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Vital Medication for the Eligible Uninsured

                                    .




Why not just submit individual applications?

    Most free clinic patients require 4-6
    medications from an average of 4 different
    companies
    Frequently changing eligibility criteria and
    the drugs available in the program
    Typically there is a 2 to 6 week wait to
    receive medication
    Receiving medication through a bulk
    program does not eradicate the need to
    submit individual applications to other
    companies – it simply allows clinics to help
    more people with the same resources




                                                   1
The costs of individual applications

According to a 2005 study that surveyed clinics
in several states – “clinic staff spent an average
of 111 hours per month (12 hours for
pharmacists, 20 hours for physicians, and 79
hours for other staff) in processing
applications. In fact, two-thirds of clinics that
did not use the manufacturer PAPs cited the fact
that they are “too time-consuming and
complex.”
 -The American Journal of Health-System Pharmacy




The costs of individual applications

According to a 2007 study – the average total
cost per individual application is $25.18
which includes personnel, supply and
submission costs. This is a conservative
estimate as the study was conducted during
non-working hours when there were no
distractions / interruptions and included only
the most experienced staff who were able to
complete applications most quickly (no
volunteers). The estimated annual cost of
providing PAP service at the clinic studied
was $81,835.
 -The Journal of Managed Care Pharmacy




                                                     2
Institutional Patient Assistance Program
                   IPAP
 Definition
   A type of patient assistance program (PAP) in
   which a manufacturer donates free drugs to a
   hospital, clinic, or other health care institution,
   rather than to a patient. IPAP agreements
   usually establish inventory control procedures
   and give manufacturer sponsors audit rights. –
   Safety Net Hospitals for Pharmaceutical Access
   (SNHPA)

 Types of IPAPs
   Individual Relationships, Warehouse Model,
   Broker Model, Other




Benefits of IPAP?
 Patient
   Medication is immediately available
   Required eligibility paperwork is
   completed just once a year

           “Without Staleva, my early onset Parkinsons would be
           completely out of control. My quality of living would
           be seriously hampered. This enables me to prepare
           for the future by considering employment for the first
           time in two years. This program changes people’s
           lives.” - Pamela Moore, Patient at the Free Clinic of the New
           River Valley




                                                                           3
Benefits of IPAP?
      Clinic
        Separate/different eligibility paperwork is not
        required – same form used for all
        Consistent standards for proof of income and
        income thresholds
        Saves time & resources currently dedicated to
        completing individual applications for
        medication assistance
        Reduces pharmacy costs for purchased
        medications
        Allows for better patient compliance & health
        outcomes (versus uncertainty of $4 Rx being
        filled or refills ordered on-time)




    Unique Broker Model
 Rx Partnership serves as a broker, facilitating the
  distribution of free prescription medication from
 participating pharmaceutical companies directly to
Affiliate free clinics and community health centers
            which it credentials and monitors.

                      Result:
A streamlined, efficient and cost-effective process
                             cost-
which delivers more drugs to a greater number of
                 patients in need




                                                          4
What does RxP do?
  RxP functions …
    As an IPAP (Institutional Patient Assistance
    Program)
    Replacement drugs are tied to specific
    patient/dispensing data
    Solicits free medications from pharmaceutical
    companies
    Rx Partnership coordinates the distribution of
    medications directly to nonprofit, licensed
    Affiliate pharmacies (FCs, CHCs & central fills)
    Credentials, monitors, and audits Affiliates




                                                       5
Rx Partnership Success
 20 Affiliate free clinics, health
 centers and central fills
 Over $32 million in retail value of
 prescriptions distributed to date
 More than 150,000 free
 prescriptions for over 25,000
 unduplicated patients have been
 filled to date




A Resource Network
 Clinics connect with each other to share
 information – RxP Roundtable
 RxP e-newsletter, annual report, website,
 Affiliates only area of website
 Common issues – eligibility questions, legal
 residency, how to get supplies, what to do
 when a medication is no longer available on
 PAP, etc.




