their Medi-Cal pharmacy benefit. This is a full drug carve out for all 14 million Medi-Cal enrollees.  It’s an opportunity to join a team led by Billy Thomas and his leadership team who are the best in the business. I also think it’s an opportunity to join a team where growth and development is a big part of the culture. We’re just very proud of the work that we have done with the state of California so far and are excited about serving them in a meaningful way. Anyone who’s interested in being part of that team should find out more. It’s a great team and it’s important work.

Learn more about joining the Medi-Cal team here.

New data from the Centers for Disease Control and Prevention shows that suicide rates have risen to over 30% in the US since 1999.[1] Since COVID-19 began, suicidal ideation in the US has more than doubled, with younger adults, racial/ethnic minorities, essential workers and unpaid adult caregivers experiencing disproportionately worse effects.[2] As suicide has reached crisis-level proportions in our nation, it’s time to recognize suicide as a public health crisis and learn about the warning signs and the skills needed to save a life.

Know the warning signs of suicide

It is hard to tell whether a person is thinking of suicide. Most people who take their own life show one or more warning signs, either through what they say or do.

• Feelings: Expressing hopelessness, talking about suicide or having no reason to live, showing moods such as depression, anxiety, irritability
• Actions: Showing severe/overwhelming pain or distress, using drugs or alcohol, searching for ways to end their life
• Changes: Withdrawing from activities, isolating from friends and family, sleeping more or less
• Threats: Talking about, writing about or making plans to kill themselves
• Situations: Going through stressful situations including loss, change, personal humiliation or difficulties at home, school or with the law

Take action to prevent suicide

Suicide remains the second leading cause of death among Americans between the ages 10 and 34, according to the CDC.[3] It is a major health crisis—and preventable. When someone says they are thinking about suicide or says things that sound as if they are considering suicide, it is important to pay attention and take action. Suicide is often preventable.

• Ask and listen: “Are you thinking about killing yourself?” is not an easy question, however, a study by the National Institute of Mental Health shows considering suicide may reduce rather than increase suicidal thoughts. Be willing to listen and discuss their feelings.
• Keep them safe: Reducing a person’s access to highly lethal objects or places is an important part of suicide prevention. Asking if the at-risk person has a plan and removing access to lethal means can make a difference.
• Get them help: Connect with a trusted family member, friend or mental health professional. Call the National Suicide Prevention Lifeline’s (1-800- 273-TALK (8255)) and the Crisis Text Line’s number (741741). Save these numbers in your phone so they’re there when you need them.
• Stay connected: Staying in touch after a crisis or discharge from care can make a difference. Let them know they matter and you care. Leave a message, send a text or call them.

For more information and helpful resources, visit MagellanHealthcare.com/Prevent-Suicide.

If you are in crisis or considering suicide, or if someone you know is currently in danger, please dial 911 immediately.

[1] https://www.nimh.nih.gov/health/statistics/suicide

[2] https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm

[3] https://www.nimh.nih.gov/health/statistics/suicide

Think back to New Year’s Eve, Tuesday, December 31, 2019. Maybe you had big plans that night to ring in the new year, or maybe you were spending a quiet evening at home. In either case, you probably had expectations about 2020 and hopes that it would be happy, healthy and prosperous…

Fast forward a couple months to February, 2020 when we began hearing more about a new coronavirus, COVID-19, originating from Wuhan, China that had made its way into the United States and was beginning to spread.

Changes caused by COVID-19

We started to see our world and our lives drastically change, experiencing loss and grief in several forms. For many of us, there were no more commutes to work, as we began to work from home if we were lucky enough to keep our job. There was no more getting the kids off to the bus stop or waiting in the drop-off line, as schools closed and switched to a virtual learning environment.

Parents lost the luxury of being able to fully concentrate on their jobs, as they were forced to take on the roles of teacher or daycare worker and daytime entertainer for their kids. Kids missed out on receiving the first-class education they depended on to feel prepared for the next school year or even college.

