Background

• High drug costs continue to burden patients as is shown by 24% of patients reporting difficulty with affordable medication access.1 The 2017 inflation-adjusted per capita retail prescription drug cost was $1,025.1 In comparison, 1997 was $404, and 2007 was $908.
• Specialty-branded medications have increased in price by 57% since 2014.
• In 2017, 20% of the healthcare dollar went to Physician and Clinical Services.2 As a result, payors are gradually requiring that office-administered medications, like injections and infusions, be dispensed through a pharmacy on pharmacy benefits instead of through the clinic or facility on medical benefits. Once dispensed to the patient, the medications can be taken to the clinic/facility for administration.
• The specialty pharmacy services team embedded in the neurology clinic noted the need for patient financial assistance with migraine medications. They also recognized an opportunity to more effectively manage approval of office-administered medications on patients’ medical or pharmacy benefits.
  
  

Objectives

To assess the impact of integrating high touch SPS in a neurology clinic by measuring migraine medication affordability.

Primary objective:  Minimize copay burden on patients for CGRPra and Ona A prescriptions run through pharmacy benefits.

Secondary objectives:

• Assess the amount of dispenses with $0 copay.
• Measure growth in number of Ona A 100mg vials run on pharmacy benefits.

Read about the team's findings by downloading the Outcomes Study below.

Download the abstract: