Patients with chronic conditions, rare diseases or who otherwise have a need for specialty medications to improve their health are faced with many roadblocks.
Specialty drug prices are rising, copays are increasing and patient financial programs are experiencing intense scrutiny, payment cuts and manufacturer restrictions. Having a dedicated pharmacy professional to help them navigate these roadblocks is crucial in a patient’s care journey.
Specialty medications are unique and can be complicated – especially for patients. These therapies require a high-touch level of care, education and service to set patients up for success. Medications are far from the only element on their care plans, so if specialty pharmacy professionals can ease this part of their overall burden, patients can focus on getting better.
Specialty Pharmacy Services to Keep Patients Healthy
According to a study published in The Annals of Pharmacotherapy, medication nonadherence costs over $670 billion annually due to 12 million hospitalizations and more than 275,000 deaths. When patients have access to specialty medications to keep them healthy, their adherence will improve and hospitalizations decrease. When a hospital or health system opens their own specialty pharmacy or launches a specialty pharmacy program within an existing pharmacy landscape, patient access and care are optimized.
Born out of Boston Medical Center, Clearway Health partners with hospitals and health systems to build, develop and operate their own specialty pharmacy program, improve access to care and provide personalized support to vulnerable patients, families, providers and care managers to eliminate barriers and ensure medications are received on time.
“I choose to use Clearway Health's specialty pharmacy over other pharmacies because my Pharmacy Liaison respects my privacy, my schedule and helps me understand the potential side effects that I may not be cognizant of,” a patient partnered with a Clearway Health Liaison explains. “And most of all, it's efficient. I don't have to make multiple calls, I don't have to wait.”
Clearway Health Pharmacy Liaisons enroll patients in the specialty pharmacy program through a referral from the provider. The Liaisons work alongside the care team in the clinics and collaborate with providers and staff to handle administrative and counseling functions, providing hospital or health system clinicians more time to focus on other elements of patient care.
Innovative Patient Assistance Program
Beyond the Pharmacists and Pharmacy Liaisons that Clearway Health embeds in specialty clinics, they provide an ongoing strategic partnership to evolve the successes of the specialty pharmacy program. Clearway Health identifies ways that hospitals and health systems can leverage the 340B program to expand services to patients in their communities. Recently, the company recognized the challenge of increasingly high co-pays and low medication adherence and created a solution for their client. They created a 340B patient assistance program to pass savings directly to patients, helping them to access and afford their specialty medications. In just 18 months, the program has helped over 400 patients receive 2,500+ prescriptions – funneling nearly $3 million toward financial assistance for patients who are on specialty medication therapies.
Some of the ways that Clearway Health helps its clients succeed with programs such as this is by working with drug companies to create savings in their contracts. This includes expanding group purchase access, creating sub-340B savings, forging direct purchasing relationships and negotiating performance-based contracts for rebates.
Steadfast Focus on the Patient
When a patient is diagnosed with a life-changing condition that requires specialty medication regimens, medication access and affordability often becomes a roadblock to their recovery. Clearway Health's services put the patient first and works collaboratively with the clinical care team, the patient and their caregivers to support the patients' understanding of their condition, how important it is to adhere to their treatment and to ensure access to their medication.
“My experience with [my Pharmacy Liaison] Amanda has been the best I’ve had in 20 years. She’s been instrumental in acquiring the care and medication that I need,” said a patient. “She makes sure that I receive my medication at the lowest cost…and this makes an enormous difference in my ability to pay for food and other staples that otherwise would not have been possible to afford. With Amanda on my side, [getting my medication] is one less thing for me to worry about.”