Healthcare workers risked their lives and those of their family to care for the people who were getting sick from COVID-19, worried they had been infected and wanted to get tested, or needed regular healthcare. Essential workers in grocery stores, post offices, public transportation, and other industries also became heroes as they continued to come to work to keep the country running, despite fearing for their own health and lives.

And there wasn’t a roll of toilet paper or paper towels to be found.

Social isolation

Across the board, we didn’t get to spend precious in-person time with our extended family and friends because we were doing our part to bend the curve and stop the spread of COVID-19. We didn’t get to go to the gym and may have fallen behind in our physical fitness. Our kids didn’t get to participate in their beloved sporting or other extracurricular events. Medical procedures were cancelled. Vacations were cancelled. Weddings were cancelled. Graduations were cancelled. Everything was cancelled.

Our dreams and plans were put on hold.

COVID-19 mental health toll

We certainly couldn’t have imagined this would be how the year would start off and end. Spring, summer, fall and winter, and all that comes with each, did not happen the way we have all become accustomed to for our entire lives.

And while we have done our best to adapt, the grief and loss of loved ones, financial security and social normality we have experienced over the past year has taken its toll on our mental health.

Where to go from here

We encourage you to watch a recording of our webinar “Coping with grief and loss during COVID-19” with Paula Hensley, MD, Magellan Healthcare senior medical director; Sagar Makanji, PharmD, Magellan Rx vice president, clinical strategy and programs; and Mark Santilli, PharmD, Magellan Rx senior director, clinical strategy and programs, as they share knowledge and tips for persevering after grief and loss due to COVID-19 and answer audience questions.

For additional COVID-19 resources from Magellan Health, click here.

Many of us can now say we have experienced the trials and tribulations of parenting during a pandemic. We have attempted to juggle full-time work and regular household duties, along with being a full-time teacher or daycare worker and entertainer for our kids. While we’re all doing the best we can in taking on these new and challenging roles, some parents and caregivers may be wondering about their child’s mental health after they have missed out on so much and dealt with new stress and uncertainty – certainly as many of us know that our own mental health has been affected.

If you’re worried about your child’s mental health or noticing any issues, read on for tips and knowledge shared by Magellan’s Linda Y. Evans, MD, FAPA, child psychiatrist and medical director, and Greg Dicharry, CPRP, youth empowerment director.

Children behavior changes

Changes in your child’s behavior may be a sign of mental health difficulties that should be closely monitored. Depending on the age of your child, stress can manifest in different ways. Toddlers and young children aged 2-6, may show signs of regression and lose the ability to do things previously learned, like toilet training. School-aged children and teenagers may show a disinterest in going to school and/or begin to see falling grades. The most common symptom in teenagers is irritable mood. Kids of all ages may experience vague body complaints, like a headache or belly ache, changes in sleep or appetite, difficulty concentrating, loss of pleasure in activities previously enjoyed, and withdrawal from social interactions.

Often, even the child may not recognize these symptoms as the result of mental health issues. It is important for parents and caregivers to be a barometer for behavioral or other changes in their children – as they may be the first to notice – to be able to identify if their mental health may be suffering. When parents keep the lines of communication open, allowing their kids to share their thoughts and feelings, they are better equipped to identify any troubling signs of childhood depression, anxiety or other mental health conditions.

The child’s primary care physician (PCP) also plays a role in screening for mental health concerns and can be a good first point of contact if parents are seeking additional help. With the shortage of child psychiatrists and mental health professionals trained to work with children in our country, PCPs are increasingly adopting a model of collaborative, or whole-person, care to screen and treat children for mental health issues before they get worse because of potentially waiting long periods to see a specialist.

Interrupted school and family routines

While there’s not much we can do about changing work, school and social arrangements due to the pandemic, it’s important to consider the stability of our kids’ environment and instill predictability in their lives to the extent that’s possible.

