ORLANDO, Fla. — Specialty medications – those used to treat patients with rare diseases or chronic conditions – can be expensive. That is why AllianceRx Walgreens Prime – one of the largest specialty and home delivery pharmacies in the U.S. – has dedicated team members who provide information on financial assistance programs available to eligible patients. Over the last two years, AllianceRx Walgreens Prime has connected eligible patients to more than $600 million in financial assistance.
“While therapies for patients with chronic conditions have evolved greatly, they have done so at a price,” says Lisa Mymo, vice president, Pharmacy and Financial Services at AllianceRx Walgreens Prime. “Because of the complex and often rare conditions these high-touch drugs treat, they can range in cost from thousands of dollars a month to hundreds of thousands of dollars per year. We want to eliminate financial barriers to access and connect our patients with resources to help make these treatments affordable.”
Working together for the patients’ future
The amount of assistance to which AllianceRx Walgreens Prime connected patients in 2020 increased by nearly 14% over 2019. Mymo attributes this increase to rising drug costs and increased out-of-pocket costs for patients.
AllianceRx Walgreens Prime continues to invest in tools and technology to help connect qualified patients with resources that help them start and stay on therapy. AllianceRx Walgreens Prime recently launched a new financial navigation technology platform, TailorMed. This technology proactively identifies patients with financial risk and automatically connects them with personalized financial assistance resources. This includes not only manufacturer assistance programs and national foundations, but also provides access to local charitable foundations and government programs.
Mymo references research showing that as a patient’s out-of-pocket cost share rises, primary rate of adherence drops. According to IQVIA Institute for Human Data Science’s 2020 report, prescription abandonment rates are less than 5% when the prescription carries no out-of-pocket cost; it rises to 45% when the cost is over $125 and to 60% when the cost is over $500. “We’re constantly evaluating the tools and technology that enable our patient financial services team members to connect patients to any and all sources of funding. This is vital to helping our patients remain adherent to these costly life-changing or life-saving therapies,” says Mymo.
Making vital connections
John Segina has been a group supervisor of Patient Financial Services at AllianceRx Walgreens Prime for a little over eight years. Segina started as a payment resolution supervisor before transitioning to the insurance department. While on the job, Segina realized quickly that many people who take expensive specialty medicines to treat their chronic or long-term condition struggle to afford their copays. He and his team turn to a number of resources for their patients – financial assistance can include manufacturer copay programs, free goods, bridge programs and foundational programs.
“I remember patients living with asthma who experienced sticker shock over a newly prescribed medication. When they learned the cost was $4,393 a month — even with insurance — it was devastating to them,” he says. “Thankfully, AllianceRx Walgreens Prime was there to help.”
As the specialty pharmacy schedules orders, Segina’s team reaches out to patients to confirm their financial responsibility, or copay. Utilizing the latest technology, Segina is able to scan nationally for available resources. He identified a nonprofit foundation that offered funds to help pay for the asthma medication based on the patient’s financial need and diagnosis. The copay went from $4,393 per month to $5 per month.
“While every situation is different, we strive to provide this level of attention and support to patients every day,” says Segina. “Patients mostly want reassurance, respect and the confidence that we will do whatever it takes to help address their concerns,” he says. “We are helping them get medicine they otherwise would not be able to afford. As long as we are giving this effort for every patient, I believe we are making a difference.”