The growth and complexity of biosimilar agents for infusion therapy is generating a need for effective tools to optimize product selection and manage costs. Frequent changes in payer policies lead to frustrating delays in the authorization process and create obstacles that impact patient care. Recognizing these challenges, Amplify Rx is leveraging technology to simplify biosimilar strategy and bring best practices to health systems.
“Our aim is to improve operational efficiency and create new revenue opportunities,” said Lisa Blanchette, PharmD, MHA, co-founder of Amplify Rx. “We remove barriers that delay care and add unnecessary cost.”
The Rise of Biosimilars
Biosimilar products, used increasingly to treat cancer, inflammation, respiratory and other conditions, are FDA-approved biologics that demonstrate similarity and effectiveness when compared to brand-name biologics.
“Biosimilars are expensive to make,” explained Amplify Rx co-founder Curtis Wander, PharmD. “They’re complex and require millions of dollars in manufacturer investment. Biosimilar adoption in the US has lagged behind European nations. Amplify Rx is focused on supporting biosimilar adoption and ensuring a growing and competitive biosimilar marketplace to ultimately lower healthcare costs.”
Delays in the Authorization Process
The biosimilar market offers a promising avenue for cost reduction in healthcare. However, the complexities associated with choosing the right biosimilar product for each unique patient encounter are substantial. These disparate and dynamic factors include:
- New biosimilars continually enter the marketplace
- Procurement prices change frequently, impacting reimbursement
- Payers change covered biosimilars constantly and without notice
- Payers are not aligned on which biosimilar products will be covered
- Reimbursement rates differ across payers
Amplify Rx is the Industry Expert in Biosimilar Strategy
Amplify Rx, offers a software solution that allows consistent patient-level selection of a biosimilar that is both covered by the payer formulary and drives the best profitability for the health system. Amplify Rx leverages unique insights and technology to maximize biosimilar strategy through real-time decision support for optimal product selection. The web-based application offers the following benefits:
- Real-time decision support to allow the authorization team to quickly identify the best biosimilar product for each patient, considering their insurance and the organization’s procurement and reimbursement strategies.
- Streamlined authorization process that boosts efficiency by instantly knowing the best covered product for different insurance providers.
- Maximized financial opportunities which enhance the experience for prescribers by avoiding unnecessary notifications about therapies that aren’t covered while maximizing financial margin opportunities – estimated at up to $3,000 per encounter.
Inova Health System Improves Efficiency and Profitability with Amplify Rx Partnership
A recent collaboration between Amplify Rx and Inova Health System demonstrates the value of a robust biosimilar product strategy. Inova, based in Falls Church, Va., services more than one million patients across 250 care sites, including five hospitals and six infusion centers.
Prior to its partnership with Amplify Rx, Inova, like many health systems, struggled with selecting the optimal biosimilar, which led to unrealized financial opportunities and operational frustrations due to payer policy uncertainties.
Amplify Rx is now servicing 98 cancer-infusion chairs across four Inova infusion centers, and the results speak volumes:
- The accuracy of selecting the optimal biosimilar at Inova skyrocketed from 36% to over 99%.
- This improvement has translated into a substantial increase in efficiency and has created an additional $250,000 per month in new margin opportunity for Inova.
“Amplify Rx has successfully unlocked cutting-edge software capable of real-time decision-making,” said Christiana Showunmi, PharmD, MBA, Manager of 340B Programs at Inova. “The Amplify Rx team has been phenomenal to work alongside and they bring a wealth of knowledge along with a meticulous expertise to healthcare."
“We are observing increased interest among health systems to adopt more disciplined approaches to their biosimilar strategies,” said Amplify co-founder Matt Gibson, PharmD, MS. “Some health systems have the resources to manage the biosimilar selection process manually, and they can achieve about a 40% overall optimization rate. They know what they’re doing, but may not be able to realize consistent, optimal results. Others are sacrificing profitability for operational simplicity and using a workhorse strategy while leaving thousands or millions of dollars on the table. In either case, Amplify Rx provides the solution for streamlining operations while simultaneously capturing the margin opportunity. Health systems can have both.”
The case study of Amplify Rx and Inova is a testament to the significant impact that specialized technology solutions can have on operational efficiency and financial health. For health systems grappling with the biosimilar market’s complexities, adopting technologies can lead to better healthcare outcomes and substantial financial benefits.
For more information, visit amplifyrxsolutions.com