Additionally, there are many things that parents and caregivers can do to keep their kids content and engaged amid the chaos and unprecedented change we’re all experiencing. To make up for lost in-person social time with friends and family, virtual meetups can be scheduled. That could be a fifteen-minute Facetime call with grandma and grandpa every Wednesday night at 7:00, or a periodic Zoom/interactive video game gathering with friends. Parents can also take time with their kids away from the screens to play a board game or do a project to make home-time more fun. Exploring and supporting your kids’ passions is a way to get them involved in activities that will bridge the gaps of interrupted routines and help prevent negative mental health outcomes.

Family stress affecting children

We have all been affected by the drastic changes, uncertainty, loss and isolation caused by COVID-19. And it’s not hard for our own stress and worry to be noticed or even absorbed to some extent by our kids. While we’re focusing on our family’s well-being, it’s important to practice self-care and recognize that our own mental health is of paramount importance. Having healthy caregivers is an essential component in the normal development of kids.

When parents are navigating divorce and co-parenting arrangements during COVID-19, it can be even more difficult to filter out the negativity for our kids, especially when parents have different points of view about things like in-person vs. virtual learning, the vaccine and mask wearing. Although it can be difficult to share your kids with an ex-spouse, it’s important to remember they need both of their parents. When parents work together for the benefit of their children and keep the focus on them, the impacts of divorce can be mitigated. Implementing a flexible custody arrangement during COVID-19 is also encouraged; for example, if the child wants to see a parent when it’s not their day for visitation, it might be beneficial to the child to honor their request.

To alleviate stress and some of the burden, parents and caregivers can consider connecting with others who understand the struggles and support each other. They can look for parent support groups in their communities.

Back to school and bullying

For kids who experience any level of social anxiety, the transition back to school, or even a new school, from the comfort of home may be more difficult. While some kids may be happy to get right back to the in-person learning environment, a gradual adjustment may work better for others.

Teachers can be especially helpful in ensuring that children are adjusting well and that a child withdrawing from the group is noticed. When the teacher has a trusting relationship with students, they can initiate conversations to try to understand how a child is doing and if their emotional needs are being met. The teacher’s insights are critical for parents and caregivers who cannot be with their kids at school.

Parents and teachers should be especially sensitive to look for bullying and have a zero-tolerance policy for kids being cruel to one another. Children must understand that bullying is unacceptable, as it can lead to serious and disastrous consequences for those who are targeted.

In general, what kids need for healthy development is a stable routine, predictability, a safe environment and healthy parents or caregivers. COVID-19 has disrupted all of these conditions, leading to increased mental health disorders and interrupted development. There are many things that parents and caregivers can do to nurture their child’s mental health and address what they need for healthy development. We encourage you to explore Magellan’s following resources for additional information and support:

• Mental Health Month website for comprehensive tips and resources to support yours and your family’s mental health.
  • Be sure to check out the recording of our webinar, How are your kids doing? under “Previous events”
• Understanding and Meeting the Needs of Children and Adolescents at High Risk: Foundations of a Model clinical monograph highlighting evidence-based research on the prevention and treatment of problematic behaviors and various types of behavioral health challenges in children and adolescents.
• Stay Home for MY LIFE virtual youth fest, featuring inspirational speakers, uplifting entertainment, fun activities and more, taking place on the 4^th Thursday of each month, from 6:00 – 7:30 p.m. ET, for youth and young adults who have experience with mental health, substance use, juvenile justice and foster-care-related issues, as well as professionals and caregivers across the country.

Magellan Rx has been a market leader in developing forward-thinking solutions to combat rising specialty spend on the medical benefit for nearly 20 years. With a passion for solving complex pharmacy challenges, such as biosimilar management, we roll up our sleeves and tackle what is truly driving trend while ensuring a high quality of care for the members we serve.