                                                6
Are you interested in
    learning more about
    Rx Partnership and how
    our approach might work
    for you?


Amy Yarcich, Executive Director
804-377-1057 x1557
AYarcich@RxPartnership.org
2924 Emerywood Pkwy, #300
Richmond, VA 23294
                                    www.RxPartnership.org




        Abbott Patient Assistance Foundation’s Diabetes
        Care Patient Assistance Program
            Free glucose test strips & glucometers
            www.abbottpatientassistancefoundation.org/diabetes
            _care.asp for qualification requirements and
            application form

      For Patients Unable to Participate in the Foundation
        Program
        The FreeStyle Promise™ Program
            Savings Up to $600 per year on test strips ($15 co-
            pay per month) & free FreeStyle Lite meter
            Access to Certified Diabetes Educators, Registered
            Nurses and Nutritionists
            www.myfreestyle.com




                                                                  7
GSK Access Applications – Program for Part D
Patients
   It is available after patient spends $600 out of pocket
   on any TrOOP eligible costs (not just GSK meds), do
   not have to be in the donut hole
   More information at www.GSK-Access.com


Bridges to Access – new enrollment options will be
coming in early fall that will allow self enrollment by
mail




In March 2008 Merck Patient Assistance Program
raised it’s eligibility limit from 200% to 400% of
FPL
   While RxP maintains a 200% threshold for
   consistency, we realize this may mean some of your
   patients ineligible for RxP may apply for Merck’s
   individual PAP
   Hopefully this signals an industry change that will
   allow RxP to raise the threshold in the future




                                                             8
Patient Assistance Now resource for PAP and links
to outside programs patients may qualify for –
www.PatientAssistanceNow.com




New PAP website launched -
www.patientassistanceprogram.sanofi-aventis.us
Reminder that sanofi PAP eligibility is based on
CURRENT income – very critical for recently
unemployed and uninsured




                                                    9
Additional Resources

  2009 Medicaid Denial Memo from DSS
  Tax Transcript Fact Sheet
  Roche Diagnostic’s ACCU-CHECK PAP
     ACCU-CHECK test strips for eligible patients
     www.accu-chek.com/us/customer-care/patient-
     assistance-program.html
  BD offers monthly shipments of needles, syringes
  and educational materials (quantity maximums on a
  monthly basis apply)
     Use the BD Order Form


Other Resources to Share?




                                                      10

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Rx Partnership

  • 1. Vital Medication for the Eligible Uninsured . Why not just submit individual applications? Most free clinic patients require 4-6 medications from an average of 4 different companies Frequently changing eligibility criteria and the drugs available in the program Typically there is a 2 to 6 week wait to receive medication Receiving medication through a bulk program does not eradicate the need to submit individual applications to other companies – it simply allows clinics to help more people with the same resources 1
  • 2. The costs of individual applications According to a 2005 study that surveyed clinics in several states – “clinic staff spent an average of 111 hours per month (12 hours for pharmacists, 20 hours for physicians, and 79 hours for other staff) in processing applications. In fact, two-thirds of clinics that did not use the manufacturer PAPs cited the fact that they are “too time-consuming and complex.” -The American Journal of Health-System Pharmacy The costs of individual applications According to a 2007 study – the average total cost per individual application is $25.18 which includes personnel, supply and submission costs. This is a conservative estimate as the study was conducted during non-working hours when there were no distractions / interruptions and included only the most experienced staff who were able to complete applications most quickly (no volunteers). The estimated annual cost of providing PAP service at the clinic studied was $81,835. -The Journal of Managed Care Pharmacy 2
  • 3. Institutional Patient Assistance Program IPAP Definition A type of patient assistance program (PAP) in which a manufacturer donates free drugs to a hospital, clinic, or other health care institution, rather than to a patient. IPAP agreements usually establish inventory control procedures and give manufacturer sponsors audit rights. – Safety Net Hospitals for Pharmaceutical Access (SNHPA) Types of IPAPs Individual Relationships, Warehouse Model, Broker Model, Other Benefits of IPAP? Patient Medication is immediately available Required eligibility paperwork is completed just once a year “Without Staleva, my early onset Parkinsons would be completely out of control. My quality of living would be seriously hampered. This enables me to prepare for the future by considering employment for the first time in two years. This program changes people’s lives.” - Pamela Moore, Patient at the Free Clinic of the New River Valley 3
  • 4. Benefits of IPAP? Clinic Separate/different eligibility paperwork is not required – same form used for all Consistent standards for proof of income and income thresholds Saves time & resources currently dedicated to completing individual applications for medication assistance Reduces pharmacy costs for purchased medications Allows for better patient compliance & health outcomes (versus uncertainty of $4 Rx being filled or refills ordered on-time) Unique Broker Model Rx Partnership serves as a broker, facilitating the distribution of free prescription medication from participating pharmaceutical companies directly to Affiliate free clinics and community health centers which it credentials and monitors. Result: A streamlined, efficient and cost-effective process cost- which delivers more drugs to a greater number of patients in need 4
  • 5. What does RxP do? RxP functions … As an IPAP (Institutional Patient Assistance Program) Replacement drugs are tied to specific patient/dispensing data Solicits free medications from pharmaceutical companies Rx Partnership coordinates the distribution of medications directly to nonprofit, licensed Affiliate pharmacies (FCs, CHCs & central fills) Credentials, monitors, and audits Affiliates 5
  • 6. Rx Partnership Success 20 Affiliate free clinics, health centers and central fills Over $32 million in retail value of prescriptions distributed to date More than 150,000 free prescriptions for over 25,000 unduplicated patients have been filled to date A Resource Network Clinics connect with each other to share information – RxP Roundtable RxP e-newsletter, annual report, website, Affiliates only area of website Common issues – eligibility questions, legal residency, how to get supplies, what to do when a medication is no longer available on PAP, etc. 6
  • 7. Are you interested in learning more about Rx Partnership and how our approach might work for you? Amy Yarcich, Executive Director 804-377-1057 x1557 AYarcich@RxPartnership.org 2924 Emerywood Pkwy, #300 Richmond, VA 23294 www.RxPartnership.org Abbott Patient Assistance Foundation’s Diabetes Care Patient Assistance Program Free glucose test strips & glucometers www.abbottpatientassistancefoundation.org/diabetes _care.asp for qualification requirements and application form For Patients Unable to Participate in the Foundation Program The FreeStyle Promise™ Program Savings Up to $600 per year on test strips ($15 co- pay per month) & free FreeStyle Lite meter Access to Certified Diabetes Educators, Registered Nurses and Nutritionists www.myfreestyle.com 7
  • 8. GSK Access Applications – Program for Part D Patients It is available after patient spends $600 out of pocket on any TrOOP eligible costs (not just GSK meds), do not have to be in the donut hole More information at www.GSK-Access.com Bridges to Access – new enrollment options will be coming in early fall that will allow self enrollment by mail In March 2008 Merck Patient Assistance Program raised it’s eligibility limit from 200% to 400% of FPL While RxP maintains a 200% threshold for consistency, we realize this may mean some of your patients ineligible for RxP may apply for Merck’s individual PAP Hopefully this signals an industry change that will allow RxP to raise the threshold in the future 8
  • 9. Patient Assistance Now resource for PAP and links to outside programs patients may qualify for – www.PatientAssistanceNow.com New PAP website launched - www.patientassistanceprogram.sanofi-aventis.us Reminder that sanofi PAP eligibility is based on CURRENT income – very critical for recently unemployed and uninsured 9
  • 10. Additional Resources 2009 Medicaid Denial Memo from DSS Tax Transcript Fact Sheet Roche Diagnostic’s ACCU-CHECK PAP ACCU-CHECK test strips for eligible patients www.accu-chek.com/us/customer-care/patient- assistance-program.html BD offers monthly shipments of needles, syringes and educational materials (quantity maximums on a monthly basis apply) Use the BD Order Form Other Resources to Share? 10