Building on the success of our industry-first medical pharmacy program, including management of medical benefit oncology drug spend, we began to focus on advancing biosimilar utilization in 2015. Our goal was to empower health plan customers with education and strategies that turned biosimilar availability into cost savings while maintaining clinical quality. From the high-cost autoimmune category to oncology and beyond, our philosophy to biosimilar management involves three key components:

• Proactive Management: Assessing and developing clinical protocols while educating and communicating with network providers
• Medical Pharmacy Execution: Leveraging Magellan Rx’s innovative medical management expertise by incorporating biosimilars into key utilization management programs such as medical prior authorization and provider reimbursement/fee schedule management
• Expert Opinion: Continuously working to gain insights from our advisory board of specialists and Expert Clinical Network of key opinion leaders

But first, what is a biosimilar?

According to the U.S. Food and Drug Administration (FDA), a biosimilar is a drug type that is highly similar to an FDA-approved biologic, or reference product, with regards to its purity, molecular structure, and bioactivity. The biosimilar approval pathway starts with an application submission that includes analytical studies, animal studies, and at least one clinical study. A biosimilar is approved by the FDA after evaluation and testing to show it is as safe and effective as its reference product.

As of April 2021, there are now 29 FDA-approved biosimilar products across three different categories—20 have been launched to date, and 18 are oncology or oncology support.

Magellan Rx’s approach

In 2015, ahead of the first biosimilar approval in the U.S., our work began with a committee of experts to review the biosimilar landscape and potential impacts for payers. By 2016, we had established our first biosimilar-over-reference policy on the medical benefit, and in 2017 additional clients opted into the strategy with more growth in biosimilar savings.

The program was expanded in 2018 to include infliximab—the biosimilar for Remicade, a top spend drug used to treat autoimmune conditions such as rheumatoid arthritis and inflammatory bowel disease—by leveraging a comprehensive utilization management solution. As part of this initiative, our team of highly-trained pharmacists worked with physician offices and hospitals to ensure appropriate utilization for each patient’s unique situation.

Also in 2018, we established an Oncology Biosimilar Workgroup to prepare for future launches in this high-spend category (in fact, oncology and oncology support accounts for more than 40% of total medical pharmacy spend across the Commercial, Medicare, and Medicaid lines of business¹). We aimed to educate health plan customers, members, and providers through individualized strategies that consider clinical, financial, and regulatory factors. The oncology biosimilar program was launched in 2019 as oncology biosimilars hit the market, with early adopter implementation that resulted in maintaining or expanding member access to clinically-effective treatments while delivering significant drug spend savings.

Due to the success of the infliximab program and proactive approach to the launch of oncology biosimilars, we experienced a rapid expansion in 2020 as clients, representing millions of lives, began to adopt these innovative solutions. Oncology biosimilar utilization surged, and the (measured by the number of prior authorizations approved for the first two therapies with biosimilars compared to the reference brands) for early adopters. We also showcased results in research presented at the 2020 AMCP Annual and AMCP NEXUS industry events.

So far in 2021, biosimilar uptake continues to increase. Our team of experts previewed results from the oncology biosimilar program at the 2021 AMCP Annual event and spoke to The Center for Biosimilars on strategies that payers are using to promote biosimilar adoption.

Looking ahead, Magellan Rx remains committed to the biosimilar-first strategy and will continue to expand the program to include additional categories and available biosimilar agents as they are approved by the FDA. For more on payer management concerns related to biosimilars, read page 24 of the latest Magellan Rx Management Trend Report.  For up-to-date pipeline news, check out the MRx Pipeline Report. Have questions or want to implement a solution to meet the needs of your unique population? Connect with us today!

To learn more about Magellan Rx’s work, click here. 

1. Magellan Rx Management Medical Pharmacy Trend Report™, © 2021.

By: Linda Y. Evans and Greg Dicharry

Before the COVID-19 pandemic started wreaking havoc on various aspects of our “normal” lives, including our mental health, 1 in 6 children aged 2-8 years in the United States was diagnosed with a mental, behavioral or developmental disorder.[1] While these children have endured the impacts of drastic changes over the past year, so too have others who did not previously have a mental health diagnosis; some children have been newly diagnosed with a mental health condition as a result of COVID-19. When considering how to nurture the mental health of our children during a pandemic, we must understand their pre-pandemic mental state and monitor how they are coping.

Children diagnosed with a mental health condition before COVID-19

For children who experienced mental health challenges before COVID-19, the pandemic may have imposed new complications. In many cases, before COVID-19, families practiced a routine in their daily lives, which helped everyone manage their feelings and behaviors. When routines changed – kids were no longer going to school, adults were working from home, or not at all, and in-person interactions with friends, extended family, and even doctors were cut off – that familiarity and rhythm, and the associated therapeutic effects, were lost. Another part of the pre-pandemic routine for many children with a mental health diagnosis was the special help received by trained teachers and therapists in schools. While this support could be a vital lifeline, it was completely cut off for the kids who depended on it. Other treatment options, through primary care and other outpatient settings, also dwindled due to office closures caused by COVID-19. As a result, an increasing number of children were seen for mental health-related care in emergency departments (EDs). From mid-March to October 2020, the Centers for Disease Control and Prevention reported an increase in the proportion of mental health-related ED visits among children aged 5-11 years (24%) and 12-17 years (31%) compared with the same period in 2019.[2]

Serious mental health impacts for children as a result of COVID-19

Children and youth who started off 2020 without a mental health diagnosis may not have ended the year in the same way, as newly developed depression and other mental health conditions were caused by the pandemic. A CDC report on mental health, substance use, and suicidal ideation during the COVID-19 pandemic shows that while 11% of adults seriously contemplated suicide in June 2020, the same was disproportionately reported by young people aged 18 to 24 (26%).[3] The serious effects on younger children include delays in social and emotional development, as their brains are forming amidst irregular human activity. In some cases, when parents weren’t adjusting or handling the increased stress and uncertainty well, maltreatment in the form of child neglect or abuse has resulted.

Negative mental health consequences of COVID-19 for all children

Because of COVID-19, all children are coping with unprecedented change and loss. Children feel the family stress of economic hardships, health concerns, social isolation, exhaustion, bereavement, and worsening mental health and substance use. And children have stressors of their own. When healthy outlets, like school, sports, and social engagements, are lost, that energy may become more negative and unproductive. The impacts of missed once-in-a-lifetime childhood events, like birthdays, graduations, and family vacations, may not even be fully realized until later in life. Children and youth may also experience their own anxiety and stress about what the future looks like.

The state of mental healthcare for children

There have always been barriers for children to access mental healthcare. Among them are stigma, availability, misinformation, and lack of information. While these factors impact access to care for adults, as well, they may be more pronounced for children. Parents are afraid or do not want to accept that their child is affected by a mental illness. There is a shortage of child and adolescent psychiatrists and therapists trained to work with children in our country. In addition, many parents and caregivers are misinformed about child psychiatric services that are meant to improve a child’s mental state, and not necessarily their behavior, although the latter may be a secondary effect.

With the pandemic, parents may be so preoccupied that they cannot see potential conditions in their children. The advent of a pandemic has stretched an already thin system of specialized mental healthcare for children at a time when it may be needed the most. And misinformation continues to plague our news sources and social media.

Where to go from here

There are many things that parents and caregivers can do to support and nurture their child’s mental health. We encourage you to learn more in a recording of the webinar, “How are your kids doing?” where I was joined by Greg Dicharry, CPRP, youth empowerment director, to share knowledge and our years of experience working with children to improve mental health and wellness and answer audience questions.

[1] https://www.cdc.gov/childrensmentalhealth/data.html

[2] https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a3.htm

[3] https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm